“Keto” diet, what you didn’t know

The ketogenic diet, keto, is not new. And although its use had other therapeutic origins other than weight loss, in recent years, it has been raised several times as a slimming strategy. But in reality, this possibility arose in the seventies, quite some time ago, when it was called the Atkins diet.

Here we continue, almost 50 years later, wondering if the ketogenic diet works or not to lose weight. You can imagine the generic answer: it is possible that for a given profile of people with an X metabolism and a Y mentality, this diet adapts well to their circumstances and “works” for them.

Some ketopurists often argue that the diet proposed by Atkins to lose weight more than ketogenic was hyper protein , which is still another test of the scarce, not to say null, unanimity that exists in dietary issues even within the same current (if the Atkins diet was ketogenic, or it should not be beyond any doubt, since he defined in his work his slimming proposal as ketogenic , and so they have also signed different scientific publications).

What is a ‘ketogenic’ diet?

If we look at the origin of the expression – keto-gene diet – it is that way of feeding that favours our metabolism to generate ketone bodies. Thus, when in the blood there is a certain amount of this class of compounds in circulation, it is said that the organism has entered ketosis.

What are ketone bodies?

They are a series of substances that, as a fuel, are generated in our cells – mainly those of the liver and also those of the kidneys – in particular situations. In English, they are called ketone bodies and hence the keto diet and the current ketofiebre.

They are mentioned in the plural, but do these ketone bodies have a specific name?

Yes, ketone bodies to which we refer in this context are mainly three: the acetoacetic acid, the beta-hydroxybutyric acid and to a lesser extent, the acetone.

When do you enter ketosis?

Short answer: when there are no carbohydrates available in the blood as fuel, and then fatty acids are used to generate ketone bodies that will be used as an energy source.

Long answer: the maintenance of the precise life of the constant consumption of energy (underline the “constant”). Characteristically in our environment, that energy is contributed directly – or almost – by food after digestion, especially those foods rich in carbohydrates. However, when circulating carbohydrates are depleted, as well as the scarce reserves of them in the liver and muscle, more rapid energy is not provided with food – more carbohydrates -, the metabolism has an obligation to obtain power from an alternative route. In this way, fatty acids are mobilized to form, in the mitochondria, the famous ketone bodies that will be used by the different cells to obtain energy, which includes the nervous system, muscle tissue, and so on.

What is the proportion of macronutrients in a ‘ketogenic’ diet?

In ketogenic diets, fats are prominent protagonists. Therefore, they must contribute between 60% to 70% of the total caloric value of the diet; proteins would contribute 15% to 25% and carbohydrates never more than 10%. This is the most essential part: carbohydrates should never provide more than 10% of the total energy value of the diet. If they are included, the ketogenic process will never be launched. Some standards that favour a large part of the population find it difficult to follow.

What would be an example of a daily menu?

  • Breakfast: Scrambled egg with mushrooms and onion, infusion without milk or sugar.
  • Food: Grilled chicken breast fillets with soy sauce and sauteed broccoli.
  • Dinner: Smoked salmon rolls with avocado.

You can forget about all the foods made with cereals (whole or not), fruits, legumes and a good part of vegetables and tubers unless they are present in anecdotal quantities.

What is the reason why the ketogenic diet is proposed as a slimming method?

There is no single explanation. There are three, and they are not exclusive. As the biologist, Santiago Campillo explains wisely in this article, any of the following three reasons, or their synergy, are those advocated by ketogenic diet advocates to support their slimming benefits. First, by almost eliminating or drastically reducing the presence of carbohydrates in the diet, the possibility of accumulating fat and even glycogen is eliminated. Second, fatty acids of our adipose tissue are used to obtain energy in a very inefficient process – in fact, it is the least efficient of all the biologically possible ones to get power-, so the amount of fatty acids that are required is older. Third, the presence of fat in the diet is quite well related to satiety: although lipids are the immediate principle that brings more calories per unit of weight, they are also one of the elements that contribute most to satiety. To this aspect, it must be added that the state of ketosis itself has been related to a decrease in appetite.

Is it dangerous to follow a ketogenic diet?

No, and yes. By definition, no, since the fact of “entering ketosis ” is an entirely natural process – in the circumstances already mentioned – that is set in motion to safeguard a more significant and irreparable evil such as dying by not being able to continue encouraging lifetime. However, entering ketosis is not without risk as long as that ketosis is the gateway to ketoacidosis.

What is ketoacidosis, is it dangerous?

It is the decrease in blood pH due to the high concentration of ketone bodies in it (which have an acidic character). The normal pH blood is confined to a very narrow range, beyond which both upwards and down- critical biological functions are altered, the more visible and attractive, oxygen transport. Beyond those pH limits, and also depending on the time that remains, life is severely compromised.

This situation is serious for everyone and is especially dangerous in some people, such as in patients with type 1 diabetes and kidney patients, among others. It should be recognized that, although they are not frequent, ketoacidosis situations have also been reported in the case of people who have followed a strict low carbohydrate diet.

Is it easy to follow a ketogenic diet?

It will depend on the training and motivation of each one. It is necessary to agree that, for the general population.

It is not easy to follow this kind of diet because it is not easy to follow them for long enough: this study contrasted the low adherence to this kind of diet among a population of cancer patients. And the diets that are not adherent are the ones that have less success in achieving their goals. We are quite clear that regardless of the name it has and whatever its characteristics, the diet that works best for weight loss is the one that keeps its users longer practicing it. It is common for keto exaltedargue that not only is it easy to follow, but it is also especially pleasant. If they were right, populationally speaking, it is something that should make us go back to the previous argument: then obesity would have long ceased to be a problem.

Does it work to lose weight?

There seems to be little doubt that in the concise term, ketogenic diets are effective for losing weight. But in the medium and long time, they have not proven to be better than other dietary patterns with a different nutritional profile. That is to say, and it happens to them like the rest of the diets to lose weight: they always seem to work initially … but then not. It is what “dieting” has to be done — it takes off and on — while weight is also taken as the variable to be controlled, as opposed to assuming continuous changes in our lifestyles (and regardless of weight).

Recall that above all questions of aesthetics and size, the issue of overweight and obesity is a matter of public health.

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