Keto Diet, Weight Loss, and Balance

A ketogenic (keto) diet is high in fat and protein and low in carbohydrates.

What happens if you eliminate carbs?

Here are some thoughts from a Gastroenterologist...not to upset anyone.

If you completely eliminate carbs, then your body will look for energy from other sources — like fat. Fat when broken down for energy (or fuel), produces ketones. Thus, the ketogenic (keto) diet name.

The long-term sustainability of the ketogenic diet is unlikely to work for most people, and the long-term benefits, or negative effects on health, are not yet known.

The point is that for a sustainable, balanced, healthy approach to eating and weight — it is OK to consume both carbs and fat. Focus on portion control and avoiding processed foods.

For a sustainable, balanced, healthy approach to eating and weight — it is OK to consume both carbs and fat

Now you have a sense of my opinion. Read more below if you are still OK with me.

A patient asked me about going on a keto diet for weight loss. What did I say?

1. "Personally, I do not eat with the ketogenic (keto) diet."

2. "The keto diet is a diet that is high in fat and protein—and low in carbohydrates."

3. "Our body usually looks for glucose (sugar) that we get from carbohydrates for energy. If you eliminate carbohydrates with the keto diet—your body looks for a different source of energy. It goes to the liver to break down stored fat into molecules called ketones in a process called "ketogenesis."

4. "The true ketogenic diet model is that 90% of your daily calories come from fat. That is not sustainable, nor a healthy approach to weight loss — even though you will lose weight in the short term."

Does the keto diet work?

Yes. It does work...but, that can be misleading.

Compared to the "calorie-reduction" diet, you can achieve a faster rate of weight loss with a keto diet. Faster is not always better.

I do not endorse quick fixes or solutions to weight loss, nutrition, diet, and lifestyle choices. Think long-term. Think sustainable, healthy, lifelong decisions.

What happens in my body with the keto diet?

The premise or goal of the ketogenic (keto) diet is to use stored fat as fuel.

To do this you need to limit your daily carbohydrate intake — typically it is limited to 20 to 50 grams of carbohydrates daily. This depends on body size and some people need a more restricted diet to get to the goal state of "ketosis."

For ketosis, you need to limit your daily carbohydrate intake to 20 to 50 grams of carbohydrates

For a perspective...

22 to 30 grams carbohydrates = 1 sports bar

22 to 30 grams carbohydrates = 1 large banana

1 large banana has 22 to 30 grams of carbohydrates

How long does it take to get to a state of "ketosis" with the ketogenic (keto) diet?

Typically will take only two to four days to reach a state of "ketosis." Ketosis is the state in which fat becomes the main source of fuel or energy for your body.

Is it safe?

In the short term, a keto diet is probably safe. But over time, it's tough to keep off your weight this way. Ask yourself what are your goals? Are they short or long-term?

Is it sustainable for long-term weight loss?

No.

Check out this video from Cedars-Sinai "What Do We Know About the Keto Diet?"

What about "keto breath"?

Many people on ketogenic (keto) diets find their breath has a "fruity" smell. This is because of the elevated ketone levels — more specifically, the ketone called acetone. Acetone is a ketone in both your urine and breath. So higher levels of ketone and acetone are the cause of the famed "keto breath."

I want to try the keto diet. What should I do?

If you want to try the keto diet (some popular examples are the Atkins, South Beach, and less so the Paleo diet) — I suggest making the best choices you can in the foods you consume.

What are the healthiest sources of fat?

• Olive oil

• Avocados

• Nuts (almonds, walnuts)

If I try the keto diet — what should I do after a few weeks?

I suggest you shift to a more sustainable, balanced, long-term lifestyle choice. Focused on the well-established, and proven effective diet — such as the "reduced-calorie" Mediterranean-style diet. Drink plenty of water. Make healthy choices. Focus on portion control. Increase your physical activity.

What is the takeaway from the keto diet?

For fast results, it will work. You will see weight loss. Your breath will change. It is probably safe for the short term — ideally under the guidance of a dietitian or nutritionist.

Long-term it is not a sustainable, healthy, or sound dietary choice. It will be very challenging, not to mention, unhealthy, to keep the weight off with the ketogenic (keto) diet.

This looks more "balanced" to me. Just an opinion of a Gastroenterologist.

Recently, many of my patients have been asking about a ketogenic diet. Is a ketogenic diet safe? Would you recommend it? Despite the recent hype, a ketogenic diet is not something new. In medicine, we have been using it for almost 100 years to treat drug-resistant epilepsy, especially in children. In the 1970s, Dr. Atkins popularized his very-low-carbohydrate diet for weight loss that began with a very strict two-week ketogenic phase. Over the years, other fad diets incorporated a similar approach for weight loss.

What is a ketogenic (keto) diet?

It is a diet that causes the body to release "ketones" into the bloodstream.