Ask a Dietitian: What Is the Ketogenic Diet?

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There are lots of approaches to losing weight, and success varies. The ketogenic diet, which has been around since the 1920s, has been purported to help with weight loss. Unlike most diets, which have limited scientific evidence supporting their long-term impact, the ketogenic diet shows some promise.

In a nutshell, the ketogenic diet is a food pattern that puts your body into a state of ketosis. To understand ketosis, it’s important to first understand how your body uses the three big macronutrients: carbohydrates, protein and fat. In a typical diet pattern, carbohydrates are your body’s main source of fuel (40 to 60 percent of your calories come from carbohydrates). Protein is mainly used to build muscle (roughly 20 to 30 percent of calories). Fat (20 to 30 percent of calories) is used to make essential compounds used by your body, and serves as a backup source of fuel.

In a ketogenic diet, carbohydrate intake is dropped to about 10 percent (roughly 20 grams of net carbohydrate per day), while fat is boosted to 60 to 70 percent of calories and protein remains at 20 to 30 percent of calories. This drop in carbohydrate intake drives your body to use fat as its primary source of fuel. As your body turns fat into fuel, it leaves behind ketone bodies in the blood, creating ketosis.

More and more research shows that ketosis, and the ketogenic diet, bring about many changes in our appetite hormones. In addition to the lower calorie intake, the diet’s beneficial influence on these hormones may play a role in overall weight loss. In fact, comparisons of high-fat, low-carb, ketogenic diets with low-fat diets seem to favor the ketogenic diets both in terms of actual weight loss and key blood tests, like triglycerides and cholesterol. While the initial results are promising, more research is needed to understand the long-term impact of following a ketogenic diet.

For most people, adopting a ketogenic diet means a drastic change in the macronutrients you eat. You consume more non-starchy vegetables, butter, oil, cheese, meat and seafood. Following a food pattern that limits your net carbs to 20 grams a day requires you to choose your foods carefully so you get all the vitamins and minerals your body needs. Knowing the carbohydrate content of foods, as well as the fiber-versus-starch breakdown of foods, is essential to maintaining a ketogenic diet. In some cases, you may need to take a multivitamin supplement. And some individuals may not do well on the ketogenic diet given its high fat percentage, so it’s important to know your body. Additionally, this diet pattern is not recommended for diabetics or pregnant or nursing women. As with any major change in your food intake, choosing to start a ketogenic diet should be done under the guidance of a physician and registered dietitian.

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