What is it and how to do it. Does it work? Do you have results? Ketogenesis? Definitive Guide to the Ketogenic Diet

The ketogenic diet, also known as the keto diet, is a weight loss eating plan that seeks to increase fat intake and significantly decrease carbohydrate intake.


Today, the efficacy of this diet and its results have been subjected on multiple occasions to the rigor of the scientific method – and in all of them, it has escaped unscathed.

So far, most health professionals and nutritionists consider the diet to be effective for rapid, intense, and safe weight loss.


This food modality is not only applied to eliminate overweight, but it also has medical applications.

ketogenic diet

It seems to be a treatment for different pathologies, such as diabetes, epilepsy, among others.


When the body detects a shortage of carbohydrates, it modifies the biochemical pathways that take place inside the cell.

Since there is no glucose, this eating plan forces the body to generate energy analogs called ketone bodies, generated by the excision of fats.


How does fat loss occur by consuming more fat? Is the ketogenic diet safe? Who should apply it? Does the ketogenic diet fit my weight loss goals?

This and other questions about the famously controversial high-fat diet will be answered in this article, based on the latest scientific research.


Historical Perspective


The ketogenic diet dates back to the early 1920s. The first person to use this term in nutrition was Russell Wilder, who introduced this dietary measure as a treatment for epilepsy.


In the same period, Harvard doctors Stanley Cobb and W.G. Lennox noted how fasting helped treat the symptoms of the disease, agreeing with the idea that treatment of the disease should be related to dietary modifications.


For more than a decade, the diet was very popular as a treatment for this condition, specifically in the pediatrics area.

Subsequently, the pharmaceutical company succeeded in producing epilepsy agents, which eventually displaced the meal plan.


Currently, the ketogenic diet “revived” and, almost exponentially, achieved great popularity, being widely used by users who want to lose weight quickly and easily.

It is also used as a treatment for type 2 diabetes and other conditions – we will further develop its medical applications.


Lose Fat by Eating Fat: What to Eat for the Ketogenic Diet?


In a typical American diet, we will find that more than 50% of the components are carbohydrates. Every day, this person would consume between 200 and 250 grams of carbohydrates.

In addition to the intake of processed foods, this high intake of carbohydrates is not recommended.
In essence, the ketogenic diet consists of strictly reducing carbohydrate intake, moderating protein consumption, and increasing fat intake.


Based on a standard diet of 2,000 calories per day, during the ketogenic diet carbohydrate intake should not exceed 20 to 50 grams per day.

In percentage terms, an average ketogenic diet is divided into:

  • Fats, with more than 60% of the diet
  • 30% protein
  • 10% carbohydrate

Later on, we will see that there are variations of these percentages.


A well-formulated ketogenic diet not only limits carbohydrate intake, but it also involves a moderate to low protein intake of no more than 1 gram per kilogram of body mass.

This varies if the person who wishes to follow the diet is constantly attending the gym. In the case of intense physical work, protein intake can increase to 1.5 grams per kilogram of body mass. Therefore, there are several types of ketogenic diets.


Types of ketogenic diets


Today, nutritionists have developed a series of variations of the ketogenic diet that seeks to meet the requirements and habits of people who want to join this lifestyle. The most popular are:


As we saw the fundamental principle behind all variants is to keep carbohydrate intake to a minimum.

Standard ketogenic diet

70% fat, 20% protein, 10% carbohydrate.

Cyclic ketogenic diet

This diet is based on alternating periods of carbohydrate consumption with the ketogenic periods described in the standard diet. For example, five days with a maximum carbohydrate restriction and two days with moderate intake.

“White” ketogenic diet (targeted)

This modality allows the addition of extra carbohydrates in periods where the person will be under physical stress, such as intense training. It is widely used by people who perform some sport, such as athletes or weightlifters. This is a very common question among people interested in doing it, since they want to lose weight but without losing the ability to attend the gym and have a good performance in it.

High protein ketogenic diet

This last variant of the diet seeks to increase protein intake, modifying the ratio of nutrients to 60% fat and 35% protein.


Who should follow a ketogenic diet?


When choosing a meal plan, we must ensure that the dynamics of the diet are in line with our goal – just as we would with a training plan.

When we go to the gym we train our muscles according to what we want: if we want to lose weight we will do strong aerobic sessions. But if we want to gain muscle mass we will focus on weight lifting. The same goes for choosing a diet.


Currently, there are more than two dozen diets that promise rapid and effective weight loss without health compromises.

So what are the advantages of the ketogenic diet over its diverse alternatives?
The most notable result of a ketogenic diet is weight loss.

If this is our goal, we can ask our doctor or nutritionist to start this meal plan.

In contrast, if our goal is to gain weight, tone our body, gain muscle mass, etc., it would be advisable to look for another system that suits our purpose.


Who shouldn’t follow a ketogenic diet? , is kept diet safe?


It is suggested that people suffering from medical conditions such as diabetes, blood pressure problems, pancreatitis, liver failure, disorders related to fat metabolism, deficiency of carnitine, and some enzymes related to central metabolism, among others, should be cautious when implementing the ketogenic diet.


Pregnant and breastfeeding mothers should carefully consider whether or not to implement this feeding plan. It could have consequences for the baby and for the quality of breastfeeding.


As with any drastic dietary change, a prior medical check-up is suggested to ensure that the body will receive adequate carbohydrate reduction in daily meals.


What foods will I eat and what won’t? what can you eat on a keto diet?


The ketogenic diet is based on the high consumption of meats, eggs, sauces, cheeses, fish, among others.


As for fats, the diet focuses on the consumption of natural and “healthy” fats found in high proportions in foods such as avocado, nuts, coconut oil, among others.

Logically, we are not going to establish a diet based on hydrogenated oils such as margarine or palm oil.

It is an extremely restrictive diet, so its followers face multiple drawbacks to follow in the long term.


The foods to avoid are high in fiber and carbohydrates, namely:

  • Pasta
  • Chocolates and other sweets
  • Rice
  • Fruit, among others.

If you have not been clear about the foods allowed for this wonderful diet, we leave you more information here.


What drinks are allowed?


However, the ketogenic diet does not restrict our drinks to a simple glass of water. We can include tea or coffee (avoiding sugar or sugar-beating coffee), and we can add a little milk in a moderate way.


As for alcoholic beverages, the diet does not include beers. Today there are some variants of this drink, which have decreased its caloric content to enter into the foods allowed in this diet.


However, moderate consumption of red and white wine is allowed. Other stronger drinks, such as vodka, brandy, whiskey, tequila, etc., can be consumed but without adding any type of sugar and juice.


However, the consumption of these drinks tends to destabilize the diet. Not because of the drink itself, but when an individual consumes alcohol, it increases the likelihood that he or she will abandon the diet and consume some of the “forbidden” foods.


Physiology of the ketogenic diet


In our diet, we consume three main macromolecules or biopolymers: carbohydrates, lipids, and proteins.


When we consider a specific food plan, we must properly balance these three nutrients. Its success will depend on this.


The famous ketogenic diet proposes the consumption of foods high in fat and low in carbohydrates. You’re probably thinking that fat intake and weight loss are contradictory.

Popular knowledge indicates that high-fat consumption is related to a number of pathologies such as coronary heart disease, diabetes, cancer, among others.


This new balance of nutrients tries to simulate in the body the conditions of a fast so that the body uses as the main source of energy the fats and not the carbohydrates – since they are absent.


To understand why the ketogenic diet is effective, we must delve a little deeper into the chemical reactions that occur in our metabolism.


What happens when we don’t eat carbohydrates? What does it mean to be in a state of ketosis: gluconeogenesis and ketogenesis?


Our body’s favorite energy source – particularly our brain – is glucose and carbohydrates in general.

The reactions that degrade them allow the production of energy in the tissues of our body, which drive life.


When we deprive our body of carbohydrate intake (less than 50 grams per day) the secretion of insulin is reduced and the body must make some metabolic adjustments, entering what is known as the “catabolic state”.


Once the body’s energy reserves are depleted (we store it in the form of glycogen), two pathways begin glyconeogenesis and ketogenesis.


The first metabolic pathway is an internal or endogenous pathway of the body that takes place in the liver and the final product is glucose.

However, this internal production is not sufficient if the lack of glucose is prolonged. At this point comes into play the metabolic pathway that gives the name to our diet: ketogenesis.


Ketogenesis and ketone bodies


Ketogenesis consists of the production of chemical compounds that will serve as an alternative to glucose and replace it as the main source of energy.

These are the ketone bodies, and they are the protagonists of the diet. There are two main types: acetoacetate and β-hydroxybutyrate, both of which are the product of fat breakdown.


The production of ketone bodies occurs mostly in the heart, muscles, and kidneys.


During this process, changes in insulin levels and low carbohydrate intake result in a significant reduction in the accumulation of fat and glucose in the body.

At the same time, these hormonal changes contribute to the degradation of existing fats, promoting weight loss.

In addition, ketone bodies can control excess free radicals, thanks to their antioxidant capacity.


Not to be confused with ketoacidosis!


The metabolic process we have just described includes what happens inside our cells when we correctly apply the ketogenic diet.


This nutritional ketosis is considered by professionals to be a safe state, where the ketone bodies are in the bloodstream in low amounts – so that the pH (i.e. the level of acidity) of the blood is not altered.


Another event that is related to ketone bodies is ketoacidosis.

However, this state is quite dangerous, it could even be considered life-threatening! It occurs when ketone bodies increase in concentration, altering the pH of the blood. When the diet is followed correctly, this event does not occur.


Will, the ketogenic diet make you hungry?


A cliché image of a restrictive diet is the assault on the refrigerator late at night. However, as the ketogenic diet is high in fat, people who follow it feel full most of the time, as fats have an optimal ability to fill us up.


Thanks to this property of satiating for many hours, several of the people who follow the ketogenic diet also include intermittent fasting, which consists of reducing feeding hours – not reducing the quantity or quality of food.

Advocates of intermittent fasting argue that they consume the food they need when “the body really needs it.


That is, instead of eating breakfast at 7 a.m. and ending the day with dinner at 7:30 p.m., intermittent fasting restricts feeding hours to more confined spaces, such as 1 p.m. to 7 p.m.

So if you are one of those people who are intolerant of hunger, but want to lose a few pounds, you could consider this diet within your options.


Is the ketogenic diet a weapon against epilepsy?


As we mentioned, the genesis of the ketogenic diet was related to the creation of a feeding plan against epilepsy. But does it really work?


Epilepsy is a neurological disorder, common in the population. Since time immemorial this pathology has been treated with modifications in the patient’s diet. For example, more than a century ago it was simply a matter of fasting.


According to the research, the ketogenic diet (including the variants mentioned) is a viable alternative to patients who cannot use the drugs for various reasons, or who are resistant to them.


Generally, the version for children and adolescents who suffer from this condition is more pleasant in terms of taste and is less restrictive.


The ketogenic diet as a weapon against obesity, losing weight with the ketogenic diet


There is no doubt that obesity is an epidemic. Significant excess weight has been linked to a wide range of cardiovascular diseases and metabolic disorders, including hypertension, diabetes, and even certain types of cancer. It has been estimated that 2.8 million people die each year from this condition.


Obesity does not have a single direct cause; it involves a series of environmental and genetic factors that together will define a person’s weight. It is therefore difficult to pinpoint a single solution, although the ketogenic diet appears promising.


As mentioned, proper implementation of a ketogenic diet results in weight loss. For these reasons, it is usually used in patients suffering from obesity.

If you want more information on how to lose weight without exercising, we recommend that you read this very interesting article.


According to a review published in the International Journal of environmental research and public health by the researcher Paoli (2014), the ketogenic diet is effective to fight against this health problem.


Is the keto diet effective? Outcomes


Short-term results


Diet outcomes vary from individual to individual. Most commonly, however, a person loses more than 10 kilos in an average of 2 weeks.


As the diet has an initial diuretic effect, the first few days weight loss is due to water loss. Subsequently, the body continues losing weight, but this time due to fat loss.


Diet also has other results that go beyond weight loss. It tends to improve blood sugar levels, which is very positive for patients with diabetes.

The regulation of cholesterol levels is not congruent with the studies performed.


The transition to the diet should be gradual and controlled, with constant testing of kidney function.


This weight loss is rapid and intense, so the person often feels pleased with the progress of the diet.

The effects of the diet have been mostly short-term, and the most salient conclusions assume that weight loss can be sustained for at least two continuous years.

So far, the procedure is considered to be safe, tolerable, and effective.


Short-term complications tend to be few, such as dizziness, vomiting, and poor tolerance for physical activity. But they can be treated quickly with serum intake.


Long-term results


Unfortunately, there are few studies that have thoroughly evaluated the long-term effects of the diet – it is difficult to follow up on patients who are willing to maintain this mode of feeding, as it is usually implemented for short periods of time.


A long-term study was conducted by a group of researchers and published in the journal Experimental and Clinical Cardiology.

Based on this evidence, the ketogenic diet has long-term benefits, such as lowering cholesterol and triglycerides. This study helped demonstrate that the ketogenic diet appears to be safe for long periods of time.


We know that not everything can be positive, so we also have the negative side of the diet. Some nutritionists do not recommend it and do not consider it safe in the long term.

Under this nutritional perspective, a healthy diet involves all of the macro-nutrients in adequate amounts to avoid generating stress on the body.

Could the ketogenic diet put you in jail?

Suppose you are driving your car, while you are following your ketogenic diet to the letter.

Unfortunately, you pass the speed limit and are stopped by the police. The officer doubts you, and routinely decides to implement a breath alcohol test and comes out positive!

What if you haven’t had any alcohol in months? Acetone in the body can be converted to isopropanol by an enzyme in the liver, generating a false positive.

Although this event is not very common, it is one of the curious facts of the diet. Therefore, it is normal to feel a strange taste in your mouth.


References


Ávila, E. (2006). La dieta cetogénica. Rev Chil Epilepsia, 1, 25-33.
Boison D. (2017). New insights into the mechanisms of the ketogenic diet. Current opinion in neurology, 30(2), 187–192.


D’Andrea Meira, I., Romão, T. T., Pires do Prado, H. J., Krüger, L. T., Pires, M., & da Conceição, P. O. (2019). Ketogenic Diet and Epilepsy: What We Know So Far. Frontiers in neuroscience, 13, 5.


Dashti, H. M., Mathew, T. C., Hussein, T., Asfar, S. K., Behbahani, A., Khoursheed, M. A., … Al-Zaid, N. S. (2004). Long-term effects of a ketogenic diet in obese patients. Experimental and clinical cardiology, 9(3), 200–205.


Feinman, R. D., Pogozelski, W. K., Astrup, A., Bernstein, R. K., Fine, E. J., Westman, E. C., … & Nielsen, J. V. (2015). Dietary carbohydrate restriction as the first approach in diabetes management: critical review and evidence base. Nutrition, 31(1), 1-13.
González, O. (2019). Alcohol y dieta cetogénica:¿ cuál es el alcohol bajo en carbohidratos?. Compartir, 3, 25.


Masood, W., & Uppaluri, K. R. (2019). Ketogenic Diet. In StatPearls [Internet]. StatPearls Publishing.
Paoli A. (2014). Ketogenic diet for obesity: friend or foe?. International journal of environmental research and public health, 11(2).


Paoli, A., Bianco, A., & Grimaldi, K. A. (2015). The ketogenic diet and sport: a possible marriage?. Exercise and sport sciences reviews, 43(3), 153-162.