The ketogenic or keto diet is not new: a hundred years ago, before the advent of effective anticonvulsants, French pediatricians found that certain dietary restrictions reduced the frequency of seizures in children with drug-resistant epilepsy.
Based on metabolic studies, a therapeutic diet without starches and sugars was developed, which became part of the complex treatment of epilepsy at the beginning of the 20th century.The author of the name “ketogenic diet” is said to belong to the American doctor Russell M. Wilder, who used it to treat epilepsy in the 20s and 30s.last century.
The keto diet includes a high-fat diet, moderate protein intake, and very low carbohydrate intake.For most people, this nutrient ratio is considered safe for a limited period of time and not only helps you lose extra pounds, but also has therapeutic uses.
Instructions for use
A low-carbohydrate keto diet for epilepsy, which was widely used in foreign clinical practice, helped reduce the frequency of seizures in children of different ages by 62-75% (after 12 weeks of dietary treatment).At the same time, children who are prescribed such a diet must be registered with doctors who will monitor their normal growth and weight gain, and also make nutritional adjustments according to the needs of each child.
Diets with minimal amounts of carbohydrates are increasingly being used for other diseases.Researchers have shown that ketogenic diets are useful in treating patients with DeVivo disease, deficiency syndrome of the protein GLUT1 (which transports glucose across the blood-brain barrier), and several other inborn errors of metabolism.
It is believed that this nutritional system may slow the progression of amyotrophic lateral sclerosis (Charcot disease);Indications for the ketogenic diet include neurodegenerative diseases such as Alzheimer's and Parkinson's.Clinical trials are currently underway on the effect of the ketogenic diet on the condition of patients with autism, depression, type 2 diabetes mellitus (non-insulin dependent) and polycystic ovary syndrome.
The most famous keto diet for weight loss is the Atkins diet for treating obesity, developed by Dr.Robert Atkins modified and popularized (Dr. Atkins Diet Revolution, 1972).Although experts consider only the introductory phase of this diet to be ketogenic.And in fairness, it should be noted that many American doctors worked on the principles of the ketogenic diet long before him: Peter Huttenlocher, Alfred Pennington, Richard McCarnes and others.For example, in 1958 R. McCarnes wrote the book “Eat Fat and Grow Slim,” which is essentially the same low-carbohydrate diet that was originally introduced to treat epilepsy.
Since the deposition of excess adipose tissue in the form of triglycerides concentrated in its cells occurs as a result of excessive consumption of foods containing carbohydrates (no one doubts this fact), limiting carbohydrates in the diet to a minimum - a keto diet for a month - helps to reduce fat reserves, that is, lose weight.
In addition, the keto diet for oncology - by increasing the oxidative stress of cancer cells - has been found to significantly reduce the growth rate of malignant tumors in the colon, stomach, prostate and lungs.In addition, it has already been proven that some cancers are more sensitive to chemotherapy due to the induced state of ketosis.
For the past two decades, the ketogenic diet has been used by bodybuilders to reduce the fat layer beneath the skin.In colloquial language, this is known as giving up the keto diet.
The essence of the keto diet
On a standard keto diet, your total daily calories should consist of 70-80% fat, 15-20% protein, and 5% carbohydrates (less than 50g per day).
Typically, the ratio of fat to protein and carbohydrates is 3:1 (i.e. 3 grams of fat per gram of protein + carbohydrates).With a ratio of 4:1, 90% of energy comes from fats, 8% from proteins and only 2% from carbohydrates (about 20 g per day).
The essence of the diet to reduce excess weight is to bring 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 produced by eating foods containing carbohydrates.
Carbohydrates in food are converted into glucose, but when a person consumes very few carbohydrates and a lot of fat, a chain of biochemical reactions is triggered in the body.Schematically, this process looks like this.First, due to reduced blood sugar levels, the pancreas begins to produce more hormone glucagon, which stimulates the breakdown of glycogen stored in the liver into glucose and releases it into the blood.Secondly, 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 (fatty acids).Thirdly, due to an increase in glucagon levels, the activity of lipase, an enzyme that breaks down triglycerides (fats) accumulated in the cells of adipose tissue, increases significantly.
In addition, in the first two weeks after the keto diet there is a significant weight loss due to the removal of water from the body, which is also accompanied by increased glucagon production.And that's why a temporary side effect of a high-fat diet can be dehydration, which nutritionists counteract 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 particularly effective for men with abdominal obesity.
If a therapeutic diet for obesity recommends reducing calorie intake to 2000 (2300) kcal per day, then the ketogenic diet controls calories not so strictly (but a reduction of at least 10-20% will not do any harm).However, carbohydrate consumption must be reduced fivefold: instead of 250 g to a maximum of 50 g per day.
Remember that the majority of calories on a keto diet come from foods rich in natural fats and moderate amounts of protein.That said, this is not a “protein load” as some might think.And if a man is used to eating a lot of meat, then his body enters the state of adaptive ketosis much more slowly.Therefore, you need to limit the protein content: per day to 1-2 g of protein per kilogram of body weight that you want to achieve by losing weight.Example: If the starting weight is 112 kg and the desired weight is 85 kg, the amount of protein during the course will be 85-170 g.
The exact ratio of fats, proteins and carbohydrates in the diet (in grams) depends on the age, goal, level of physical activity and health status of each individual man.But short-term fasting during the keto diet is recommended for everyone: in the first two days of switching to this nutritional system, you should drink plenty of water and limit yourself to one meal a day (in a very small quantity).By the end of the first week, you should avoid carbohydrates as much as possible (below is a list of foods for the keto diet), but portion sizes will decrease slightly.
Another nuance: they claim that the keto diet does not lose its effectiveness without exercise, and to lose weight you do not need to go to the gym or simply do additional physical exercises.However, since physical activity as part of a healthy lifestyle accelerates the burning of excess fat, you should not lie on the couch.In addition, you can seize the moment and build muscle mass following the example of bodybuilders: gaining weight on a keto diet is possible only with muscle strain, and then the subcutaneous fat disappears, revealing strong muscles.
Keto diet for women
The problem with the keto diet is that research into its effectiveness and safety has so far only focused on men.The question naturally arises as to whether the keto diet is suitable for women, as female hormones tend to be more sensitive to most dietary changes.
Although opinions vary, most experts say that the ketogenic diet brings positive results, especially in perimenopausal or menopausal women.This nutritional system allows you to lose excess weight, control blood sugar levels, improve sleep quality and reduce menopausal symptoms such as hot flashes or night sweats.
However, there are also negative reviews and even complaints about nausea, fatigue and constipation due to the diet (more details below in the “Possible Complications” section).It is also worth mentioning that switching to a keto diet is contraindicated in cases of irregularities in the menstrual cycle, thyroid diseases or during pregnancy and breastfeeding.
Women are recommended to combine periodic fasting with a ketogenic diet, i.e.According to Western nutrition experts, this diet allows the body to take a break from digestive function and direct energy resources to restore tissue cells and hormonal balance.
If a woman with a body weight of 75 kg and a height of 165-168 cm wants to lose weight to about 68 kg, she should switch from 2300 kcal per day to an intake of no more than 1855 kcal.Protein should be 1-1.5 g per kilogram of ideal weight, i.e.h.You can consume around 68-102g of protein, 240-350g of fat and 18-20g of carbohydrates (in pure water, without fiber) every day.
How is a keto diet different from a high-fat diet?
A high-fat or LCHF diet differs from a keto diet in the proportions of proteins, fats and carbohydrates in the food, and a high-fat diet assumes a ratio of 50% fat and 25% protein and carbohydrates.
In Europe, the high-fat (low-carb) diet is called the Swedish diet.This is obviously due to the Swedish therapist Annika Dahlqvist, who began to recommend her diabetics to eat more fat and limit carbohydrates, which contradicted the officially accepted recommendations of endocrinologists in Sweden.
Among the modifications of the ketogenic nutritional system, starting with the Atkins diet and the LCHF diet, one can name strange nutritional recommendations, for example, egg fasting in the keto diet - when you have to eat only boiled chicken eggs with mayonnaise for several days...
Cyclic keto diet and other modifications
In recent years, the standard keto diet (SKD) has been modified in many ways.This is how the high-protein ketogenic diet (HPKD) came into being, in which 60% of calories come from fat, 35% from protein and 5% from carbohydrates.
The Targeted Ketogenic Diet (TKD) is more moderate as carbohydrates can be eaten before and after exercise;It is considered a sport, so the number of calories gained from consuming carbohydrates is higher than SKD.
The cyclic keto diet (CKD) or, according to another version, the rotational keto diet (alternate) is a low-carbohydrate diet with alternating periods of consumption of high or moderate amounts of carbohydrates: 5-6 days - a minimum amount of carbohydrates, then a carbohydrate load is carried out on a keto diet - for one or two days carbohydrates are consumed without restriction.The unknown authors of this version of the keto diet try to justify their innovations by the need to replenish glycogen reserves, restore hormonal levels and thyroid activity, as well as ensure moral and psychological stability - to continue the diet.In fact, whatever is lost in six days comes back immediately.
Benefit
As clinical practice abroad shows, after a ketogenic diet (followed from six months to two years, with a gradual return to a normal diet), almost 20% of children with epilepsy experience seizures much less often, and many of them can reduce or completely abandon the use of anticonvulsants.
Based on the results of two dozen randomized controlled trials, experts have concluded that the benefits of the keto diet include significant and relatively rapid loss of excess weight, especially in cases of severe obesity.Despite the high fat content, this diet led to a reduction in systolic blood pressure, blood sugar and insulin levels, plasma C-reactive protein levels and an increase in high-density lipoprotein (HDL), or good cholesterol, over 24 weeks in a significant percentage of patients.
In 2008, the American Diabetes Association (ADA) revised its dietary guidelines and recognized low-carbohydrate diets as an effective short-term dietary intervention for patients with non-insulin-dependent diabetes.
And yet, during a keto diet, the skin responds to a lack of carbohydrate foods in its own way, for example, there may be a reduction in acne.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 products recommended for the keto diet includes: any meat and meat by-products;Bird;fish and seafood;eggs (all types);Cream, sour cream, butter (butter and vegetable).Hard cheese is very useful on a keto diet.However, be careful with regular milk as it contains a lot of lactose – milk sugar, a disaccharide carbohydrate.But fermented milk products can be consumed safely: During the fermentation of fermented milk, lactose is hydrolyzed.
Instead of popcorn, sweets or chips, walnuts (approx. 13 g carbohydrates per 100 g) and sunflower seeds (10.5 g carbohydrates per 100 g) are suitable.The number of calories is 655 or 600.
It is recommended to include the following in the menu:
- Mushrooms (except dried porcini and boletus), the ideal option is champignons (only 0.5 g of carbohydrates per 100 g).
- all types of leafy greens and vegetables that do not contain complex carbohydrates from starch: broccoli and kohlrabi;White cabbage, cauliflower and Brussels sprouts (3-6 g carbohydrates per 100 g);Cucumbers, zucchini, zucchini, eggplant, peppers (green), tomatoes, radishes, leeks, rhubarb, green beans and leeks (range 1.8-4.5g carbohydrates per 100g).
You can eat a little berries: strawberries (100 g contains about 8 g of carbohydrates), cherries, raspberries, blackberries, cranberries (100 g contains 12 g of carbohydrates).
If you maintain moderate consumption during a keto diet for weight loss, you can occasionally eat 100g of apricots, pineapple or grapefruit: that's about 11.8-12.4g of carbohydrates.However, you shouldn't eat bananas: every 100 grams of carbohydrates contain almost 23 g.
What are you not allowed to eat?You must give up bread and all flour;Pasta;sugar, honey and confectionery;any cereal porridges;potatoes, carrots, beets, celery root;pumpkins and all melons;Legumes and most fruits.
Menu for a week of keto diet
Of course, in order to get rid of excess fat reserves in your own body, it is important to create a menu for the week of the keto diet.And the information in the previous section will help.
For breakfast you can cook scrambled eggs or omelette - with onions, mushrooms and spinach, bacon and tomatoes.Coffee or tea, of course without sugar.
Lunch can consist of a salad (a recipe for one of these can be found below), vegetable soup or soup with meatballs (no potatoes, rice or noodles), chicken broth and boiled chicken, fried fish or pork and mushroom stew.
For dinner, choose a protein such as turkey, beef, fish, seafood that goes well with broccoli, Brussels sprouts, green beans or peppers seasoned with cream cheese sauce as a side dish.
Keto diet recipes
Taking into account the list of foods allowed on a ketogenic diet, you can cook so many different dishes that it is impossible to list even a tenth of the keto diet recipes.Try these three.
Chicken baked with vegetables
Products for two servings: 500 g of chicken (thigh, breast or fillet, cut into medium pieces), a tablespoon of vegetable oil, 1 green pepper (cut into medium-sized cubes), half an onion (cut into small cubes), 500 g of cauliflower (disassembled into florets), half a small hot pepper (finely chopped), 50 g of butter, 100-150 g of fat sour cream, 50 g of hard cheese (grated on a coarse grater).grater), salt and ground black pepper to taste, ground coriander (half a teaspoon).
Preparation:
- Preheat the oven to 180°, grease a baking dish or frying pan with vegetable oil;
- Simmer onions and peppers (sweet and bitter) separately in vegetable oil;
- Blanch the cauliflower florets in boiling salted water for three minutes and drain the water.
- Put the chicken in a mold (frying pan), salt and pepper, add onions, peppers and cabbage (distribute the vegetables evenly over the meat);
- Sprinkle cilantro on top, apply butter (in several pieces over the entire surface), pour in sour cream, sprinkle with grated cheese and put in the oven for 40-45 minutes.
Quick salad with ham or beef brisket
Products for two servings: 100 g of ham or brisket, 250 g of lettuce (dry well after washing), two fresh cucumbers, one tomato, two chicken eggs (hard-boiled), 60 g of dill or parsley, 1 tablespoon of olive oil and the same amount of mayonnaise, salt to taste.
Preparation:
- Cut brisket or ham into large strips;
- Quarter boiled eggs, cut vegetables into thin slices;
- Put the lettuce leaves on a dish, put the ham on top, put eggs and vegetables on top, 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, 350 g of fresh mushrooms, half an onion (finely chopped), 2 tablespoons of vegetable oil, half a teaspoon of nutmeg, a clove of garlic, 4 tablespoons of sour cream or cream, 2 tablespoons of chopped herbs, salt and ground black pepper, to taste.
Preparation:
- Pour vegetable oil into a deep pan or saucepan with a thick bottom, add onion and chopped garlic and simmer for five minutes;
- Put pieces of meat in and fry a little;
- add chopped mushrooms, mix, add nutmeg and ground black pepper, salt;
- Cook over 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
The 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 impaired 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 kidney failure;
- intestinal dysfunction, Crohn's disease;
- abdominal tumors;
- Condition after cancer chemotherapy.
Particular caution should be taken when considering the advice of bodybuilders to "stimulate" metabolism using pharmacological agents: you should not risk your health in order to achieve a super effect.
Possible risks
The risks associated with long-term diet for the complex treatment of epilepsy in children include the threat of growth retardation (due to reduced levels of insulin-like growth factor 1), deterioration of bone mineralization (due to calcium deficiency), and nephrolithiasis (formation of kidney stones).Hyperlipidemia (high blood fats) occurs in almost 60% of children, and cholesterol levels can increase by about 30%.
Rare side effects include cardiomyopathy, long QT syndrome (disorder of the ventricular rhythm of the heart), deficiency of vitamins, micro- and macroelements.
The most common side effect is constipation, which almost a third of those who want to lose weight complain about: a lack of fiber intake affects them.In addition, the ketogenic diet may be associated with increased fatigue, weakness, headaches and dizziness in the early stages;in women - dysmenorrhea.
If weight does not decrease on a keto diet, most likely there is too much protein in the diet, since more than half of excess proteins in the body are converted into glucose, i.e.h.the process of induced ketosis is disrupted.
If the muscles hurt a lot during a keto diet, the cause may be associated with both a violation of gluconeogenesis - the synthesis of glucose from muscle lactate (lactic acid) - and with the enzymatic breakdown of glycogen in muscle tissue under ketosis conditions.
At the beginning of the diet, fluid loss occurs due to the reduction in carbohydrate intake; on a keto diet, even mild kidney failure can cause leg swelling.
Weight loss reviews and results
Reviews of doctors who prescribe a ketogenic diet to patients with neurodegenerative diseases boil down to emphasizing its unconditional effectiveness: even with senile dementia and Parkinson's disease, patients' attention increases, memory and adequacy of perception significantly improve.
Typically, reviews and results from those wanting to lose weight are commented on by experts.But the considerable controversy surrounding all low-carbohydrate diets also contributes to the evaluation of concrete results.
According to the American Journal of Clinical Nutrition, researchers found that men and women who switched to a keto diet lost an average of 8 to 10 pounds more within six months than those who restricted their fat intake.British obesity experts (British National Obesity Forum) also note that low-carb, high-fat diets are superior to low-fat diets in terms of weight loss effectiveness.Although her many colleagues claim that the results provided by the keto diet for weight loss are “contrary to the available evidence.”