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    What is ketogenic diet and how to lose weight with a ketogenic diet?

    What is ketogenic diet?

    In recent days ketogenic diet is becoming a popular method of losing weight. Ketogenic diet is a high-fat but low-carb diet. Not only does it help in losing weight1, it also offers several other benefits.

    Also termed as keto, it requires a drastic reduction in carbohydrate intake while replacing them with fat. Such an intervention caused the body to go into a metabolic state called as ketosis. Under this state of ketosis body becomes extremely efficient in burning fat. This process also leads to conversion of fat into ketones in the liver. These ketones supply energy to the brain.

    As a result, ketogenic diet is useful in reducing blood sugar levels2,3,4 along with insulin levels.

    Different kinds of ketogenic diet

    1. Standard ketogenic diet

    This diet involves very low-card diet with moderate protein content and high fat diet in a proportion of 5%, 20% and 75% respectively.

    2. Targeted ketogenic diet

    In this type of ketogenic diet, one can consume carbs as pre-workout and post -workout meals.

    3. Cyclical ketogenic diet

    In cyclical ketogenic diet high-carb feeds are alternated with ketogenic diet, for example a 2 days of high-carb diet follows a 5 days cycle of ketogenic diet.

    4. High-protein ketogenic diet

    This diet is similar to standard ketogenic diet except that it is richer in proteins with a ratio of 35% proteins, 60% fat and 5% carbs.

    In common practice high-protein and standard ketogenic diets are most utilized. Cyclical and targeted ketogenic diet are commonly utilized by athletes and bodybuilders.

    Ketogenic diet in weight loss

    Not only is ketogenic diet an efficient way to lose weight, it also reduces risks of several lifestyle related diseases. In fact, research5 has shown that a ketogenic diet is much more effective than a low-fat diet. Apart from that such diet makes you feel full easily, thus reducing food intake and weight loss. You don’t even have to keep track of food intake.

    Another study6 established that subjects on ketogenic diet had a weight loss of more than 2.2 times in comparison to subjects on low-fat calorie-restricted diet. There was also an improvement in triglyceride and HDL levels.

    Yet another study7 revealed a weight loss of over 3 times more among subjects on ketogenic diet than subjects on Diabetes UK’s recommended diet.

    There can be several explanations behind the supremacy of ketogenic diet in weight reduction than a low-weight diet. One of the reasons is increased intake of proteins. Other reasons can be lower blood sugar, increase in ketones, and improved insulin sensitivity.

    Other health benefits of ketogenic diet

    1. Ketogenic Diets in Diabetes

    Diabetes involves high blood sugar levels and impaired insulin function. Since ketogenic diet reduces blood sugar levels, improves insulin function and aids in fat loss, it helps in prediabetes, type 2 diabetes and metabolic syndrome8, 9.

    A study9 showed improvement in insulin sensitivity by 75% in subjects on ketogenic diet. Another study8 revealed that 7 subjects out of 21 participants on ketogenic diet were able to completely stop their medication for diabetes.

    2. Heart disease

    Ketogenic diet is found to be effective in improving risk factors like blood pressure, blood sugar, body fat and HDL levels10, 11.

    3. Cancer

    Ketogenic diet is already being used in treating several types of cancer to slow the tumour growth12, 13, 14.

    4. Alzheimer’s disease

    Alzheimer’s disease is also found to improve symptoms in Alzheimer’s disease and delay it progression15, 16, 17.

    5. Epilepsy

    According to research16 ketogenic diet has shown to massively reduce seizures in children with epilepsy.

    6. Parkinson’s disease

    A study showed that ketogenic diet helps in improving symptoms of Parkinson’s disease as well18.

    7. Polycystic ovary syndrome

    The reduction in insulin levels with ketogenic diet can also be helpful in polycystic ovarian disease.

    8. Trauma to brain

    An animal study established that ketogenic diet is able to improve concussions and augments recovery in case of brain trauma19.

    9.  Acne

    Low insulin levels along with reduction in sugar and processed foods can help in reducing acne20.

    Foods to include in your diet

    When preparing your diet chart make sure to include the following food items

    Fatty fish: Trout, salmon, mackerel and tuna.

    Eggs: Go for omega-3 whole eggs or pastured eggs.

    Meat: Chicken, red meat, ham, steak, sausage, turkey, bacon.

    Butter and cream: If possible, go for grass-fed.

    Nuts: Walnuts, almonds.

    Seeds: Pumpkin seeds, flaxseeds, chia seeds etc.

    Oils: Avocado oil, extra virgin olive oil, coconut oil. Make sure your oil is healthy.

    Avocados: Freshly prepared guacamole or fresh whole avocados

    Condiments & spices: Pepper, salt, herbs and other spices

    There are also several keto supplements available like ketoforce, one of the more popular products. However, you must always consult a dietitian or your doctor before starting out a diet regime or supplements.

    Foods to exclude from your diet

    All foods high on carbs should be avoided. Following food items should either be excluded from your diet completely or reduced to minimum:

    Grains: Cereal, wheat-bases products, pasta, rice etc.

    Sugar-rich foods: Fruit juice, soda, cake, smoothies, candies, ice cream etc.

    Fruit: All fruits should be avoided. Berries can be taken in small portions.

    Legumes: Lentils, peas, kidney beans, chickpeas etc.

    Root and tubers: Carrots, potatoes, parsnips, sweet potatoes, parsnips, etc.

    Fat-free products: Products which are highly processed to reduce fat are usually rich in carbs.

    Sauces: These are rich in sugars and unhealthy fats, thus should be avoided

    Unhealthy fat: Processed vegetables oils, margarine, mayonnaise and other unhealthy fat products should be avoided

    Alcohol: Carb content in alcoholic beverages can shift your metabolism out of ketosis, thus should be avoided

    Sugar-free foods: Often rich in sugar alcohols, these foods can disturb ketone levels.

    Useful ketogenic snacks

    Sometimes you might feel hungry in between meals. What would you do? Taking a wrong snack can harm your entire hard-work. Thus, we have a list of keto-approved items that you can take as a snack while on ketogenic diet.

    • Cheese
    • Fatty fish or meat
    • Nuts or seeds
    • A couple of hard-boiled eggs
    • Olives with cheese
    • 90% dark chocolate
    • Full-cream yogurt mixed with cocoa powder or nut butter
    • Celery with guacamole and salsa
    • Strawberries with cream

    References:

      1. Freeman JM, Kossoff EH, Hartman AL. The ketogenic diet: one decade later. Pediatrics.2007 Mar;119(3):535-43.
      2. Veech RL. The therapeutic implications of ketone bodies: the effects of ketone bodies in pathological conditions: ketosis, ketogenic diet, redox states, insulin resistance, and mitochondrial metabolism. Prostaglandins Leukot Essent Fatty Acids.2004 Mar;70(3):309-19.
      3. Fukao T, Lopaschuk GD, Mitchell GA. Pathways and control of ketone body metabolism: on the fringe of lipid biochemistry. Prostaglandins Leukot Essent Fatty Acids.2004 Mar;70(3):243-51.
      4. Westman EC, Mavropoulos J, Yancy WS, Volek JS. A review of low-carbohydrate ketogenic diets. Curr Atheroscler Rep.2003 Nov;5(6):476-83.
      5. Eric C Westman, William S Yancy, Jr, John C Mavropoulos, Megan Marquart, and Jennifer R McDuffie. The effect of a low-carbohydrate, ketogenic diet versus a low-glycemic index diet on glycemic control in type 2 diabetes mellitus. Nutr Metab (Lond). 2008; 5: 36. Published online 2008 Dec 19. doi:  10.1186/1743-7075-5-36
      6. Brehm BJ1, Seeley RJ, Daniels SR, D’Alessio DA. A randomized trial comparing a very low carbohydrate diet and a calorie-restricted low fat diet on body weight and cardiovascular risk factors in healthy women. J Clin Endocrinol Metab.2003 Apr;88(4):1617-23.
      7. Dyson PA1, Beatty S, Matthews DR. A low-carbohydrate diet is more effective in reducing body weight than healthy eating in both diabetic and non-diabetic subjects. Diabet Med.2007 Dec;24(12):1430-5. Epub 2007 Oct 29.
      8. Yancy WS Jr1, Foy M, Chalecki AM, Vernon MC, Westman EC. A low-carbohydrate, ketogenic diet to treat type 2 diabetes. Nutr Metab (Lond).2005 Dec 1;2:34.
      9. Boden G1, Sargrad K, Homko C, Mozzoli M, Stein TP. Effect of a low-carbohydrate diet on appetite, blood glucose levels, and insulin resistance in obese patients with type 2 diabetes. Ann Intern Med.2005 Mar 15;142(6):403-11.
      10. Hession M1, Rolland C, Kulkarni U, Wise A, Broom J. Systematic review of randomized controlled trials of low-carbohydrate vs. low-fat/low-calorie diets in the management of obesity and its comorbidities. Obes Rev.2009 Jan;10(1):36-50. doi: 10.1111/j.1467-789X.2008.00518.x. Epub 2008 Aug 11.
      11. Santos FL1, Esteves SS, da Costa Pereira A, Yancy WS Jr, Nunes JP. Systematic review and meta-analysis of clinical trials of the effects of low carbohydrate diets on cardiovascular risk factors. Obes Rev.2012 Nov;13(11):1048-66. doi: 10.1111/j.1467-789X.2012.01021.x. Epub 2012 Aug 21.
      12. Weihua Zhou, Purna Mukherjee, Michael A Kiebish, William T Markis, John G Mantis, and Thomas N Seyfried. The calorically restricted ketogenic diet, an effective alternative therapy for malignant brain cancer. Nutr Metab (Lond). 2007; 4: 5. Published online 2007 Feb 21. doi:  10.1186/1743-7075-4-5
      13. Klement RJ. Calorie or carbohydrate restriction? The ketogenic diet as another option for supportive cancer treatment. Oncologist.2013;18(9):1056. doi: 10.1634/theoncologist.2013-0032.
      14. Vidali S, Aminzadeh S, Lambert B, Rutherford T, Sperl W, Kofler B, Feichtinger RG. Mitochondria: The ketogenic diet–A metabolism-based therapy. Int J Biochem Cell Biol.2015 Jun;63:55-9. doi: 10.1016/j.biocel.2015.01.022. Epub 2015 Feb 7.
      15. Maciej Gasior, Michael A. Rogawski, and Adam L. Hartman. Neuroprotective and disease-modifying effects of the ketogenic diet. Behav Pharmacol. Author manuscript; available in PMC 2008 May 5. Published in final edited form as: Behav Pharmacol. 2006 Sep; 17(5-6): 431–439.
      16. Choragiewicz T1, Zarnowska I, Gasior M, Zarnowski T. [Anticonvulsant and neuroprotective effects of the ketogenic diet]. Przegl Lek.2010;67(3):205-12.
      17. McPherson PA, McEneny J. The biochemistry of ketogenesis and its role in weight management, neurological disease and oxidative stress. J Physiol Biochem.2012 Mar;68(1):141-51. doi: 10.1007/s13105-011-0112-4. Epub 2011 Oct 8.
      18. Vanitallie TB1, Nonas C, Di Rocco A, Boyar K, Hyams K, Heymsfield SB. Treatment of Parkinson disease with diet-induced hyperketonemia: a feasibility study. Neurology.2005 Feb 22;64(4):728-30.
      19. Prins ML, Fujima LS, Hovda DA. Age-dependent reduction of cortical contusion volume by ketones after traumatic brain injury. J Neurosci Res.2005 Nov 1;82(3):413-20.
      20. Paoli A1, Grimaldi K, Toniolo L, Canato M, Bianco A, Fratter A. Nutrition and acne: therapeutic potential of ketogenic diets. Skin Pharmacol Physiol.2012;25(3):111-7. doi: 10.1159/000336404. Epub 2012 Feb 11.
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