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Ketogenic Diet: A Detailed Guide for Beginners

Published: 15.08.2021
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The keto diet was created for the therapy of diabetic patients, but some doctors decided to try it for weight loss. Let's find out who it is suitable for and what it can be dangerous for, choose products and make a menu.

What is the keto diet?

The keto diet, or ketogenic diet, is a low-carb, high-fat diet. The keto diet helps lower blood sugar levels, increase insulin sensitivity, improve well-being, and lose weight by changing the metabolism [1].

Changing food causes a state of ketosis, a metabolic regime in which the body gets its fuel from animal food [2]. The primary source of energy becomes ketone bodies: acetone, acetoacetate, and beta-oxybutyric acid.

These are substances that are formed in the liver from the body's fatty tissues and consumed fats. Ketone bodies feed internal organs, muscle tissue, and the brain instead of glucose [3], [4].

The process of ketosis can be started by fasting, but the keto diet allows you to enter this state and stick to it permanently without risk to your health.

Signs of ketosis:

  • acetone or fruity breath;
  • increased levels of ketone bodies in the blood, urine, and breath;
  • decreased appetite and sense of hunger;
  • the decline of strength, which can be replaced after a few days by average well-being and increased brain activity;
  • gastrointestinal disorders, thirst, and frequent urination;
  • weight loss;
  • irritability;
  • insomnia.

Ketosis is a natural metabolic state in which fats and body fatty tissues become the primary energy source instead of glucose [4].

Types of the keto diet

  • standard: 75% of fat, 20% of protein, and 5% of carbohydrates from the total caloric content of the diet;
  • cyclic: five days of keto alternates with two days of high-carbohydrate food;
  • targeted: suitable for those who play sports;
  • with high protein content: differs from the standard variant in the ratio of elements (60% fat, 35% protein, and 5% carbohydrates).

Most studies and expert articles focus on standard and high-protein regimens [5]. Cyclic and target options are less studied and recommended for athletes and bodybuilders.

The keto diet is an eating regimen with a high percentage of fats and a minimum of carbohydrates. The body gets energy from animal foods instead of glucose. Such a diet can help lower blood sugar and insulin levels and help you lose weight.

Foods to avoid on the ketogenic diet

The keto diet cannot be called carbohydrate-free: their daily amount is 5% of the diet or 20-50 grams of the product.

But to start and maintain the state of ketosis, you need to remove or reduce the amount of high-carbohydrate foods from the menu:

  • Cereals and foods with starch: rice, pasta, cereal, potatoes;
  • Sugar-containing foods and beverages: sodas, fruit juices, pastries, and so on;
  • Any fruit except berries;
  • Beans and beans;
  • Dietary foods and foods with a low percentage of fat;
  • Sauces and flavorings that contain sugar and unhealthy fats;
  • Alcohol.

Foods to include in your diet

The main foods that go into a keto diet [6]:

  • meat: steaks, sausages, bacon, chicken, and turkey;
  • fish: salmon, tuna, mackerel;
  • seafood;
  • eggs;
  • butter and sour cream;
  • cheeses: cheddar, goat, cream, mozzarella, or mold cheese;
  • nuts and seeds;
  • olive oil, coconut oil, and avocado oil;
  • fresh avocado and guacamole;
  • low-carb vegetables: most green vegetables, tomatoes, onions, peppers;
  • seasonings: salt, pepper, spices, and spicy herbs.

Low-carbohydrate foods that are suitable for the keto diet [7]:

  • 0% carbs: beef, lamb, chicken, eggs, pork (including bacon), jerky, salmon, sardines, trout, butter, olive oil, coconut oil and avocado oil, water, coffee, tea.
  • 0-5%: liver, shellfish, shrimp, tuna, lobster, cod, tomatoes, cauliflower, cucumbers, asparagus, mushrooms, cheese, sour cream, yogurt (including Greek yogurt).
  • 5-10%: broccoli, onions, Brussels sprouts, kale, eggplant, sweet peppers, green beans, avocados, olives, strawberries.
  • 10-15%: grapefruit, apricot, walnuts.
  • 15-25%: almonds, peanuts.

As a snack, experts advise eating seafood, cheese, olives, meat, hard-boiled eggs, nuts, berries, dark chocolate, and small portions of food leftover from breakfast, lunch, and dinner.

Menu for the week by day

Monday

  • Breakfast: bacon, eggs, tomatoes.
  • Lunch: chicken salad with feta cheese and olive oil.
  • Dinner: salmon and asparagus in oil.

Tuesday

  • Breakfast: scrambled eggs with goat cheese, tomatoes, basil.
  • Lunch: smoothie of almond milk, peanut butter, and cocoa with sugar substitute.
  • Dinner: meatballs, cheddar cheese, and vegetables.

Wednesday

  • Breakfast: keto milkshake - for example, with peanut butter or strawberries.
  • Lunch: shrimp salad with avocado and olive oil.
  • Dinner: pork ribs with broccoli, lettuce, and parmesan.

Thursday

  • Breakfast: omelet with avocado, salsa, sweet peppers, onions, and spices.
  • Lunch: nuts, celery sticks with salsa, and fresh guacamole.
  • Dinner: chicken in pesto sauce with cream cheese and fresh vegetables.

Friday

  • Breakfast: yogurt with peanut butter, cocoa, and sweetener.
  • Lunch: Beef with coconut oil and vegetables.
  • Dinner: bunless burger with bacon, cheese, and egg.

Saturday

  • Breakfast: Mushroom omelet with ham and cheese.
  • Lunch: ham, cheese, nuts.
  • Dinner: Whitefish, egg, and spinach in coconut oil.

Sunday

  • Breakfast: scrambled eggs with bacon and mushrooms.
  • Lunch: Burger with salsa, cheese, and guacamole.
  • Dinner: steak, salad, egg.

Natural foods are suitable for the keto diet: meat, fish, butter, eggs, cheese, mushrooms, low-carbohydrate vegetables, nuts, and seeds.

The effectiveness of losing weight on the keto diet

No diet by itself has a lasting effect on weight loss and can be harmful to health. After temporary weight loss, people go back to their previous state, and sometimes they gain more weight than before the diet change.

A safe and effective way to achieve your desired weight and maintain your health and fitness is to find a suitable lifestyle and diet plan with the help of experts that you can follow at all times [8].

Experts confirm that the keto diet is 2.2 times more effective for weight loss than a low-fat diet [9], [10].

The weight loss comes at the expense of [11]:

  • increasing the amount of protein in the diet;
  • decreased appetite;
  • changes in eating habits;
  • to obtain energy from fats instead of glucose;
  • rapid fat burning;
  • improved metabolism due to increased insulin sensitivity.

The keto regimen does not require constant calorie counting, creates a feeling of fullness, accelerates the process of burning fat, and prevents their formation [12], [13].

The harm of the keto diet

In 2018, Polish professor Maciej Banach presented a report on the harms of low-carbohydrate diets at the Congress of the European Society of Cardiology. Studies showed that in a control group of 24,000 participants, the risk of dying from heart disease, stroke, and cancer was 50%, 51%, and 35% higher among those who followed a high-fat, low-carb diet [14].

In January 2020, the International Physicians Committee for Responsible Medicine recommended that low-carbohydrate diets, including the keto diet, be removed from the Dietary Guidelines for Americans 2020-2025. Doctors pointed out that such diets increase the risk of heart disease [15].

In addition, the state of ketosis has side effects to be aware of [2], [16].

Keto Flu

A general worsening of the condition occurs with a diet change and lasts several days. Symptoms:

  • physical fatigue,
  • headache and dizziness,
  • a decrease in attention and performance,
  • sense of hunger,
  • sleep disturbance,
  • irritability,
  • digestive disorders,
  • increased thirst,
  • frequent urination,
  • muscle cramps,
  • rapid heartbeat.

It is necessary to strictly follow the diet during the first weeks to adapt to the new regime. If you have keto-flu symptoms, you must eat plenty and drink at least 2 liters of fluid daily, preferably containing electrolytes.

Experts recommend adding oils (fatty acids derived from coconut oil and palm oil), minerals (salt, soda, magnesium), caffeine, creatine, whey protein, and foods containing fiber to your diet. In addition, you need to reduce physical activity.

Risk group: anyone is transitioning to a keto diet.

Ketoacidosis

Ketosis is a natural physiological condition in which the body produces the number of ketone bodies it needs. Ketoacidosis is a pathological condition where glucose and ketone bodies are excessive, leading to coma and death. Ketoacidosis can be caused by diabetes, prolonged starvation, or a reaction to an increase in fat in the diet.

Risk group: people with type I and type II diabetes, children ages 1-13, nursing mothers.

Kidney stones

According to studies, a ketogenic diet can provoke kidney stone formation in 6.7% of patients.

Risk group: children have epilepsy.

The keto diet for diabetes

Researchers have confirmed the benefits of the keto regimen for people with type II diabetes. In one case, 95% of patients reduced or waived medication compared with 62% of participants who followed a high-carbohydrate diet [21], [22]. In another, 75% of study participants had increased insulin sensitivity.

In addition, there are studies on the possible use of ketosis to combat cancer cell formation, treat acne, childhood epilepsy, heart and brain diseases, Parkinson's and Alzheimer's syndromes. But the scientific material collected so far is insufficient for a reasonable conclusion [23], [24].

The keto diet is effectively used in the therapy of type II diabetes. In other cases, the medical benefits of a low-carbohydrate diet require additional research.

Physician's review of the keto diet

We asked a candidate of medical sciences, a gastroenterologist, and a dietitian of GMS Clinic.

Is the keto diet good or bad?

"It's all about the dose." Today, this dietary strategy is not recognized by any of the world's healthy communities, and therefore cannot be recommended by official medicine.

In this type of nutrition, the energy content of the diet is more than 80% provided by fats. The consumption of carbohydrates is limited to 20 g per day or 50 g, which is more gentle and somewhat better tolerated.

The keto diet is often low-carbohydrate (and the transition to ketosis is associated with this) and often high-protein. This type of diet has an abundance of saturated fats, including trans fats and protein.

It often happens that most followers of the keto diet at the initial stage do not have a clear understanding of what foods are acceptable in a ketogenic diet, but it is more or less clear what should be avoided. This is why meat products are used, which has its consequences.

This can provoke a deficit of dietary fiber found in carbohydrate foods and a possible shortage of water-soluble vitamins such as C and minerals. Such a diet can hardly be considered safe. And it is tough to stick to it for a lifetime, but this is the only option that ensures a stable weight, as far as weight loss is concerned.

What are the consequences and dangers of the keto diet?

Initial weight loss can be impressive, even before the body has transitioned to ketosis and the actual burning of fat at the expense of water. One gram of carbohydrate retains four times as much fluid in the body as protein, and the first thing one notices is a decrease in body volume. If there is a lot of extra weight, the result is initially encouraging.

But it's worth remembering that everything will come back if the diet is the same. And it's not all rosy. Here are some of the negative consequences:

  • general weakness, fatigue during adaptation;
  • hypoglycemia;
  • bad breath and sweat smell (due to the abundance of meat food);
  • stool disorders (constipation or tendency to diarrhea);
  • nausea;
  • pancreatic and gallbladder disorders, especially if there is any stage of gallstone disease;
  • gastric dyspepsia;
  • kidney stones (for long-term adherence) and conditions of kidney function;
  • possible deterioration of the lipid profile toward atherogenic;
  • weight return when you switch to a regular mixed diet.

I also associate this eating strategy with an increased risk of osteoporosis, brain deterioration.

There are several reputable foreign studies with which cardiologists are more familiar, indicating that replacing carbohydrates with fat and protein in the diet to lose weight significantly increases the risk of cardiovascular disease by about 3.5-5%. The risk of stroke and heart attack can increase if you change the type of diet.

Accordingly, if a person does not have the disorders mentioned above, you can try the keto diet and evaluate the effect if you wish.

A similar strategy, but without introducing ketosis, but with a significant restriction of carbohydrates (just by reducing simple carbohydrates), is reasonable to use to start in patients with carbohydrate metabolism disorders, when, for example, glucose or insulin levels are elevated. Once encouraged by the first results in reducing body volume, it is always easier to continue.

How about just not eating sweets and simple carbs? Does that also help lower sugar and lose weight without ketosis?

Given the data on long-term and maximally effective dieting strategies and my own experience, I can say that it is possible to lose weight when giving up sweets: sweet foods are high in calories and stimulate the appetite.

But most people are unlikely to maintain the effect, and the lost kilos will come back. A person always wants what he is forbidden, and in an impulse of a moment of weakness, he allows himself and overeats.

But such a diet, not at all low in carbohydrates but with a limit on simple sugars, can lead to weight loss and, consequently, the normalization of blood glucose levels.

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Author:
Jerry M. Vaughan
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