Eliana Lakritz MS RD LDN, Clinical Dietitian, Baystate Noble Hospital (WNG file photo)
by Eliana Lakritz MS RD LDN, Clinical Dietitian, Baystate Noble Hospital
Lately, I have been asked a lot about the ketogenic (keto) diet and whether it can help with weight loss. Even though the keto diet has been given a lot of attention within the past year or so, it has been around for almost 100 years. When followed strictly, the keto diet has been very effective in preventing seizures in children with drug-resistant epilepsy. If your goal is weight loss, however, it is important to discuss this diet so that you can be educated about its efficacy and outcomes.
The Keto Diet Basics
The ketogenic diet is a very low carbohydrate diet that in effect, puts the body into a state of “ketosis.” Instead of using carbohydrate for fuel (which is the cells’ preferred source), stored fat is broken down into ketone bodies, which circulate through your blood and are used in place of carbohydrates for energy. This occurs after 2-4 days of strict carbohydrate restriction of less than 20-40g daily. Compare this to the typical 50% of calories from carbohydrates that most people typically consume (about 250g carbohydrates in a 2000 calorie diet) to understand how restrictive it is.
Since the diet restricts carbohydrates so drastically, the main food components are primarily the other macronutrients, protein and fat. This includes oils, butter, red meat, processed meat, poultry, fish, cheese, nuts/seeds, and eggs.
Discussing the Evidence
One of the most prominent health concerns of this diet is the increase in high saturated fat foods that are typically consumed, such as cheese, steak/beef, processed meats, and butter. These can ultimately raise cholesterol levels and put you at greater risk for heart disease, stroke, and other conditions. A high protein diet such as the keto diet can also worsen existing kidney disease.
There is some evidence that in the short-term, the keto diet can improve blood glucose levels in type 2 diabetics due to the carbohydrate restriction. There is less evidence to support its use for long-term management.
As far as weight loss is concerned, very low carbohydrate diets like the keto diet can lead to quick weight loss compared to a low-fat or Mediterranean diet. These results however, do not seem to be sustained over the long-term. This evidence is not surprising because such restrictive diets are very difficult to maintain throughout your lifetime. By definition, very low carbohydrate diets also do not include carbohydrate sources rich in satiating fiber such as fruits, whole grains, and legumes that also provide important nutrients.
The “Take-Home” Message
While the keto diet may help you achieve short-term weight loss and glycemic control in diabetics, it is not a long term solution to weight loss because it is so restrictive. Rapid weight loss and subsequent regain is likely, which can be harmful to your health. The keto diet can also be harmful if you rely on unhealthy protein sources such as high saturated fat, processed foods. It is more practical and there is more evidence to suggest that a balanced diet of lean proteins, nuts/seeds, fruits, vegetables, legumes, and whole grains can support weight management, heart health, and longevity.
If you are interested in learning more about nutrition counseling sessions with a registered dietitian at Baystate Noble Hospital, please call 413-568-2811 ex: 5671 for more information.
