The ketogenic diet is a high-fat, adequate-protein, low-carbohydrate diet that in medicine is used primarily to treat difficult-to-control (refractory) epilepsy in children. The diet forces the body to burn fats rather than carbohydrates. Normally, the carbohydrates contained in food are converted into glucose, which is then transported around the body and is particularly important in fueling brain function. However, if there is little carbohydrate in the diet, the liver converts fat into fatty acids and ketone bodies. The ketone bodies pass into the brain and replace glucose as an energy source. An elevated level of ketone bodies in the blood, a state known as ketosis, leads to a reduction in the frequency of epileptic seizures. Almost half of children and young people with epilepsy who have tried some form of this diet saw the number of seizures drop by at least half, and the effect persists even after discontinuing the diet. There is some evidence that adults with epilepsy may benefit from the diet, and that a less strict regimen, such as a modified Atkins diet, is similarly effective. The most common adverse effect is constipation, affecting about 30% of patients—this was due to fluid restriction, which was once a feature of the diet, but this led to increased risk of kidney stones and is no longer considered beneficial.
Stomach growling? Reach for a handful of macadamia nuts, which have the highest amount of fat and lowest amount of carbs in the nut family, according to previous research in the journal Nutrients. Nutrition aside, they’re snacking all-stars because they’re easy to bring with you and don’t need to be refrigerated. Keep a stash wherever you spend your day — in the car, at your desk, or in the pantry at home.
There are many ways of implementing a low carbohydrate, ketogenic diet plans but most involve following a higher fat, moderate protein, low carb food plan. (The Atkins diet is one of the most famous ketogenic diets, but certainly not the only one). Many people think of ketogenic diets as high protein diets but this is incorrect. They are moderate protein diets.
'Cutting out carbs without advice can be dangerous, and can put you at risk of deficiencies in the long-term,' warns Dr Barclay. 'If you're looking to lose weight, burning fat may sound like the key to success, but in actual fact it comes with some risks, and may not be effective in the long term. The ketogenic diet is a short-term solution to a long-term health problem.'
It's only when you combine lots of fat and lots of carbohydrates in your diet that you get into trouble. The sugar from the carbohydrates drives up your insulin levels, and those high insulin levels cause the body to mishandle the way fats are metabolized. More fat is stored or circulates in the blood. This causes the metabolic syndrome and weight gain associated with insulin resistance and starts the health problems that should be associated with a high carb diet, not a ketogenic diet plan.
The first modern study of fasting as a treatment for epilepsy was in France in 1911. Twenty epilepsy patients of all ages were "detoxified" by consuming a low-calorie vegetarian diet, combined with periods of fasting and purging. Two benefited enormously, but most failed to maintain compliance with the imposed restrictions. The diet improved the patients' mental capabilities, in contrast to their medication, potassium bromide, which dulled the mind.
Following the ketogenic diet can be safe in the short term but it does come with health concerns. 'It's not something that I recommend for the general population for the long-term,' says Dr Barclay. 'By drastically cutting out carbohydrate-containing foods, you'll miss out on the nutritional benefits of healthy choices like whole grains, fruit, starchy vegetables, and legumes such as beans, chickpeas and lentils.'
Lunch: pat dry chicken and cut into cubes. Lightly (!) salt and pepper. Heat a skillet over medium heat, once hot add coconut oil and fry chicken cubes until brown from all sides. Remove chicken, and add crushed garlic, curry paste and fish sauce to pan. Stir until fragrant and remaining oil in pan and curry paste are well combined. Then add coconut milk and whisk until well combined. Simmer and reduce sauce until desired consistency (1-3 minutes). Pour sauce over chicken and sprinkle with sesame seeds. Serve with baby spinach.
Sweeney does not stick to a specific macronutrient balance when he begins his own ketogenic diet plan. Instead, he maintains a diet that includes no more than 50 grams of carbohydrate per day. When he goes over 0.6 on the ketone meter (a device used to measure blood for the presence of ketones) he goes up to 70 grams of carbohydrates and takes a ketone supplement.
Conklin's fasting therapy was adopted by neurologists in mainstream practice. In 1916, a Dr McMurray wrote to the New York Medical Journal claiming to have successfully treated epilepsy patients with a fast, followed by a starch- and sugar-free diet, since 1912. In 1921, prominent endocrinologist Henry Rawle Geyelin reported his experiences to the American Medical Association convention. He had seen Conklin's success first-hand and had attempted to reproduce the results in 36 of his own patients. He achieved similar results despite only having studied the patients for a short time. Further studies in the 1920s indicated that seizures generally returned after the fast. Charles P. Howland, the parent of one of Conklin's successful patients and a wealthy New York corporate lawyer, gave his brother John Elias Howland a gift of $5,000 to study "the ketosis of starvation". As professor of paediatrics at Johns Hopkins Hospital, John E. Howland used the money to fund research undertaken by neurologist Stanley Cobb and his assistant William G. Lennox.
The ketogenic diet is calculated by a dietitian for each child. Age, weight, activity levels, culture and food preferences all affect the meal plan. First, the energy requirements are set at 80–90% of the recommended daily amounts (RDA) for the child's age (the high-fat diet requires less energy to process than a typical high-carbohydrate diet). Highly active children or those with muscle spasticity require more calories than this; immobile children require less. The ketogenic ratio of the diet compares the weight of fat to the combined weight of carbohydrate and protein. This is typically 4:1, but children who are younger than 18 months, older than 12 years, or who are obese may be started on a 3:1 ratio. Fat is energy-rich, with 9 kcal/g (38 kJ/g) compared to 4 kcal/g (17 kJ/g) for carbohydrate or protein, so portions on the ketogenic diet are smaller than normal. The quantity of fat in the diet can be calculated from the overall energy requirements and the chosen ketogenic ratio. Next, the protein levels are set to allow for growth and body maintenance, and are around 1 g protein for each kg of body weight. Lastly, the amount of carbohydrate is set according to what allowance is left while maintaining the chosen ratio. Any carbohydrate in medications or supplements must be subtracted from this allowance. The total daily amount of fat, protein and carbohydrate is then evenly divided across the meals.
Indeed, there's plenty of research to support ketogenic diets in the treatment of some devastating neurological conditions. But can it really help the average Joe or Joanne lose weight? Well, yes, in theory — especially ultra low-calorie versions. But is it suitable for long-term, sustainable weight loss and improved health? The jury's still out on that.
These cheesy, crunchy crackers are perfect for snacking when you’re on the run. They’re seasoned with rosemary and made with a mix of almond flour and cheese. While the instructions list is long, they actually come together quite easily and you’ll definitely get the hang of it by the second time — and with crackers this good, there will be a second time! Just a few of these keto snacks will satisfy any hunger panes.
This bread has a few more carbs than you might be eating, but each bite is worth it, particularly if you have low potassium. The ingredients are simple: bananas (not too ripe), almond flour, walnuts, eggs, olive oil and baking soda. But you’ll be impressed by the scrumptious loaf that comes out of your oven. A warm slice of this with a pat of grass-fed butter makes a tasty keto snack or breakfast.
Reduced hunger. Many people experience a marked reduction in hunger on a keto diet. This may be caused by an increased ability of the body to be fueled by its fat stores. Many people feel great when they eat just once or twice a day, automatically ending up doing a form of intermittent fasting. This saves both time and money, while also speeding up weight loss.
So you've decided you want to try out the high-fat, low-carb diet, better-known as the fat-burning ketogenic diet. Whether it's to lose weight, have more energy, or fuel workouts differently, going keto is a popular choice right now. But figuring out a keto meal plan on your own is no easy feat, especially since eating a diet super high in fats doesn't come naturally to many people who are accustomed to the traditionally carb-heavy American diet. (It's especially hard if you're vegan and want to try keto.) But this should help: Keto experts explain how to set yourself up for success, plus provide ideas for exactly what keto foods to eat when you're first getting started. (While you're at it, check out these Low-Carb Keto drinks That Will Keep You in Ketosis.)
The ketogenic diet achieved national media exposure in the US in October 1994, when NBC's Dateline television programme reported the case of Charlie Abrahams, son of Hollywood producer Jim Abrahams. The two-year-old suffered from epilepsy that had remained uncontrolled by mainstream and alternative therapies. Abrahams discovered a reference to the ketogenic diet in an epilepsy guide for parents and brought Charlie to John M. Freeman at Johns Hopkins Hospital, which had continued to offer the therapy. Under the diet, Charlie's epilepsy was rapidly controlled and his developmental progress resumed. This inspired Abrahams to create the Charlie Foundation to promote the diet and fund research. A multicentre prospective study began in 1994, the results were presented to the American Epilepsy Society in 1996 and were published in 1998. There followed an explosion of scientific interest in the diet. In 1997, Abrahams produced a TV movie, ...First Do No Harm, starring Meryl Streep, in which a young boy's intractable epilepsy is successfully treated by the ketogenic diet.
There are many scenarios that can cause constipation with the ketogenic diet. Most people assume it’s a fiber issue; but it’s not that simple. You want to compare what you were doing before ketosis and after. Look at the change in vegetable fiber consumption; if you don’t have enough gut bacteria to digest all these vegetables, they will cause bloating, constipation, gas and all kinds of digestive issues. Some people can digest vegetables and others can’t. Some people can’t digest cabbage or cruciferous veggies. So, you might have to switch to less fibrous vegetables, such as various kinds of lettuce, and especially kale and beet greens, for your potassium. Electrolytes greatly help with constipation, too. If you need more support getting electrolytes, try my electrolyte powder. It helps supply the 4,700 mg a day of potassium you need, which is hard to manage without eating loads of vegetables.
Most people have probably heard of the Atkins diet, which is a pretty general take on ketogenic eating. Wildly popular in the 70s and again in the 90s, Atkins and the low-carb diet are one of the best ways to lose weight. In fact, one of the biggest benefits to low carb eating is that it is a very efficient way to lose weight without much effort. The combination of filling meals that reduce overeating and the fact that, when you’re in ketosis your body burns stored fat for energy makes this an ideal diet for people whose primary goal is fat loss.
Note: Are you a vegetarian or vegan and want to go on a ketogenic diet? It’s still possible! Just keep in mind that the dietary restrictions can sometimes be a little bit intense. Make sure to plan ahead and prepare to aid your success. To help out, we’ve published articles (with 7 day meal plans included) for both the vegetarian ketogenic diet and the vegan ketogenic diet.