Drastically reducing ingested carbohydrates is one of the most classic weight loss strategies. And an example of this method is the ketogenic diet, which emerged in the 1920s as a treatment for epilepsy, gained fame for its powers in weight loss in the 1960s and has evolved over time.

And indeed, the effectiveness of the diet is high (note 4.3 out of 5), but at a high cost: "physiologically, it makes sense to decrease appetite through the production of ketone bodies, but the diet brings many important side effects", explains the nutritionist Mariana del Bosco.

Maintenance is also bad, even more so when done on your own. "It is a diet to be used in the short term and cannot be done by everyone", emphasizes Andrea Pereira, nutritionist at the Department of Oncology and Hematology at Hospital Israelita Albert Einstein and juror of the VivaBem Diet Ranking.

That's why she ranked 20th in the 2020 Ranking, among the 26 evaluated diets. Learn more about her below:

What is ketogenic diet

The name comes from ketosis, a kind of fat burning induced by radically cutting carbohydrates. It works like this: by reducing this nutrient, which is the main supplier of glucose that gives energy to the cells, the body looks for other sources of fuel, mainly fat, which is the most ingested nutrient in the ketogenic diet.

The process, in addition to using body fat, gives rise to ketone bodies, molecules that interfere with hormones involved in appetite, such as ghrelin. Ketosis is the main asset of the ketogenic diet, which can vary in format and calorie intake limit. In general, carbohydrate consumption is below 50 g per day. To get an idea, we usually eat about 200 g or more of the nutrient daily.

How to do the ketogenic diet

First, talk to a professional to understand your energy requirement, an individual measurement that takes into account factors such as age, gender, current weight, height, and physical activity level. From there, he may or may not set a daily calorie limit. The menu is not pre-set, but rather adapted to each person's tastes, and is made up of meat and some derivatives —with the exception of milk—, unlimited vegetables and fats of any kind.

There is no exact number of meals per day, as each person feels hungry at different times. In order to induce ketosis, the body needs to spend time in a carbohydrate shortage. Therefore, the diet has a minimum duration of 2 to 3 weeks, and can reach 6 months. Overall, due to the severe restriction, the program lasts around 40 days.

During the first week, which is an adaptation phase, the lack of glucose for the brain can cause side effects such as bad mood, tiredness and weakness. But then the tendency is for the mood to stabilize and the body to "get used" to the new way of manufacturing energy.

Types

In the classic ketogenic diet, carbohydrate consumption is low (between 4% and 10% of daily calories), fat reaches 90% and cannot be less than 60%, and the rest of the calories come from protein. The amount of calories varies individually, but is usually between 1000 and 1400 per day.

There is also a version that radically reduces the number of calories, to less than 800, the VLCKD (very low calories ketogenic diet) where the number of meals and the menu is more controlled. There are usually six ready-made powdered meals a day, and we only add a few greens and vegetables.

Ah, it is worth mentioning that the ketogenic diet is different from the low carb diet , which has also gained fame for reducing carbohydrates from the daily menu. In low carb, carbohydrate intake can reach 150 g per day, while in ketogenic the limit varies between 20 and 50 g.

Foods Allowed on the Ketogenic Diet 

Physical exercise must be combined with diet for effective and healthy weight loss. However, as the organism is turning around with little energy, some care is necessary. The tip here is to focus on carbohydrate consumption before training. For example: a juice containing 100 g of watermelon and 100 g of beet has approximately 30 g of carbohydrates.

Now, if you are going to start moving along with the feeding program, the recommendation is to take it easy. And even if the individual already practices activities, the ideal is to slow down the pace, because some people cannot stand the exercise and may experience weakness and cramps.

Is the ketogenic diet safe?

Yes, but with reservations. First, the diet cannot be done for a long time, as it is too restrictive. It is effective in the short and medium term, but the physiological mechanisms involved raise concerns. For example, people with diabetes or high blood pressure should be aware that adjustments to medications often need to be made. Otherwise, there is a risk of hypertension and hypoglycemia crises due to changes in metabolism.

Those who have liver or kidney diseases cannot follow this diet, as the increased intake of proteins and fats can overload these organs. Not to mention that cutting carbohydrates means not eating many foods with vitamins and minerals that are important for health, such as cereals, legumes and fruits. Most of the clinical studies done so far indicate the use of supplements along with the ketogenic diet.

The high consumption of fats is another point to be considered before opting for the plan. Medical societies and international organizations advocate a low-fat diet. By making 90% of calories come from fat, there is a risk of increased triglycerides and cholesterol, which can be a problem for those who already have high levels of these molecules.

Due to all these factors, although safe in most cases, the ketogenic diet cannot be done without medical supervision.

 Does the diet really lose weight?

Yes. As carbohydrates make up the bulk of meals, cutting them out reduces the number of calories you consume each day -- which naturally leads to weight loss. Other than that, ketosis consumes body fat, which also leads to the rapid weight loss that the diet is famous for.

A review conducted by the Federal University of Alagoas and published in 2013 in the British Journal of Nutrition compared 13 studies conducted worldwide with the VLCKD diet and fat-restricted diets and concluded that the ketogenic diet is more effective for weight loss. There are also other indirect benefits, such as better insulin action, the hormone that puts sugar into cells, and a decrease in circulating glucose, which is good for diabetics.

But the effects can be temporary, especially if the diet is done on its own. In this case, the abrupt restriction can trigger eating spikes that harm the fat burning process. Even because of this, after a while breads, sugars and company return to the menu.

Total and prolonged restriction can lead to binge eating. It is common for the famous rebound effect to occur, when the weight lost comes back at once due to the lack of maintenance of good habits.

Is it worth it or not?

The experts heard by the report say that yes, the ketogenic diet has its value, especially in the fight against obesity and/or metabolic syndrome. As long as, of course, it is done with follow-up, and has a limited duration of a maximum of six months. There is also a weighting on the menu. For example, it's no use not eating potatoes but exaggerating on bacon because it's fat.

Finally, the big problem with ketogenic, and practically all diets, is keeping the scales in place after they are over. It is necessary to find a food strategy that allows the maintenance of lost weight in the long term. Care begins when the restriction period is over, with the gradual and very well controlled reintroduction of carbohydrates. Yes, they come back!

Thursday, June 8, 2023

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