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Are ketogenic diets the best for weight loss?

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Have you heard all the buzz recently about going keto?

Back in 2017 I wrote an article on diet trends and made a prediction that keto diets would be all the rage. It seems I hit the nail on the head. Somebody should buy me a lottery ticket.

Followers and promoters of the ketogenic eating pattern are popping up thick and fast and now include the likes of Pete Evens, Guy Sebastian, and Gwyneth Paltrow.

So, is the diet all it’s cracked up to be?

Ketogenic books, detoxes, cleanses, supplements and programs often proclaim they use a science-based approach. Upon closer look, many promoters pick and choose which scientific papers they reference and don’t often present you with a balanced view.  This is further compounded by the arguments for the diet’s use being based on anecdotal evidence (personal testimony). This kind of evidence is highly subjective and flawed, particularly in comparison to more rigorous forms of research like a randomized controlled trial, subjected to peer review.

The problem is, any good marketer knows that personal testimony is far more effective at convincing its audience than a rigorously conducted scientific study. We can’t connect emotionally to a research paper, but it’s super easy to connect to a story about a person who struggled with the same struggles that we do and then found the answer they were looking for.

That being said, there is evidence to support the use of ketogenic diets in a number of circumstances such as treating epilepsy and obesity. When it comes to weight loss, however, the research does not say that it’s superior to other dietary methods, which is commonly touted by its promoters above.

What is a Keto diet?

The word ‘keto’ is short for ketogenic. To make complex biochemistry as simple as possible, a ketogenic diet is a very low carbohydrate diet that if followed for long enough, forces the body to metabolically adapt to burning fat.

The lack of carbohydrates means the fat is metabolised differently and it’s converted into a group of chemicals called ketones. This metabolic adaptation is called ketosis. The brain can’t use fat for energy, it prefers glucose. Being in ketosis means your brain can still function without glucose (carbohydrate)  because it switches over to using ketones for energy instead.

The metabolic adaption, combined with a decreased energy intake, which is easy to achieve after cutting a large amount of carbohydrate rich foods out of your diet, results in rapid weight loss, particularly in the first few weeks. Once ketosis has fully kicked in it can also suppress your appetite, helping with weight loss even further.

To achieve ketosis, you need to reduce your carbohydrate intake down to a maximum of 20-30g per day.  The challenge is that carbohydrate is present in nearly all foods, not just the obvious ones. It’s in processed foods, grains, legumes, starchy vegetables and fruit, but it’s also in dairy, other vegetables, nuts, and seeds. Ensuring your keto diet is well-planned and contains plenty of nutrient dense whole foods, is just as vital as reducing the carbs.

When you first start reducing carbohydrates you feel pretty awful. It’s common to get headaches, feel nausea and irritability. Once you’re in ketosis, you start to feel better as your brain switches over from glucose to ketones to function.

Unfortunately, ketosis alone is not enough to result in weight loss. You have to create an energy deficit. If you’re still consuming more energy from food than your body needs, you won’t lose weight. You might be in ketosis and your body is burning fat, but it’s burning the excess fat from your diet, not from your body’s fat stores.

Does it work?

Over the short term, if you consistently stick to it and create an energy deficit, a ketogenic diet will result in weight loss. However, whether the diet works or not shouldn’t really be your question. Most diets will work, provided they create an energy deficit and you can stick to it consistently.

Consistency is the key here. Deviating from the diet on occasions or not cutting back on the carbs enough will mean that you won’t achieve ketosis and weight loss won’t happen.

Also, what about when you stop the diet? How do you intend on maintaining your weight loss?

Do you want to avoid carbohydrate rich foods forever? If not, you’ll want to pay close attention when you start introducing them back in, so you can find a healthy balance. Introducing carbs back into your diet shifts the body out of ketosis. Combine this with an increased appetite that occurs from the body going through a period of dietary restriction and an environment of delicious, carbohydrate rich foods and you’re in a prime position to overeat. This can then lead you to feel guilty about your food choices and tempted to restrict carbs again. This restriction/binge cycle breaks your consistency and is a common post-keto diet effect I see in many people who have come to me trying to find a more balanced approach.

It’s also important to note that we don’t know the long-term effects of the body remaining in ketosis indefinitely.

Potential pitfalls 

It limits a range of healthy foods
A ketogenic diet removes or greatly limits perfectly healthy foods. Lots of research supports the benefits of regularly eating whole grains, legumes, starchy vegetables and fruit, all foods that need to be removed from your diet in order to achieve ketosis. These foods provide a range of nutrients shown to be essential in our diets. In fact, the research supporting a plant-based diet, which is often higher in carbohydrate, is very strong.

It’s difficult to meet the recommended vegetable intake
Vegetables are the cornerstone of a healthy diet and provide vitamins, minerals, a range of phytochemicals and fibre. They’re important for immune function, gut health and heaps more. Vegetables contain small amounts of carbohydrate, but you’re not supposed to consume much carbohydrate on the ketogenic diet, only 20-30g. To give you some perspective, 5 serves of vegetables (depending on what you choose) is approximately 15g of carbs. This means that if you have carbohydrates from another food source, you may run out of room for your vegetables. Prioritizing the vegetables is vital if you’re following this diet and you mustn’t let other carbohydrates push them out. You need the nutrition as well as the fibre, talked about below.

You can’t meet your daily fibre intake
Constipation is a common side effect of a ketogenic diet. This is because fibre, vital for a healthy, functioning gut is found in foods like wholegrains, legumes, fruit and starchy vegetables, all foods that are removed from this dietary pattern.

It’s recommended that you include 25-30g of fibre per day. This is impossible when you can only consume 20-30g of carbohydrate per day.

My verdict

If you plan your keto diet well and build habits to stay consistent, then it will help you lose weight. Just be mindful that what you’re doing may not be sustainable long-term and that you will have to eventually learn how to eat well for the rest of your life, not just over the short term.

I find it difficult to promote a dietary pattern that removes a range of healthy foods that we know promote good health in our bodies, especially when I can help people lose weight while eating from all food groups.

Regardless of the approach you take, if you want to lose weight you need to:

  • create an energy deficit
  • be consistent every single day
  • ensure high diet quality

And to do the things above you need to create a sustainable approach built on daily habits. If that’s what you’re after, I can help.

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