Should I Keto or not?

The above question is asked to me everyday now. The question before that, should I fast? The question before that, should I try the HCG Diet? South Beach? Atkins? So, the question I have to ask myself is why are the same people still searching for a nutrition plan that works for them and that they can sustain?

The only logical answer is they are still not satisfied with their results. If something has worked and solved an issue of nutrition in someone's life, there would be no new plans. Are they simply searching for a plan that they can stick with, enjoy, that is easy, that is healthy, life sustaining, life improving, and so on?

Originally the Ketogenic diet was designed for epileptic children to help control seizures. Now even more exciting, many studies suggest that most metabolic disorders, malignancy, trauma and ischemia and neurodegenerative diseases such as Parkinson's and Alzheimer's may be improved by using the Ketogenic diet. All of these are super exciting and very helpful in the world today! That being said lets find out if "I should Keto or not?".

The basic point of the Ketogenic Diet is to transfer our body's natural source of energy and calorie burn from carbohydrate to fat. The plan is usually composed of around 5% carbohydrate, 5-10% protein, and 85-90% fat. When the body is starved of carbohydrate our liver produces something called a ketone that can be used as an immediate energy source for the body. The reason a Ketogenic protocol seems to work on the disorders and diseases listed above is simple. Not only does the brain and body prefer and use carbohydrate as an energy source, so does disease. Subjects studied in most clinical cases similar to the ones above see an increase in mitochondrial function and an allowance of substrate delivery to dying cells. This means that the rouge or diseased cells from a body do not have an energy source to feed from(carbohydrate) but our healthy cells do(ketones). In addition to the sources listed below a study from Kristin W. Baranano, MD, PhD and Adam L. Hartman, MD named The Ketogenic Diet: Uses in Epilepsy and Other Neurologic Illnesses is one of the best I have found at explaining the current findings and effects of disease of the Keto diet.

Let's revisit the question of "Should I Keto?". If you have a condition discussed above I would certainly discuss it with my team of doctors and see if you should give it a go. If you are looking to shed some excess weight and body fat should you jump on this wagon? Here are a lists of positive and negative findings from individuals who have.

POSITIVE:

-It is a food type restrictive diet. Why this is a good thing is simply because there is less confusion. "Can I eat eggs?" -Yes. "Can I eat whole grains?" -No. Where on a more traditional macro-nutrient, calorie counting, or point counting plan there is room for flexibility if daily adjustments are made throughout the day and week. Sometimes the flexibility of choice may lead to confusion or too much limberness in a weight loss plan.

-Potential inflammation decrease. Higher levels of circulating insulin in the blood can cause inflammation throughout the body. However, some studies show this is due in part to reducing inflammatory carbohydrate sources such as refined and processed sources from the diet. Meaning, even if on a moderate carbohydrate diet, if the carbs are mainly fruits, vegetables, and whole grains inflammation would also be reduced.

-Conscious food intake. I have always been a fan of recording food intake. How can someone be educated on how they are fueling the body and the body's reactions over time to a certain intake if it is not monitored? Accurately?.....it cant! This type of program needs to be highly monitored to ensure the user is actually in a state of producing ketones for the body's energy source.

-Fast and immediate effects. The world wants results and solutions faster than ever. A nutrition program as one sided as this one definitely delivers just that. Someone who has been eating freely, especially processed carbohydrates and added sugars in the diet will see a fast and significant response in the body and on the scale from the ketogenic nutrition plan.

NEGATIVE:

-Initial low energy "flu". The severity of a low carbohydrate diet, no matter how extreme, is dependent on where the individual begins. Meaning, if someone was drinking soda and eating crackers on a regular basis his/her reaction and side effects are more severe than an individual who is conscious and records their nutrition. Some initial effects of starting may be fatigue, weakness, dizziness, headaches, bad breath, irritability, and nausea that can last a few days or a few weeks.

-Fast water weight loss. Taking carbohydrate out of the diet will cause initial weight loss simply due to the fact that a carbohydrate cell holds water and by eliminating them from your diet it will in turn cause a diuretic/dehydrating effect for the body. Eliminating glucose and glycogen stores is sure to cause water loss as well. Each gram of glucose carries along with it 3-4g of water.

-Highly monitored. Recording nutrition is more of a task than most realize. Whether using a system of point counting, macronutrient/calorie counting, or measuring ketones, the amount of monitoring is needed simply for education of a program. Ketogenic eating is one of the most difficult. In order to make sure the body is in ketosis it is common to measure them through urine test or blood test. While being conscious of what is going into your body is all so important this program requires additional steps to ensure the numbers are accurate.

-Usually lower fiber intake than needed. Many fibrous green vegetables have too high of net carbohydrate to sustain ketosis for the body. While an adequate fiber intake everyday may be achieved, it will be difficult. Here is a good reference for the top 10 vegetables if you are attempting the plan.

https://www.everydayhealth.com/ketogenic-diet/diet/best-sources-fiber-on-keto-diet/

-Difficulty choosing high quality sources of fat and calories. While keto dieters embrace fat intake most find it difficult to stick to high quality sources of fat. Well-sourced protein and fat options are a must if looking to increase health along with fat reduction on this program. You'll need a lot of it! Make sure your fat intake is primarily low saturated and high quality and well sourced protein are consumed.

-Transitioning my be difficult. If using the keto diet for a year or under to jump start your weight loss or even a handful of years it may be difficult to level off and maintain a balanced macronutrient plan. A mind frame change is necessary. All of a sudden green beans and brown rice have a place in the diet and that can be a hard adjustment for some. One cracker may often leads to a full sleeve or a plate full of fettuccine the next visit to The Hill!

Take away..................

Keto shows potential to help with many diseases and disorders! Using it as a weight loss diet comes with positives and negatives. For me the education and discipline is better spent on having a diet that does not restrict certain foods 100% at all. I enjoy my ice cream cone every few months with my kids without the fear of falling out of ketosis. I enjoy the variety of all fruits and vegetables that are available when my wife and I go to the local market! I also enjoy the process of finding out where my body performs at a high enough level while maintaining certain joys of life. Choose your amount of sacrifices you are willing to make and do that! Priorities are the key. Find a nutrition program that you can adhere to and you enjoy life with. That is a sustainable and long term life plan!

and of course..........before starting any diet talk to your physician or registered dietitian.

-The Ketogenic Diet: Uses in Epilepsy and Other Neurologic Illnesses

Kristin W. Barañano, MD, PhD and Adam L. Hartman, MD

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