health, Lifestyle, Nutrition

Bacon, Avocado, and a Side of Ketones

The Ketogenic Diet Craze

As a Registered Dietitian, others often ask many, albeit, silly questions about the ketogenic diet. The ketogenic diet is currently the trendiest fad since deeming kale the supreme superfood of the planet. Thankfully, we now know that, in fact, you don’t have to add kale to your smoothies to be considered healthy. And, similarly, following a ketogenic diet is not necessarily the epitome of health either. Que good ole’ apples, sweet potatoes, banana muffins, and all the other delicious carbohydrates on this planet that are certainly more nutritious than ketones!

So what is the ketogenic diet and why has it gained so much popularity?

Ultimately, people following a ketogenic diet aim to achieve ketosis. In laymen’s words, ketosis occurs when someone consumes such a low carbohydrate diet, the body does not have enough glucose to supply the metabolic processes that create energy. Some people attain ketosis when consuming 50 grams of carbs a day, but most accomplish this feat only by consuming 20-25 grams of carbs per day. That is the equivalent of a large apple and maybe a zucchini a day. In terms of macronutrients, ketosis usually requires one to consume a very high fat, moderate protein, and very low carbohydrate spread.

To give you an idea of what it takes to achieve ketosis, I created a “simple,” sample meal plan. I use quotations around simple because keto meals can be quite complicated, requiring many expensive oils, meats, and supplements, and can be very inconvenient as well.

Sample Meal Plan

3 fried eggs cooked in avocado oil 2 slices full-fat bacon ½ avocado Sauteed spinach w/ coconut oil     (11g CHO)6oz baked chicken breast 2 cups lettuce 1 TBSP olive oil Smoothie w/ frozen zucchini, spinach, MCT oil, brain octane, and ½ an avocado      
(7g CHO)
4oz grass fed beef Cauliflower rice w/ ghee butter Eggplant & squash roasted in w/e oil you haven’t already used that day
(8g CHO)
Nuts & seeds (avoid peanuts) Spoonfuls of almond and coconut butters
Bulletproof coffee/drinks
Beef jerky
Raw veggies Seaweed chips Other unimaginable concoctions one has to create to avoid carbs like the plague

What deliciously, nutritious foods can you not eat if trying to achieve ketosis? Well, you would have to avoid basically all fruit, legumes like lentils, peanuts and peas, starchy vegetables like sweet potatoes, beets, green beans and corn, all grain products, all dairy, and nearly everything that is pre-packaged. While many people can be happy on this diet and may learn to create delicious carbohydrate-free muffins, breads, and, well, everything else, is it really worth all this effort? Is this sort of meal plan truly “healthier” than a balanced one that includes all food groups?

Ketogenic Health Claims

Numerous health claims have fueled the fire about the ketogenic diet. Many foodies and bloggers alike endorse this diet as a miracle or cure-all solution. Indeed, this dietary pattern renders benefits for certain groups of people with unique dietary and/or disease states such as epilepsy and Alzheimer’s, but it is hardly a “miracle” diet.

The first health claim revolves around metabolic health. One of the most common reflections of poor metabolic health these days, insulin resistance, occurs when receptors on your cells become less sensitive to insulin. This prevents glucose from entering cells that need it, so glucose remains in your blood stream, otherwise known as, high blood sugar. In simple terms it works like this; because people with insulin resistance already have a surplus of glucose circulating in their blood, they rarely need to break down fat stores to use for energy. They already have enough glucose to in their blood to fuel their needs. Thus, if they severely limit their carbohydrate intake, they will be forced to break down their fat, and consequently create ketones to use as fuel instead. Ketosis advocates propose that this is a metabolic advantage because it takes more energy to break down fat and create ketones. However, scientific research does not necessarily show this, and even exclaims that the difference is so minute that it does not truly make a difference.

Furthermore, ketosis is commonly promoted as a weight loss method. Similar to the mechanism discussed above, ketosis may lead to weight loss because it regularly taps into fat stores to create energy. Normally, the body only recruits these fat stores when it burns through glucose and glycogen stores, which isn’t often. However, weight loss may occur simply because people must remove an entire food group from their diet. People may accidentally consume less calories because they literally have less options, and/or because they simply feel fuller from all the fat they are consuming, as it is normally more satiating. Overall, research is inconclusive, at best, about whether ketosis is any better at inducing weight loss than consuming a balanced, high fiber diet full of lean proteins, healthy fats, and complex carbohydrates with a side of exercise. This latter type of eating and exercising is hardly a miracle, and may be less glamorous, but it is backed by research and also allows you to enjoy your favorite pumpkin bread, overnight oatmeal, and even ice cream sundaes!

Thirdly, ketosis fanatics claim that it may elicit exercise performance benefits. Traditionally, exercisers have been encouraged to consume higher amounts of carbohydrates. Studies show that consuming large amounts of carbohydrates prolongs time to fatigue in endurance exercise and may also help improve strength in exercisers desiring to build muscle. Without a doubt, carbohydrates supply more fuel for the body at high intensities of exercise like sprinting, jumping, and even during some endurance races if the exerciser is using substantial effort. On the other hand, fat supplies more fuel during low intensity exercise, such as walking, slow jogging, and yoga or stretching. Thus, even if the body accomplishes keto-adaptation, elite exercisers or people exercising above 60-70% of their maximum intensity, may require energy faster than the rate at which they can obtain it from fat. Meaning, carbohydrates are, indeed, quite necessary for intense exercise. Sure, one may be able to use more fat as energy during regular, less intense exercise, but they probably won’t get that half marathon PR any time soon.

The Bottom Line

So all this rave about ketones because it may improve metabolic health, weight loss and physical performance? Many other, less rigid, less time-consuming, and enjoyable methods can achieve these outcomes as well. However, while research is inconclusive about the benefits of a ketogenic diet on those three facets, it is slightly more sound for neurologic disorders and other diseases such as epilepsy, Alzheimer’s, Parkinson’s, Polycystic ovarian syndrome, certain cancers, and, potentially, brain disorders.

The overarching theme of the research and studies reveals that it is unsettled whether the ketogenic diet is truly more beneficial than overall balanced, healthy eating patterns, especially in the long-term. Consuming only 20-50 grams of carbohydrates a day is very challenging, and, frankly, unnecessary. While many people could certainly benefit from consuming less high-sugar, refined carbohydrates such as soda, crackers and packaged cookies, etc., there is no need to eliminate an entire macronutrient. Whole grains, starchy vegetables, fruits and various other carbs can be nutritious fuel for our body when consumed in appropriate portions in a mindful way.

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