The ketogenic diet (Keto for short) is currently the buzz word among everyone from celebrities and athletes, to friends and neighbors. I hesitate to call it a diet because it’s really a lifestyle. Ketosis is the state the body enters when the liver starts breaking down fat for fuel instead of glucose for energy. For the body to maintain ketosis, a high fat, moderate protein and low carbohydrate intake must be maintained. Keeping carbs under 20 grams a day is ideal especially in the beginning stages. How does eating more fat cause the body to lose weight? 

There are two dominating theories of weight loss: the energy balance theory which says take in less calories than you burn and the endocrine theory that says our hormones determine fat storage, which is the hypothesis the ketogenic diet is based upon. We communicate with our bodies by the foods we eat. When we are in a state of nutritional ketosis we no longer experience blood sugar spikes which in turn keeps insulin levels low. Low insulin levels signal our bodies to tap into our own fat stores for energy and stimulates a catabolic state of fat burning as opposed to fat storing. The end product of broken down fats are ketone bodies which our cells use as energy instead of glucose, the broken down product of carbohydrates. 

For decades in our country fat has been demonized as the culprit for heart disease and atherosclerosis (now proven to be wrong science), and as a result, our diet consists predominantly of carbohydrates in the form of sugar and grains. We now know that inflammation in the culprit for almost every chronic reversible disease like diabetes, heart disease, arthritis, chronic pain, autoimmune disease and even cancer. To many people, the concept of restricting grains, fruits and some vegetables seems extreme. It exposes the level of brainwashing we’ve been subject to when you go into any grocery store and find that 80% of the foods have sugar added to them. Navigating the grocery store becomes a job! There are hidden sugars in everything, even packaged meats. To become your own health advocate, you have to read every label and educate yourself on how whole food nutrition is both paramount in preventing and treating disease. 

Changing the way we eat can be overwhelming at first. A great way to start is to eliminate processed foods. Anything that comes in a package or has to undergo chemical processing to make it edible is not food! This includes all vegetable oils. The best oil to consume is olive oil, coconut oil or avocado oil. Concentrate on whole foods that are high in fat like eggs and butter, avocado and nuts(not peanuts or cashews) and pair with high quality protein such salmon, grass fed beef and pork. Full fat dairy is considered ketogenic, but for some, it may be a source of inflammation. Carbs should come in the form of nutrient dense greens, asparagus, broccoli, cauliflower, fiber rich vegetables, with the avoidance of beets, carrots, corn, legumes, and any starchy vegetables. Grains like pasta, bread, rice, oatmeal, cereal, are off limits. 

Proper keto meals allow you to feel full so snacking isn’t really an issue. Because of the nutritional (macro) content of ketogenic eating, portion control comes naturally. Nourishing fats and proteins are satiating and make you feel full because of the restored presence of the fullness hormone, leptin. Carbs suppress the secretion of leptin so it’s easy to overeat on a high carb low fat diet. Once you are adapted to utilizing fat as the primary source of energy, sustaining this lifestyle is not difficult because cravings disappear thanks to steady state glucose and insulin levels. 

Clearly, this style of eating garners much criticism because change is difficult. It’s obvious that the last 3 decades of the standard American diet have left us fat, sick, and inflamed. I believe a health revolution is on the horizon as more individuals take responsibility for their bodies. Each person needs to take the time and presence of mind to evaluate their own body and determine what “diet” works best for them. High fat may not be the answer for everyone but neither is high sugar. I personally have evolved to a state of metabolic flexibility where I can switch between ketones and glucose as my fuels. This takes time and intuition to know what my body needs and when. Nutrition is a huge part of health, but so is movement and sleep. That will be my next post.

Lisa Caprio

Lisa Caprio

MD

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