By Stephanie Mandel, NC Integrative Nutritionist NYC
Many of us know by now that increasing healthy fats and lowering sugar and refined carbohydrates in the diet are important steps toward optimal metabolism and overall health. It’s likely that you or someone you know has tried a variation of the a low-carb diet like paleo, Whole30, or a paleo-style sugar detox for any number of health goals. You may be less familiar with the high-fat, very low-carb diet with a cultish following akin to that of crossfit or veganism, known as the ketogenic diet, or “keto” for short.
Yet another example of something old that’s become new again, the keto diet has been used as a medically therapeutic diet for over 100 years. It’s become a well-established component of treatment for those with epilepsy and other neurological conditions, obesity and metabolic syndrome, as well as different types of cancer; before insulin became available as a medication, keto was the accepted treatment for diabetics.
In recent years, a low-carb, high-fat diet has has earned recognition as an effective way to get lean and improve mental and physical performance. Countless blogs and products have turned up to support a keto lifestyle, promoting keto as a weight loss method with plenty of other benefits.
What is keto?
The ketogenic diet restricts carbohydrates to 20-50 grams per day (for reference, the average American eats around 300 grams per day — think a muffin or croissant for breakfast, a sandwich for lunch, pasta or potatoes with dinner, and perhaps a cookie, candy or even a “healthy” bar between meals), making up the rest of the calories with healthy fat and moderate protein. I like to frame a healthy keto diet to my clients like this: “Think Atkins, but less bacon and cheese and more avocados, eggs, and coconut oil.” Keto’s unique macronutrient ratio isintended to shift your mitochondria — your cells’ energy factories — from burning glucose(sugar) for energy to burning fat, in the form of ketones, as its primary fuel source.
A clean keto diet is comprised of:
● 70-80% healthy fats from healthy oils (avocado, coconut, olive, etc.), animal fats like duck fat, small amounts of nuts and seeds, and butter or ghee (I find most people do better without other sources of dairy, but it’s an individual decision based on multiple factors)
● 15-20% protein from whole eggs, fatty fish like wild salmon and sardines, dark meat from organic pasture-raised chicken and turkey
● 5-10% carbs from limited quantities of non-starchy vegetables, primarily leafy greens, broccoli, cauliflower, zucchini, etc.
The diet excludes:
● Refined carbohydrates like bread, pasta, muffins
● Starchy foods like potatoes and root vegetables
● Sugar in all forms, except for very small amounts of low-sugar fruit like organic berries
for some people
● Excessive protein, as protein can be converted into glucose in the body
● A “clean” keto diet excludes highly unstable, processed and damaged fats, including trans fats, fried foods, and vegetable and seed oils like corn oil and canola oil, which are high in omega-6 fatty acids and therefore encourage inflammation
What are the supposed benefits of keto?
It is well established that shifting to a ketone-based metabolism can be highly beneficial for those with brain- and nerve-related conditions like epilepsy, Parkinson’s, Alzheimer’s and autism, as well as depression. There is also growing evidence that keto may inhibit tumor growth in many types of cancer, and decrease the risk for heart disease. It may also help with migraines, depression and other mood-related issues, and improve mental energy and focus.
And, naturally, its broadest appeal comes from its ability to allow the body to become more efficient at burning fat. Who doesn’t want that?
Is it worth trying?
If you have one of the conditions mentioned above, I encourage you to speak with an integrative physician or nutritionist about keto as a therapeutic option to support healing. It can be an extremely effective way to break a cycle of weight gain, insulin resistance and other metabolic issues.
That said, if you’re relatively healthy and just want to lose weight or improve mental focus, the potential benefits of keto come down to more specific things about you:
● Gender: I’ve found in my practice that men tend to respond better to a keto diet (and low-carb diets in general) for weight loss than most women, generally speaking. Women, especially those who are still menstruating or are concerned about fertility, may need more carbs than keto allows to feel well.
● Thyroid or HPA axis function: Anyone with adrenal or thyroid issues may find that keto isn’t right for them, as the low carb intake can be interpreted as a stress signal by the body, in turn potentially aggravating those issues.
● Genetics: There are certain genes that may predispose certain people toward responding well to a ketogenic diet. We’re still in the early stages of understanding this, but a simple genetic test like 23andme, and online filters like Nutrahacker, can give you a sense of whether you’re “coded” to do well with keto. If you do pursue genetic testing, even with online interpreters, it’s useful to review your results with an integrative nutrition professional to help you act accordingly.
The bottom line: Keto can provide remarkable benefits when used for certain conditions, by the right type of person, and with skilled supervision. It’s always best to consult a nutrition professional before embarking on a keto experiment to determine whether it may be right for you, to help ensure optimal nutrient levels and a smooth transition from carb-burning to fat- burning, and to monitor longer term effects. If you decide keto isn’t your cup of butter coffee, there are many other routes toward weight loss, better energy, mood, focus, and overall health.
An integrative nutritionist can help you choose the best next move.
Stephanie Mandel, part of The Joyful Approach Tribe is an Integrative Nutritionist at The Morrison Center in New York City, where she partners with clients to help them find their best path toward achieving their health, fitness and spiritual goals.