What is a keto diet? It's certainly trendy right now for various reasons, including celebrity advocates, impressive weight loss stories and athletes who swear by it. But the keto diet is more than a fleeting diet trend and our understanding of the keto diet and its link to overall health, is gaining momentum.
Since the ketogenic diet is currently popular, there also (unfortunately) tends to be a lot of misinformation circulating about what it is and how to follow it. I turned to Noor Struik of The Nourishing State, a registered dietician and nutritional epidemiologist, to help answer a few basic questions about the keto diet. Noor specializes in low-carb, high-fat diets for weight management, controlling diabetes, and managing other medical issues. She helps people reach their nutritional goals and improve their overall health. Plus, she’s extra awesome because she’s weighing in here to help address many common keto diet questions! 🙂
keto 101: q&a with The Nourishing State
q: what exactly is a keto diet?
a: A ketogenic diet is low carb, high fat intake with a sufficient amount of protein. The goal with a keto diet is to induce a metabolic state called ketosis, which is when the body switches to burning fat instead of burning glucose for energy. Keto-friendly foods and recipes may also be referred to as "low-carb," or LCHF (low-carb, high-fat) and while these terms overlap, they’re not quite interchangeable. Most (but not all) low-carb recipes are keto-friendly, but may not be totally keto because they are too high in carbs and may not include a sufficient amount of fat. Many keto diet followers can use low-carb recipes if they are mindful about the amount of carbs and add high-quality fats to help stay in ketosis.
q: why did you first become interested in the keto diet?
a: I first became interested in the keto/LCHF diet when I was working in private practice in the Netherlands and saw a lot of clients with type 2 diabetes. I noticed that the standard dietary guidelines weren’t helping, and I believed all my clients were accurately reporting their dietary intake. I began training in LCHF diets and started working with this approach, seeing great results with many of my clients!
While working as a dietitian, I pursued my master’s in Nutritional Epidemiology which brought me to Australia for a master’s internship with the Commonwealth Scientific and Industrial Research Organization (CSIRO), the national science arm of Australia. I couldn’t be more excited, as my research focuses on LCHF diets and diabetes – my main areas of interest. After two months of living in Australia, a fellow researcher and dietitian advised me to try the keto diet myself, to manage my headaches after two serious concussions the year before. This has made such a difference, and motivates me even more to help people get the right dietary advice. So, I started my own dietary practice to help people achieve their health goals. I’m planning to combine this with a PhD in – of course – the keto diet and metabolic flexibility.
q: who might benefit from a ketogenic diet and why?
a: The ketogenic diet can be beneficial for a wide range of people for various reasons. Since ketones are a potent energy source for the brain, many people experience increased energy and mental clarity. Athletes on a keto diet claim it helps boost endurance and overall performance. Others looking to lose weight generally find more success when cutting out carbs and sugar. And there is an increasing amount of medical research on how a ketogenic diet might benefit people with the following health conditions:
- diabetes- The keto diet's emphasis on no sugar (other than natural sugars from low-glycemic foods) and minimal carbohydrates, help to maintain a low, stable blood glucose level, necessary for diabetics.
- celiac disease- Since wheat products are too high in carbs for the keto diet, LCHF foods and recipes are almost always gluten-free.
- cancer- There is some research, specifically in the area of brain cancer, that points to a therapeutic ketogenic diet as a potentially beneficial therapy alongside conventional treatment. The idea summarized is that cancer cells cannot burn ketones in the same way they use glucose as energy, which results in a "starvation" state, weakening the cell and potentially making it more vulnerable to chemotherapy and radiation. Several preclinical studies have provided evidence for the anti-tumor effects of a ketogenic diet and its synergy with conventional treatments.
- seizures- The Charlie Foundation has pioneered the study of the ketogenic diet as a therapy for epilepsy and, in recent years, other neurological disorders. Its board consists of influential doctors, dieticians and researchers who have spent decades expanding the keto community and championing ketogenic diet programs in medical institutions worldwide.
- obesity and weight loss- Low-carbohydrate, high-fat diets significantly promote greater weight loss compared to low-fat diets. By reducing your carb intake, the insulin levels in your blood decrease, which makes it possible to burn fat. Short-term, weight loss occurs from increased water excretion, increased energy and calorie-burning. Long-term, a keto diet increases fat-burning, reduces hunger and cravings, improves metabolic function, and reduces inflammation, among other benefits.
- acne - Evidence supports a link between refined carbohydrates and acne, and the ketogenic diet could be effective in reducing the severity and progression of acne.
- GI distress – GI distress is likely caused by inflammation. A ketogenic diet may therefore be beneficial to reduce your symptoms, as the ketones produced by your body are anti-inflammatory.
q: is a keto diet safe?
a: For most people, a ketogenic diet is safe to practice long-term and may even contribute to improved overall health. However, this varies from person to person and it's very important to work with a licensed nutritionist or dietitian, before implementing a ketogenic diet.
q: how do you start a keto diet?
a: Implementing a keto diet should occur with the help of a nutritionist (like myself) or dietician who can help you understand macronutrients, which foods are keto-friendly, and how to make the best low-carb/high-fat food choices. If you are opting for low-carb foods, that's one thing, but if your goal is to get into ketosis, you should first consult with a doctor or nutritionist to learn if it's the right choice for your personal health.
q: what can you eat on a keto diet?
a: A traditional keto diet consists of a macronutrient ratio of 4:1, meaning 4 grams of fat for every 1 gram of carbohydrates and protein. Typically, you'd want about 75-80% of your caloric intake to come from healthy fats, about 15-20% from protein, and around 5% from carbs. Here are a few examples of keto-friendly foods:
- Healthy fats for a keto diet- coconut oil, olive oil, MCT (medium-chain triglyerides) oil, avocados and avocado oil, fat-dense nuts and seeds (macadamias, almonds, flaxseed), fatty fish (wild salmon or sardines), and full-fat dairy options (if you are okay with dairy) like cheese, Greek yoghurt and sour cream
- Protein sources for a keto diet- fatty fish, grass-fed or pasture-raised meats, nuts and high-protein vegetables. Keep in mind the macronutrient ratios here, because too much protein can also increase blood sugar.
- Carbohydrate sources for a keto diet- most of the carbohydrates you consume on a keto diet should be from vegetables and a minimal amount of fruit. Low-carb, nutrient-dense and fiber-rich vegetables include broccoli, cauliflower, celery, leafy greens, zucchini, brussels sprouts, asparagus and green beans, among others. When it comes to fruit, opt for low-sugar fruits like raspberries and blueberries.
q: what are net carbs and do I need to track them?
"Personally, I believe it’s more important to focus on satiety and how certain foods/meals make you feel, versus counting carbs."
a: You’ll find that some people on a keto diet track macronutrients- grams of fat, protein and carbs that make up your total caloric intake. This can be helpful to ensure your macronutrients are within the appropriate ratio for a keto diet, however, it’s not always necessary. Personally, I believe it’s more important to focus on satiety and how certain foods/meals make you feel, versus counting carbs. If you do choose to track your macros, your net carbs are what you'd count to come up with your total amount of carbohydrates for the day. Net carbs are the carbohydrates in a food minus the amount of fiber. For instance, if one cup of raw broccoli has 6 grams of carbs and 2.4 grams of fiber, your net carbs would be 3.6 grams.
q: what are some common misconceptions about a keto diet?
a: The biggest misconception is the idea you can’t eat tasty foods while being on a keto diet. Think of it- all the best flavor is in the fatty and protein-rich foods! Carbs just serve as the way to get the flavorsome goodies into your mouth. It can take a bit of time to know how to incorporate keto meals into your diet, but with plenty of mouthwatering recipes online and the help of a dietitian to tailor it to your needs, you’ll be good to go in no time.
Saturated fat has been demonized for ages, but without scientific grounds.
Another misconception is the fact that saturated fat is bad and should be banned from our diet. Saturated fat has been demonized for ages, but without scientific grounds. Research actually shows that saturated fat isn’t bad at all, as long as we burn it for fuel. And let that be the case while following a keto diet. ☺