What is the keto diet? Does it really help you lose weight?

The keto diet, according to the stories of its fans, is a very magical way to remove fat (sorry, today there will be a lot of fat), preserve muscles, improve athletic performance, well-being and improve your health.

Let's figure out if this is so, if the ketogenic diet has side effects and contraindications, and what needs to be considered before starting it.

Let's define the concepts

Strictly speaking, only one that causes an increase in the level of ketone bodies in the blood can be called a ketogenic diet.

But since this level is extremely rarely controlled by research participants and simply adherents of this type of diet, then in this article, all food options with the amount of carbohydrates less than 10% of the daily calories will be called a keto diet. This includes the low-carb-high-fat diet, which is often singled out as a separate type of diet.

Most sources have the following calorie limits for the two diets:

  • Keto diet - up to 5% carbohydrates per day,

  • Low-carbohydrate-high-fat diet - 5-10%.

The keto meal plan download free can be here.

Physiology

There is no way without her. So, with an ordinary varied diet with carbohydrates covering up to 60% of the daily energy requirement, the body receives almost all of its energy from glucose - the final product of the breakdown of carbohydrates.

Energy systems of cells of all organs are adapted to work on glucose fuel. Energy from it easily and quickly becomes available to cells. Glucose penetrates all natural barriers of the body (for example, there are such in the brain), and some organs can receive energy only from it - for example, the liver and red blood cells.

But what if your blood glucose level drops - for example, you haven't eaten for a long time? Or has the owner of this blood switched to a keto diet? This is where the fat enters the scene. It breaks down into ketone bodies (hence the name of the diet) - short fragments of fatty molecules, which include beta-hydroxybutyric acid, acetoacetic acid and acetone. As you can see, two of the three ketone bodies are acids. Let's remember for the future.

Further, ketone bodies are distributed throughout the body, due to their small size, they penetrate well through the barriers in the vessels of organs, are absorbed by cells (except for liver cells, they cannot) and give even more energy per unit mass than glucose.

What's the catch?

First, ketone bodies are acids. And an increase in their concentration in the blood shifts its acid-base balance.

Yes, in healthy adults, blood pH will not change to critical levels. And in children or, for example, diabetics, this is a fairly common occurrence.

Have you heard about "elevated acetone" in young children? Which, in order to return to a normal state, it is necessary to drip glucose or, if the state allows it, to drink a teaspoon of sweet compote (because any large volumes cause vomiting) for several days? This is ketoacidosis - an increased content of ketone bodies with acidification of the blood, which we try to artificially induce through diet.

Second: the receipt of energy from ketone bodies chemically proceeds in a completely different way compared to glucose. With a normal diet, this pathway is rarely involved, and there are few necessary enzymes.

Therefore, the transition between a regular and a keto diet can be difficult. But - and this attracts athletes - the keto diet trains the way to get energy from fats, and subsequently the body is more easily rebuilt for it.

The ketogenic diet and excess weight

Everything looks very optimistic here. In this study, over a year on the keto diet, obese people lost 19.9 kg, and people with the same obesity, but simply limited calories - 7 kg. Moreover, weight continued to decline after switching from keto back to a regular diet.

In a similar study lasting two years, participants on a keto diet lost 12.5 kg mainly due to fat, their waist size decreased, while during the same time on a regular diet, people lost only 4.4 kg.

Or, for example, here: on a keto diet combined with exercise, participants lost weight through fat. During the same time, the control group with a regular diet and the same training gained weight. The calorie content of the diet in both groups was not limited.

A review of publications on the effectiveness of the ketogenic diet for obesity confirms its effectiveness and makes several important warnings:

 

  • It is imperative to monitor the work of the kidneys;

  • An accurate, gradual transition to a keto diet and back to a traditional diet is important;

  • Duration can vary from two weeks to a year or more (usually a severe restriction of carbohydrate intake - less than 5% of daily calorie intake - is prescribed for a limited period, milder options - for several months or more);

  • The keto diet is a treatment for obesity and the attitude towards it should be like any other medicine, with the control of the condition and the supervision of a doctor.

The keto diet and athletic performance

Based on the characteristics of the metabolism of glucose and ketone bodies, it can be assumed that a traditional diet with a large amount of carbohydrates better meets the needs of the body during short high-intensity activities.

And the keto diet trains your ability to get energy from fat, improving your tolerance and performance in long-term, low-intensity exercise. Well, the pounds dropped at the same time clearly make the situation easier. Research partially confirms this.

For example, in a group of athletes involved in race walking, after three weeks of the keto diet, VO2max increased, but the results worsened, since more oxygen is needed for the oxidation of ketone bodies. In the group on a diet with periodically or constantly available carbohydrates, the results improved with the same workouts (more details here).

As we suspected, even a short-term (4 days) keto diet degrades the results of anaerobic high-intensity exercise.

After 12 weeks on the keto diet, endurance athletes lost 5.9 kg in weight, decreased body fat, increased their ketone body levels by 5 times, but did not change the results in endurance training (compared to the control group, who got her usual amount of carbs). Perhaps due to the fact that during the test exercises, the keto group drank water with electrolytes, and the control group drank carbohydrate drinks.

The combination of powerlifting and the keto diet helps to effectively remove fat while maintaining athletic performance (research), and is logically not suitable for gaining muscle mass.

Total:

  • The keto diet boosts VO2 max and is great for endurance-focused training seasons when long, low-intensity training predominates.

  • Large training volumes combined with a keto diet reduce fat, weight, and post-exercise muscle damage (since no lactate is produced from ketone bodies).

  • On the other hand, a decrease in glycogen stores and low activity of enzymes that break it down impair the results of high-speed work (conclusions from here).

The ketogenic diet and various diseases

When the keto diet first appeared (and it was 1920, then people did not suffer from obesity, they were happy about it), it gained popularity as an effective means of relieving epilepsy. Now it is also used as an additional treatment for cases of epilepsy that are difficult to drug therapy, although how it works at the molecular level has not been fully understood.

In patients with type 2 diabetes mellitus (not dependent on insulin), the keto diet has proven to be an effective (better than the usual low-calorie diet) and a fairly safe way to lose weight and control blood glucose levels.

Also, the keto diet helps with polycystic ovary syndrome, reducing both psychological and physiological symptoms (a large overview on several pathologies with recommendations is here).

Side effects

The keto diet is not the most physiological diet, it greatly modifies the metabolism, forcing it to work in a "standby" mode, which is rarely used with a normal diet.

Therefore, various unpleasant sensations, especially when switching to a keto diet and vice versa, are quite common. The most common are headache, nausea, vomiting, stool disorders, and back pain.

Less commonly, violations of mineral and fat metabolism, the formation of kidney stones, metabolic acidosis (a change in blood pH to the acidic side) are possible. In children and people with impaired insulin sensitivity, acidosis can reach critical levels, leading to coma.

To prevent these side effects while on a keto diet, you need to take vitamins, minerals, protein, drink plenty of water, and eat lots of vegetables. It is possible to include alkalizing drugs in the diet.

Who is the keto diet contraindicated for?

First of all, people with congenital disorders of fat metabolism. If you have one, most likely you know about it. But it doesn't hurt to check.

Also, the keto diet is prohibited for people with porphyria and pyruvate carboxylase deficiency (forgive such words here, but, again, if a person has any of these diagnoses, he will see him and will not risk his health on a keto diet).

People with type 2 diabetes who are taking inhibitors of the sodium-glucose cotransporter type 2 (e.g. Dapagliflozin). They should change treatment or avoid the keto diet as well.

A complete list of contraindications is here.

Total: what, to whom and how to eat and whether you need it at all

The keto diet is actually more effective than simple calorie restriction in helping to reduce body fat weight without losing muscle. It also helps with some endocrine pathologies.

A low-carb diet stimulates the energy pathway from fat, making it easier for the body to reorganize itself into this variant of metabolism during prolonged low-intensity exercise. In this case, the results do not change, and sometimes even worsen. They always get worse in the sprint. The keto diet should be practiced in the middle of the training season, when important starts are far away, volumes are high, and speeds are low.

Before changing the type of diet, you need to make sure that everything is in order with your fat metabolism. Entering and exiting the diet should be gradual, with careful monitoring of well-being. During the diet, it is important to drink plenty of water, eat vegetables, take vitamins and minerals.

It is better to treat the keto diet not as a diet, but as a therapeutic measure that requires constant laboratory and preferably medical supervision.

As a safer option with similar results, we suggest a low-carbohydrate-high-fat diet (in which about 10% of the daily diet is carbohydrates) with periodic inclusion of healthy carbohydrate foods such as whole grains in the diet. She has fewer side effects, and the results are similar.

And as an experiment, try removing fast carbohydrates from your diet. There is a lot of harm from them, no benefit (except for the joy of eating a delicious cake), the weight will decrease, at the same time you will find out what it is like with the restriction of carbohydrates - a successful experiment from all sides!

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