The ketogenic or ketogenic diet is not new: one hundred years ago, before the advent of effective anticonvulsants, French pediatricians observed that certain dietary restrictions reduced the frequency of seizures in children suffering from drug-resistant epilepsy.
Based on metabolic studies, a therapeutic diet was developed, without starch or sugar, which at the beginning of the 20th century became part of the complex treatment of epilepsy.It is said that the author of the name “ketogenic diet” belongs to the American doctor Russell M. Wilder, who used it in the treatment of epilepsy between the 1920s and 1930s. last century.
The ketogenic diet involves a high-fat diet, moderate protein intake, and very low carbohydrate intake.For most people, this ratio of nutrients is considered safe for a limited period of time and not only helps in losing extra pounds, but also has therapeutic applications.
Indications for use
A low-carbohydrate ketogenic 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 dietary treatment for 12 weeks).At the same time, children who are prescribed such a diet should be registered with doctors who monitor their normal growth and weight gain, and also make dietary adjustments in accordance with the needs of each child.
Diets with minimal amounts of carbohydrates have begun to be used for other disorders.Researchers have shown that ketogenic diets are useful in treating patients with DeVivo disease, a deficiency syndrome of the protein GLUT1 (which transports glucose across the blood-brain barrier), as well as several other congenital metabolic defects.
It is believed that this nutritional system can slow the progression of amyotrophic lateral sclerosis (Charcot disease);Indications for the ketogenic diet include neurodegenerative pathologies such as Alzheimer's and Parkinson's diseases.Clinical studies are being conducted 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 best-known ketogenic diet for weight loss is the Atkins diet for the treatment of obesity, modified and popularized by Dr. Robert Atkins (Dr. Atkins Diet Revolution, 1972).Although experts consider only the induction phase of this diet ketogenic.And, in fairness, it should be noted that long before him, many American doctors worked on the principles of the ketogenic diet: Peter Huttenlocher, Alfred Pennington, Richard McCarnes and others.For example, R. McCarnes wrote the book Eat Fat and Grow Slim in 1958, which is essentially the same low-carb diet originally introduced to treat epilepsy.
Since the deposition of excess adipose tissue in the form of concentrated triglycerides in its cells occurs due to excessive consumption of carbohydrate foods (no one doubts this), limiting carbohydrates in the diet to a minimum (a ketogenic diet for a month) helps to reduce fat reserves, that is, to lose weight.
In addition, the ketogenic diet for oncology, by increasing the oxidative stress of cancer cells, has been found to significantly reduce the growth rate of malignant tumors located in the colon, stomach, prostate and lungs.Furthermore, it has already been shown that some cancers are more sensitive to chemotherapy due to the induced state of ketosis.
For the past two decades, bodybuilders have used the ketogenic diet to reduce the layer of fat under the skin: in their lingo, this is called cutting on a ketogenic diet.
The essence of the keto diet.
On a standard ketogenic diet, your total daily calories should come from 70% to 80% fat, 15% to 20% protein, and 5% carbohydrates (less than 50g per day).
Typically, the ratio of fat to protein to carbohydrates is 3:1 (i.e. 3 grams of fat for every gram of protein + carbohydrates).If the ratio is 4:1, then 90% of the energy comes from fat, 8% from protein and only 2% from carbohydrates (about 20 g per day).
The essence of the diet used 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, which comes from eating foods containing carbohydrates.
Carbohydrates in food are transformed into glucose, but when a person consumes too few carbohydrates and too much fat, a chain of biochemical reactions is triggered in the body.Schematically this process looks like this.First, due to decreased blood glucose levels, the pancreas begins to produce more of the hormone glucagon, which stimulates the catabolism of glycogen stored in the liver into glucose and release it into the blood.Secondly, ketogenesis is activated, that is, the liver produces ketone bodies (acetoacetate, which is then transformed into β-hydroxybutyrate and acetone) and the conversion of dietary fat into free carboxylic (fatty) acids.Thirdly, due to an increase in the level of glucagon, the activity of lipase - an enzyme that breaks down triglycerides (fats) accumulated in adipose tissue cells - significantly increases.
Additionally, in the first two weeks of following the ketogenic diet, significant weight loss occurs due to the removal of water from the body, which is also associated with increased glucagon production.And therefore, a temporary side effect of a high-fat diet can be dehydration, which nutritionists advise combating by drinking up to two liters of water a day.
Many people believe that an important advantage of the ketogenic diet is the absence of hunger, the need to count calories, and exercise for hours to burn off excess calories.
Ketogenic diet for men
The ketogenic diet is considered especially effective for men with abdominal obesity.
If a therapeutic diet for obesity recommends reducing caloric intake to 2000 (2300) kcal per day, then the ketogenic diet does not control calories so strictly (but reducing them by at least 10-20% will not hurt).But carbohydrate consumption should be reduced five times: instead of 250 g to a maximum of 50 g per day.
Remember that most of the calories in a ketogenic diet come from foods high in natural fats and moderate amounts of protein.That is, it is not a “protein load”, as some may think.And if a man is used to eating a lot of meat, his body will enter a state of adaptive ketosis much more slowly.Therefore, you will have to limit protein: per day to 1-2 g of protein per kilogram of body weight that you are trying to achieve as a result of weight loss.Example: If the starting weight is 112 kg and the desired weight is 85 kg, then the amount of protein during the course is 85-170 g.
The exact proportion of fat, protein and carbohydrates in the diet (in grams) will depend on the age, goal, level of physical activity and health status of each man.But short-term fasting during the ketogenic diet is recommended to everyone: in the first two days of switching to this food system, you should drink plenty of water and limit yourself to one meal a day (in a very small amount).At the end of the first week, you should eliminate carbs as much as possible (below is a list of foods for the ketogenic diet), but portion sizes decrease very slightly.
Another nuance: they claim that the keto diet without sport does not lose its effectiveness, and to lose weight it is not necessary to go to the gym or simply do any additional physical exercise.But physical activity, as part of a healthy lifestyle, accelerates the burning of excess fat, so lying on the couch is not a good idea.In addition, you can take advantage of the moment and, following the example of bodybuilders, build muscle mass: gaining weight on a ketogenic diet is possible only with muscle loading, and then subcutaneous fat will disappear, revealing strong muscles.
Ketogenic diet for women
The problem with the keto diet is that to date, research on its effectiveness and safety has only focused on men.A natural question that arises is whether the ketogenic diet is suitable for women, given that female hormones tend to be more sensitive to most dietary changes.
While opinions vary, most experts say that the ketogenic diet produces positive results, especially in perimenopausal or menopausal women.This nutritional system allows you to lose excess weight, control blood glucose levels, improve sleep quality and reduce menopause 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 ketogenic diet is contraindicated in case of irregularities in the monthly cycle, pathologies of the thyroid gland or during pregnancy and lactation.
Women are recommended to combine periodic fasting with a ketogenic diet, that is, simply skipping lunch and taking a 10-12 hour break between morning and dinner, which after 50-55 years produces a rejuvenating effect (this is data from a 2016 study published in the Journal of the American Medical Association).According to Western nutrition experts, this dietary regimen allows the body to take a break from digestive functions and direct energy resources to restore tissue cells and balance hormones.
If a woman with a body weight of 75 kg and a height of 165-168 cm seeks to lose weight to approximately 68 kg, she should go from 2300 kcal per day to consuming no more than 1855 kcal.Protein should be 1-1.5 g per kilogram of ideal weight, that is, daily you can ingest about 68-102 g of protein, 240-350 g of fat and 18-20 g of carbohydrates (in pure water, without fiber).
How is a ketogenic diet different from a high-fat diet?
A high-fat or LCHF diet differs from a ketogenic diet in the proportions of protein, fat and carbohydrates in the diet, 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.Obviously, this is due to the Swedish therapist Annika Dahlqvist, who began recommending her diabetes patients to consume more fats and limit carbohydrates, which contradicted the officially approved recommendations of endocrinologists in Sweden.
Among the modifications of the ketogenic food system, starting with the Atkins diet and the LCHF diet, one can name strange dietary recommendations, for example, egg fasting on the ketogenic diet, when for several days it is only necessary to eat chicken eggs boiled with mayonnaise...
Cyclic ketogenic diet and other modifications.
In recent years, the standard ketogenic diet (SKD) has been modified in many ways.Thus emerged the high protein ketogenic diet (HPKD), 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 consumed before and after training;It is considered a sport, so the amount of calories obtained by consuming carbohydrates is greater than in SKD.
The cyclical keto diet (ERC) or, according to another version, the rotational (alternating) keto diet, 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 carbohydrate loading is carried out on a keto diet - one or two days carbohydrates are consumed without restrictions.The unknown authors of this version of the ketogenic 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, everything that is lost in six days is recovered instantly.
Benefit
As foreign clinical practice shows, almost 20% of children with epilepsy after a ketogenic diet (followed from six months to two years, with a gradual return to a normal diet) experience seizures much less frequently and many of them are able to reduce the intake of anticonvulsants or abandon them altogether.
Based on the results of two dozen randomized controlled studies, experts have concluded that the benefits of the keto diet include a significant and fairly rapid loss of excess weight, especially in severe obesity.Despite the large amount of fat, this diet over 24 weeks resulted in a significant percentage of patients with reductions in systolic blood pressure, blood sugar and insulin levels, plasma C-reactive protein levels, and an increase in high-density lipoprotein (HDL), i.e. good cholesterol.
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 ketogenic diet, the skin reacts in its own way to the lack of carbohydrate foods, for example, acne may decrease.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 ketogenic diet includes: any meat and meat by-products;bird;fish and shellfish;eggs (all types);cream, sour cream, butter (butter and vegetables).Hard cheese is very useful on a ketogenic diet.But be careful with regular milk, as it contains a lot of lactose, the milk sugar, which is a disaccharide carbohydrate.But fermented milk products can be consumed without fear: during the fermentation of fermented milk, lactose undergoes hydrolysis.
Instead of popcorn, sweets or chips, nuts (about 13 g of carbohydrates per 100 g) and sunflower seeds (10.5 g of carbohydrates per 100 g) are suitable.The number of calories is 655 and 600, respectively.
It is recommended to include in the menu:
- Mushrooms (except dried boletus and boletus), the ideal option is mushrooms (only 0.5 g of carbohydrates per 100 g).
- all types of leafy greens and vegetables that do not contain complex starchy carbohydrates: broccoli and rutabaga;white cabbages, cauliflower and Brussels sprouts (3-6 g of carbohydrates per 100 g);cucumbers, zucchini, zucchini, eggplant, bell peppers (green), tomatoes, radishes, leeks, rhubarb, green beans and leeks (range 1.8 to 4.5 g of carbohydrates per 100 g).
You can eat a little berries: strawberries (100 g contain about 8 g of carbohydrates), cherries, raspberries, blackberries, blueberries (100 g contain 12 g of carbohydrates).
If you maintain moderate consumption while following a ketogenic diet for weight loss, you can occasionally eat 100 g of apricots, pineapple or grapefruit: this is approximately 11.8-12.4 g of carbohydrates.But you shouldn't eat bananas: every 100 grams of carbohydrates contain almost 23 g.
What can't you eat?You will have to give up bread and all flour;pasta;sugar, honey and confectionery sweets;any cereal porridge;potatoes, carrots, beets, celery roots;pumpkins and all melons;legumes and most fruits.
Menu for a week of keto diet
Of course, getting serious about getting rid of excess fat reserves in your own body requires creating a menu for the week of the ketogenic diet.And the information in the previous section will help with this.
For breakfast you can prepare scrambled eggs or omelettes with onion, mushrooms and spinach, bacon and tomato.Coffee or tea, natural, without sugar.
Lunch can consist of a salad (the recipe for one of them is detailed below), vegetable soup or soup with meatballs (without potatoes, rice and noodles), chicken broth and boiled chicken, fried fish or pork and mushroom stew.
For dinner, choose a protein, such as turkey, beef, fish, seafood, with which, as a side dish, broccoli, Brussels sprouts, green beans or bell peppers, seasoned with cream cheese sauce, go well.
Keto Diet Recipes
Taking into account the list of foods allowed on a ketogenic diet, so many different dishes can be prepared that it is impossible to list even a tenth of the ketogenic diet recipes.Try these three.
Baked chicken with vegetables
Products for two servings: 500 g of chicken (thighs, breast or fillet, cut into medium pieces), a tablespoon of vegetable oil, 1 green pepper (cut into medium 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 fatty sour cream, 50 g of hard cheese(coarsely grated) grater), salt and ground black pepper to taste, ground coriander (half a teaspoon).
Preparation:
- Heat the oven to 180°, grease a baking dish or frying pan with vegetable oil;
- Separately simmer onions and peppers (sweet and bitter) in vegetable oil;
- Blanch the cauliflower inflorescences in boiling salted water for three minutes, let the water drain;
- put the chicken in a mold (pan), salt and pepper, add the onion, pepper and cabbage (distribute the vegetables evenly over the meat);
- Sprinkle cilantro on top, put butter (several pieces, all over the surface), pour sour cream, sprinkle with grated cheese and put in the oven for 40-45 minutes.
Quick salad with ham or breast
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 the brisket or ham into large strips;
- cut the boiled eggs into quarters and the vegetables into thin slices;
- place the lettuce leaves on a plate, place the ham on top and the eggs and vegetables on top, add 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 pulp, 350 g of fresh mushrooms, half an onion (finely chopped), 2 tablespoons of vegetable oil, half a teaspoon of nutmeg, one clove of garlic, 4 tablespoons of sour cream or heavy cream, 2 tablespoons of chopped herbs, salt and ground black pepper, to taste.
Preparation:
- pour vegetable oil into a deep frying pan or saucepan with a thick bottom, add onion and chopped garlic, cook over low heat for five minutes;
- put pieces of meat and fry a little;
- add chopped mushrooms, mix, add nutmeg and ground black pepper, salt;
- simmer for 15 minutes, then add sour cream (cream) and herbs;
- Cover the dish with a lid and simmer until cooked (about 15 more minutes).
Contraindications
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" the metabolism with the help of pharmacological agents: you should not risk your health in pursuit of a super effect.
Possible risks
Risks associated with a diet used long-term in the complex treatment of epilepsy in children include the threat of growth retardation (due to decreased levels of insulin-like growth factor 1), impaired bone mineralization (due to calcium deficiency) and nephrolithiasis (kidney stone formation).Hyperlipidemia (elevated lipids in the blood) occurs in almost 60% of children and cholesterol levels can increase by approximately 30%.
Rare side effects include cardiomyopathy, long QT syndrome (disturbed 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 lose weight complain about: the lack of fiber intake affects it.In addition, the ketogenic diet in the initial stages may be accompanied by increased fatigue, weakness, headaches and dizziness;in women - dysmenorrhea.
If weight does not decrease with a ketogenic diet, it is most likely that there is too much protein in the diet, since more than half of the excess protein in the body is transformed into glucose, that is, the induced ketosis process is interrupted.
When muscles hurt a lot on a ketogenic diet, the reason 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 from muscle tissue in conditions of ketosis.
At the beginning of the diet, reducing carbohydrate intake causes fluid loss and leg swelling can occur on a ketogenic diet even with mild kidney failure.
Reviews and results of losing weight.
Reviews of doctors who prescribe a ketogenic diet to patients with neurodegenerative pathologies boil down to affirming its unconditional effectiveness: even with senile dementia and Parkinson's disease, patients' attention increases, memory and adequacy of perception significantly improve.
Usually, experts comment on the reviews and results of those who lose weight.But the significant controversy surrounding all low-carb diets also contributes to the evaluation of specific outcomes.
Thus, according to the American Journal of Clinical Nutrition, researchers found that men and women who switched to a ketogenic diet, on average, lost between 3.6 and 4 kg more in six months than those who limited their fat intake.British obesity experts (British National Obesity Forum) also point out that low-carbohydrate, high-fat diets are superior to low-fat diets in terms of effectiveness for weight loss.Although his numerous colleagues claim that the results of the keto diet for weight loss are “contrary to the available evidence.”