The Ketogenic Diet - Naturopathic Perspectives

A lot of buzz has been generated about the ketogenic, or “keto,” diet. This nutritional plan consists of eating a diet that is low in carbohydrates and high in quality fat, preferably from quality sources. The basic ketogenic food groups include:

Background and Health Benefits

• High-fat dairy
• Meat
• Eggs
• Low-starch vegetables
• Some Fruits (berries, lemon, lime)
• Healthy oils
• Spices
• No Sugar beverages (water,tea,coffee)

The history of the ketogenic diet is deep-rooted in medicine from the 1920s as a treatment for epilepsy; however, there are Biblical references in the New Testament from Matthew 17:14–21 referencing this treatment as a cure for an epileptic.[1] With a positive side effect of more than just weight loss, the ketogenic diet has also received attention because this nutritional plan has shown positive results and, at times, better results than conventional treatments for patients with metabolic syndrome and a variety of chronic diseases, such as Alzheimer’s, diabetes, obesity, cancer, autoimmune disease, reproductive disease, infertility, and cardiovascular disease.[1][2][3][4][5][6][7]

Flipping the Metabolic Script

How does a ketogenic, or a low-carbohydrate high-fat (LCHF), diet work? The standard Western diet relies primarily upon carbohydrate consumption, which tends to come from fast foods, restaurants, sodas, sugary foods, and overly processed foods.[4] Did you know a diet higher in carbohydrates goes hand-in-hand with lower fat consumption?[6] Fat is necessary for basic metabolic functions such as hormone synthesis, nutrient absorption, maintaining core temperature, and providing energy. Furthermore, diets high in sugar have been linked with increased risk of atherosclerosis and other coronary heart disease, as sugary diets promote insulin and leptin resistance, malfunctioning platelets, impaired glucose uptake, nonalcoholic fatty liver disease, and increased blood levels of uric acid, glucose, and insulin.[3]

Ketosis is achieved when dietary carbohydrates are reduced dramatically. This results in a decrease in insulin production and resultant decrease in fat formation, or lipogenesis.[1][3] Ketosis results when the body utilizes ketones for fuel instead of glucose. Health benefits from ketosis include better blood-sugar regulation, less hunger and cravings, food satisfaction and satiety, natural weight loss, improved energy, and improved mental clarity.[1][2][3][4][5][6][7] With your body’s insulin being at a reduced level in ketosis, it will naturally burn fat for fuel. Pretty cool!

Is the ketogenic diet safe? The first thing most people criticize about the ketogenic diet is the notion of an increase in cholesterol values. Researchers have found favourable blood-lipid panel profiles for participants following LCHF diets.[3][4][5][6] Furthermore, researchers have linked lower fat consumption with increased risk for total mortality, including both cardiovascular and noncardiovascular diseases, such as stroke, myocardial infarction (MI), and diabetes.[3][5][6][7] The common denominator in chronic disease and a subsequent increase in associated mortality events is linked more to insulin resistance and metabolic syndrome.[3][7]

The literature vastly shows the ketogenic diet to not only be effective, but also safe. With any nutritional plan, the guidance of a qualified provider—such as a naturopathic doctor, functional medicine practitioner, and/or nutritionist—is preferred, along with recommended monitoring of progress and outcomes including vital signs, laboratory values, and reported signs and symptoms.

Ketogenic Basics

Before starting a ketogenic diet, each individual will need to fine-tune their ketogenic diet plan or “find their macros.” An individual’s specific amount of daily grams of net carbohydrates (calculated by taking total carbohydrates and subtracting the fibre), protein, and fat requirements will vary slightly. Variables to be considered when macros are calculated include gender; amount of physical activity; and health goals, such as weight loss, muscle building, and/or disease management. When starting the ketogenic diet, the first two weeks most individuals will need between 20 and 25 g of net carbohydrates per day. From that point, most individuals will need between 30 and 50 g of net carbohydrates per day.[1] In this wonderful age of technology, there are free apps you can download to your phone to help you calculate your macros! Typically, a ketogenic diet will consist of the following percentage of daily calories: 75% from fats, 20% from protein, and 5% from carbohydrates. A simpler way to think about this is in grams of net carbohydrates per day as mentioned above.

Eating a ketogenic diet does not mean you get a free pass to eat all the bacon that you want! Try to avoid processed polyunsaturated and processed trans fats, such as vegetable and seed oils as well as processed meats. Your ketogenic fat friends are of the saturated, monounsaturated, natural trans, and natural polyunsaturated types of fat. Saturated fats include:

• Red Meats
• Butter
• Coconut oil
• Ghee
• Heavy Cream
• Eggs

Monounsaturated fats include:

• Avocados
• Extra virgin olive oil (EVOO)

Natural trans fats include:

• Grass-fed meats
• High-fat dairy

We will talk more about food quality later. Lastly, examples of natural polyunsaturated fats include:

• Fish
• Nuts
• Seeds

The ketogenic diet is founded upon principles of adhering to certain food groups; however, in order to be safe and successful, a few basic tips must be followed. With higher circulating ketone bodies with the shift to a fat-burning metabolism, make sure you are drinking at least 2–3 litres of water per day. Also, make sure to keep your electrolytes in balance, especially potassium, magnesium, and calcium. The biggest mistake most ketonians make when following a ketogenic plan is they don’t eat enough fat. Make sure you are hitting your macros and track your progress. These tips can also help you avoid the “keto flu,” which results from a shift in water and electrolytes as the body is shifting into ketosis. Exogenous ketone supplements can help to expedite this process. Find a support group locally or online. You never know what new friends await you in the keto community! Lastly, stay organized and try to meal-plan. This will save you time, money, and loads of frustration or obstacles.

Remember the notion of food quality we talked about earlier? When adopting any nutritional plan in order to lose weight, enhance your health, and/or manage specific diseases,it is always a good idea to find the best-quality sources of food possible. Think of a scale using a “good-better-best” approach. Organic; non-GMO; locally sourced; grass-fed; and free of hormones, gluten, dairy, and/or specific allergens are key words to look out for when searching for your best-quality sources of food. Phrases such as “all-natural” on foods can be misleading, with a common practice called greenwashing. Look at your nutritional labels and food apps to help you identify the quality of the ingredients in your food. This way, you will marry the benefits of adopting a ketogenic nutritional plan with high-quality foods in order to achieve your health and wellness goals.

Conclusion

Are you not sold on the keto mind-meld yet? Yes, it is an entirely new concept to adopt, considering most of us have been raised on the concept of a low-fat diet as being hearthealthy and saturated fat being the enemy. Once you get it and try it, you will be able to debunk the low-fat diet myths and wonder, “where has keto been all of my life?” I have seen clients, friends, family, and myself transform from this life-changing nutritional plan.