If you’re looking to get a jump-start on your health and fitness goals, you may be thinking about trying a low-carb eating plan such as the ketogenic diet. Maybe you’ve heard the phrase before — it’s a huge diet buzzword — but aren’t sure what it means.
Here’s a primer: The popular ketogenic diet is a low-carb, high-fat diet. Meanwhile, you’ll aim for moderate protein in your meal plan. In other words, it’s a far cry from the fad low-fat diet approaches of yesteryear — and, really, from other diets in general.
The main way ketogenic diets differ from other popular low-carb diets is that keto diets aim to drive your body into a metabolic state called ketosis, in which the body starts burning stored fat as a source of energy, instead of carbohydrates, says Stacey Mattinson, RDN, who is based in Austin, Texas. Once you’ve adjusted your food intake to get there, your body can enter a state of ketosis in 1 to 3 days, she adds. Nutritional ketosis can also happen if you eat another restrictive diet — specifically, a very low-calorie diet. Typically, that type of diet consists of 600 to 800 total calories per day and is doctor supervised and medically recommended.
Potential Benefits to Know Before Starting the Ketogenic Diet
Research supports considering a ketogenic diet in three circumstances: to treat epilepsy (in the case of the classic ketogenic diet), to help stabilize blood sugar and aid weight loss in type 2 diabetes management, and to generally support weight loss, says Mattinson (though the last two purposes still need to be studied more).
Another thing to keep in mind: The potential benefits of keto discussed here are for the popular, standard ketogenic diet, not other spins on the keto diet, such as the cyclical ketogenic diet or the targeted ketogenic diet. Those keto diets have even less research on them. While the classic keto diet has a wealth of research about its benefits for those with epilepsy, we won’t be discussing that here either.
Keto and Diabetes
Theoretically speaking, it makes sense that keto could benefit people with diabetes, since the diet calls for moderating carbohydrate intake. And that lower carb intake has the potential to increase insulin sensitivity in individuals who are managing diabetes, as research suggests.
The good news: Mattison called research on keto supporting blood sugar management in people with diabetes “promising.” “A ketogenic diet may cause a reduction in A1C — a key test for diabetes that measures a person’s average blood sugar control over two to three months — something that may help you reduce medication use,” she says.
Despite the ability of keto to lower blood sugar levels, one big concern is that you eat a lot of fat on keto, and those may be saturated fats, which are unhealthy and associated with a higher risk of cardiovascular disease, or heart disease, when eaten in excess.
In one trial involving 33 people with prediabetes or diabetes, going on a ketogenic diet or a Mediterranean diet, which is a type of plant-based diet, for 12 weeks improved blood sugar control, as measured by A1C levels. That said, neither the low-carb, high-fat diet nor the plant-based diet performed better than the other. One benefit of the low-carb diet was that it reduced triglycerides better than the Mediterranean diet, and yet there were downsides: The keto diet increased LDL (“bad”) cholesterol, and those on the diet got fewer nutrients, particularly folate, vitamin C, magnesium, and fiber, because of everything that the keto diet cuts out (e.g., fruits, whole grains). The overall takeaway, researchers said, is that it’s best to work with your clinician on making an informed choice that is suited your health concerns, food preferences, and lifestyle.
Despite the potential blood sugar benefits of keto, because people with type 2 diabetes have an increased risk of heart disease, there is a specific concern that eating so much saturated fat may drive up LDL cholesterol levels and further increase the odds of heart problems. So, if you have type 2 diabetes, talk to your doctor before attempting a ketogenic diet, especially if you have other risk factors for heart disease, such as high blood pressure. The doctor may recommend a different weight loss diet for you that may help improve your blood sugar levels, such as a reduced-calorie diet.
Those with epilepsy should also consult their doctor before using a ketogenic diet as part of their treatment plan. If you do opt to go through with the keto diet, consider working with a registered dietitian nutritionist who is also a certified diabetes care and education specialist. They can help you develop a healthy low-carb meal plan that is high in fat but low in saturated fats, and which contains plenty of healthy foods such as low-carb veggies.
Besides diabetes, the keto diet may also help improve short- and long-term cognition among people who are living with Alzheimer’s disease and experiencing mild cognitive impairment, according to a systematic review of randomized controlled trials. Researchers caution that further research is needed to confirm these findings and prove a cause-and-effect relationship between the ketogenic diet and preventing dementia.
Keto and Weight Loss
Looking to lower your body fat percentage? You’ve probably heard that keto diets can help — and that they can make a big impact on your weight right away. There may be some truth to that notion, although how much weight you lose will vary by individual.
“Ketogenic diets will cause you to lose weight within the first week,” says Mattinson. Thanks to its low-carb nature, keto will force the body to first use up all its glycogen stores, which is the storage form of carbohydrates, she explains. With depleted glycogen, you’ll drop water weight. While it can be motivating to see the number on the scale go down, keep in mind that most of this is water loss initially.
But the ketogenic diet can also be an effective weight loss option over time. One review suggested that this low-carb diet can spur fat loss in people with obesity when used for a couple of weeks and for up to one year. And a meta-analysis noted that one likely reason for weight loss is that all of the fat consumed when on this diet may suppress hunger.
One downside of the ketogenic diet for weight loss is that it’s difficult to maintain, especially compared to a traditional diet or other diets that have less stringent rules. “Studies show that weight loss results from being on a low-carb diet for more than 12 months tend to be the same as being on a normal, healthy diet,” says Mattinson. While you may be eating more satiating fats (like peanut butter, regular butter, or avocado), the very low-carbohydrate nature of keto means that you are way more limited in terms of what’s allowed on the diet, which can make everyday situations, such as eating dinner with family or going out with friends, far more difficult. Because people often find this diet tough to sustain, it’s easier to rely on as a short-term diet than as a long-term lifestyle.
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