The Keto Diet: What’s It All About?


KETO DIETING IS ALL THE rage right now. I read about it in journals and consumer publications, and patients have repeatedly solicited my opinion on this diet.

So what’s it all about?

The keto concept has been around for quite some time; the Zone diet, paleo diet, Atkins diet and South Beach Diet are just variations of the same theme. The idea behind this fat-full food frenzy is that carbohydrates, such as pasta, rice, potatoes, bread, cookies, cake, candy, juices and alcohol, are all just sugars, and sugars are what make you fat. This concept is contrary to the recommended diet of the 1950s, where grains were proposed to be a staple of a healthy American diet and saturated fats were shunned as the cause of coronary artery disease.

The claim that all fat is bad for you stems from an erroneous study performed by a Minnesota physiologist, Ancel Keys, called the Seven Countries Study. In that study, Keys correlated a high-fat diet with a higher risk of cardiovascular disease. However, the study itself was compromised, as Dr. Keys cherry-picked the data to fit his premise.

When you look at the data in totality, a high-carb diet and increased sugar consumption correlated with a higher risk of cardiovascular disease, not the fat. Even more astounding, it was found that a high-protein, high-fat, low-carbohydrate diet promoted fat loss. Put these two pieces of info together, and the keto diet craze was born.

While we all know food is fuel, all foods are not created equal when it comes to energy production. Just like rocket fuel has more power than unleaded gas, which has more energy than plain olive oil, the same holds true for our foods. While fats are jam-packed with seven calories of energy per gram, proteins and carbohydrates have about four calories per gram.

When you eat a meal, your body, the amazing chemistry factory that it is, has an unbelievable way of breaking down that meal into parts. Enzymes break down the burger and fries that you just ate into building blocks of fats, proteins and carbs, all of which cause a different biochemical reaction within your body.

Carbohydrates, while great for providing short bursts of energy, also cause your body to secrete insulin, a hormone that tells your body to transform those sugars from the carbohydrates into fat, where it can be stored for future energy use. Even proteins, such as meat, chicken and fish – great for building muscle and replenishing vital enzymes – can be stored as fat if eaten in excess. Fats, like oils, butters and avocados, are broken down into little packets of energy called ketones. These ketones provide a steady energy source.

But in addition to the food you eat, energy can come from multiple additional internal sources. Fuel can come from fat stored in your body, aka your love handles or beer belly; glycogen, which is a form of stored sugar; and, if necessary – like in starvation mode – from protein by breaking down muscle tissue. These processes are triggered by what you eat. For example, when you scarf down that piece of birthday cake and ice cream, your body uses what it needs immediately and stores the rest as fat for later. However, if you were to reduce your carbohydrate intake for a period of time, forgo the slice of cake and ice cream and follow a ketogenic diet, your body would tap into stored fat and break it down to create ketones, thereby accelerating weight loss. In fact, research has found ketogenic diets reduce appetite and dietary intake greater than traditional diets.

Following a keto diet is generally safe if you’re relatively healthy and if the fats you choose are heart-healthy ones. In fact, going keto has been shown to be beneficial to patients with specific medical conditions, including those with certain cancers or even epilepsy.

However, the ketogenic diet doesn’t come without side effects. The process of changing body fuel from carbohydrate to fat can cause electrolyte disturbances, which can lead to leg cramps. Limiting your intake of fruit and vegetables will reduce your intake of fiber and can increase your risk of constipation. Bowel changes may also occur as the body adjusts to dietary changes. Reduced carbohydrate intake can also increase the risk of dehydration as increased water is released through more frequent urination. And some experience the keto flu, with symptoms of brain fog, fatigue, dizziness and insomnia.

While consuming extra water can prevent dehydration, and adding electrolytes to water or drinking Gatorade and Powerade can reduce the risk of leg cramps, fatigue and headaches, my best advice is to follow the keto diet for a short period of time. Then slowly reintroduce nutrient dense carbohydrates back into your diet. While the evidence shows that weight loss can occur with any consistent diet, a ketogenic diet is just another tool in achieving your weight-loss goal.

More recently, some have proposed adding ketones into your diet. This practice is done to artificially raise the level of ketones in the bloodstream in order to gain the benefits of ketosis, without waiting for ketosis to occur by dietary changes alone.

Here are my thoughts: Ketosis caused by gulping down a supplement and not by restricting your carb intake has not been proven to accelerate fat and weight loss. There really are no shortcuts for long-term benefits. However, the supplement may be a good way to transition into the ketogenic diet by providing the extra energy that’s sorely needed when initially cutting out carbs from your diet. And it also may prevent the symptoms of the keto flu.