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The ketogenic (or “keto) diet is a very low carb, high fat, moderate protein eating plan.  

It’ has recently gained a lot of popularity in the wellness sphere because of some of its health benefits.  

A ketogenic diet has been shown to help some people lose weight (yes, even with high fat intake).  It can also help improve certain health conditions, such as epilepsy in children.  

Read on for the low down on how it works (AKA “ketosis) and whether or not it’s something you should consider. 

What is "ketosis?"

Ketosis is the metabolic state your body enters when it preferentially burns fat for fuel.  

You see, carbohydrates (sugars and starches) are typically the preferred fuel for your brain and muscles.  Your cells will use carbohydrates for fuel first….if carbohydrates are available in the blood stream.  We typically refer to this as “blood glucose” or “blood sugar.”  

However, when very low amounts of carbohydrates are available to be used for fuel, your body can make a switch and start burning fat as its primary fuel source.  When this happens, the by-product of all this fat burning is a compound called “ketones.”  

Ketogenic literally means “the generation of ketones.”

If you remain on a very low carb diet for any length of time (days), your blood level of ketones will increase.  This is the metabolic state known as “ketosis.”  It simply means your body is now burning fat as its primary fuel source.  

(PLEASE NOTE:  “ketosis” from a ketogenic diet is NOT the same thing as diabetic ketoacidosis.)

Keto for weight loss...

Weight Loss

With a high fat meal plan, it may be surprising to learn that this can result in dramatic weight loss for some individuals.  

But…it’s true!

In certain people, a ketogenic plan can have more dramatic weight loss effects than low-calorie and low-fat plans.  

Part of the reason this works is because eating primary fat and protein promotes a lot of satiety…I mean a LOT.  If I had patients on a ketogenic meal plan, I rarely had to worry about them overeating.  They’d simply get too full!  If anything, I had to make sure they ate enough.  This promotes less food intake overall.  

Another reason ketogenic plans work for some...

As stated, a keto plan is a very low carbohydrate way to eat.  When you take in less carbohydrates, your body produces less insulin.  High levels of insulin in your blood stream can promote fat storage, especially around the abdomen.  This fat storage tends to be INSIDE the abdominal cavity, around your vital organs.  This type of fat is known as “visceral fat” and, unfortunately, it’s metabolically active.  

This means it actually does stuff inside us…and it ain’t good.  Visceral fat has its own set of chemical messengers that promote badness by way of inflammation.  

If you are a person who has lots of circulating insulin at baseline, meaning you simply put out more insulin in response to a given amount of carbohydrates eaten, you may be more apt to gain weight more easily than someone who has an appropriate insulin response to the exact same amount of carbohydrates.  

So, it stands to reason…..reduce the carbs = reduce the level of insulin = less weight gain around the belly.

Who benefits from keto?

First, let me start off by saying that I do NOT believe a ketogenic meal plan is warranted for every single person needing to lose a bit of weight.    

In my experience, a ketogenic plan has been most beneficial for individuals with metabolic syndrome, type 2 diabetes, and polycystic ovarian syndrome (PCOS).  Why?  Because these ailments promote insulin resistance and result in a naturally higher insulin level for nearly everyone.  Thus, reducing carbohydrates to a minimal level can be quite life-changing.  

People that have a bit of weight to lose but have a normal amount of circulating insulin in response to foods will likely lose weight on a ketogenic diet….but there is a lot more work and effort involved to keep the levels of carbohydrates low enough to keep you in ketosis.   

I will tell you, there’s a lot more work involved to keep your grams of carbohydrates per day below 40 than is involved in keeping them below 80.  For some, this may be worth the effort – others may not find that to be the case.  

I’m not one to put every single person on a “low-carb” plan.  However, I’ve not come across too many people who want to drop a few pounds that wasn’t eating a significant amount of carbohydrates, namely processed carbohydrates.  

To put this in perspective for you, the Standard American Diet has 300-400 grams of carbs per day.  That’s WAY too much for the average person.  If I can get someone down below 100-150 grams per day – that alone can result in dramatic weight loss for many people.  Going lower, to a ketosis level, may give no additional weight loss benefit at all.  

How to DO keto....

A ketogenic plan typically consist of getting 60-75% of your calories from fat, 20-35% from protein, and 5-10% from carbohydrates.  Many people find this quite restrictive and are unable to stay on the plan for a long period of time.  

Others flourish on the plan and find tremendous health benefits. 

The foods to focus on for a healthy ketogenic plan aren’t what people joke about.  A good keto plan doesn’t consist of bacon fried in butter, topped with hollandaise sauce.  (Insert other keto assumptions here.)

A responsible plan will include fatty fish, quality red meat, eggs, nuts, seeds, healthy oils, avocados, and lower carbohydrate vegetables such as cucumbers, celery, peppers, zucchini, leafy greens, etc.  

It’s essential to avoid foods that are high in carbohydrates such as sugary foods, desserts, grains, fruits, legumes, starchy vegetables, alcohol, and most “diet” foods.  (Note, a small amount of fruit is acceptable, as long as it keeps you within your allotted carbohydrate percentage.)


Something to consider....

Due to the restrictive nature of the plan, and the avoidance of many fruits and vegetables, may people find it necessary to supplement with a multivitamin to meet all their nutritional requirements.  This is because fruits and vegetables are the source of many micronutrients, vitamins, and minerals.  

Wrapping it up...

A keto plan may or may not be the right thing for you.  As always, a discussion with your physician should be had before starting any new diet.  

However, the ketogenic way of eating has been shown to be beneficial for weight loss and certain health conditions for some individuals.  But, again, it’s not for everyone.  


One thought on “The Keto Diet 101

  1. Dr. Hodges, I have been doing low carb since Jan (when I heard about you from my Dr.) I have lost 70lbs!

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