What is the keto diet?

Keto seems to be the diet buzz word over the last few years. So, what is it exactly? And why is it so popular?

The keto diet short for ketogenic diet is very low in carbohydrates and focuses on foods high in fat and moderate protein. The general consensus of the keto diet is that between 10 – 30 grams of carbohydrate should be consumed a day and 60 – 80% of total calories comes from fat with the remainder from protein.

Eating in this fashion induces ketosis, which occurs when the body produces ketones for fuel. Ketones are produced when the body uses fat as energy instead of carbohydrates.

Benefits of the ketogenic diet

After reviewing the scientific literature, the interest in the ketogenic diet is justified due to a host of beneficial effects. Initially the keto diet was used to reduce seizures in those suffering from epilepsy back in the 1920’s, however since then a host of other benefits have been discovered.

Proven benefits of the keto diet:

• • efficient and often rapid weight loss
  • reversing type 2 diabetes
  • lowering blood pressure
  • reducing insulin levels
  • alieviating PCOS symptoms
  • reducing free testosterone in women (Batch et al., 2020)
  • reducing inflammation
  • symptom management for chronic diseases (Crosby et al., 2021).
  • it has even been proven to starve cancer cells (Dowis & Banga, 2021)!

However, despite some strong evidence on the health benefits of this diet experts remain divided on what the best diet is.

Comparing keto to the standard western diet (SAD)

The Australian dietary guidelines recommends that the majority of our energy intake is from carbohydrates. Between 45% – 65% of the diet is recommended to come from carbohydrate sources. On a 2,000 calorie diet, (the average suggested calories for an adult), a whopping 300 grams of carbohydrates is recommended a day. 300 grams a day is much higher than the 15 – 30 grams of carbohydrates recommended on the ketogenic diet.

Weight loss and keto diet

A significant body of research exists regarding the ketogenic diet and weight loss. Evidence points to a ketogenic diet resulting in significantly more weight loss than a low-fat diet. Although there is some evidence that a vegetarian diet that is extremely low in fat – less than 10% of energy intake – had better weight loss results (Crosby et al., 2021). Ketogenic diets have a better basal metabolic rate however which affects the body’s ability to burn calories efficiently (Masood et. al, 2022). Short term studies have shown that being in ketosis increases calorie expenditure in comparison to diets higher in carbohydrates (Crosby et al., 2021).

Although there has never been more research and information on nutrition, obesity and chronic disease is an epidemic of growing proportions. According to the World Health Organisation 2.8 million die each year as a consequence of being overweight or obese (WHO, 2021). In Australia the government states that 2 in 3 adults and 1 in 4 children are overweight or obese (AIHW, 2017).

It is not just obesity that is on the rise, unfortunately poor nutrition is associated with a host of other health issues such as high blood pressure, type 2 diabetes, some cancers, cardiovascular disease, fatigue, brain fog, depression, poor immune health, chronic inflammation, poor wound healing and more (Oz, 2017).

Issues with the ketogenic diet

This diet can be difficult to maintain long term, however that can be said for almost any diet. Particularly when the majority of social events are centred around foods that are rich in carbohydrates, sugar and unhealthy fats.

Another potential issue is that studies showing the effects of maintaining this diet more than two years are lacking.

There are some concerns with getting enough fibre in the diet which affects the beneficial bacteria in the gut. The fibre from a variety of fruits and vegetables is necessary for the production of short chain fatty acids.  Short chain fatty acids assist with the absorption of nutrients, hormones and healthy immune function. Studies show that these fatty acids also have a protective effect against cancer and decrease inflammation (Crosby et al., 2021).

However it is still more than possible, a list of high fibre and low carb foods have been provided below.

When an extremely low number of carbohydrates are consumed over a long period of time as a result of eating only specific fruits and vegetables nutrient deficiencies can occur. Even when only nutrient dense foods are consumed nutrient deficiencies are still common (Crosby et al., 2021).

What foods can you eat on a keto diet?

Low carb high fibre vegetables, fruit and nuts

It is still possible to get adequate fibre intake on a low carbohydrate diet, however education on high fibre low carb foods is important.

Vegetables

• All leafy greens such as spinach, bok choy & rocket
• Lettuce
• Broccoli
• Cauliflower
• Brussels sprouts
• Cabbage
• Celery
• Zucchini
• Cucumber
• Artichoke
• Mushrooms

Fruit

Unfortunately, most sweet fruits are high in carbohydrates. For example one large orange or apple will most likely push you over the daily carbohydrate limit.

• Avocado
• Olives
• Tomato
• Eggplant
• Blueberries
• Raspberries
• Raw coconut
• Strawberries
• Blackberries

 Nuts & seeds

The below are the best options, cashews and pistachios should be avoided as they have a higher carbohydrate content.

• Almonds
• Brazil nuts
• Pecans
• Macadamias
• Chia seeds
• Flaxseed
• Hemp seeds
• Walnuts

 Seafood

Aim for wild caught and lower mercury seafood such as oysters and other shellfish, trout, salmon, whiting and anchovies. Limit tuna and avoid swordfish, barramundi and flake as they tend to have higher levels of heavy metals. Heavy metals accumulate in older and bigger fish that eat other fish.

Meat

Choose grassfed and organic where possible. It is important that the animals are eating as natural diet as possible. Often conventional livestock are fed GMO, heavily sprayed crops such as soy, corn and other grains. These grains are usually lower quality than ones ‘fit for human’ consumption and can be mouldy. Mould is of course best avoided; it can start growing in the digestive tract and cause a host of problems.

Dairy

The keto diet tends to be quite high in dairy products such as cheese, dairy can be inflammatory for people, depending on the composition of your gut microbiome. One the other hand dairy from pastured animals can be quite healing for others.

Fats

Olive oil, coconut, ghee and butter are the best options. When consuming a high fat diet it is more important than ever to be consuming beneficial fats instead of loading up on highly processed and inflammatory seed oils. Avoid any seed / vegetable oil as they are highly processed and heat treated to extract the oils, deodorised and bleached.

Before going keto

Before going keto is wise to get in touch with a trusted and knowledgeable nutritionist. This is because going keto is often a major dietary change which may have some side initial effects known as ‘keto flu’. Keto flu is a group of symptoms which may appear when first commencing and can include feeling nauseous,  dizzy, fatigued, headaches and gastrointestinal discomfort. There are a range of theories why this occurs, my theory is that it causes sudden and significant microbiome changes which can cause the carb loving bacteria to die off causing a herximer reaction.

For those with extensive health issues or those seeking optimal health it may be worth considering gut microbiome testing and testing for nutrient deficiencies in order to correct them first.

Conclusion

In light of this evidence, are the high carbohydrate government dietary guidelines suitable when the obesity epidemic is continuing to increase at an alarming pace? Whilst I am against a strict keto diet on a long-term basis, short term it can be extremely beneficial for health for a variety of reasons. It is particularly beneficial for those who are obese and / or have a chronic disease.

Generally, I am a believer in a higher fibre and phytonutrient intake from a more diverse range of fruits and vegetables than keto offers. However, it is generally a good idea to keep starchy, often white or beige carbohydrates low for optimal health and lower inflammation.

There is no one diet that is going to be the best fit for all people unfortunately. It is best to get in touch with an expert who can help guide you on a personalised diet plan to meet your nutrient requirements, deficiencies and any possible intolerances. Contact me today to work with a university qualified nutritionist who specialises in gut health, intolerances and micronutrient deficiencies.

I would love to work with you on finding your optimal diet, book an appointment with me here.

References

AIHW. (2017). Overweight & obesity Overview. Australian Institute of Health and Welfare. Retrieved 9 September 2022, from https://www.aihw.gov.au/reports-data/behaviours-risk-factors/overweight-obesity/overview

Batch, J., Lamsal, S., Adkins, M., Sultan, S., & Ramirez, M. (2020). Advantages and Disadvantages of the Ketogenic Diet: A Review Article. Cureus. https://doi.org/10.7759/cureus.9639

Crosby, L., Davis, B., Joshi, S., Jardine, M., Paul, J., Neola, M., & Barnard, N. (2021). Ketogenic Diets and Chronic Disease: Weighing the Benefits Against the Risks. Frontiers In Nutrition, 8. https://doi.org/10.3389/fnut.2021.702802

Dowis, K., & Banga, S. (2021). The Potential Health Benefits of the Ketogenic Diet: A Narrative Review. Nutrients, 13(5), 1654. https://doi.org/10.3390/nu13051654

Masood W, Annamaraju P, Uppaluri KR. Ketogenic Diet. [Updated 2022 Jun 11]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK499830/

Oz, H. (2017). Nutrients, Infectious and Inflammatory Diseases. Nutrients, 9(10), 1085. https://doi.org/10.3390/nu9101085

WHO. (2021). Obesity. Retrieved 9 September 2022, from https://www.who.int/news-room/facts-in-pictures/detail/6-facts-on-obesity#:~:text=Obesity%20has%20reached%20epidemic%20proportions,of%20being%20overweight%20or%20obese.

By nutritionist Chrissy

Chrissy is a university qualified nutritionist who graduated with honours at La Trobe University in Melbourne. One of her favourite hobbies is to read the scientific literature on how to optimise health. When she’s not reading, writing or working she’s with her 3 children outdoors, practicing yoga, jogging or cooking up a storm in the kitchen. Chrissy has overcome some debilitating chronic health issues (low mood, adrenal fatigue, insomnia, very bad acne to name a few) with the power of nutrients and correcting gut health, at 39 she now feels better than she did in her 20’s.