The Keto Diet - it’s the talk of the town right now, and with good reason. It seems like everyone knows someone who has had great success with it. Just because someone else does well with it, does that make it the right diet for you? We’re going to explore some of the basics about the diet, as well as some of the important points to keep in mind if you are going to try it. As with any diet, there are exceptions to the rules - if something sounds like it’s not going to work for you because of an allergy, aversion, or other reason you have for avoiding a food or method… you know your body best. 

What is the Keto Diet? 

The Keto diet is designed to get you into a state of ketosis, which is where your body is using fat for fuel. Ketones are the byproduct of fat metabolism in the body, and are usually made in small amounts throughout a normal day. A diet that is aimed at creating a ketotic state is one that is designed to get you burning enough fat that there is a measurable output of ketones from your body. When you are in ketosis, it is a sign that you are utilizing fat as your primary fuel source throughout the day and therefor reducing your (presumably) excess body fat. 

The Keto diet is not the only diet that is intended to get you into a state of ketosis. In fact, all weight management diets that are centered around weight loss are intended to get you into this state through one method or another. The Keto diet is different because it aims to get you into ketosis by consuming a very high proportional amount of fats compared to the other major macronutrients. The basis for this is when a high amount of fat is available for the body to use as fuel, it will switch to preferentially burning fat for energy instead of carbohydrates. The body usually attempts to burn carbohydrates and sugars for fuel (because the biochemistry is a lot simpler and takes less energy), so to make it burn fat instead takes some coercing. 

A Quick Biochemistry Lesson (Macronutrients too!)

Macronutrients are the major energy molecules you have probably heard about before : Proteins, Carbohydrates, and Fats. 

The body uses proteins as the building blocks for most processes by breaking them down to Amino Acids and recombining them as needed to make muscle, blood proteins, etc etc etc - the list is long. You can use protein as an energy source too, but it is a demanding process in terms of energy expended for energy gained and the byproduct (ammonia type chemicals in most cases) is not something you want a lot of in your body. 

The body uses carbohydrates through a process called Anaerobic metabolism (meaning done without oxygen), and is able to break carbohydrates down into energy very efficiently. This efficiency is why your body will normally try to use carbohydrates for energy before other macronutrients, as it happens quickly and gives a decent return on energy gained for energy spent. 

The real magic happens with fat metabolism. The body breaks down fats through Aerobic metabolism, which takes longer and is more taxing than the Anaerobic carbohydrate metabolism. However, once the fats are broken down and transformed into energy, the return of energy gained per molecule of fat is much higher than that of either carbohydrates or proteins. This means that your body is capable of doing a lot more work with the energy gained from fats once it breaks them down, but it takes longer and requires more chemical processes. 

The summary of it is this : Carbohydrates cost 2 energy (ATP) to make and get you 6 energy, for a net of 4. Proteins also net 4 ATP. Fats that get broken down in the body net 9 ATP OR MORE, depending on the particular fat that is broken down. 

Keto Nuts and Bolts

When eating this way, the goal is to make the majority of your daily caloric intake come from fats (between 70%-75%), followed by protein (15%-20%) and then lastly, carbohydrates (~10%). These are somewhat conservative numbers, with some extreme diet recommendations ranging up to 85% fat / 10% protein / 5% carbohydrates. Usually, to achieve a majority the diet is going to require a lot of oils, nuts, butters, and creamy textured foods.

This is difficult to do when also trying to follow a separate set of guidelines in conjunction with the Keto diet, such as vegetarian, nut free, lactose intolerant, etc. Difficult does not mean impossible, however, just that there will be more preparation and ingredient shuffling going on than the average Keto dieter will do.

One very important part of this diet that gets overlooked by some individuals is the vegetable content. The misconception as people begin to look at recipes is that the vegetables are either too high in carbohydrate content or not necessary. The truth is, vegetables in this diet are extremely important because they are the main source of dietary fiber as well as providing valuable vitamins and minerals. They also add much needed volume to the diet, as most high fat foods are very dense and do not take up much space. Without maintaining a healthy amount of vegetables on the Keto diet, it can be easy to eat too many dense, high fat foods in order to feel full, which translates to more calories than you need.

Some vegetables lend themselves well to this diet, usually the leafy greens and deep, dark colored vegetables. There are of course notable exceptions, such as cauliflower (which is a major staple for most Keto diet plans) and peppers. Often the brighter, more colorful veggies are lower in fiber and higher in sugar, which makes them taste sweeter but not helpful for Keto. The biggest and most popular examples of this are corn and carrots. A great breakdown of the net carbohydrates per food can be found here.

Another important part of this diet is selecting high fat foods that are healthy fats. The distinction between healthy and unhealthy fats is how saturated the chemical bonds of the fat are with carbon molecules. Unsaturated fats are generally considered the healthiest, and include vegetable oils, nuts, and avocados. Saturated fats should be approached with some caution to their quantity and what they are combined with, and include whole milk, butter, cheeses, meats, and coconut. Trans fats are the unhealthiest, and are usually found in fried foods, fast food, processed food, and anything labeled “partially hydrogenated”.

When doing a Keto diet and aiming for a healthy lifestyle, keep your fat selections to primarily unsaturated fat when possible, and saturated fats to complement the gaps. An unhealthy version of the Keto diet would be one that is composed of entirely saturated fats (red meat, cheese, cream and coconut) without any vegetables or unsaturated fats, such as avocados and olive oil.

Ketosis : Keep an eye on it

The Keto diet can be a tricky one for some individuals with existing health conditions. The diet was first studied in relation to epilepsy and helping to prevent seizures (which it does), but it also can play a large role in people who have been diagnosed with diabetes. While many cases of Type 2 diabetes will respond very well to a diet like this when coupled with exercise, individuals with Type 1 diabetes should consult their managing physician before attempting it. The danger lies in dropping too far into ketosis if the insulin levels are not controlled well and the ketosis is not carefully monitored, leading to a condition known as ketoacidosis.

Even in individuals without pre-existing health conditions, starting this diet can be challenging. Often people will experience the “Keto flu”, a nausea/headache/fogginess and decreased energy while making the transition into ketosis. As the body depletes it’s stored carbohydrates and is searching for more, your body will resist utilizing the stored fats for energy and you will seem like you are constantly running out of gas. Additionally, as you are using up your carbohydrates, you will be urinating most of your electrolytes out at first, so you may feel dehydrated, have brain fog, and get muscle cramps. A great solution to this is to stick closely to the diet for the first few weeks, supplement with a liquid electrolyte solution, and stay very well hydrated.

To make sure that the diet is actually doing what you think (and hope) it is, ketosis test strips are readily available at most pharmacies that you can use to check your levels. In order to stay safe but to maintain an overall fat burning state for energy, you want to stay at a +1 to +2 ketosis (the test kits will explain the grading system). Anything more than that is somewhat dangerous, while anything less than that probably will not help you reach your goals.

Key To a Keto Lifestyle

The biggest key to this diet, as with most, is consistency. The Keto diet in particular is not very forgiving to “cheat days”, as the body gets a taste for carbohydrates and quickly makes the switch to processing them for energy again. This can mean that after one cheat day you may notice increased water retention, some weight gain, and then having to go through a short period of the “keto flu” again before getting back on track.

One of the major keys to success here is preparation. The more that you can do to plan ahead, prepare meals for yourself beforehand, or check the menu where you will be going and see what options might fit the diet, the better you will be able to stay on track. This diet in particular is more difficult to succeed with when doing it on the fly, so bulk meal preparation as well as overhauling the ingredients in your pantry that you keep on hand will be extremely helpful. 

Another key to the low-carb, high-fat lifestyle is being able to get back on track when you fall off the wagon. Inevitably everyone takes a cheat day, or can’t resist a slice of birthday cake, or whatever life throws at you. The most important thing with this diet (and nearly any other) is being able to enjoy the cheat meal, and then get back on track toward your goals. 

Dr. Paul Harris holds a Doctor of Chiropractic degree from Texas Chiropractic College and a Master’s of Exercise and Health Sciences from University of Houston Clear Lake. He is the owner of Delta V Chiropractic and Sports Medicine and an avid human movement specialist.