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Breaking down the ketogenic diet

Nutritionists from the University of Maryland Medical System regularly provide a general information column to The Baltimore Sun's health blog. The latest post is from Shanti Lewis.

Can adding more butter and heavy cream to your diet improve your glucose control, help you lose weight, improve neurological function, reduce inflammation and enhance energy? Proponents of the ketogenic diet would advocate that this high-fat, low-carbohydrate, low-protein diet can.

While low carbohydrate diets have been trendy in recent years, the ketogenic diet is among the most restrictive of the low carbohydrate options. A study in the Annals of Internal Medicine found that a low carbohydrate diet was more effective for weight loss and lowers cardiovascular risk factors when compared to a traditional low fat diet in healthy adults (without evidence of heart disease or diabetes).

How does the ketogenic diet work?

The body tends to break down carbohydrates into glucose as it is the preferred method of obtaining energy. However, when carbohydrates are severely restricted, the liver converts fat into fatty acids and ketone bodies to be used as an alternative energy source in a process called ketosis.

What can you eat?

In order to promote the production of these fatty acids and ketone bodies in this diet, 80-90 percent of calories consumed must come from fat with the rest coming from a combination of protein and carbohydrates. Generally, carbohydrates are restricted to 5% of total calories; the Institute of Medicine recommends carbohydrate consumption be 45-60% of total calories. Most people who are compliant with a ketogenic diet must restrict all fruit and a lot of dairy products. Typical foods on a ketogenic diet include oils, butter, cream, nuts, non-starchy vegetables, high-fat meats, eggs, cheese and avocado.

Will I lose weight?

There is a good chance of weight loss for several reasons. First, the body will be using fat as its primary source of energy. Second, a high-fat diet is likely to increase your satiety and you will likely eat less. However, weight loss may not be sustainable in the long run as this diet is extremely restrictive and compliance is hard to achieve.

Is following the diet dangerous?

Most healthy adults can tolerate a moderate amount of ketosis but sticking to a strict ketogenic diet can lead to complications such as weakness, fatigue, bad breath and a strange body odor. Additionally, the diet is low in essential nutrients, such as vitamins and minerals that are often found in grains and dairy products. As a result, individuals who strictly adhere to this diet may need to take supplements and consider a multivitamin. The low fiber composition of the diet might also lead to gastrointestinal discomfort.

Making healthy and sustainable changes, along with practicing mindful eating may be more effective in improving health and losing weight in the long-term.

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