If you want to jumpstart weight loss, improve body composition, or lower blood sugar, a ketogenic diet can help you reach your goals. “Going keto” has become a mega fad recently–and I’m not a fan of fad diets–but the ketogenic diet has a long history and proven track record for weight loss, brain health, and even cancer. A ketogenic diet can help you reach your health goals if you’re frustrated or just want quick results. But please be aware that this diet is not a cure-all, nor is it for everyone.
A ketogenic diet is a high fat, moderate protein, low carbohydrate diet that has been used therapeutically for over 100 years to treat epilepsy and cancer. More recently it’s hit the mainstream as a quick weight loss diet. Keto evangelists proclaim six pack abs, unicorn health, and crystal clear thinking.
But a ketogenic diet isn’t right for everyone (as I wrote about here). In general in my practice, I shy away from fad diets or a cookie cutter approach. Every person has a unique physiology, and therefore we all have unique diet needs that will change throughout the course of our lives in response to stress, aging, activity level, and health status. And while I do NOT recommend a keto diet long term (for reasons I explain at the end of the post), it can be beneficial for certain people to jumpstart weight loss and improve metabolic markers (think blood sugar, blood pressure, weight, inflammation) in a few short months. With a few exceptions, you can use the keto diet to ignite your health goals.
What is a Ketogenic Diet?
Let’s keep it simple: a ketogenic diet puts the body into ketosis, meaning you are switching over from burning glucose, the body’s primary fuel source, to burning fat for fuel. Fat is a cleaner burning energy source that does not produce as much metabolic waste as glucose. Metabolic waste increases oxidation (read: aging) and free radicals.
The keto diet is predominantly fat, about 70 percent of your daily calories; moderate protein (20 percent); and very low amount of carb (5 – 10 percent). When you restrict carbs and beef up on the fat, your body can’t get the glucose it needs from carbs, and you start burning fat for energy. Your liver converts fatty acids from the fat in your diet to ketones, an alternative energy source.
When you eat carbohydrates like grains, vegetables, sugar, fruit (anything that isn’t a protein or a fat), the carbs are broken down into glucose, and your body releases insulin, a hormone, to transport the glucose into your cells for energy. If you dramatically restrict carbs, your body uses fatty acids that the liver converts to ketones for fuel. While this is a more stressful way for your body to obtain energy, it is a fast way to burn fat because you’re using both stored and dietary fat for fuel.
Many report that burning ketones instead of glucose results in weight loss, crystal clear thinking, greater energy, less inflammation, more satiety, and a boost in overall wellbeing.
I Recommend Keto For the Following:
- weight loss, especially for those who have more than 30 pounds to lose, those stuck in a weight loss plateau, or if you want to quick weight loss results
- menopausal or peri-menopausal women having trouble shedding stubborn weight (unless you have hypothyroid issues)
- for metabolic syndrome: to reduce blood sugar, inflammation, abdominal weight
- for sugar sensitive people prone to hypoglycemia
- cancer treatment and recovery
The body prefers to burn glucose for fuel, but for many people, higher carb foods and sugars make up far too much of their dietary calories in the form of breads, pasta, soda, sugar-rich coffee drinks, pastries, cereals, and grains. This can cause energy fluctuations (hello 3pm energy crash), weight gain, irritability, metabolic syndrome (weight gain, abdominal fat, high blood pressure, high blood sugar), and sugar cravings. When you teach your body to burn fat for fuel, these annoying issues disappear.
Benefits of a Keto Diet
- fast weight loss: burning ketones suppresses hunger and encourages you to burn both your stored body fat and dietary fat for fuel. This (most often) results in fast weight loss
- better energy: ketones provide a more stable fuel source over glucose
- easier meal prep: many of my clients report that it’s much easier to cook and meal plan their keto meals
- MAY lower inflammation and blood glucose levels: because going keto often results in quick weight loss, you may experience lower blood sugar and inflammation levels. This is not true for everyone, and in fact, the opposite may occur because some people aren’t genetically adapted to handle so much fat in their diets. That’s why you need to get routine blood work– so you can monitor how your body responds.
- better clarity and productivity
- may produce new mitochondria (the energy powerhouse of the cell) resulting in better energy and anti-aging
- reduced sugar cravings when you switch over to burning fat instead of carbs for fuel.
- reduction in digestive symptoms and skin issues: certain plant foods (like nightshades that are high in lectins) can trigger an inflammatory response in some people that can cause skin issues or digestive problems.
- may be beneficial for brain health and Alzheimer’s. Ketones are great for your brain.
How to Use a Ketogenic Diet for Your Health Goals
As mentioned, I do not recommend a ketogenic diet long term. There may be some benefit to cycling in and out of ketosis (more on this later), but staying in ketosis indefinitely can be stressful for the body and for your microbiome. Please get regular blood work to assess inflammation and lipid levels, or consider genetic testing to determine if a high fat diet is best for you.
Additionally, keto affects women differently than men! This is because keto impacts your hormones, and women’s endocrine systems are more sensitive to perceived starvation (which is what a keto diet mimics) than a man’s because that’s not a safe environment to sustain a growing fetus. Some women may fare better doing some type of modified (less hard core) keto.
That said, I recommend using a keto diet for 3-6 months or until you reach your health goals, then cycling in and out of keto or transitioning to whatever diet is best for you long term. For most humans (there is never a one size fits all approach!) I typically recommend an anti-inflammatory Mediterranean type diet with about 50% plant foods and appropriate amounts of protein and fats depending on your health goals, age, gender, activity level.
Switching over to a keto diet can be a bit of leg work initially: Make sure you do your research so you understand how to shop for and prepare meals. You’ll be ditching grains, starches, legumes, sugar, and in some cases, dairy. You’ll also want to eat organic protein as often as possible.
Pick a Monday to begin, and spend the weekend prior planning your meals and shopping. Soon you’ll get used to your new eating routine and it’ll become a habit. If weight loss or metabolic improvement is your goal, I recommend pairing keto with an overnight intermittent fast of 12-16 hours. Read my intermittent fasting article here.
Typically it can take 2-3 weeks to become “keto adapted,” and in the interim, many people report feeling flu-like and generally crappy as your body moves from burning glucose to fat. You can lessen these “keto flu” feelings by taking electrolytes (1 tsp of this one daily) and drinking plenty of water. Make sure you are using high quality sea salt to salt your food. I like this brand. Here are some 5 ways to measure your ketones to determine if you are in ketosis.
Your diet will look like this:
- 70% fats: the base of your diet will be fats like butter (if you are ok with dairy), coconut oil, olive oil, coconut milk, ghee, avocado (actually a fruit).
- 20% protein like eggs, meat of all types. fish. Organic, pasture-raised, and wild.
- 10% low starch carbs like greens, cruciferous, low glycemic berries, nuts
- booster foods like fermented foods for gut health, electrolytes. I recommend this one.
Here’s an example keto day:
- overnight intermittent fast for 12-16 hours
- large glass of room temp water with lemon and electrolytes when you wake up
- bulletproof coffee with MCT oil OR breakfast of 2-4 eggs cooked in butter or coconut oil with spinach, 1/2 avocado, side of raw kraut
- lunch: salmon filet drizzled in butter with sea salt, side salad of arugula with olive oil dressing or roasted broccoli
- dinner: 6oz grass fed steak or bunless burger with herbs cooked in coconut oil sprinkled with sea salt
- you can also do any number of “fat bomb” snacks to get your fats up during the day.
The key is to hit your target for fats and make sure you don’t get too much protein to stay in ketosis. You’ll need to log everything you’re eating until you get the hang of it. Find an app that gives you a macronutrient (protein, fat, carb) breakdown.
Once you’ve reached your goals, you don’t want to go back to your old diet after all your hard work. You can choose to cycle in and out of keto or transition to a sustainable diet for the long term. For weight loss, blood sugar, and blood pressure control long term, I recommend a lower carb long term diet with minimal added sugars. Aim to keep carbs around 100 grams to maintain your benefits.
Because keto mimics starvation, it creates stress on the body long term and that can be a trigger for thyroid and other hormone imbalances, especially in women. As I mentioned, some women may not see any benefit on keto or may feel worse due to hormonal changes. Cycling in and out of ketosis may help this issue. For cycling, you can do keto for 5-6 days per week and increase carbs for 1-2 days. That brings you out of ketosis. The goal is to eat just enough carbs without contributing to weight gain, and increasing carbs a couple times a week reduces stress on your body and allows for more fibers and starches that feed your gut bacteria.
Periodically cycling out of ketosis may replenish glycogen stores and signal to the body that there is not actually a shortage of food and thereby negating many of the side effects associated with the stress response of starvation. (source)
A keto diet can be dangerous if you have certain health conditions such as
- kidney disease
- fatty liver
- low thyroid function, hypothyroidism
- adrenal fatigue or hormone imbalance
- women with irregular cycles
- history of eating disorders
I do not recommend keto for people with hypothyroid, adrenal/mitochondrial fatigue, or chronic constipation. Most reputable practitioners I know/admire, like Dr Sara Gottfried, Mark Sisson, and JJ Virgin, also caution against long term keto. Mark Sisson says, Not everyone needs to be on a ketogenic diet. Even fewer need to be on a ketogenic diet for life. I’ll admit to being a bit leery of long-term, protracted ketosis in people who aren’t treating a medical condition. It just doesn’t seem necessary.” (source)
Anecdotally (meaning from surveys I have personally conducted and with my own clients) about 50 percent of people do not see benefit from keto. That means it made them feel worse or they did not reach their goals. Some of these people may have had underlying dysfunction such as hypothyroidism (very common in peri- and postmenopausal women), hormone imbalance, or perhaps they hadn’t figured out their ideal macros. BUT, not everyone will benefit from a ketogenic diet, as there are at least ten genetic variations that may make a person less likely to benefit from keto. (source) Don’t beat yourself up if you do keto with your husband and he loses 30 pounds and your weight doesn’t budge. Hormones.
In some people a ketogenic diet may cause rather than decrease inflammation. As I mentioned, the best way to determine if keto is working for your body is to have bloodwork 3 months after you start and every 3-6 months after if you stay on a ketogenic diet longer than 6 months.
Finally, make sure you don’t fall into the meat and fat only trap. Your body needs antioxidants and fibers from plant foods, even if in small amounts on this diet, to nourish your microbiome, which is the foundation of your immune system and digestion.
How has a ketogenic diet worked for you? Please comment below.
Mary Vance is a Certified Nutrition Consultant and author specializing in digestive health. She combines a science-based approach with natural therapies to rebalance the body. In addition to her 1:1 coaching, she offers courses to help you heal your gut and improve your health. Mary lives in San Francisco and Lake Tahoe in Northern California. Read more about her coaching practice here and her background here.