The Ketogenic Diet

Keith loves food. His entire life he’s been a foodie, trying new tastes and flavours. As he got a few years older, this love of food seemed to work as a disadvantage for him. His metabolism slowed, his previously active work turned into a desk job and life seemed to be busier than ever. After visiting his doctor, he was told to lose ten pounds for his health. He knew his friend Josh has recently lost weight on the ketogenic diet and sought him out to learn how to start. Eating bacon and butter seemed like it would fit right into his love of food. His wife suggested he meet with a health professional before embarking on this journey to make sure this was a healthy weight loss tactic.

I’m sure almost everyone has heard the term “keto” thrown around, but what is it really? The ketogenic diet is very high fat (>70% of your diet), moderate in protein (20-25% of your diet) and very low in carbohydrate (<5% of your diet). Health Canada recommends a much more balanced approach of 20-35% of protein, 45-65% of carbohydrate and 10-35% of fat – so how is this achieved? The basis of the diet is meat, fish, butter, eggs, cheese, heavy cream, oils, nuts, avocados, seeds and low carb green vegetables. The goal of the diet is to put your body into ketosis. Optimally, our body prefers carbohydrates, broken down into glucose, as its main energy source. In ketosis, the absence of carbs means our bodies switch from glucose to breaking fat cells into ketone bodies to use as fuel.

I’m sure the burning question is whether this diet causes weight loss, and the answer is yes – with a few caveats. There are a few reasons many folks see quick, significant weight loss on this diet. First, you’re cutting out a significant number of foods, including fruit, milk, yogurt, rice, pasta…the list goes on. This means you’re also cutting a significant number of calories from your diet since fat is very satiating you need to eat fewer calories to feel full. Finally, there is an initial period of water weight loss, since the glucose, or glycogen, is bound to water in our bodies. Cutting the carbs means dropping the water weight.
Despite the promising news that this diet often does cause weight loss, there are some concerns from a health and lifestyle standpoint.

1.   Keto “flu,” which is your bodies adaptation to using ketones, is common in the first few weeks. Symptoms like fatigue, brain fog, headaches and acetone smelly breath and pee are common.

2.   Sports performance, especially aerobic exercise, can be largely affected. Much of our research to date focuses on timing and portions of carbohydrates, electrolytes and fluid for optimal endurance performance. Remember, using ketones for energy is our bodies secondary fuel choice.

3.   Loss of muscle mass is another concern for those looking to get “lean” on the keto diet. Research has shown that even with adequate protein intake, our bodies need carbs to promote the release of insulin to properly process the protein we eat.

4.   Cutting out multiple foods groups may result in a calorie deficit; however, it can also result in a nutrient deficit including fibre, vitamin D, calcium, magnesium, selenium and zinc. A lack of fibre means a greater chance of constipation since fibre-rich foods like whole grains, fruit, beans and legumes are all a no-no.

5.   Finally, the keto diet has had little research on the sustainability of initial weight loss. Like any other diet, going keto is restrictive, sets the stage for disordered eating in the future and, focuses more on quantity than quality. Overall, focusing on eating whole foods, cooking more foods at home, implementing mindful eating and watching portions is key to healthier, long-term weight management.

*This short article does not allow covering every benefit and drawback to the keto. It also doesn’t cover the use of this diet for chronic conditions such as heart disease and diabetes, this review focused strictly on weight loss. It can be used as a stepping stone to give you some unbiased information on our evidence-based knowledge to date. For a detailed review of whether this diet may work for you, I would suggest visiting a health professional for a full assessment.