By Brandon Roberts, Ph.D.
The ketogenic diet has been all the rage for the past few years. If we look at search trends with Google, the peak of popularity hit in 2018. However, keto isn't new, and has been studied by scientists for almost 100 years.
The popularity of going keto has caused a lot of debate - is the diet something special or is it just another fad? How hard is it to do? What the heck is ketosis, and will it help me lose weight?
Let's tackle those questions one at a time with some science to back it up.
The ketogenic diet is a very low carbohydrate (<50g), low protein, and high fat diet. There are variations of keto that involve high protein, but that's not the original diet. The goal of the ketogenic diet is to get you into ketosis. This happens by the lack of carbohydrates, not the high fat intake. As your body depletes its internal carbohydrate stores (glycogen) it starts to create ketones. The three ketones are: B-Hydroxybutyrate, acetoacetate, and acetone. These ketones can be used for energy and can be measured in the urine or blood, except for acetone, which is exhaled (it smells sweet). The exact numbers for being in ketosis are debatable but the literature suggests 1-2mmol of B-hydroxybutyrate is the goldilocks zone.
The hardest part about the ketogenic diet is making it through the "keto flu" which occurs for the first week or two. The symptoms include headache, foggy brain, fatigue, irritability (aka hangry), yet this term is not recognized by medicine. During this period you also go through the 'keto flush' where you can see large drops in body weight due to water loss that are stored with glycogen. The large decreases in water can be motivating to people who are dieting yet can be replenished just as quickly as they are lost.
The ketogenic diet can definitely help you lose weight if you adhere to it. So will any diet. While there are some who believe it creates a metabolic advantage, this wasn't the case in a recent clinical trial. That doesn't mean it's useless - it does have some perks - such as reducing hunger. On the other hand, adherence can be difficult after a few months, then again so can any diet.
The ketogenic diet is a tool. It's more garden variety than DIY. You can use it over short periods to lose weight if you want. I wouldn't recommend most athletes go keto since the bulk of the literature shows that it decreases in performance. That doesn't mean it's not possible. It just means it's not optimal. It goes against almost every sports nutrition recommendation from a scientific perspective. All of that said, if you can use the ketogenic diet to reach your goals then do it - just don't think it's magic or biohacking.
Brandon Roberts is a scientist, coach, writer, and physique athlete. He has a Ph.D. in muscle biology and is currently studying how ketone supplements affect muscle. He also coaches for Macros Inc and writes comprehensive, evidence-based articles for Examine.com, SCI-Fit, and Medium. You can find him on Facebook, or his website.
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