It seems like the debate in the health/wellness/fitness/weight loss world regarding the ketogenic diet and whether it is the best way to lose weight or not, has been going on for decades. In reality, it’s only been in the past few recent years (maybe since the Adkins Diet gained popularity back in the early 2000’s). But if there has ever been a “diet” that has turned friends and family against each other, it’s the keto diet.
Fans of keto are extremely loyal to it. They will defend it until the end of time. I get it…….someone tries what they call a keto diet, they lose weight, they seemingly still eat large amounts of tasty foods like cheese, bacon and nut butters – which are high calorie, low volume foods – and they rave about how they eat all the “fattening” foods they want and still lose weight. What’s not to love?
In this article, we are going to discuss what a true ketogenic diet is, whether most people who say they are doing keto actually are, and what it means to eat low-carb (but not keto) and discuss the differences between the two. And for fun, we will also discuss the reason weight loss can happen with ANY diet protocol, and why it often does not happen for people eating a keto-style of diet. This article, as with all articles I write, is from a weight loss perspective.
WHAT IS A TRUE KETOGENIC DIET?
You can do a quick Google search and find millions of articles on the ketogenic diet. I am taking the following excerpt directly from www.hsph.harvard.edu:
“In 1920 it was introduced as an effective treatment for epilepsy in children in whom medication was ineffective. The ketogenic diet has also been tested and used in closely monitored settings for cancer, diabetes, polycystic ovary syndrome, and Alzheimer’s disease.”
Read that last sentence again. “Closely monitored settings”. No context was given in that excerpt, however, in a medical setting or research setting, you could assume it means that the type of food, type of fat, frequency of meals, meal timing, portion sizes, etc. were all controlled. Unlike real life settings where a person is left to their own discretion. That can be an important distinction.
The main idea behind a ketogenic diet is that you deprive the body of carbohydrates (the macronutrient most responsible for creating glucose in our bodies). Glucose is the main energy source for all the cells in the body. If glucose is not present for several days, insulin decreases and the body starts to become “fat adapted”, meaning it uses dietary fat as its energy source instead of glucose due to the absence of carbohydrates. The liver produces ketones from stored body fat, and when glucose is low enough that the body starts using dietary fat as its primary source of energy, ketones accumulate in the blood, and this is called ketosis. The reason this happens when glucose is absent and not when it’s present is because glucose in the blood produces an insulin response (insulin releases into the blood – and insulin prohibits ketones from being too prominent). To follow a ketogenic diet in its true form, the state of ketosis must be reached and held steady. To do this, dietary fat intake must be very high and carbohydrate intake must be very low.
Take note that it is dietary fat (not body fat) that is used for energy when carbohydrates are not eaten. Dietary fats are fats that you eat (butter, cheese, nuts, etc). Body fat is the fat that is stored in your body (the jiggly stuff you are trying to get rid of). There is a big difference there and many people confuse which “fat” that they are burning for energy when eating a keto or keto-style of diet.
Speaking of dietary fat and carbohydrate intake, let’s talk a little about how much fat and how little carbohydrates a true ketogenic diet requires.
All foods are made up of three macro-nutrients: protein, carbohydrates and fats. A balanced diet could look like 30% of your daily caloric intake from protein, 40% from carbs and 30% from fats.
A true ketogenic diet looks like this: 15% protein, 15% carbs, 70% fat. (With some recommendations of 10% protein, 10% carbs, 80% fats). If you were to break that down by grams per macronutrient per day, it might look like this: 75 grams protein, 40 grams carbs, 165 grams fat.
For reference, 40 grams of carbs is approximately one small potato (2”x3”) or half of a regular bagel. When you consider that all vegetables, fruits, grains and legumes contain carbohydrates, those foods need to be almost completely eliminated from the ketogenic diet. Alcohol as well. Although a lot of alcohol is marketed as “low carb”, if you consider how it’s made (using wheat and grains, and sometimes sugar or fruit), regardless of how the marketing department of the alcohol producer spins it, there are indeed carbs in alcohol. As a matter of fact, if you are someone who tracks your macros, you already know that alcohol is tracked as a carbohydrate.
You can see that a true keto diet is VERY low carb and VERY high fat with low protein. In order to become “fat adapted” and use that high amount of dietary fat as your energy source, you would need to follow this structure daily and ideally for the rest of your life – not switching back and forth between a keto diet and a regular balanced diet.
WHAT IS A LOW-CARB DIET?
A low-carb diet is just as it sounds – a diet that still includes a decent amount of carbs, but in a moderate amount instead of a high amount. It also allows for moderate fats and higher protein.
Many nutrition professionals consider 150 grams of carbs per day to be the upper limit of a low-carb diet. This would account for 600 daily calories, or 25-30% of the daily calorie intake. A low-carb diet may look like this: 40% protein, 30% carbohydrates, and 30% fats or 40% protein, 25% carbs, and 35% fats.
While a low-carb diet allows for many more carbs than a ketogenic diet, most still focus on getting the carbs from vegetables and a little bit of fruits, and limiting breads, pastas and starchy vegetables like potatoes. LIMITING not ELIMINATING.
Low-carb diets can be helpful for those who are Type 2 diabetic or have pre-diabetes, as the reduction in carbohydrates helps limit the amount of insulin released in the blood.
It has been my experience that many people who say they are “doing keto” are just eating less carbs than they used to. They oftentimes aren’t really eating low-carb either, just “less carb”. And they definitely aren’t doing true keto.
WHICH IS BETTER FOR WEIGHT LOSS: KETO OR LOW-CARB?
Before we get into which is better – or IF one is better – for weight loss, let’s talk for a minute about how weight loss occurs.
The only way to lose weight (body fat) is by being in a caloric deficit. That means you are eating fewer calories than you are using on a day-to-day basis. For example, if you eat 1800 calories per day, but through movement and normal daily activities, including internal bodily functions that keep you alive (aka metabolism), you burn 2200 calories per day, that means you are in a -400 per day caloric deficit. If you sustain this deficit over a period of time, you lose weight and body fat. This is the only way to do that.
A true ketogenic diet can cause weight loss, as can a low-carb diet. With a keto diet, by nearly eliminating all carbohydrates and eating high amounts of fat, two things happen. One is your body doesn’t hold onto as much water as it does when you consume carbs. The name carbohydrate tells you that it is water bearing, hydrate is in the name! And two is that fat is a highly satiating macronutrient. That means that it makes you feel fuller and for a longer period of time than carbs do. Combining those two things means you will not be carrying as much water weight and you will likely feel full more often due to the high fat content, therefore not overeating and likely eating fewer calories than someone on a higher carb diet might.
A low-carb diet can cause weight loss in much the same way, but it has two highly satiating macronutrients working in its favor – protein and fat. Both protein and fat make you feel full for longer periods of time. Protein also causes your body to use more calories to break it down and digest it, so that’s like a two-for-one. And consuming higher protein as you would with a low-carb diet, allows the body to build more lean muscle if you are resistance training (and it allows you to preserve more muscle mass even if you aren’t resistance training so the weight you lose will be more body fat and not as much muscle mass) because protein is what builds and preserves muscle in the body. By keeping carbs on the lower end but not too low or eliminated, you still get plenty of glucose for energy and it’s used up quickly without being stored as body fat.
But neither diet will cause weight loss unless you are in a calorie deficit.
If you choose to go a low-carb or ketogenic route in your weight loss journey, the most important thing to think about is which one will you be able to stick with for the long term? Losing weight is about consistency and adherence to a calorie deficit. If you are someone who doesn’t enjoy eating carbs, but you do enjoy healthy fats and fatty cuts of meat, keto might be a good fit for you. If you are someone who still wants to be able to incorporate carbs into your daily diet but doesn’t mind eating fewer carbs than most people do, then a low-carb diet might be right for you. Whichever you choose, be sure you are ready to make it a lifestyle. Neither one is meant to be done for a few weeks on and a few weeks off.
CAN YOU DO A KETOGENIC OR LOW-CARB DIET AND NOT LOSE WEIGHT?
Completely eliminating or radically reducing your carb intake absolutely can be a way to create a calorie deficit and lose weight. But it is possible to cut out all carbs and not lose weight at all.
With a ketogenic diet, fat content is very high. 1 gram of fat is 9 calories. In comparison, protein and carbs each contain 4 calories per 1 gram. This means that fat is over twice the number of calories as the same amount of carbs or protein. In a normal day scenario, this would mean that ½ cup worth of carbs would be less than ¼ cup of fats. That’s a big difference in the volume of food you are eating. Although fat is a highly satiating macronutrient as discussed above, it is also very easy to overeat because of the low volume. You look at less than ¼ cup of a food and think it’s not enough to satisfy your hunger, so you double it. If you do that often, you will not be in a calorie deficit and will not lose weight. If you do it often enough, you may even put yourself in a calorie surplus, and gain weight.
Vegetables are a high volume, typically high fiber, lower calorie food. You can eat a large amount of them, for 100-150 calories, and the fiber makes you feel full as does the large volume you can eat for those few calories. In contrast, fat is low volume and high calorie. Three cups of mixed vegetables like spinach, carrots and broccoli have less calories than 2 tbsp of peanut butter. Which will make you feel fuller and more satisfied from a hunger perspective?
A logical, non-scientific, regular ol’ reason why people initially lose weight on a ketogenic or low carb diet, but then end up gaining weight, is that they lose the water weight from stored carbohydrates and are eating less carbs in general so by default they are eating fewer calories. However, over time, their body has no more excess water to shed, and weight loss can stall. Along with that, they are eating double the amount of fatty foods than they were prior to starting keto to “get their stomach full” and by doing so, are consuming too many calories.
Any nutrition protocol you choose to use for weight loss is fine. Ketogenic, low-carb, balanced meals, intermittent fasting or flexible dieting. They all work if a calorie deficit is maintained. Choose the one that will work best for your lifestyle and goals and be sure you can stick with it for a very long time.
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