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The Ketogenic (Keto) Diet is one of the most popular diet of recent years. It consists of eating high fat, moderate protein, and low carbs. Although it seems like the current fad, it was originally developed in the 1920s as a way to mimic fasting to treat patients with epilepsy. Since then, there have been promising results in treating conditions such as obesity, type 2 diabetes, metabolic syndrome, heart disease, high blood pressure, polycystic ovarian syndrome, among many other conditions. The diet may have some notable health benefits; however, it is not without risks or the right choice for everybody. As always, consult the appropriate professionals before making a big dietary change. We will explore the science and the metabolic mechanisms behind the Keto Diet, the general guidelines, and whether or not this type of diet might be the right fit for your health needs and lifestyle.

Background on Metabolism

To understand the mechanisms behind the Keto Diet, we need to first define how the body creates, uses and stores energy a.k.a. the metabolism. Metabolism is a group of chemical reactions that take place within the body’s cells for the use of energy. It is essentially the body’s process of converting food into energy to be utilized in our muscles, cells, nerves, blood vessels, lungs, stomach, and heart.  

There are three forms of energy which all serve complementary but distinct roles: carbohydrates, proteins, and fats. First, carbohydrates are the fast, most readily available source of energy to the body. When they are digested, it becomes broken down into glucose and activates the release of insulin.  Insulin is a hormone found in the pancreas that is responsible for getting glucose into the bloodstream and storing excess into the muscles and liver called glycogen). Next, proteins are a less accessible form of energy that help with satiety. They are the building blocks for muscle tissue and cells, aid in the immune system and cell turn over. Finally, fats are essential for cell growth, insulation for temperature regulation, and act as stored energy for future use (unused, excess glycogen eventually turns into fat). When there is excess energy, it becomes stored as fat in the form of triglycerides. Triglycerides are made up three fatty acid molecules with an adjoining alcohol molecule, glycerol. They are the foundation of lipids, fatty organic compounds.

What is the Keto Diet and How Does It Affect the Metabolism?

The Keto Diet is a low-carb, moderate protein, high-fat diet – the inverse of the average high carb diet. The ratios of the macronutrients tend to vary on the fat and the protein amounts (depending on individual goals, such as building muscle or losing weight) but the carb amount always remains very low. The typical ranges are between 55%-75% healthy fats, 15%-35% proteins, and 5%-10% carbs. Ketogenic-friendly foods and beverages include: natural fats, seafood and meat, vegetables that grow above ground, cheese, eggs, water, black coffee, and tea. Foods and beverages to avoid include starches and simple sugars.

The emphasis on low carbs is very important because it allows the body to use up all the glucose and glycogen stores (in the liver and muscles) and enter ketogenesis.  Ketogenesis is the process of turning fat stores, as opposed to carbohydrates, into the main energy source.  The liver produces ketones and breaks down fatty acids from triglycerides after all the glucose and glycogen are used up.  This means that triglycerides and LDL cholesterol lower while insulin and hormone sensitivity increases.

To note, eating low carbs has some benefits, but it may deplete and deprive the body of essential electrolytes, such as sodium, potassium, magnesium, phosphorus, and zinc which are important for cell function and body regulation. There are electrolyte solutions and supplements to main healthy levels within the body.

Who Might Benefit from the Keto Diet and Who Should Avoid It?

Because the Keto Diet helps the body become fat-adapted and more efficient at burning fat for fuel, it can help with weight loss, LDL cholesterol, insulin resistance, and hormone irregularities.  It can help treat obesity, type 2 diabetes, metabolic syndrome, heart disease, high blood pressure, polycystic ovarian syndrome, epilepsy, and potentially many others.

This diet may not to be the best fit for the following groups of individuals who have/are: a history of eating disorders, Crohn’s Disease, vitamin and mineral deficiencies, young athletes (they need carbs for high-intensity sports), a hyper-sensitivity to cholesterol, kidney or liver complications, type 1 diabetes, high blood pressure,  pregnant/nursing women, taking medications (discuss it with your doctor first).

Like with any other diet program, it is important to factor in one’s medical history and concerns, goals, and lifestyle before diving into a major change. The Keto Diet shows promising results for many people, but understanding your individual needs and risk factors nets the best, healthy results!