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May 31, 2016 / Nicole Villeneuve

Going Ketogenic? Benefits and Risks You Should Know

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If you’ve spent much time around anyone following an Atkins plan or in strict Paleo circles, you may have heard the terms ‘ketosis’ or ‘ketogenic’. These terms refer - broadly - to a metabolism fueled by fat, as opposed to one fueled by glucose from carbohydrates.

While the body is designed to run on either source, not every individual body will thrive on a purely ketogenic diet. Here’s what you need to know if you’re thinking of making the switch.

Decided keto is the right fit? See sample meals designed for your goals on PlateJoy.  

What is ketosis?

Ketosis occurs in the body when the body primarily relies on the breakdown of fat for energy. In a typical carb-heavy North American diet, the body will defer to carbs, breaking these down first for fuel as they’re easiest to metabolize. In the absence of ample carbohydrates, the body will shift gears and instead use fat from ingested and stored sources.

Don’t we need glucose?

Yes: the brain and liver in particular rely on glucose as their primary fuel, and going without any glucose for an extended period can be dangerous; however, the liver will naturally produce a fatty acid called a ketone body (or “ketone”) as a byproduct of protein conversion. These can help fulfill part of the brain’s need for glucose.

Ketogenic diet benefits and risks

As you might expect, one of the main reasons for embarking on a nutrition plan like this would be to lose weight. Once the body is running on fat for fuel, it is easier to access and utilize its own stored fat -- a process called ‘lipolysis’ -- which can lead to an overall reduction in weight. Ketosis has also been shown to restore insulin sensitivity and regular metabolic function in those whose bodies have become insulin resistant.

Ketosis has also been shown to be effective in treating neurological diseases like Alzheimer’s and Parkinson’s, possibly because of the switch from glucose to ketones for fuel in the brain.  

In addition to being higher in healthy fats and micronutrients, a well-managed ketogenic diet is lower in processed foods, toxins, sugar and inflammatory substances than a Standard American Diet.

When is ketosis unsafe?

While some groups might benefit from this way of eating, particularly for weight loss, ketosis is unsafe for anyone with a metabolic condition that prevents normal use of fat for fuel. Type I diabetics should also be careful and consult a physician about their insulin stability before attempting to remove all carbohydrates from the diet.

It’s also not advised for women looking to become pregnant or increase fertility, nor is it advisable for those participating in high-intensity athletic training. The body can produce its own glucose from fat and protein via ketone bodies, but not to the extent these activities require.

Additionally, it’s important to know that ketosis can contribute to uncomfortable and potentially problematic conditions like constipation, kidney stones, bone density loss, stunted growth, Vitamin C deficiency, thyroid problems, low energy and mood disorders.

Switching to ketosis if you decide it’s right for you

If you’re trying a ketogenic diet,  you’ll be looking for meals very low in carbohydrates and moderate in protein but high in fat, forcing your body to switch to using ketones for fuel.

Getting most of your calories from whole food-sourced fats will begin this process. Concentrate on foods like coconut, olive oil, avocado, beef tallow, ghee or butter, eggs, macadamia nuts and full-fat dairy. These high-fat foods will provide lasting satiety.

When it comes to protein, opt for fatty wild-caught fish like salmon, mahi mahi, mackerel, catfish, trout and tuna in addition to poultry, pork, beef and game meats. Look out for added sugars and preservatives: avoid these whenever possible.

Although starchy veggies are out because of their higher carb load, you’ll need the micronutrients offered by non-starchy plants. Incorporate green leafy veggies, crucifers like cabbage, kale, broccoli and cauliflower, tomatoes, onions, mushrooms and peppers.

To help you keep track on a keto diet, you can get help with a keto diet grocery list and meal plan.

Is there such a thing as a moderate ketogenic diet?

If you decide that a full-on ketogenic diet is too difficult or too risky for you, you can still reap the insulin-stabilizing and weight-reducing benefits without the potential long term risks by practicing a “cyclic ketogenic diet”. This more flexible approach would mean adhering to a ketogenic plan for three to four days, followed by a higher carbohydrate day or two, repeated weekly. This would be ideal for someone participating in a high-intensity sport or who might have other mitigating risk factors.

Nicole Villeneuve

Nicole Villeneuve is a certified Diabetes Prevention Lifestyle Coach. A graduate of Yale University, she previously worked in book publishing, with a focus on cookbooks and health, and ran the food blog Paper and Salt. Her writing has been featured in Bon Appetit, Food & Wine, The New York Times Magazine, The Paris Review, and The Daily Beast. Nicole lives in San Francisco and loves cooking, reading, exploring new restaurants, and running by the ocean. You can (very occasionally) find her on Twitter.


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