The popularity of low-fat diets has faded, but restricting one nutrient while increasing another is still popular in the world of weight loss. The ketogenic diet, which increases fats while reducing carbs, is the subject of a recent book, “The Deliciously Keto Cookbook.”
Authors Molly Pearl and Kelly Roehl say now is the time to jump onboard.
“There’s a lot of hype around it,” says Roehl, a licensed dietitian and nutritionist at Rush University Medical Center in Chicago. “It’s important for the general public to understand it correctly.”
With origins in ancient Greek medicine, this eating plan has been used effectively since the 1920s to help control seizures in children with epilepsy.
For epileptics resistant to anti-seizure medication, the diet combined with a fasting period has proved effective in reducing seizures in 30 to 40 percent of patients, and sometimes eliminating them.
But as a weight-loss prescription, the diet is controversial. High levels of fat, moderate amounts of protein and a very low carbohydrate intake fill out the diet’s pie chart.
“It encourages healthy eating, lots of fibrous vegetables and healthy fats,” Roehl said. “It’s a really flexible diet to follow.”
The clinical plan includes 80 to 90 percent of daily calories from fats, 8 to 12 percent of calories from protein and the rest from carbs, according to Dr. Dominic D’Agostino, whose research lab at the University of South Florida tests metabolic therapies including the keto diet.
The diet forces the body to burn fat instead of glucose from carbohydrates, a process known as ketosis. Adherents must check their blood ketone levels by urinating on a ketone test strip.
Detractors of the diet point out that ketosis is an unhealthy state for the body as it can lead to dehydration and a lowered immune response, known as the “keto flu.” If carbohydrate intake dips too low and ketosis goes too far, it can lead to ketoacidosis, where blood turns acidic. This can lead to a coma, or even death.
So how many carbs is the sweet spot? To reach a state of ketosis, between 20 and 50 grams per day is recommended. A cup of cooked brown rice, for example, contains 46 grams of carbohydrates.
Although D’Agostino doesn’t research ketogenic dieting for weight loss, he recognizes it as a convenient side effect. “It’s effective for weight loss because of the carbohydrate restriction. Ketones are energy molecules that tell your brain to stop eating, and the ketogenic diet suppresses your appetite,” he said.
Proponents say the keto diet also provides better cognitive functioning, more satiety, and may even be protective against cancer and reverse metabolic diseases such as diabetes.
Las Vegas-based registered dietitian and nutritionist Michelle Albrecht, co-owner of the Food Connection, said the diet can be effective but not worth it in the long term.
Albrecht explained that the ketogenic diet switches the body’s fueling system from the carb cycle to a process known as glyconeogenesis. The problem, she said, is the body can become adjusted to this new fueling method and stop getting the same results.
Other problems could arise from the high amounts of fat.
Is keto ever the way to go? “I wouldn’t say, ‘no, this wouldn’t work,’ but it wouldn’t work for everybody,” Albrecht said. “Is it good to be on something like this forever? I personally would never prescribe it to any of our patients.”