Keto-Style Eating

Judy Seybold, MS, RDN, LD, CLC
Chief Nutrition Officer

The Ketogenic-style (Keto) eating is a highly popular diet, originally designed to help control epilepsy in children and now focused on rapid weight loss. Keto is part of a group of low-carbohydrate diets with most calories coming from fat.

The premise of the Keto diet is that it removes carbohydrates to the point where the body must burn stored fat for fuel. It is essentially a high fat diet with about 70 to 80 percent of calories coming from fat, with only about 5 percent from carbohydrates and the rest from protein. These amounts may be slightly different depending on the source of diet information.

Eating this nutrient composition switches the body from burning carbohydrates (glucose) for energy to burning fat (ketones). For carbohydrates, the diet generally restricts to 25-50g/day, and these are mostly from non-starchy vegetables. Protein must be somewhat limited because excess protein can be processed in the body in a way that takes you out of ketosis. Suggested effects reported from the Keto diet are a loss of appetite, increased metabolism, muscle mass increase, improvement in blood pressure, and decreased heart disease risk. There is not enough scientific research to support these claims yet.

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The hypothesis underlying the reported success of this diet is that fat doesn’t increase insulin the way carbohydrates do. You don’t have insulin spikes that could lead to fat storage. Instead you burn off ketones for energy.

The success of this diet depends a lot on the execution. Many people choose meals like bacon and eggs because the type of fat isn’t restricted, and others modify the plan for healthier eating utilizing more unsaturated fats. Whole grains and legumes are also very restricted on this plan. The Keto diet can put stress on kidney function since its effectiveness is dependent on the body going into ketosis. Long-term health benefits are questionable and still being researched.

Many people choose to follow a modified Keto diet and do not restrict carbohydrates or protein enough to get into ketosis. This choice is often made to ensure more compliance with the diet. For many dieters, extreme restriction of carbohydrates is quite challenging.

Keto Diet Pros:

• It is well understood that a ketogenic diet is helpful for children with epilepsy who are not able to find help with other medical treatment.
• Many people enjoy successful weight loss while following a Ketogenic or even modified Keto diet.
• A high-fat diet that includes favorites like bacon is very appealing to people who associate dieting with giving up their favorite high-fat foods.

Keto Diet Cons:

• Long-term risks include kidney stones and liver damage because of the effects of ketosis.
• With a very high-fat diet, there is a risk of dieters ingesting a large amount of saturated fat which can contribute to cardiovascular disease. It is important to focus on healthy, unsaturated fats like those in olive oil and avocados.
• The Ketogenic diet limits popular sources of fiber, and a low-fiber diet can bring complications of gastrointestinal issues, including constipation.

Keto Diet Tips:

In general, the Keto diet provides the majority (about 80%) of your calories from fat, which comes from either eating high-fat foods or adding fat through oils, sauces, and toppings to otherwise lean foods. It is important to keep in mind that calories from fat are not unlimited in the Keto diet. Like most diet plans, a reasonable calorie restriction must be made to promote weight loss. Eating a high-fat, high-calorie bunless cheeseburger at every meal isn’t what this diet is all about!

• Foods Included: meat, poultry, fish, seafood, eggs, low-carb veggies, avocados, cheese, nuts, seeds, oils, unsweetened coffee and tea
• Foods Very Limited/Avoided: high-sugar fruits, starchy vegetables (corn, potatoes, beets), juices, grains, dairy milk, beans, legumes, sugar (any form)

For a 2,000 calorie/day diet, Keto would include about 170g fat, 60g protein, and 25g carbohydrate.

A typical meal on the Keto diet might include:

• Breakfast: fried egg, breakfast sausage, sliced tomatoes, and avocado
• Lunch: tossed salad with bacon, goat cheese, and vegetables topped with olive oil & vinegar
• Dinner: grilled steak with mushroom cream sauce, sautéed peppers and zucchini

Long-term data proving the safety and efficacy of this diet is not available, so proceed with caution. It’s important to work with your physician or registered dietitian nutritionist that can monitor you while you are following this plan. Your individual metabolism affects the point at which you produce ketones.

Additional Resources
The Cleveland Clinic
Academy of Nutrition and Dietetics