The ketogenic or keto diet is not new: a hundred years ago, before the arrival of effective anticonvulsants, French pediatricians realized that certain dietary restrictions reduced the frequency of seizures in children suffering from 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 20-30s.century ago.
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 you lose extra pounds, but also has therapeutic applications.
Instructions for use
A low-carb keto diet for epilepsy, which is widely used in foreign clinical practice, helps reduce the frequency of seizures in children aged 62-75% (after 12 weeks of dietary treatment).At the same time, children prescribed such a diet must be registered with a doctor who monitors their normal growth and weight gain, and also makes diet adjustments according to the needs of each child.
Diets with minimal amounts of carbohydrates have begun to be used for other disorders.Researchers have shown that the ketogenic diet is useful in treating patients with devivo disease, GLUT1 deficiency syndrome (which transports glucose across the blood-brain barrier), as well as several other metabolic defects.
It is believed that this nutritional system can delay the development of amyotrophic lateral sclerosis (Charcot's disease);Indications for a ketogenic diet include neurodegenerative pathologies such as Alzheimer's and Parkinson's disease.Clinical studies are currently underway on the effects of the ketogenic diet on the condition of patients with autism, depression, type 2 diabetes mellitus (non-insulin) and polycystic ovary syndrome.
The most famous Keto diet for weight loss is in the form of the Atkins diet for the treatment of obesity, 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, in fairness, it should be noted that long before him, many American doctors worked 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 this is basically the same low-carb diet that was originally introduced to treat epilepsy.
Since the excessive deposition of adipose tissue in the form of triglycerides concentrated in its cells occurs due to the consumption of excessive carbohydrate foods (no one doubts this fact), limiting carbohydrates in a minimal diet - a keto diet for a month - helps reduce fat reserves, that is, lose weight.
In addition, it was found that the keto diet for oncology - by increasing the oxidative stress of cancer cells - significantly reduces the growth rate of malignant tumors located in the colon, stomach, prostate gland and lungs.In addition, it has been proven that some cancers are more sensitive to chemotherapy due to the induced state of ketosis.
Over the past two decades, the ketogenic diet has been used by bodybuilders to reduce the layer of fat under the skin: in their slang this is called cutting the keto diet.
The essence of the keto diet
On a standard keto diet, your total daily calories should come from 70-80% fat, 15-20% protein, and 5% carbohydrates (less than 50g per day).
Normally, the ratio of fat to 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 energy comes from fat, 8% from protein and only 2% from carbohydrates (about 20 g per day).
The essence of the diet used to lose weight is to introduce the body into a state of adaptive ketosis - when the body receives energy (ATP) mainly from ketone bodies in the blood, and not from glucose, which comes from eating food containing carbohydrates.
Carbohydrates in food are converted into glucose, but when a person consumes very little carbohydrate and a lot of fat, a chain of biochemical reactions is triggered in the body.Schematically this process looks like this.First, due to a decrease in blood glucose levels, the pancreas begins to produce more of the hormone glucagon, which stimulates the catabolism of glycogen stored in the liver into glucose and releases it into the blood.Second, ketogenesis is activated, that is, the liver produces ketone bodies (acetoacetate, which is then converted into β-hydroxybutyrate and acetone) and the conversion of dietary fat into free carboxylic acids (fat).Third, due to increased glucagon levels, the activity of lipase, an enzyme that breaks down triglycerides (fat) accumulated in adipose tissue cells, increases significantly.
In addition, in the first two weeks 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.And therefore, a temporary side effect of a diet rich in fat can be dehydration, which nutritionists advise to combat by drinking up to two liters of water per day.
Many people believe that an important advantage of the keto diet is the absence of hunger, the need to count calories and exercise for hours to burn excess calories.
Keto diet for men
The keto diet is considered very effective for men with abdominal obesity.
If the therapeutic diet for obesity recommends reducing calorie intake to 2000 (2300) kcal per day, then the ketogenic diet does not strictly control calories (but reducing it by at least 10-20% will not hurt).But the consumption of carbohydrates must be reduced five times: not 250 g to a maximum of 50 g per day.
Remember that most of the calories on the keto diet come from foods that are high in natural fats and moderate amounts of protein.That is, this is not a "protein load", as some people think.And if a man used to eat a lot of meat, then his body will enter the state of adaptive ketosis more slowly.Therefore, you need to limit protein: every day to 1-2 g of protein per kilogram of body weight that you are trying to achieve due to weight loss.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 fat, protein and carbohydrates in the diet (in grams) depends on the age, goals, level of physical activity and health status of each man.But short-term fasting during the keto diet is recommended for everyone: In the first two days of switching to this food system, you should drink a lot of water and limit yourself to one meal a day (in very small amounts).By the end of the first week, you should eliminate carbohydrates as much as possible (below is a list of foods for the keto diet), but the portion sizes are slightly reduced.
Another nuance: they claim that the keto diet without sports does not lose its effectiveness, and to lose weight you do not need to go to the gym or just do additional physical exercises.But physical activity, as part of a healthy lifestyle, accelerates the burning of excess fat, so you can't lie on the couch.In addition, you can take advantage of this time and, following the example of bodybuilders, build muscle mass: gaining weight on a keto diet is possible only with muscle load, and then the subcutaneous fat will disappear, 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.A natural question that arises is whether the keto diet is suitable for women, since women's hormones tend to be more sensitive to most dietary changes.
Although opinions vary, most experts say the ketogenic diet produces positive results, especially for perimenopausal or menopausal women.This nutritional system allows you to lose excess weight, control blood glucose levels, improve sleep quality and reduce menopausal symptoms such as hot flashes or night sweats.
However, there are also negative reviews, as well as complaints 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 in case of irregularities in the monthly cycle, pathology of the thyroid gland, or during pregnancy and lactation.
Women are recommended to combine periodic fasting with a ketogenic diet, that is, skipping lunch and resting for 10-12 hours between morning and evening meals, which after 50-55 years gives a rejuvenating effect (this is data from a 2016 study published in the Journal of the American Medical Association).According to Western nutritionists, this nutritional regimen allows the body to rest from the digestive function and a direct source of energy to restore tissue cells and balance hormones.
If a woman with a body weight of 75 kg and a height of 165-168 cm tries to lose weight to about 68 kg, she should go from 2300 kcal a day to consume no more than 1855 kcal.Protein should be 1-1.5 g per kilogram of ideal body weight, that is, every day you can get about 68-102 g of protein, 240-350 g of fat and 18-20 g of carbohydrates (in pure water, without fiber).
How does a keto diet differ from a high-fat diet?
A high-fat or LCHF diet differs from a keto diet in the proportion of protein, fat and carbohydrates in the diet, and a high-fat diet assumes a ratio of 50% fat and 25% protein and carbohydrates.
In Europe, a high-fat (low-carb) diet is called the Swedish diet.Obviously, this is due to the Swedish therapist, Annika Dahlqvist, who began to recommend that her patients with diabetes consume more fat and limit carbohydrates, which is contrary to the officially approved recommendations of endocrinologists in Sweden.
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, fast eggs on the keto diet - when for several days you have to eat boiled chicken eggs with mayonnaise ...
The keto diet cycle and other modifications
In recent years, the Standard Keto Diet (SKD) has been modified in many ways.Thus, the high-protein ketogenic diet (HPKD) appeared, where 60% of calories come from fat, 35% from protein and 5% from carbohydrates.
The targeted ketogenic diet (TKD) is simpler, as carbohydrates can be consumed before and after training;It is considered a sport, so the number of calories obtained from eating carbohydrates is higher than SKD.
The Cyclical Keto Diet (CKD) or, according to another version, the cyclic (alternating) keto diet, is a low-carb diet with alternating periods of consuming high or moderate amounts of carbohydrates: Minimal carbohydrates.The unknown author of this version of the keto diet tried to justify their innovation with the need to replenish glycogen reserves, restore hormone levels and thyroid activity, as well as ensure moral and psychological stability - to continue the diet.In fact, everything that was lost in six days returned immediately.
Benefits
As shown by foreign clinical practice, almost 20% of children with epilepsy after a ketogenic diet (followed from six months to two years, with a gradual return to a normal diet) experience less frequent seizures, and many of them can reduce the intake of anticonvulsants or completely abandon them.
Based on the results of two dozen randomized controlled studies, experts have come to the conclusion that the benefits of the keto diet include excessive and fairly rapid weight loss, especially in severe obesity.Despite the high amount of fat, this diet for 24 weeks produced a significant percentage of patients with a reduction in systolic blood pressure, blood sugar and insulin levels, C-reactive plasma protein levels, and an increase in high-density lipoprotein (HDL), which is good cholesterol.
In 2008, the American Diabetes Association (ADA) revised its dietary guidelines and recognized the 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 to the lack of carbohydrate food in its own way, for example, 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 eat?The list of recommended products for the keto diet includes: any meat and meat by-products;birds;fish and seafood;eggs (all types);Cream, sour cream, butter (butter and vegetables).Hard cheese is very useful on the keto diet.But be careful with regular milk, because it contains a lot of lactose - milk sugar, which is a disaccharide carbohydrate.But fermented milk products can be eaten without fear: During the fermentation of fermented milk, lactose undergoes hydrolysis.
Instead of popcorn, sweets or chips, walnuts (about 13 g of carbohydrates per 100 g) and sunflower seeds (10.5 g of carbohydrates per 100 g) are suitable.The number of calories are 655 and 600 respectively.
It is recommended to include in the menu:
- Mushrooms (except porcini and dried boletus), the ideal choice is Champignons (only 0.5 g of carbohydrates per 100 g).
- All types of leafy greens and vegetables that do not contain starchy complex carbohydrates: broccoli and kohlrabi;white, cauliflower and Brussels sprouts (3-6 g of carbohydrates per 100 g);Cucumbers, zucchini, zucchini, eggplant, bell peppers (green), tomatoes, radishes, leeks, rhubarb, green beans, and leafy greens (range 1.8-4.5 g of carbohydrates per 100 g).
You can eat some berries: strawberries (100 g contains about 8 g of carbohydrates), cherries, raspberries, blackberries, cranberries (100 g contains 12 g of carbohydrates).
If you observe moderation in its use while following a keto diet for weight loss, then you can sometimes eat 100 g of apricots, pineapples or grapefruits: This is about 11.8-12.4 g of carbohydrates.But you can not eat bananas: every 100 grams of carbohydrates contains almost 23 g.
What can you not eat?You have to give up the bread and all the flour;pasta;sugar, honey and candies;any cereal porridges;potatoes, carrots, beets, celery root;pumpkins and all melons;legumes and most fruits.
Menu for a week of keto diet
Serious about getting rid of excess fat reserves in your own body, of course, requires a menu for the week of the keto diet.And the information in the previous section will help with this.
For breakfast, you can cook scrambled eggs or omelets - with onions, mushrooms and spinach, bacon and tomatoes.Coffee or tea, naturally, without sugar.
Lunch can consist of salad (the recipe for one of them is given below), vegetable soup or soup with meatballs (no potatoes, rice or noodles), chicken soup and stewed chicken, fried fish or pork and stewed mushrooms.
For dinner, choose proteins, such as turkey, beef, fish, seafood, which - as a side dish - broccoli, brussels sprouts, green beans or bell peppers, seasoned with cream cheese sauce, go well.
Keto Diet Recipes
Taking into account the list of allowed foods on the ketogenic diet, you can prepare so many different dishes that it is impossible to list even a tenth of the keto diet recipes.Try these three.
Baked chicken with 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) (grated on a coarse grater), salt and ground black pepper to taste, ground coriander (half a teaspoon).
Setup:
- Heat the oven to 180 °, grease a baking dish or pan with vegetable oil;
- Separately onions and peppers (sweet and bitter) in vegetable oil;
- Blanch the puffed cauliflower florets in salted boiling water for three minutes, let the water drain;
- Put the chicken in a mold (pan), salt and pepper, add onion and pepper and cabbage (distribute the vegetables evenly over the meat);
- Sprinkle coriander on top, put butter (several pieces, all over 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 meals: 100 g of ham or brisket, 250 g of lettuce (well dried after washing), two fresh cucumbers, one tomato, two chicken eggs (hard), 60 g of dill or parsley, 1 tablespoon of olive oil and the same amount of mayonnaise, salt to taste.
Setup:
- cut brisket or ham into large strips;
- Cut boiled eggs into quarters, vegetables into thin slices;
- Put the salad leaves on the dish, put the ham on top, and the eggs and vegetables on top, add salt;
- Mix vegetable oil with mayonnaise, add finely chopped herbs, mix and pour this sauce over the salad.
Pork stew with mushrooms
Products for three servings: 300-400 g of pork pulp, 350 g of fresh champion, half an onion (finely chopped), 2 tablespoons of vegetable oil, half a teaspoon of nutmeg, one clove of garlic, 4 tablespoons of sour cream or heavy cream, 2 goals.
Setup:
- Pour vegetable oil into a deep pan or pot with a thick bottom, add onion and chopped garlic, simmer for five minutes;
- Put the pieces of meat and fry a little;
- Add chopped mushrooms, mix, add nutmeg and ground black pepper, salt;
- Cook on low heat for 15 minutes, then add sour cream (cream) and herbs;
- Cover the dish with a lid and simmer until done (about another 15 minutes).
Contraindications
Absolute contraindications to switching to a ketogenic diet include:
- Diabetic ketoacidosis caused by insulin deficiency;
- congenital and secondary carnitine deficiency;
- pyruvate carboxylase deficiency;
- mitochondrial diseases caused by beta-oxidation of fatty acids;
- Porphyria;
- pronounced abnormalities in blood composition, 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;
- stomach tumor;
- conditions 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 endanger your health in pursuit of super effects.
Possible risks
Risks associated with diets used long-term in the complex treatment of epilepsy in children include the threat of growth retardation (due to a decrease in the level of insulin-like growth factor 1), deterioration of bone mineralization (due to calcium deficiency) and nephrolithiasis (kidney stone formation).Hyperlipidemia (high blood lipids) occurs in almost 60% of children, and cholesterol levels can increase by about 30%.
Rare side effects include cardiomyopathy, long QT syndrome (ventricular rhythm disorder), vitamin deficiencies, micro and macro.
The most common side effect is constipation, which almost a third of those who lose weight complain about: the lack of fiber intake affects it.In addition, the ketogenic diet in the early stages can be accompanied by increased fatigue, weakness, headaches, and dizziness;in women - dysmenorrhea.
If the weight is not turned off with the keto diet, then most likely there is too much protein in the diet, because more than half of the excess protein turns into glucose in the body, that is, the process of ketosis is interrupted.
When the muscles are very sore on the keto diet, the reason may be associated with a violation of gluconeogenesis - the synthesis of glucose from muscle lactate (lactic acid), and with the enzymatic breakdown of muscle tissue glycogen under ketosis.
At the beginning of the diet, reducing carbohydrate intake leads to fluid loss, and leg swelling with the keto diet can occur even with minor kidney failure.
Weight loss reviews and results
Reviews from doctors who prescribe a ketogenic diet to patients with neurodegenerative pathologies boil to express its unconditional effectiveness: even with indolent dementia and Parkinson's disease, the patient's attention, memory and perceptual adequacy are significantly improved.
Usually, the reviews and results of those who lost weight are commented by experts.But important controversies surrounding all low-carb diets also contribute to the assessment of certain outcomes.
Therefore, according to the American Journal of Clinical Nutrition, researchers found that men and women who switched to a keto diet, on average, lost 3.6-4 kg more than those who limited their fat intake.British obesity experts (British National Obesity Forum) also note that a low-carbohydrate, high-fat diet is superior to a low-fat diet in terms of weight loss effectiveness.Although many of their colleagues claim that the results that the keto diet gives for weight loss are "contrary to the available evidence."