The Ketogenic Diet: Everything You Need to Know

Published May 10th, 2022 by Chris Riley
Fact Checked by
Erik Rivera
Medically Reviewed:
Dr. Angel Rivera

The ketogenic diet, also called the keto diet, is a high fat, low-carbohydrate diet that has been used for over a century to treat epilepsy.

In recent years, the ketogenic diet has also been used to help with weight loss and improve overall health including losing weight because it causes you to burn more calories than many other diets.

It is also a great way to improve your health because it can lower your blood sugar and cholesterol levels as well as have other possible health benefits.

In this article, we will discuss the ketogenic diet in detail and answer all of the questions you may have about it.

What is the ketogenic diet?

The physician Rollin Turner Woodyatt was the first to implement the ketogenic diet in 1921 in an attempt to treat epilepsy patients after studying the correlation between diet and diabetes.

The ketogenic diet is a high fat, low carbohydrate diet that forces your body to burn body fat instead of glucose, also known as glucose, as a source of energy.

It is called the ketogenic diet because when your body breaks down fat for energy, ketone bodies are produced in your liver and ketosis is a metabolic state in which ketones are present in your blood and used as a source of fuel by your body.

The ketogenic diet has been shown to be effective in treating epilepsy, weight loss, diabetes, and cancer among several other medical conditions that we will detail below.

A ketogenic diet is very similar to other low-carb diets such as the Atkins diet.

keto diet

What are the different types of ketogenic diets?

There are four different types of ketogenic diets that vary in the ratio of fat, protein, and carbohydrates, and they are:

Standard ketogenic diet (SKD)

The standard ketogenic diet is a very low-carb diet with a moderate protein intake while also being a high-fat diet.

When you follow this version of the diet, your diet will consist of 70% fat, 20% protein, and 10% carbohydrates.

Cyclical ketogenic diet (CKD)

The cyclical ketogenic diet is a ketogenic diet that involves periods of higher carbohydrate intake followed by periods of ketosis, which is also known as carb cycling.

For example, you may eat a ketogenic diet for 3 days in a row, and then on the fourth day, you eat a higher carb meal and then repeat the cycle.

Targeted ketogenic diet (TKD)

The targeted ketogenic diet is a variation of the standard ketogenic diet where you consume more carbohydrates around the days you exercise.

Athletes and bodybuilders often use the targeted ketogenic version of the diet because it allows them to have more energy during their workouts.

High protein ketogenic diet (HPKD)

The high protein ketogenic diet is a variation of the ketogenic diet where you consume more protein while still maintaining a ketogenic state.

Again, bodybuilders and athletes prefer this diet to help them maintain their muscle mass while also being in a ketogenic state.

What is ketosis?

Ketosis is a metabolic state in which ketones are present in your blood and used for energy by your body.

The ketogenic diet forces your body to burn fat instead of glucose for energy and ketosis is a result of that.

When you are in ketosis, your body is burning fat for energy instead of carbohydrates, which is why the ketogenic diet is an effective weight-loss tool.

Other ways you can enter into a state of nutritional ketosis is by fasting, such as intermittent fasting, or consuming a very low-carbohydrate diet.

The way to tell if your body has entered ketosis is to test for ketones in your urine, blood, or breath and all three testing instruments are widely available online.

What are the health benefits of the ketogenic diet?

The ketogenic diet has been shown to be effective in treating numerous different medical conditions. The most common health benefits of the ketogenic diet include:

Weight loss

The ketogenic diet is an effective weight-loss tool because it forces your body to burn fat for energy instead of carbohydrates.

It is one of the most effective tools for weight loss and some studies have even shown it as more effective than a low-fat diet.

It's also one of the easiest diets to follow because it doesn't require counting calories or logging the foods you eat, although you will have to carb count, and you do not have to monitor your fat intake as closely.

Managing diabetes

Diabetes, also called diabetes mellitus, is a chronic condition where you have an elevated level of blood sugar due to your body's inability to use blood sugar for energy.

When you eat or drink something, your body breaks it down and glucose, also called blood sugar, eventually gets absorbed into your bloodstream which can raise blood sugar levels.

If you are diabetic, the reason you have such a difficult time lowering your blood sugar is that your pancreas stops making insulin, a hormone used by your cells to convert blood sugar into energy, or your cells become less insulin sensitive, meaning they stop reacting to insulin and do not use it anymore.

The ketogenic diet has also been shown to be effective in managing diabetes by lowering blood sugar levels and improving insulin sensitivity.

In fact, some studies have shown that the ketogenic diet is a great recommendation if you have type 2 diabetes as a first line of treatment due to obesity also being a risk factor for it.

Other studies have also shown that if you use the keto diet you increase your insulin sensitivity by decreasing the insulin resistance in your cells. In some of these studies, especially for people with type 2 diabetes, they found themselves also using their medications less to manage their blood glucose levels.

As always, if you have diabetes, talk to your doctor or health care provider before trying a new diet plan about any health conditions you may have as well as any medications you may be taking.

Epilepsy

The ketogenic diet was originally developed in the 1920s to treat epilepsy and it is still one of the most effective treatments for it in children.

In fact, a ketogenic diet is recommended as a treatment option for children with uncontrolled epilepsy by many doctors and health care providers.

The keto diet has also been shown to be effective in reducing seizure frequency in children with drug-resistant epilepsy.

Cancer

Cancer is a disease where cells in the body grow out of control and can form tumors.

The ketogenic diet has been shown to be effective in treating cancer by slowing down tumor growth which is thought to be due to lower levels of insulin in your body when on the keto diet. More study is needed to prove the efficacy of these studies.

Alzheimer's disease

Alzheimer's disease is a progressive brain disorder that affects memory, thinking, and behavior.

The ketogenic diet has been shown to be effective in treating Alzheimer's disease by improving cognitive function and reducing the rate of progression of the disease.

Parkinson's disease

Parkinson's disease is a brain disorder that affects movement.

The ketogenic diet has been shown to be effective in treating Parkinson's disease by improving the symptoms of the disease and reducing cognitive impairment.

Heart disease

The ketogenic diet has been shown to be effective in treating heart disease, also called cardiovascular disease, by reducing the risk factors for it such as high blood pressure, high cholesterol, and obesity.

It has been shown to reduce LDL cholesterol and triglyceride levels which can help lower blood pressure.

By reducing these risk factors, the ketogenic diet can help reduce developing the risk of heart disease, such as hardened arteries or heart failure, although it is uncertain for how long.

Acne

Acne is a common skin condition that can affect you at any age and the ketogenic diet in studies has shown to help in treating acne by reducing inflammation and sebum production.

It is believed that the reduction in acne is due to lower insulin levels although it is uncertain why it happens and more research is needed to draw any definitive conclusions.

Polycystic ovary syndrome

Polycystic ovary syndrome is a hormonal disorder that can affect women of childbearing age.

The ketogenic diet helps to treat polycystic ovary syndrome and it is believed that the keto diet's effect on reducing insulin levels is the reason for these improvements although more research is needed to confirm these claims.

Brain trauma

Brain trauma is a serious injury to the head that can cause long-term problems and the ketogenic diet may help with treating brain trauma by reducing the damage caused by the injury and improving cognitive function.

It is thought to help in repairing your brain by encouraging your brain to use ketones for energy when on a ketogenic diet.

Are these health benefits backed by scientific research?

While many studies and clinical trials have been conducted to prove the effectiveness of the ketogenic diet on many different medical conditions, more research is necessary for most of them to be conclusive.

As with any diet or treatment, it is always best to talk to your doctor or health care provider before starting a ketogenic diet to treat any medical problem.

What foods can I eat on the ketogenic diet?

The ketogenic diet is a high-fat, low-carbohydrate diet but the exact macronutrient composition of your food intake varies depending on the specific type of ketogenic diet you are following, typically, it consists of 60-80% fat, 15-30% protein sources, and less than 50 grams of carbs per day.

There are a wide variety of foods available to you and some examples of keto-friendly foods include:

Seafood

  • Salmon
  • Tuna
  • Sardines
  • Clams
  • Trout
  • Mackerel
  • Crab
  • Shrimp

Meat and poultry

  • Beef
  • Chicken
  • Turkey
  • Ham
  • Bacon
  • Pork

Dairy

  • Most unprocessed cheeses like cheddar, goat cheese, blue cheese, mozzarella, cream cheese, brie, cottage cheese, feta, provolone, string cheese, and parmesan
  • Yogurt, including greek yogurt
  • Heavy cream
  • Butter
  • Ghee
  • Half and half
  • Unsweetened soy milk

Vegetables

  • Leafy green vegetables like lettuce, spinach, and arugula
  • Cooking greens like collard greens, bok choy, kale, mustard greens, and cabbage
  • Herbs such as thyme, rosemary, sage, mint, and oregano
  • Peppers
  • Summer squash
  • Avocadoes
  • Cauliflower
  • Mushrooms
  • Tomatoes
  • Cucumber

Nuts and seeds

  • Pumpkin seeds
  • Walnuts
  • Almonds
  • Chia seeds
  • Flax seeds

Oils

  • Olive oil
  • Avocado oil
  • Coconut oil

Other keto-friendly foods include eggs, dark chocolate, cocoa powder, raspberries, strawberries, salt, pepper, and most spices.

Please note, that the above list is not an all-encompassing list and that many other foods in these categories can also be keto-friendly.

Always make sure to read any labels and check the carb content of any food before consuming it while on a keto diet.

What foods do I avoid on a keto diet?

In general, since you want to lower your carb intake on a keto diet you will want to avoid foods and drinks that are high in carbohydrates. These include:

Sugary foods and drinks

  • Sodas
  • Fruit juice
  • Smoothies
  • Maple syrup
  • Cakes
  • Ice cream
  • Sweets
  • Alcohol like beer, wine, and mixed drinks with sugary mixers like margaritas

Grains and starches

  • Bread and all wheat-based products
  • Rice
  • Pasta
  • Cereal
  • Crackers
  • Instant oatmeal

Fruit

  • Almost all fruits except raspberries and strawberries

Beans and legumes

  • Peas
  • Lentils
  • Chickpeas
  • Greenbeans
  • Soybeans

Vegetables

  • Most root vegetables such as potatoes, beets, carrots, sweet potatoes, parsnips, and yams

Other foods to avoid include mayonnaise, ketchup, BBQ sauce, honey, and vegetable oils.

From around the web: Keto Diet

Reddit Community - The Home for Ketogenic Diets

Reddit Community - What is your opinion of Keto

Pinterest - Keto Diet Recipes

Are there any side effects or risks to the ketogenic diet?

The ketogenic diet is a safe and effective way to lose body weight but there are some side effects that can occur when first starting the diet or if you are not following it correctly. These common side effects are typically called the “keto flu” and can include:

  • Diarrhea
  • Headache
  • Fatigue
  • Irritability
  • Weakness
  • Constipation
  • Vomiting
  • Bad breath
  • Lack of energy
  • Difficulty concentrating or mental fogginess
  • Indigestion
  • Increased appetite
  • Trouble sleeping

Adhering to the ketogenic diet for a long period of time may also put you at risk for adverse effects such as some nutrient deficiencies, liver problems, and kidney problems.

You also run the risk of getting acidosis, specifically ketoacidosis, which is when your blood becomes too acidic.

The risk is increased when taking certain medications for diabetes so it is always important to talk to your doctor or health care provider before starting any new diet and telling them about any medications you are taking to avoid any health risks.

Is there a way to prevent these side effects or risks?

The keto flu can be prevented or minimized by slowly transitioning into the ketogenic diet over a period of a few weeks, all while monitoring your electrolyte intake such as salt, magnesium, and potassium, watching your water intake by drinking plenty of fluids, and getting adequate sleep.

You can also talk to your doctor or health care provider about any nutrient deficiencies, such as a lack of micronutrients or lack of minerals, you may be at risk for and they can recommend supplements.

If you are at risk for ketoacidosis, it is important to monitor your blood sugar levels and ketone levels closely.

Summary

The ketogenic diet consists of limiting your carbohydrate intake to only 50 grams per day or less while getting the majority of your calories from fatty foods and protein sources.

The foods and drinks you need to avoid on the keto diet are sugary foods and drinks, grains, starchy vegetables, and fruit as well as many other foods.

You get the majority of your calories from fat or protein on a keto diet which can come from oils, nuts, seeds, meat, and low-carb vegetables.

The ketogenic diet has many potential health benefits including weight loss, possibly improving heart health, and helping to manage blood sugar levels to name a few.

There are also some risks to the ketogenic diet that you need to be aware of such as nutrient deficiencies, ketoacidosis, and the keto flu.

If you are interested in trying the keto diet or have any questions, please talk to your doctor, health care provider, or dietician to learn if it is right for you.

References and sources:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3945587/

https://pubmed.ncbi.nlm.nih.gov/30289048/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6836058/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5842847/

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