What is and does it really work?

A recent survey of registered dietitians named the low-carb keto diet once again as the most popular diet in the United States. In Ireland, it always occupies a prominent place in Google searches, with keto recipe books that occupy a prominent place in the publication lists, especially at this time of year.

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Boosting this diet is fat and a lot, up to 90 percent of daily calories.

His fans (and sellers) feed social networks with before and after photos, attributing weight loss that alters life or other effects to the diet. They shake butter in their coffee, load cheese and eat lonely hamburgers without their best friend, the bun. Basic foods, such as whole grains, legumes, fruits and starchy vegetables, are being ejected from the dish as devotees strive for ketosis, when the body begins to burn fat instead of glucose as Its main source of energy.

The diet is acclaimed for losing weight, burning more calories, reducing hunger, controlling diabetes, treating drug-resistant epilepsy, improving blood pressure and cholesterol, as well as triglycerides, the main form of fat storage in the body. People have also reported a better concentration.

First, one word: choosing a meal plan or an approach to eating is very personal. The body, tastes and background of each person are unique. The best approach to food intake is one in which you are healthy and nourished and match your social and cultural preferences. If you want guidance, it is recommended that you consult with a dietitian.

What is the ketogenic diet?

A “typical” ketogenic diet consists of at least 70 percent of the calories derived from fats, less than 10 percent of carbohydrates and less than 20 percent of proteins. The ketogenic diet, used for a long time to treat epilepsy in children, requires that 90 percent of daily calories come from fat, with an amount of protein or carbohydrates that varies as long as they are 4 grams of fat per 1 combined gram of carbohydrates and proteins. , according to the American Epilepsy Society. That can mean eating a lot of cheese, butter, eggs, nuts, salmon, bacon, olive oil and non-starchy vegetables such as broccoli, cauliflower, vegetables and spinach. For people with arithmetic problems, online applications and programs can do the calculations for you.

The goal of the ketogenic diet is to enter a state of ketosis through fat metabolism. In a ketogenic state, the body uses mainly fat for energy instead of carbohydrates; With low levels of carbohydrates, fats can be converted into ketones to nourish the body.

For ketosis, a typical adult should remain below 20 to 50 grams of net carbohydrates, measured as total carbohydrates minus fiber, every day. Crossing that threshold is easy: a thick slice of bread adds 21 carbohydrates, a medium apple 25 and a cup of milk 12. It’s not just bread and soda that comes out, but high-sugar fruits and starchy vegetables like potatoes , as well as too much protein In addition, dieters should be on high alert for hidden carbohydrates, often invisible to the eye, but covering that seemingly friendly keto fried cheese.

Can I lose weight with the keto diet?

Yes. Certainly, in the short term, it seems that way. During the first two to six months, there is evidence that a very low carb diet can help you lose more weight than the standard high carb and low fat diet, according to a recent literature review of low carb diets by the National Lipid Association in America. “At 12 months, that advantage is essentially gone,” said Carol Kirkpatrick, director of the Idaho State University Wellness Center and lead author of the new literature review. After that, weight loss seems to equalize between those two popular diet regimens. She said that keto is best used to start a diet, before moving on to a carbohydrate intake to which it can adhere in the long term.

How long does it take to see the results of the keto diet?

For some, it is the promised land of diets. Instead of shrinking through carrot sticks, they can be filled with sausage without fault with scrambled eggs. In fact, some evidence suggests that people feel less hungry while in ketosis and have less cravings. “That’s why it has become so popular for the general population,” said Dr. Mackenzie Cervenka, medical director of the Center for Diet for Adult Epilepsy at Johns Hopkins Hospital. “Because once you’re in ketosis, it’s easy to follow.”

Usually, doctors say that it takes between one and four days to enter the state, but it depends on many factors, such as the level of activity: a runner, for example, can run faster than a couch potato.

The keto diet seems to offer quick results: it may seem that the first pounds lose. That can be seductive, but it is probably the weight of the water. Then, say dietitians, return to energy in less energy out.

But can the ketogenic diet help burn more calories?

There is some evidence that it can. Research is limited and conflicting here too. It can be a very small and not significant effect for weight control. That is what one study found. In it, 17 obese or overweight volunteers moved to metabolic rooms for two months and were monitored until the last tablespoon of food. (This science account uses defining terms such as “obese” to clarify the topics of research studies.) During the first month, they consumed a high carb diet; for the second, they had a ketogenic one, with both plans equal in calories.

In the end, although insulin levels decreased while eating the hamburger without bread, they lost no more fat than when they ate bread. However, the study was limited by having a small sample size and not having a comparison group that was not in consecutive regimens.

For some, a low carb diet may be attractive. That does not mean that the diet is superior, according to a study that followed 609 overweight adults on a low carb or low fat diet for a year. In the end, both groups shed almost the same amount on average, around 12 to 13 pounds, according to the randomized clinical trial who examined a lower carb diet less restrictive than keto.

Does the ketogenic diet benefit in the long term?

Still not known. “If you tell people to follow this diet forever and for a longer period, there is no evidence,” said Carla Prado, associate professor and director of the Human Nutrition Research Unit at the University of Alberta.

The diet helps children with epilepsy: almost a third or two thirds of patients experience 50 percent less seizures after six months in the regime. (Even in the year 400 BC, people fasted to treat epilepsy. And the ketogenic diet itself is almost a century old, and it has been popular to help with seizures until the discovery of an anticonvulsant medication) . There are case studies on how 10 patients with a rare condition in the diet for a decade, but most well-designed studies in this field have not extended beyond two years.

Does a low carb diet help people with diabetes?

Yes. “Carbohydrates are the main driver of blood sugar,” said Dr. William Yancy, director of the Duke Diet and Fitness Center, which sees many promises in the diet that helps people with diabetes.

A new randomized clinical trial 263 adults with type 2 diabetes were enrolled in group medical visits, half received medication adjustments for better blood sugar control and the others underwent weight control counseling on a low carb diet. (All study participants had a BMI that was within the range of overweight or obesity.) Both groups experienced low blood sugar levels at the end of 48 weeks, according to findings in the Journal of the American Medical Association Internal Medicine. However, the weight-loss group in the low-carb diet lost more weight, required less medication and had fewer problematic episodes of low blood sugar.

For those with type 2 diabetes, a low-carb diet seems to improve average blood sugar levels better in the first year than the high-carb and low-fat diet. After that period of time, the review of the National Lipid Association found that the difference almost disappears, but with a very important benefit: low-carb participants were able to use fewer medications. “People like that because they don’t like to take diabetes medications,” said Dr. Yancy.

Is there any healthy way to eat more fat?

When Dr. Cervenka begins her epilepsy patients on a low carb diet, she does not rule out saturated fats from animal products. She wants them to get used to the new way of eating. But if cholesterol levels increase and remain so, she advises them to switch to foods and oils with mono and polyunsaturated fats such as avocado or olive oil.

While the effect of the diet on LDL (“bad” cholesterol) appears to be mixed, the National Lipid Association review found that a very low carb diet seems to improve HDL (commonly known as good cholesterol). Beyond a year, it seems that these benefits do not last, as in weight loss. Only low triglyceride levels seem to have permanence power. Other findings: the evidence on blood pressure is inconsistent, and reports of mental improvement are not supported by controlled studies.

What is the effect of all that fatty meat on your health?

And what happens, for example, after cutting fruits, legumes and whole grains, all the foods that studies aim to reduce cardiometabolic risk? Dr. Neil Stone, a preventive cardiologist, is worried about this, since he has seen the levels of bad cholesterol drastically increase in some of his patients who follow the keto diet. (It doesn’t happen to everyone, but it happens to some). “Any diet that elevates the main risk factors for coronary heart disease puts patients at long-term risk,” he said.

There are many ways to interpret the keto diet. Some people will eat a salad with chicken, dressed in olive oil, while others will delight in piles of bacon watered with diet sodas, the type of diet known as “dirty keto.” That is to eat anything, including processed foods, as long as their carbohydrates are low enough and their fat high enough to achieve ketosis.

The best diet is the one that works for you, but if you want to try this, you are recommended to avoid trans fats such as margarine, limit saturated fats by consuming lean cuts of beef, skinless chicken breast and incorporate fatty fish such as Salmon in your diet. Look for foods high in unsaturated fats such as avocado, nuts, seeds and olive oil.

Are there any side effects of the keto diet?

At first, some may experience some stomach problems and gastrointestinal (GI) problems. “Ninety percent of the calories from fat are probably going to be a shock to the system,” Linsenmeyer said. According to doctors, it is crucial to consult with a dietitian or doctor, regularly monitor cholesterol levels and replenish fluids and sodium lost by increased urination and severe carbohydrate restriction. Otherwise, within two or four days after the start of the diet, that exhaustion can cause “keto flu”, symptoms such as dizziness, lack of sleep and fatigue in some people.

“Carbohydrates have many nutrients that can help us maintain our body’s function,” said Prado. In the diet, some people experience “breath keto”, a halitosis probably caused by the production of acetone, which is one of the ketone bodies.

Possible side effects for patients with epilepsy who begin the diet include constipation due to reduced fiber intake, vomiting, fatigue, hypoglycemia, worsening reflux and increased seizure frequency. The National Lipid Association review urges that patients with lipid disorders (such as high cholesterol or triglycerides), a history of atherosclerotic cardiovascular disease (such as a heart attack or stroke), heart failure, and kidney and liver disease take precaution If you consider the diet. People who take blood thinners should be very careful.

Tips we can all agree on: eat healthy, there is no quick fix

The advice of fighting diet camps can be confusing.

Keto is not the only way to lose weight or change your life, obviously. Dietitians say it is not essential to reduce the amount of food, since a moderate low carb diet can still have benefits for diabetes or weight loss.

One thing is certain, any significant change begins with the behavior. Are you at the right point to make a change in your life? Dr. Yancy suggests asking his friends and family to support him, consult a doctor, incorporate physical activity and begin to consider it not as a temporary measure, but rather as a lifestyle change. – New York Times

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