Thursday, 25 August 2016

Diets 101: Ketogenic Diet

The Ketogenic diet has been used primarily as a weight loss diet in the past (and a very effective one at that), however more recent research has surfaced showing great promise for it's use in various diseases such as epilepsy, Parkinson's disease, diabetes and even cancer.

So what is it?

The Keto diet follows the premise of consuming a high fat and low carbohydrate diet with adequate amounts of protein. The percentage of total caloric intake per day are as follows:
Calories from fat: 60-75%
Calories from protein: 15-30%
Calories from carbohydrates: 5-10%
Carbs are the primary energy source of the body. They are easily converted to glucose and used as energy, but excess amounts can just as easily be stored as fat. With the Keto diet, carbs are reduced to an amount that is not sufficient enough to sustain the energy needs of the body. Because of this, the body is forced to adapt. It is this adaptation which enables the previously mentioned benefits of this diet to occur.

Ketogenesis is the process of breaking down and converting stored fat into ketones for energy use. The brain can only use glucose and ketones as energy, so when there is no more glucose around, ketones become the primary source of fuel. This means that lowering the amount of carbs you consume and entering a state of ketosis allows you to burn fat without even having to think about it! This is the premise behind why the weight loss is so effective and the ketone bodies themselves seem to be where the health benefits arise from.

5 Health Benefits of the Ketogenic Diet

Following a Ketogenic diet is not something that should be tackled without seeking the advice of a professional, especially if the benefits being sought are for the aid of medical conditions. That being said, there is a lot benefit to be obtained and if weight loss or disease control is something that is of interest, book an appointment and consult a medical professional first.

1. Glycemic control
Following a Keto diet has been proven to significantly impact glycemic control, leading to a decrease in blood glucose. This makes sense considering the absence of carbohydrates and sugars in the diet, but it does warrant supervision in diabetic patients who are medicated since blood sugar may drop too low.

2. Anti-inflammatory
While not a heavily researched area of the Ketogenic diet, it is inherently effective as an anti-inflammatory diet due to the elimination of proteins like gluten, and refined sugars. Further modifications can easily be incorporated on a case by case basis in order to ensure specific intolerances are avoided.

3. Weight loss
Weight loss on a Ketogenic diet comes easy. You are literally burning fat while just sitting around. Now I wouldn't recommend relying on diet alone, exercise is very important for more than just weight loss purposes, but calories still do play a role in how much weight can be lost. This diet itself however, does not feel very restrictive when it comes to consumption of foods. Once your body adjusts to working off of fat, satiety is achieved and maintained for much longer than a carbohydrate heavy diet. This means without even realizing, you'll be consuming less calories.
Less calorie consumption + constant fat burning = weight loss
Weight loss on it's own has additional benefits including lowering blood pressure, decreasing pain associated with arthritis, improving diabetic control, and decreasing the risk of cardiovascular disease.

4. Energy
Who couldn't use more energy? While on the Ketogenic diet, there will be an initial drop in energy and increase in hunger as your body adapts to these changes that are occurring. I can tell you from personal experience that they are not great BUT they do pass. If you stick with the dietary changes, after a few days the hunger will decrease, the mental clarity will improve and you stop experiencing periods of grogginess and fatigue that typically accompany a crash in energy after a carbohydrate or sugar dense meal. These changes are quite noticeable and lasting. They are most definitely worth the first few days of unhappiness. The trade off is a much longer lasting increase in energy and mental clarity.

5. Performance
While specific research in the area of exercise performance is difficult to come by, the consensus of athletes who follow a Ketogenic diet seem to all be in favour of this way of eating. When you break it down it really just makes sense for a variety of athletes. First benefit, fat loss.. More lean muscle, less weight to carry around. That alone is beneficial for most. Next benefit, efficient use of fat as energy. This means fat burning fuel is the first and last energy source. There will be no crossover between carbohydrate stores to fat stores and a crash in energy. All you're left with is a consistent conversion of energy from fat. This is useful for the endurance athlete, who has to rely on fat as a fuel source during long bouts of exercise. With the great majority of endurance performance coming from fat burning anyway (pretty much anything after 20 minutes), having optimized this method of energy conversion prior to an event can only be beneficial.
I recently experienced this first hand and can attest to the claims made by others who follow this way of eating. Patience and timing are factors that need to be considered though, if performance enhancement is your goal. There is an adaptation period in which your performance (particularly endurance) will take a drastic hit. I learned this early on by attempting to go for a light jog within 5 days of starting my Keto diet experience. After about 1 minute of jogging I felt like I had run a full marathon (or at least what I might imagine that would feel like). I don't recommend doing that at all, instead, give it some time and try to save the more serious endurance events for closer to 1 month after starting. If you persevere, you will notice drastic changes in your performance.

What to eat?!

Avoiding carbs is not all that bad! At first it feels like a daunting task, especially if you are not prepared for it. My number one tip for being successful at following through with these dietary changes is to remove temptations from your eating space. Pick a day that you want to start. In the days leading up to this, either consume or throw out any and all sources of temptation! Eat up all that pasta, have a few cookies, dump that pop down the sink and don't pretend you forgot to clean out the freezer! Not having these foods around will make things a lot easier.

Once that's out of the way, make sure you stalk up so you don't go hungry. Start to replace those foods you've gotten rid of with Keto friendly options such as:

Nuts (Almond, Walnut, Cashew, Macadamia, Hazelnut, Brazil Nut, Peanut*)
Oils and Fats (Healthy oils - Olive oil, Coconut oil, Avocado oil, Walnut oil, Sesame oil) 
                      (Fats - Butter!, Ghee, Heavy cream, Cheese)
Meats (Chicken, Turkey, Beef, Pork, Lamb, Venison, Small birds, Large birds, Rabbit, Eggs)
Seafood (Crab, Lobster, Fish**, Shrimp, Calamari)
Veggies (Avocado, Spinach, Kale, Collards, Zucchini***, Broccoli, Cauliflower, Pumpkin, Lettuce)
Drinks (Coffee, Tea, Coconut milk, Almond Milk, Cashew Milk, Water!, Vodka if you must)
            - ensure all of these are unsweetened!
Dessert (Yes, you can still have dessert. You just have to get a little creative. I suggest looking up Keto friendly dessert recipes but anything made with coconut, cocoa, cinnamon or high fat dairy is perfectly fine)

*Peanuts - Some debate here but I love my peanut butter so you can't make me not include it! Just go for ones without anything added.
**Fish - Stick to smaller fish as the primary source here as larger fish like tuna and sword fish have higher amounts of bioaccumulated toxins like mercury. Sardines are the best bet but salmon and white fish sized fish are fine as well.
***Zucchini - Get your hands on a vegetable spiralizer and replace spaghetti with a zucchini imposter! Try butter and sage as the sauce.

The key to success and maximizing the benefits that can be obtained from following this diet is choosing foods that are good for you! Yes, it is a high fat diet, but that doesn't mean you should be deep frying everything you eat. Try as much as possible to bake, steam, boil and add the above mentioned oils raw as a drizzle on top of already cooked foods. If done correctly, this high fat diet can actually reduce triglycerides and LDL cholesterol (the bad one), and increase HDL cholesterol (the good one)!

Remember that starting a diet like this is not something you should tackle on your own. Always seek the assistance of a medical professional before tackling major voluntary dietary changes especially if you're seeking therapeutic results. That being said, if this fat burning, energy producing, glycemic stabilizing diet sounds like something that interests you, book an appointment and get the wheels in motion!

Rob Raponi, CISSN, B.Kine,
Naturopathic Intern
www.msknaturopathic.com

References

Hussain, Talib A., et al. "Effect of low-calorie versus low-carbohydrate ketogenic diet in type 2 diabetes." Nutrition 28.10 (2012): 1016-1021.


Partsalaki, Ioanna, Alexia Karvela, and Bessie E. Spiliotis. "Metabolic impact of a ketogenic diet compared to a hypocaloric diet in obese children and adolescents." Journal of Pediatric Endocrinology and Metabolism 25.7-8 (2012): 697-704.

Yancy, William S., et al. "A randomized trial of a low-carbohydrate diet vs orlistat plus a low-fat diet for weight loss." Archives of internal medicine 170.2 (2010): 136-145.

Gibson, A. A., et al. "Do ketogenic diets really suppress appetite? A systematic review and meta‐analysis." Obesity Reviews 16.1 (2015): 64-76.

Zajac, Adam, et al. "The effects of a ketogenic diet on exercise metabolism and physical performance in off-road cyclists." Nutrients 6.7 (2014): 2493-2508.

Paoli, Antonio, et al. "Effects of n-3 polyunsaturated fatty acids (ω-3) supplementation on some cardiovascular risk factors with a ketogenic Mediterranean diet." Marine drugs 13.2 (2015): 996-1009.

Dashti, Hussein M., et al. "Beneficial effects of ketogenic diet in obese diabetic subjects." Molecular and cellular biochemistry 302.1-2 (2007): 249-256.