The Keto Kraze

Meat & Veggies

In recent years, the ketogenic diet, also called the keto diet, has become very popular, largely due to its appeal for weight loss. Yet, despite the popularity, the diet was ranked dead last for “Best Diets Overall” and “Best Diets for Healthy Eating” in a list published by US News in their most recent assessment of diets for 2018. The diet ranked slightly higher in the category of weight loss, but overall it scored poorly. Rankings were calculated by an expert panel of individuals in the field of nutrition and health. In general, there is science that is for and against following a ketogenic diet. Yet, its effects on the body and the long-term sustainability of following the diet are questionable.

What is the Ketogenic Diet?

The keto diet is high in fat, low in carbohydrate, and limited in protein. Normally, our bodies use carbohydrate as its main fuel source. However, with a very low carbohydrate intake, the body is triggered to burn stored fat instead. Our fat is converted to ketones, and the body uses these ketones for energy. When the body is relying primarily on ketones for energy, we call this process ketosis. Protein is limited on the keto diet because the body can turn excess protein into carbohydrate, which would prevent ketosis.

Generally, the keto diet focuses on including approximately 75% of calories from fat and approximately 5% of total calories from carbohydrates, which leaves about 20% of calories to come from protein. To put it into perspective, the typical dietary recommendation is to get about 50% of total calories from carbohydrates and approximately 25% from fat. Maintaining such a diet involves eating plenty of high-fat foods such as some meats and fish, full-fat dairy, butter, oils, avocado, nuts, and certain vegetables, while avoiding high-carb foods such as grains, fruits, beans, certain vegetables, and sweets.

Often, low-carb diets and keto diets are lumped together, but they differ in a couple of ways. Generally, low-carb diets allow up to 150 grams of carbohydrate per day, but ketogenic diets typically require no more than 25 grams per day. In addition, since excess protein interferes with ketosis, the ketogenic diet restricts protein to only the minimum needed for the body’s needs, whereas low-carb diets are not protein-restricted.

How is the Ketogenic Diet Used?

Historically, this diet was developed as an effective approach to treat drug-resistant epilepsy. Some research suggests the diet may help improve other neurological diseases such as Alzheimer’s disease and Parkinson’s disease.  The theory is that the brain cells of those with a neurological disorder or disease are able to utilize the ketones produced when following a keto diet better than they are able to use glucose.

More recently, the keto diet has become a popular weight loss diet. As mentioned earlier, with such a low carbohydrate intake, the body is triggered to burn stored fat for energy instead of relying on the glucose from carbohydrates. This process may potentially lead to weigh loss.

Following a ketogenic diet may help control blood glucose and insulin levels. With low carbohydrate intake, blood glucose remains lower and less insulin is released. Associated weight-loss with this diet can also have positive impacts for those with high blood glucose. While this may be effective for some individuals who have high blood glucose and insulin levels, it is not recommended for everyone. Depending on the type of diabetes and types of medication someone is on can greatly influence whether a keto diet would be effective or even safe.

Finally, there is recent interest in the diet as an adjunct treatment for cancer. Many cancer cells have a very high intake of glucose, a fuel for rapid, uncontrolled growth. Thus, there are theories, and some studies, which suggest that restricting blood glucose can also impede cancer cells.     

Should I Follow this Diet?

The keto diet is an extremely restrictive diet, developed for medical use. It may be effective, and even necessary, in some clinical instances, but for most people it is not a recommended approach for weight loss or a healthy lifestyle. While some research suggests it may be effective at improving diabetic symptoms, other research shows that simply eating a lower-carb diet, rather than a strict ketogenic diet, can be just as effective. For many people, a carbohydrate intake of 100 or 200 grams per day is still a reduction from normal intake and can lead to many of the same benefits!    

For weight loss, it is unlikely to be a sustainable approach. Because the diet is difficult to follow long-term, it can lead to “yo-yo” dieting, a dangerous pattern that often ultimately leads to even greater weight gain. A very restrictive diet can lead to an unhealthy relationship with food and increase stress. Stress can contribute to weight gain and increased blood sugar, leaving you where you started.

Lastly, the diet cuts out a range of healthy foods, including fruits, many vegetables, and legumes, providing fewer phytonutrients and fiber. The lack of fiber can lead to digestive issues such as constipation and adversely affect the gut microbiome. The heavy focus on macronutrients, rather than the food itself, means that a ketogenic diet could lead to increased intake of packaged foods, processed meats, and processed fats, rather than whole, nourishing foods. Be sure to consult your health care provider before following this diet if you feel it is a good fit for you. 

Pros

Cons

  • Effective therapeutic diet for epilepsy
  • May be therapeutic for cancer, neurologic conditions, and Alzheimer’s disease
  • May be effective for accelerated weight loss for certain individuals
  • May improve blood glucose and insulin levels, and associated disease states for certain individuals

 

  • Low in fiber
  • Low in fruits and vegetables, rich sources of phytonutrients
  • Deficient in certain minerals, requiring supplementation
  • May be harmful for the microbiome, due to lack of fiber and high fat
  • Should only be undertaken under medical supervision
  • Requires careful tracking and monitoring of food intake
  • Must track blood or urine ketones, as well as monitoring of liver function, kidney function, and blood lipids
  • For most individuals and most conditions, it may not be any more effective than moderate- or low- carb diet

Curious which diets ranked first in the list generated by US News? The Mediterranean diet and the DASH diet tied for first place among other diets as “Best Diets Overall.” Consider one of these diets, which are high in whole, healthy foods such as fruits, vegetables, whole grains, and healthy fats, but low in processed foods, sugar, and saturated fat. Allow yourself variety and choice, which is the key to sustainability and success for a healthy lifestyle and healthy relationship with food!

Sources:

Matthew’s Friends.  https://www.matthewsfriends.org/keto-therapies/keto-introduction/classical-mct-ketogenic-diets-traditional-diets/

Chung, Hae-Yun, and Yoo Kyoung Park. “Rationale, Feasibility and Acceptability of Ketogenic Diet for Cancer Treatment.” Journal of Cancer Prevention 22.3 (2017): 127–134.  Accessed from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5624453/

Johnston CS, Tjonn SL, Swan PD, White A, Hutchins H, Sears B. “Ketogenic low-carbohydrate diets have no metabolic advantage over nonketogenic low-carbohydrate diets.” American Journal of Clinical Nutrition. 83.5 (2006): 1055-1061. Accessed from: http://ajcn.nutrition.org/content/83/5/1055.full

Lindsey B. Gano LB, Patel M, Rho JM. “Ketogenic diets, mitochondria, and neurological diseases.” The Journal of Lipid Research.” 55, 2211-2228. Accessed from: http://www.jlr.org/content/55/11/2211.full

Paoli, A et al. “Beyond Weight Loss: A Review of the Therapeutic Uses of Very-Low-Carbohydrate (ketogenic) Diets.” European Journal of Clinical Nutrition. 67.8 (2013): 789–796. PMC. Web. 29 Jan. 2018. Accessed from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3826507/

Yancy, William S et al. “A Low-Carbohydrate, Ketogenic Diet to Treat Type 2 Diabetes.” Nutrition & Metabolism 2 (2005): 34. PMC. Web. 29 Jan. 2018. Accessed from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1325029/

Be Food Safe When Following a Ketogenic Diet

Pork ChopIf you and your healthcare provider do determine the keto diet to be the right fit for your health needs, there are food safety considerations to be made. While there are plenty of ketogenic cookbooks available, many lack proper information on how to prevent foodborne illness. Here are a few tips to safely execute key features of the ketogenic diet that could apply to any home, protecting yourself and your family from potential foodborne illness.

Infused oils

  • Because the ketogenic diet focuses on maintaining a diet with 70-75% of the daily calories coming from fat sources, infused oils are often suggested to add healthy fats to a dish while also adding flavor. Almost every ketogenic cookbook will have at least one recipe for some type of infused oil, from those containing herbs to garlic to citrus to spices. Cookbook authors encourage making infused oils to control what ingredients go into the recipe, and therefore, one’s body.
  • Beware: The Food and Drug Administration (FDA) has named garlic, vegetable, and herb infused oils as potentially hazardous food items. There have been many cases of foodborne botulism linked to the consumption of these types of infused oils. Infused oils sitting at room temperature are at the perfect conditions for Clostridium botulinum growth: anaerobic conditions, low acid environment, a pH higher than 4.6, a good source of food and moisture (the herbs, vegetables, or garlic), and they are typically not heated before eating. The FDA recommends these types of oils “be made fresh for use and not left at room temperatures.” Any leftover infused oils should be refrigerated for use within three days, frozen for longer storage, or discarded. Some ketogenic cookbooks suggest storage in dark bottles, in the pantry, for months. This information is incorrect and can be potentially dangerous.

Salad Greens

  • Salad greens are low in carbohydrates and calories but high in vitamins and minerals. They add much needed fiber to meals, while also supplying vitamin A, vitamin K, folic acid, potassium, and beta-carotene. When consuming salad greens, it is important to follow these tips to ensure safe handling and storage of leafy salad greens:
    • Keep salad greens separate from other groceries, especially raw meats.
    • Refrigerate within two hours of purchase, stored in either a plastic bag or salad keeper.
    • Wash hands before preparing dishes containing salad greens, as most recipes are made fresh and not cooked before consuming.
    • Wash leafy greens with cold water. If necessary, separate the leaves in a bowl of cold water. Greens may also be soaked in a dilute vinegar-water solution (1/2 cup distilled white vinegar to 2 cups water), followed by a clean water rinse. This has been shown to reduce microbial contamination, but might affect texture and taste.
    • Use salad greens by use-by date, if available. Otherwise use within one week of purchase.

Cross-contamination

  • Participating in a low carbohydrate diet might include preparing and eating more meats. The ketogenic diet specifically involves eating meals high in fats, and this might mean fattier cuts of beef, dark meat poultry, or something wrapped in bacon. Incorporating more meats into a diet without proper food safety knowledge, could lead to improper food handling techniques which could lead to foodborne illness. Raw meats, poultry, and seafood can harbor pathogenic bacteria that can easily spread in a kitchen. Preventing cross-contamination is an important action to prevent foodborne illness.
  • Remember to clean, separate, cook, and chill:
    • Clean: Wash your hands and surfaces often. This is especially important after hands or surfaces come into contact with raw meats. Hands should be washed with soap for 20 seconds under running water. Wash all produce before using, even if you plan to peel it. You don’t want the bacteria on the outside of the produce to be transferred to the inside when you peel it! Do not rinse raw meats, poultry, or seafood.
    • Separate: Always use separate cutting boards and plates for raw meat, poultry, seafood, produce, and eggs. This is especially important if your produce will not be cooked before eating. Keep raw meats, poultry, seafood, and eggs separate in your grocery cart and in your refrigerator, to avoid contaminating other groceries.
    • Cook: While cooking and preparing your meals, always make sure your meats reach safe minimum cooking temperatures. This is vital to safeguard against pathogenic bacteria that could be on your food. The best way to test that meats have reached their necessary temperature is by using a meat thermometer that has been accurately calibrated. After cooking, keep food hot, at or above 140°F, until it is to be served. When reheating leftovers, make sure food reaches 165°F to kill any bacteria that may have been introduced after cooking or weren’t killed in the initial cooking step.
    • Chill: Keeping foods cold is important in controlling the growth of bacteria. Perishable foods (such as those containing meats) should be refrigerated between 40° and 32°F, or frozen within two hours of cooling. Cold temperatures slow the growth of most bacteria. Never leave meats, poultry, or seafood on the counter to defrost. Bacteria multiply rapidly at room temperature, and may begin to multiply on the surface inward as the food defrosts. Defrost meats in the refrigerator, under cool water that is to be changed every 30 minutes, or in the microwave. Do not keep meats, poultry, or seafood past their expiration dates.

Hyperlinked Resources:
Colorado State University Extension. (2012). Flavored Vinegars and Oils- 9.340. http://extension.colostate.edu/topic-areas/nutrition-food-safety-health/flavored-vinegars-and-oils-9-340/.

Colorado State University Extension. (2012). Health Benefits and Safe Handling of Salad Greens- 9.373. http://extension.colostate.edu/topic-areas/nutrition-food-safety-health/health-benefits-and-safe-handling-of-salad-greens-9-373/.

Foodsafety.gov. (2018). Keep Food Safe: Check Your Steps. https://www.foodsafety.gov/keep/basics/index.html.

Foodsafety.gov. (2018). Keep Food Safe: Safe Minimum Cooking Temperatures. https://www.foodsafety.gov/keep/charts/mintemp.html