Nur Ecem Baydı Ozman, Nutrition and Diet Specialist of Acıbadem Kozyatağı Hospital, told what should be known about the ketogenic diet.
Most of the cells in our body use blood sugar from carbohydrates as the body’s main source of energy. When there is no sugar from food in the blood, cells release energy by breaking down storage fats into ketone bodies, this is called ketosis. This is where the name ketogenic diet comes from. Once the metabolism starts in ketosis, cells use ketone bodies to release energy until carbohydrates are re-entered into the body. The body’s use of storage fats instead of glucose as an energy source occurs when less than 20-50 grams of carbohydrates are taken per day for 2-4 days. The ketogenic diet is based on significantly limiting carbohydrates and increasing the amount of fat and protein. In this diet, instead of foods containing carbohydrates such as bread, pasta, rice and fruit, the amount of fat and protein in the diet is increased with foods such as meat, fish, butter and olive oil. As a result, the body burns fat for energy.
The ketogenic diet has been used for many years in the treatment of epilepsy attacks in children and successful results are obtained. The ketogenic diet is also used for weight loss. The ketogenic diet provides faster weight loss than fat-restricted weight loss diets. The first reason ketogenic diets provide rapid weight loss is because they burn fat when the body enters ketosis. Another reason is; effect of keeping protein and fats in the diet for a long time. Another reason why ketogenic diets provide rapid weight loss is that proteins, which we call thermic effect, make the body spend extra energy while being digested in the body. However, people can lose the same weight with fat-poor diets, albeit in a little longer time. In addition, since such diets are limited and cannot be applied for a long time, there may be disruptions in the weight maintenance period or the weight loss process. Ketogenic diets can lead to negative consequences when not done uncontrolled and accompanied by an expert. For example, diabetic patients using insulin may follow this diet, resulting in hypoglycemia, that is, sudden drop in sugar, resulting in coma or sudden death. Again, since the protein content of this diet may be high, kidney patients should not follow this diet. Adults who are overweight but do not have any health problems can follow this diet for a certain period of time as a result of the evaluation of a nutritionist. After the ketogenic diet is terminated, the transition to a normal diet should be carried out by a nutritionist in a controlled manner. Again, it is important that children and adolescents do not follow this diet, in order not to be deprived of essential nutrients for growth and development.
One of the risky aspects of ketogenic diets is the restriction of carbohydrates, high protein and animal fat consumption in these diets, and very little or no fruit and vegetable consumption. Vitamin-mineral losses may occur because people do not consume enough fruits and vegetables. In addition, it has been shown in the literature that a diet rich in protein and poor in fiber foods such as fruit-vegetables-whole grains can cause colon cancer. Complications may occur in the kidneys as a result of the application of such diets, which may be protein-based, especially in kidney patients. In addition, while ketone bodies are excreted from the kidneys with the urine, too much water is excreted along with it, and the person may become dehydrated or at risk of dehydration. Some studies have shown that ketogenic diets cause faster weight loss than traditional fat-restricted diets. However, the weight loss observed as the duration of the diet is prolonged is not much different in the ketogenic diet compared to the others. Another reason why rapid weight loss is observed in the first place in the ketogenic diet is the water loss it causes. Because when enough carbohydrates are not taken into the body, the glycogen stores in the liver are emptied and a large amount of water loss occurs in the body. Again, unconsciously made ketogenic diets can cause hypoglycemia, that is, very low blood sugar, deterioration in mental functions, increased blood lipids, and increased uric acid level in the blood. The long-term consequences of such a diet are not yet clear. In addition, it should not be forgotten that rapid weight loss can lead to metabolic problems and even sudden death.
The ketogenic diet is known to reduce drug-resistant epilepsy attacks, especially in pediatric patients, and is also used as a treatment method in pediatric epilepsy patients. Although the use of the ketogenic diet in the treatment of epilepsy may accelerate the weight loss process, it can be difficult to implement and a diet rich in red meat and fat. In the long run, this can increase people’s blood fats and lead to cardiovascular diseases. Due to frequent and large consumption of protein sources such as meat and fish, the level of uric acid in the blood of people may increase and gout may occur. For this reason, it will be beneficial for people to have their blood parameters such as blood fats and uric acid checked while following this diet. From the studies, there are results showing that blood fats decrease when weight is lost with the ketogenic diet, but there are also results showing that they increase in the long term. Insulin resistance can be observed in most obese people. In the case of insulin resistance, muscle cells cannot use the glucose in the blood and cannot convert it into energy. As a result, the glucose that rises in the blood is stored as fat. In some scientific studies, it has been seen that people who lose weight with a ketogenic diet improve their blood sugar regulation, and those who use insulin are either discontinued or the dose is reduced. However, these are the same results when weight loss is achieved with a fat-free diet other than the ketogenic diet. There are studies showing that the ketogenic diet provides blood sugar regulation in the short term, but the long-term effects of the diet are not known because such diets are not sustainable and it is difficult for people to follow these diets for a long time.
Instead of applying short-term popular diets, adopting a sustainable, healthy, varied and balanced diet that people can integrate into their lives has a more positive effect on metabolism and is important in terms of maintaining the lost weight. A diet rich in unprocessed foods, whole grain products, fresh colorful vegetables and fruits, lean protein sources such as lean meat, skinless chicken, olive oil, and oily seeds such as walnuts-hazelnuts-almonds is more beneficial in the long run than a diet based only on protein and fat. When people consume these nutrients in the right amount, they can both lose weight and maintain their weight more easily in the long run.
FitChef Expert Dietitian Özgül Yıldız drew attention to those who have been wondering about the ketogenic diet, which has been trending recently.
The ketogenic diet is known as a diet for high fat intake while containing low carbohydrates and protein. Emphasizing that it is necessary to be conscious while eating ketogenic, Specialist Dietitian Özgül Yıldız said, “The ketogenic diet is a low-carbohydrate, high-fat diet with many health benefits. This diet, which is rich in healthy fats and low in carbohydrates, aims to provide weight loss by burning the fat in the body. This reduction in carbohydrates puts the body in a metabolic state called ketosis. When this happens, fat burning becomes efficient for your body. The basic principle of the ketogenic diet is to eat fat to burn fat. Among the vegetable varieties that can be taken, low-carbohydrate vegetables such as broccoli, cauliflower, spinach, collard greens, lettuce, arugula can be preferred. As for fruit, raspberry, blueberry and blackberry can be preferred.” Stating that the ketogenic diet is recommended for people who want to lose weight (especially those with abdominal fat problems), diabetics, patients with blood pressure and insulin resistance, Yıldız draws attention to the fact that the diet should not be done for a long time.
Yıldız said, “Considering daily nutrition, 50 grams of carbohydrate is approximately equivalent to 2 apples, 1 slice of cheese and 1 bread. Apart from these, not consuming a food containing carbohydrates in any way is not considered a viable approach in the long run. The restricted milk group in the ketogenic diet can cause calcium deficiency and cause osteoporosis in the long term. Vegetable and fruit groups that are not recommended to be eaten can also cause vitamin and mineral deficiencies. Apart from these, there are also studies that show that the ketogenic diet negatively affects the intestinal flora. For this reason, we do not recommend ketogenic diets for a long time.”
The following meals and snacks should be considered when following a ketogenic diet. These:
- organic eggs
- Chicken and turkey meat
- Oily fish such as salmon, herring, and mackerel
- Dana eti
- Full-fat yogurt, butter, and cream
- Whole Cheese
- Nuts (almonds, walnuts, pumpkin seeds, peanuts, flax seeds)
- Peanut butter
- Healthy fats (coconut oil, olive oil, avocado oil, and sesame oil)
- Non-starchy vegetables (broccoli, tomatoes, mushrooms and peppers)
- Seasonings (Salt, pepper, vinegar, lemon juice, fresh herbs and spices.