Let’s say you’ve gone Paleo, but despite best efforts, you’re not getting the results you’re after. Or your blood sugar’s way too high, and the doc wants to put you on meds. Or perhaps hormonal issues like polycystic ovary syndrome (PCOS) are dragging you down, or you are particularly worried about developing Alzheimer’s or cancer. What can you do to start turning the ship around without drowning in a sea of meds?
Certainly a healthy diet is step No. 1. But when issues like obesity or diabetes, or hormonal or even neurological problems come into play, identifying what diet will work best for your unique circumstances can be hit or miss—hardly what you want when you’re eager to get well ASAP. Though no one diet fits all—not by a long shot—in my practice, a number of patients have achieved excellent results with the help of a standard ketogenic diet (SKD), and it’s one you may want to take a closer look at, particularly if you’re battling a health challenge or two. So is going keto right for you? Here’s a quick keto-primer for your consideration:
1. What Is a Ketogenic Diet?
In simplest terms, it’s high-fat and extremely low-carb—as in, virtually no sugar or refined carbs—which, over time, shifts your metabolism from a carbohydrate- or glucose-burning machine to a fat-burning one. For those old enough to remember it, the ’70s best seller Dr. Atkins’ Diet Revolution was among the first to popularize this style of high-fat, low-carb eating, followed more recently by less-extreme, fat-friendly carb-curbers like the Zone, South Beach, and Paleo diets. From there, the approach has been fine-tuned into the somewhat more challenging ketogenic plan, which allows a daily total intake of about 50 grams of carbohydrates (or 20g–30g of net carbs, after you subtract the fiber). In real food terms, that works out to the rough equivalent of a cup of brown rice. Remember, that’s per day, not per meal. The rest of the daily tally is made up of about 20 percent of calories from protein, plus 60 percent to 75 percent of calories coming from good fats, which are a satiating replacement for all those cut carbs. So we are talking about a low-carb, moderate-protein, high-fat diet. But it’s important to realize that a ketogenic diet is not the same for everyone, as we all have a different tolerance for carbohydrates. Some folks may need to go as low as 20g or less of carbs a day, while for others, up to 50gs of carbs still works.
2. How Does a Ketogenic Diet Work?
With significantly fewer carbs available to burn for energy, the body’s forced to start burning fat for fuel, aka ketosis, a metabolic process that produces acids known as ketones. Ketones are produced by the liver when carbohydrates are limited. Being in ketosis is a normal metabolic state and just means your body is burning fat (instead of sugar). Unfortunately, it is usually confused with ketoacidosis, a dangerous metabolic state that happens with diabetics when there are very high ketones occurring simultaneously with very high blood sugar levels, and they are not producing enough insulin. Studies have shown some of the big pluses of going keto and flipping that fat-burning switch, include facilitating body-fat loss, helping to raise HDL or good cholesterol, and reducing triglyceride and glucose levels. It’s also helpful for cutting cravings, inflammation, and chronic disease risk. But it’s not a dietary hall pass for all-bacon-and-hollandaise-sauce all the time. You’ll still need to eat healthy whole foods and good fats (more on that below). Bottom line, if you’re not in good health or have uncontrolled diabetes, proceed with caution: Too many ketones can have dire consequences in certain cases—so it’s absolutely essential for anyone beginning a keto diet to check with the doc first and closely monitor blood sugar and ketone levels. For those just getting started, ketone strips are one way to do that, but several of our team members at Be Well who are keto devotees prefer the accuracy of the Nova Max device (which also monitors blood glucose).
3) What Kinds of Foods Are Typically Part of a Standard Keto Diet?
Healthy whole foods reign supreme on a ketogenic diet. Fortunately, the options are both delicious and satisfying, thanks to all those good and filling fats and no nasty, lab-made trans fats. Some of the foods that are welcome on the keto list are:
- Grass-fed meats and pastured poultry, local, and/or certified organic
- Wild-caught fish and low-mercury fish, like those recommended in the NRDC’s Smart Seafood Buying Guide
- Full-fat butter, cream, cheese, and eggs, from pastured or grass-fed animals
- Oils and fats, like avocado oil, extra-virgin olive oil, coconut oil, lard, duck fat, goose fat
- Nonstarchy veggies, like leafy greens, avocados, tomatoes, radishes, olives, zucchini, some cruciferous veggies
- Low-sugar fruits, like raspberries, blueberries, blackberries, in small amounts
- Nuts and nut butters like almonds, hazelnuts, macadamia, pecans, walnuts (not peanuts, cashews, pistachios, though)
- Seeds like chia, flaxseed, hemp, pumpkin, sunflower
- Tea and coffee, preferably organic, non-GMO (with or without a touch of raw stevia)
4. What’s a No-go on a Standard Keto Plan?
Not surprisingly, high-carb and processed foods are off the ketogenic list, as are low-fat, sugar-free faux foods, factory-farmed meats and fish, and so-called vegetable oils like canola, corn, grapeseed, soybean, etc. Some other foods that don’t make the keto cut include:
- Starches and grains, be they whole or processed into products like bread, pasta, cereals, and chips, or desserts and baked goods
- Starchy or high-carb veggies, fruits, and legumes, like beans, white potatoes, sweet potatoes, parsnips, carrots; high-sugar fruits, like bananas, mangoes, pineapples, grapes, and all dried fruits
- Fruit juices—liquid sugar bombs to avoid at all costs
- Frankensweeteners of all kinds, like Splenda, Equal, Sweet ’N Low, etc., and “sugar-free” foods
- Low-fat, low-carb, or sugar-free products, which are heavily processed, trading fat for sugar and loaded with chemical additives
- Alcoholic beverages, many of which the body metabolizes as sugar (especially beer and white wine), interfering with ketosis. If you’re going to drink alcohol, I recommend keeping it to a minimum and opting for low-carbs spirits like tequila, whiskey, gin, and vodka (and the occasional glass of dry red wine).
5. What to Expect When Starting a Keto Plan
After a few weeks of eating a ketogenic diet, many people find they start to look and feel better than they have in a long time, and they start to enjoy the benefits of reduced body fat, lower blood sugar, and increased energy. As those benefits are first kicking in, though, some people may also experience a minor side effect or two, but those pass within a few weeks. Three of the most common side effects are bad breath, as the body starts producing ketones, ‘Keto flu’ and electrolyte imbalance; which are easily remedied. With an electrolyte imbalance, you might experience fatigue, constipation, cramps, or even heart palpitations. These effects can happen initially as the body is releasing water, salt, and other electrolytes like magnesium. Supplementing with some Himalayan sea salt and magnesium will usually help rebalance the electrolyte scales. Paying special attention to your electrolyte balance and fat intake — something most of us don’t usually think much about — is extremely important when going keto. Keeping track every day will help minimize side-effects and help fend off the dreaded ‘Keto flu,’ which can make you feel unwell for several days or more. An easy way to monitor your macronutirents is with an online tracker like My Fitness Pal, which you can adjust to meet your specific keto goals
6. Going Keto Can Make the Difference
At its core, ketogenic—and, for that matter, low-carb diets in general—can go a long way to combat the ills created and/or exacerbated by the standard American diet. Obesity, diabetes, and all manner of chronic diseases are on the rise, due in large part to nutritionally challenged diets. But going keto can help reverse the trend and even restore bodies to health, with minimal (if any) pharmaceutical intervention, by embracing foods that fuel and satisfy.
To get started, visit any number of how-to go keto websites for more information, or, for a deeper dive, take a look at one of the following titles recommended by our Be Well team members:
- Primal Fat Burner: Live Longer, Slow Aging, Super-Power Your Brain, and Save Your Life with a High-Fat, Low-Carb Paleo Diet, by Nora Gedgaudas, CNS, NTP, BCHN
- Keto Clarity: Your Definitive Guide to the Benefits of a Low-Carb, High-Fat Diet, by Jimmy Moore with Eric C. Westman, M.D.
- Wired to Eat: Turn Off Cravings, Rewire Your Appetite for Weight Loss, and Determine the Foods That Work for You, by Robb Wolf