Carbohydrates have long been considered the body’s primary source of energy. However, newer diet trends such as Whole 30, Atkins, and the Ketogenic diet significantly reduce carbohydrate intake, replacing it with fat. In many cases, these diets have led to weight loss and improved blood glucose levels. Even so, they are not typically approved or recommended by doctors or dietitians. Read on to learn why.
The Science Behind Ketosis and Ketone Bodies
While fats are a valuable source of energy for most of the body, some cells, such as brain cells, have special needs. These cells can easily use glucose from food but cannot use fatty acids directly. Under conditions of very low carbohydrate intake, such as during an extremely low-carb diet, prolonged fasting, or extended exercise, the body produces fat-like molecules called ketone bodies to fuel the brain. This is why a very low carbohydrate diet is sometimes called "ketogenic."
Ketone bodies are also linked to a dangerous complication called ketoacidosis, which can occur if insulin levels become extremely low, especially in people with diabetes. You may enter ketosis with as few as 20 grams or as many as 100 grams of carbohydrates per day. The only way to know for sure if you are in ketosis is through testing. Several testing methods exist, each with its own limitations. Urine test strips are the most commonly used.
Although ketone bodies can provide enough energy for parts of the body that cannot use fatty acids, some tissues still need at least a small amount of glucose. When dietary protein is not sufficient, the liver and kidneys make glucose by breaking down protein from the body, including muscle tissue.
What Counts as Keto?
Clinically approved recommendations for daily carbohydrate intake range from 45 to 65 percent of total calories. On a 2,000-calorie diet, this equals about 225 to 325 grams of carbohydrates per day. In comparison, low carbohydrate diets are typically limited to around 50 to 70 grams of carbohydrates per day.
How to Do Keto More Safely
A ketogenic diet usually involves consuming 25 to 30 grams or fewer of carbohydrates per day, which is about 5 to 6 percent of a 2,000-calorie diet. In place of carbohydrates, the diet becomes roughly 60 to 75 percent fat and 20 to 35 percent protein.
Diet:
- Not all fats are considered equal: a high fat diet that is especially rich in omega-3 rich fatty acids, nuts, seeds, seafood, avocado is less detrimental to the heart.
- Plenty of non-starchy vegetables are key in maintaining a regular and healthful digestion and metabolism.
- Multivitamin and omega-3 supplementation is necessary.
- When eating carbohydrate, make sure its healthy, high fiber, and whole grain to better supplement your body with more nutrients that it may be missing by not getting a balanced diet (a few examples: beans, lentils, barley, buckwheat, farro, freekeh, quinoa, etc)
Exercise:
- Regular, moderately intense physical activity 5 days per week for 30-60 minutes is necessary to reduce the negative impact on liver and cholesterol levels.
Monitoring:
- If you are on the keto diet, monitor your blood levels and symptoms, and check in with your doctor and dietitian regularly.
Takeaways
Ketogenic diets may not be harmful in some cases, but in those cases where it may be safe more research is still needed to see how effective it is in treatment of disease. With many common illnesses a ketogenic diet is not safe and should not be considered. It may help with glucose management and weight loss in some patients, but the patient should ask the doctor to review their blood results to make sure it is safe to start. After beginning a ketogenic diet, the patient should be followed more closely with blood drawn more frequently throughout the process to make sure no adverse effects are shown.