The ketogenic or keto diet is not new: a hundred years ago, before the advent of effective anticonvulsants, French pediatricians noticed that certain dietary restrictions reduced the frequency of seizures in children with drug-resistant epilepsy.
Based on metabolic studies, a therapeutic diet was developed - without starch and sugar, which became part of the complex treatment of epilepsy in the early 1900s.The author of the name "ketogenic diet" is said to belong to the American doctor Russell M. Wilder, who used it in the treatment of epilepsy in the 20s and 30s.last century.
The keto diet involves a high-fat diet, moderate protein intake, and very low carbohydrate intake.For most people, this ratio of nutrients is considered safe for a limited period of time, and not only helps to lose excess pounds, but also has therapeutic applications.
Indications for use
The low-carbohydrate keto diet, which is widely used in clinical practice abroad, has reduced the frequency of seizures by 62-75% in children of different ages (after 12 weeks of dietary treatment).However, children prescribed such a diet should be reported to doctors, who will monitor their normal growth and weight gain and adjust the diet according to the needs of each child.
Low-carbohydrate diets have been used to treat other diseases.Researchers have shown that ketogenic diets are useful in treating patients with DeVivo disease, a deficiency syndrome of the GLUT1 protein (which transports glucose across the blood-brain barrier), and several other inborn errors of metabolism.
It is believed that this nutritional system can slow the progression of amyotrophic lateral sclerosis (Charcot disease);Indications for the ketogenic diet include neurodegenerative pathologies such as Alzheimer's and Parkinson's.Clinical trials are underway on the effects of the ketogenic diet on the condition of patients with autism, depression, type 2 diabetes mellitus (non-insulin dependent) and polycystic ovary syndrome.
The best-known keto diet for weight loss is the Atkins diet for the treatment of obesity, which was modified and popularized by Dr. Robert Atkins (Dr. Atkins Diet Revolution, 1972).Although experts consider only the induction phase of this diet to be ketogenic.And to be fair, it should be noted that long before that, many American doctors were working on the principles of the ketogenic diet: Peter Huttenlocher, Alfred Pennington, Richard McCarnes and others.For example, R. McCarnes wrote the book Eat Fat and Grow Slim in 1958, and it is essentially the same low-carbohydrate diet that was originally introduced to treat epilepsy.
Since the deposition of excess fat tissue in the form of triglycerides concentrated in the cells occurs due to the excessive consumption of carbohydrate-containing foods (no one doubts this fact), limiting carbohydrates to a minimum in the diet - a one-month keto diet - helps to reduce fat reserves, i.e. weight loss.
In addition, the oncological keto diet has been found to significantly reduce the growth rate of malignant tumors located in the colon, stomach, prostate gland, and lung by increasing oxidative stress in cancer cells.In addition, it has already been proven that some cancers are more sensitive to chemotherapy due to the induced state of ketosis.
For the past two decades, the ketogenic diet has been used by bodybuilders to reduce the layer of fat under the skin: in slang, this is called keto cutting.
The essence of the keto diet
On a normal keto diet, your total daily calories should come from 70-80% fat, 15-20% protein, and 5% carbs (less than 50g per day).
Typically, the ratio of fat, protein and carbohydrates is 3:1 (ie 3 grams of fat for every gram of protein + carbohydrates).If the ratio is 4:1, then 90% of the energy comes from fats, 8% from proteins and only 2% from carbohydrates (about 20 g per day).
The essence of a weight loss diet is to put the body in a state of adaptive ketosis - when the body gets energy mainly from ketone bodies in the blood (ATP) and not from glucose, which comes from eating carbohydrate-containing foods.
Carbohydrates in food are converted into glucose, but if a person consumes very few carbohydrates and a lot of fat, a chain of biochemical reactions starts in the body.Schematically, this process looks like this.First, due to reduced blood sugar levels, the pancreas begins to produce more of the hormone glucagon, which stimulates the breakdown of glycogen stored in the liver into glucose and its release into the blood.Second, ketogenesis is activated, that is, the liver converts ketone bodies (acetoacetate, which is then converted to β-hydroxybutyrate and acetone) and dietary fats into free carboxylic acids (fatty acids).Thirdly, due to the increase in the level of glucagon, the activity of lipase, the enzyme that breaks down triglycerides (fats) accumulated in the cells of adipose tissue, increases significantly.
In addition, during the first two weeks of following the keto diet, significant weight loss occurs due to the removal of water from the body, which is also associated with increased glucagon production.Therefore, a temporary side effect of a high-fat diet can be dehydration, which nutritionists advise by drinking two liters of water a day.
Many people believe that one of the important benefits of the keto diet is the lack of hunger, counting calories and exercising for hours to burn excess calories.
Keto Diet for Men
The keto diet is considered particularly effective for men with abdominal obesity.
If the therapeutic diet for the treatment of obesity recommends reducing caloric intake to 2000 (2300) kcal per day, the ketogenic diet does not regulate calories so strictly (but reducing it by at least 10-20% is fine).But carbohydrate consumption must be reduced five times: instead of 250 g to a maximum of 50 g per day.
Keep in mind that most of your keto diet calories come from foods rich in natural fats and moderate amounts of protein.That is, it is not "protein loading" as some people think.And if a man is used to eating a lot of meat, his body enters the state of adaptive ketosis much more slowly.So you need to limit protein: 1-2g of protein per day per kilogram of body weight you are trying to achieve as a result of losing weight.Example: if the initial weight is 112 kg and the desired weight is 85 kg, then the amount of protein during the course is 85-170 g.
The exact ratio of fats, proteins and carbohydrates in the diet (in grams) depends on the age, goal, level of physical activity and health of each man.But short-term fasting during the keto diet is recommended for everyone: during the first two days of switching to this eating system, you should drink a lot of water and limit yourself to one meal per day (very small).By the end of the first week, you should avoid carbohydrates as much as possible (below is a list of foods for the keto diet), but the portion sizes will be reduced very little.
Another nuance: they claim that the keto diet does not lose its effectiveness without sports, and to lose weight you do not need to go to the gym or simply do additional physical exercises.But physical activity as part of a healthy lifestyle accelerates the burning of excess fat, so you should not lie on the couch.What's more, you can take advantage of the moment and follow the example of bodybuilders to build muscle mass: on the keto diet, you can only gain weight with muscle load, and then the fat under the skin disappears, revealing strong muscles.
Keto diet for women
The problem with the keto diet is that so far research into its effectiveness and safety has only focused on men.It's a natural question to ask if the keto diet is right for women, as women's hormones tend to be more sensitive to most dietary changes.
Although opinions vary, most experts agree that the ketogenic diet has positive results, especially for perimenopausal or menopausal women.This nutritional system allows you to reduce excess weight, control blood sugar levels, improve sleep quality and reduce menopausal symptoms such as hot flashes or night sweats.
However, there are also negative opinions, and they even complain about nausea, fatigue and constipation caused by the diet (more details below in the Possible complications section).It is also worth mentioning that switching to a keto diet is contraindicated during menstrual cycle irregularities, thyroid pathologies, or during pregnancy and breastfeeding.
Women are recommended to combine intermittent fasting with a ketogenic diet, that is, simply skip lunch and take a 10-12 hour break between breakfast and evening meals, which has a rejuvenating effect after 50-55 years (these are the data of a 2016 study published in the Journal of the American Medical Association).According to Western nutritionists, this diet allows the body to take a break from digestive functions and direct energy resources to repair tissue cells and balance hormones.
If a woman with a body weight of 75 kg and a height of 165-168 cm wants to lose weight to about 68 kg, she must switch from 2300 kcal per day to a consumption of no more than 1855 kcal.The ideal protein should be 1-1.5 g per kilogram of body weight, i.e. you can get about 68-102 g of protein, 240-350 g of fat and 18-20 g of carbohydrates per day (in pure water, without fiber).
How is the keto diet different from a high-fat diet?
A high-fat or LCHF diet differs from a keto diet in the ratio of proteins, fats and carbohydrates, with a high-fat diet assuming 50% fat and 25% protein and carbohydrates.
In Europe, the high-fat (low-carbohydrate) diet is called the Swedish diet.Apparently, this is due to the Swedish therapist Annika Dahlqvist, who began recommending to her diabetic patients to eat more fat and limit carbohydrates, which contradicts the officially approved recommendations of Swedish endocrinologists.
Among the modifications of the ketogenic food system, starting with the Atkins diet and the LCHF diet, one can name strange dietary recommendations, for example, the egg fast of the keto diet - when you only eat boiled chicken eggs with mayonnaise for several days...
Cyclic keto diet and other modifications
In recent years, the standard keto diet (SKD) has been modified in a number of ways.This is how the high-protein ketogenic diet (HPKD) was born, in which 60% of calories come from fat, 35% from protein and 5% from carbohydrates.
The Targeted Ketogenic Diet (TKD) is more moderate as carbohydrates can be consumed before and after exercise;It is considered a sport, so the number of calories gained from the consumption of carbohydrates is higher than in SKD.
The cyclic keto diet (CKD) or, according to another version, the rotational keto diet (alternating) is a low-carbohydrate diet with alternating periods of high or moderate carbohydrate consumption: 5-6 days - a minimum amount of carbohydrates, then a carbohydrate load is carried out on a keto diet - one or two days of carbohydrate consumption without restriction.The unknown authors of this version of the keto diet try to justify their innovations with the need to replenish glycogen reserves, restore hormone levels and thyroid gland activity, and ensure moral and psychological stability - to continue the diet.In fact, everything that is lost in six days comes back immediately.
Preference
As foreign clinical practice shows, nearly 20% of children with epilepsy experience seizures much less often after a ketogenic diet (followed for 6 months to two years, gradually returning to a normal diet), and many of them can reduce the consumption of anticonvulsants or completely abandon them.
Based on the results of two dozen randomized controlled trials, experts concluded that the benefits of the keto diet include significant and fairly rapid weight loss, especially in severe obesity.Despite the high amount of fat, this 24-week diet reduced systolic blood pressure, blood sugar and insulin levels, plasma C-reactive protein levels, and increased high-density lipoprotein (HDL), i.e. good cholesterol, levels in a significant percentage of patients.
In 2008, the American Diabetes Association (ADA) revised its dietary guidelines and recognized a low-carbohydrate diet as an effective short-term dietary intervention for patients with non-insulin-dependent diabetes.
However, during the keto diet, the skin reacts in its own way to the lack of carbohydrate-containing foods, for example, the number of acne can decrease.And this is confirmed by the results of a study published in the Journal of the American Academy of Dermatology.
What is possible and what is not?
what can you eatThe list of products recommended for the keto diet includes: any meat and meat by-products;bird;fish and seafood;eggs (all kinds);cream, sour cream, butter (butter and vegetables).Hard cheese is very useful during the keto diet.But you have to be careful with normal milk because it contains a lot of lactose - milk sugar, which is a disaccharide carbohydrate.However, fermented milk products can be consumed without fear: lactose undergoes hydrolysis during the fermentation of fermented milk.
Instead of popcorn, candy or chips, walnuts (about 13 g carbs/100 g) and sunflower seeds (10.5 g carbs/100 g) are good.The number of calories is 655 and 600, respectively.
We recommend that the menu include:
- mushrooms (except dried porcini and boletus), the ideal option is the chanterelle (only 0.5 g of carbohydrates per 100 g).
- all types of leafy vegetables and vegetables that do not contain starch, complex carbohydrates: broccoli and kohlrabi;white, cauliflower and Brussels sprouts (3-6 g of carbohydrates per 100 g);cucumbers, courgettes, courgettes, eggplant, bell peppers (green), tomatoes, radishes, leeks, rhubarb, green beans and leeks (1.8-4.5g carbs/100g).
You can eat some berries: strawberries (100 g contains about 8 g of carbohydrates), cherries, raspberries, blackberries, blueberries (100 g contains 12 g of carbohydrates).
If we keep their consumption moderate in addition to the weight loss keto diet, we can occasionally eat 100 g of apricots, pineapples or grapefruit: this is about 11.8-12.4 g of carbohydrates.But you should not eat bananas: 100 grams of carbohydrates contain almost 23 grams.
What can't you eat?You must give up bread and all flour;pasta;sugar, honey and sweets;porridge from any grain;potatoes, carrots, beets, celery root;pumpkins and all melons;legumes and most fruits.
Menu for a week of keto diet
If you seriously want to get rid of excess fat reserves in your own body, then of course you have to put together a menu for the week of the keto diet.The information in the previous section will help you with this.
For breakfast, you can cook scrambled eggs or an omelet - with onions, mushrooms and spinach, bacon and tomatoes.Coffee or tea, of course, without sugar.
Lunch can include salad (one of the recipes is below), vegetable soup or soup with meatballs (without potatoes, rice or pasta), chicken soup and boiled chicken, fried fish or pork and mushroom stew.
For dinner, choose a protein, such as turkey, beef, fish, seafood, with which broccoli, Brussels sprouts, green beans or bell peppers flavored with cream cheese sauce go well as a side dish.
Keto Diet Recipes
Taking into account the list of foods allowed on the ketogenic diet, you can prepare so many dishes that it is impossible to list even a tenth of the keto diet recipes.Try these three.
Chicken with fried vegetables
Products for two servings: 500 g of chicken (thigh, breast or fillet, cut into medium pieces), one tablespoon of vegetable oil, 1 green bell pepper (cut into medium cubes), half an onion (cut into small cubes), 500 g of cauliflower (picked into florets), half of a small hot pepper (510 g, 50 g finely cut), full-fat sour cream, 50 g of hard cheese (coarsely gratedgrated), salt and ground black pepper to taste, ground coriander (half a teaspoon).
Preparation:
- heat the oven to 180 °, grease the baking dish or pan with vegetable oil;
- Steam onions and peppers (sweet and bitter) separately in vegetable oil;
- Blanch the cauliflower florets in salted, boiling water for three minutes, let them drain;
- put the chicken in a mold (pan), season with salt and pepper, add the onion, paprika and cabbage (distribute the vegetables evenly over the meat);
- Sprinkle coriander on top, put butter (in several pieces, on the surface), pour sour cream, sprinkle with grated cheese and put in the oven for 40-45 minutes.
Quick salad with ham or brisket
Products for two servings: 100 g of ham or brisket, 250 g of lettuce (can be dried well after washing), two fresh cucumbers, one tomato, two chicken eggs (hard-boiled), 60 g of dill or parsley, 1 tablespoon of olive oil and the same amount of mayonnaise, salt to taste.
Preparation:
- cut brisket or ham into large strips;
- cut the boiled egg into quarters and the vegetables into thin slices;
- put the salad leaves on a dish, put the ham on it, the egg and the vegetables on top, add salt;
- mix vegetable oil with mayonnaise, add chopped herbs, mix and pour the sauce over the salad.
Pork stew with mushrooms
Products for three servings: 300-400 g of pork, 350 g of fresh champignons, half an onion (finely chopped), 2 tablespoons of vegetable oil, half a teaspoon of nutmeg, a clove of garlic, 4 tablespoons of sour cream or sour cream, 2 tablespoons of salt and ground black pepper to taste.
Preparation:
- pour vegetable oil into a deep frying pan or pan with a thick bottom, add onion and chopped garlic, simmer for five minutes;
- put pieces of meat and fry a little;
- add chopped mushrooms, mix, add nutmeg and ground black pepper, salt;
- cook over low heat for 15 minutes, then add sour cream and herbs;
- Cover the pot with a lid and steam until done (about another 15 minutes).
Contraindications
Absolute contraindications for switching to a ketogenic diet are:
- diabetic ketoacidosis caused by insulin deficiency;
- congenital and secondary carnitine deficiency;
- pyruvate carboxylase deficiency;
- mitochondrial diseases caused by impaired beta-oxidation of fatty acids;
- porphyria;
- pronounced disorders in the composition of the blood, iron deficiency anemia;
- pancreatitis;
- acute and chronic inflammation of the gallbladder (cholecystitis);
- liver dysfunction, primary or metastatic liver tumors;
- acute renal failure;
- intestinal dysfunction, Crohn's disease;
- abdominal tumors;
- condition after cancer chemotherapy.
Special care should be taken when considering the advice of bodybuilders to "stimulate" the metabolism with the help of pharmacological agents: you should not risk your health in order to achieve a super effect.
Possible risks
Risks associated with a long-term diet in the complex treatment of epilepsy in children include growth retardation (due to reduced levels of insulin-like growth factor 1), impaired bone mineralization (due to calcium deficiency), and nephrolithiasis (kidney stone formation).Hyperlipidemia (high blood fat) occurs in almost 60% of children, and cholesterol levels can rise by about 30%.
Rare side effects include cardiomyopathy, long QT syndrome (disorder of the ventricular rhythm of the heart), lack of vitamins, micro- and macroelements.
The most common side effect is constipation, which almost a third of those who lose weight complain about: it is affected by the lack of fiber intake.In addition, the ketogenic diet may be accompanied by increased fatigue, weakness, headaches and dizziness in the initial stages;in women - dysmenorrhea.
If the weight does not decrease with a keto diet, it is most likely that there is too much protein in the diet, since more than half of the excess proteins are converted into glucose in the body, meaning that the process of induced ketosis is interrupted.
If the muscles are very sore during the keto diet, the cause may be associated with a violation of gluconeogenesis - the synthesis of glucose from muscle lactate (lactic acid) - and the enzymatic breakdown of glycogen in muscle tissue under conditions of ketosis.
At the beginning of the diet, reducing carbohydrate intake leads to fluid loss, in addition to the keto diet, swelling of the legs can also occur in cases of minor kidney failure.
Weight loss reviews and results
Doctors who prescribe a ketogenic diet to patients suffering from neurodegenerative pathologies lead to the establishment of its absolute effectiveness: even in the case of senile dementia and Parkinson's disease, the patients' attention increases, memory and the adequacy of perception are significantly improved.
Usually, the opinions and results of weight loss are commented by experts.But the considerable controversy surrounding all low-carb diets also contributes to evaluating specific results.
Thus, according to the American Journal of Clinical Nutrition, researchers found that men and women who switched to a keto diet lost an average of 3.6 to 4 kg more over six months than those who restricted their fat intake.British obesity experts (British National Obesity Forum) also note that low-carbohydrate and low-fat diets are superior to low-fat diets in terms of weight loss effectiveness.Although many of their colleagues claim that the keto diet's weight loss results are "contrary to the available evidence."