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Health and diet

Keto diet myths

  written by Dr. Basudev Tewari |     July 14, 2018

Keto diet is on, now a days. People looking forward for rapid fat loss are looking forward to ketosis. But at the same time people are wary of the myths associated with ketogenic diet. Similar fears are there regarding low carb diets too.

People believe in lots of stories and twisted facts. Below I am giving a list of myths associated with keto diets. I shall discuss the actual science based facts later, in this post…

  1. It is another fad diet and can’t be sustained for long term.

  2. It is another new diet in the market and needs long term study.

  3. So much fat and saturated fat is not healthy.

  4. You don’t have carbs and thus can’t do exercises in ketosis.

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  5. Keto diet lacks glucose and thus causes dizziness, weakness and lack of energy.

  6. Brain activity and clarity decreases as brain runs on glucose only.

  7. Due to very low carbs and low glucose in blood, you can’t do exercise in ketosis. Exercise is not needed also.

  8. Keto acidosis is a dangerous and life threatening conditions in diabetes, which can occur in keto diet too.

Before busting the above keto diet myths, let us discuss keto (or ketogenic) diet in short. It is an ultra low carb diet which is used in various diets. But without calorie deficit keto is not going to work.

Keto diet is not for everyone. There are many conditions where keto diet is not safe. Check for own or family history of liver dysfunction, history of pancreatitis, kidney stone, storage disorders, gastroesophageal reflux, familial hyperlipidemia, electrolytic imbalance, poor nutritional status etc. There are several inborn metabolic diseases where ketosis is absolutely contraindicated.

Classical keto diet normally contains carbs 5% proteins 20% and fat 75%. These ratios may vary but the idea is to keep carbs very low. This must lead to ketosis, ie formation of ketone body, viz acetone, acetoacetate and beta hydroxybutyrate. The normal ketone body production is extremely low and the body mostly uses glucose as fuel source. But during ketosis, various tissues of the body adapts to usage of fatty acids and ketone bodies as fuel.

Brain and a few other tissues can’t use fat. As they can’t have glucose for fuel, ketone bodies are used as fuel. Insulin response stays low and it can’t store any extra glucose as fat. The glycogen stores are depleted very quickly.

Body simply resorts to an alternate metabolic pathway to refuel itself. Even ketone bodies can be detected in urine with dipsticks. This is done to confirm that ketosis is on. Thus body turns into a fat burning furnace. But even taking a little more carbs can throw the body out of ketosis.

Thus, it is a structured diet. This is a kind of all or none type of diet. Either you are in ketosis or you are not, there is no middle part or partial ketosis. Thus if the client is not very particular and strict, keto diet won’t work.

There are so many myths and undue fear regarding ketosis. Time to bust those keto diet myths, one by one:

high protein for fat loss

It is another fad diet and can’t be sustained for long term:

Well, keto diet is actually that secret diet to get extra lean very quick. As this is very extreme form of diet, it makes people think of it as a bad diet. This is not true. If you are doing it smartly under proper guidance, you can do it for long time. As the body gets keto adapted, (takes only few days), you can become free of the initial symptoms.

There has been several researches on keto diet. It is useful in many medical conditions like diabetes, dementia, insulin resistance etc. Even keto diet uses healthy fat options and as you get adapted to keto you can sustain for months. Just you need to check a few parameters to sustain.

Ketosis is a way by which body is taught how to stay healthy in starvation type of situation. At the same time protein helps to preserve muscles. But the ultra low carb with minimal insulinogenic effect stops storing fat and accelerates fat burning.

It is another new diet in the market and needs long term study:

Keto diet has been around for almost a century! It has been started in childhood epilepsy for treatment. Even after so many effective medications, keto diet has a role. Studies have shown it acts very well in resistant epilepsy cases.

Even in adults, there has been immense research for last few decades. Lots of studies are still going on. For details on the research based Ketogenic Diet insights, please read Lyle Mcdonald’s book The Ketogenic Diet.

So much fat and saturated fat is not healthy:

2015–2020 Dietary Guidelines for Americans has recommended maximum 10% of saturated fat. But the maximum limit on total amount of fat has been removed. Hence, intake of good amount of unsaturated fat is not bad, even in higher amounts. Just keep higher omega 3 fatty acids and avoid trans fat altogether.

But there is one caveat. Don’t think you can avoid exercise in ketosis. Without exercise, free fatty acid mobilization is not that effective. This can raise triglycerides in the body and unsettle your lipid profile. But don’t worry about good fats, even in higher amounts.

Read this article to know more about fats:

Dietary fats: Know which types to choose

You don’t have carbs and thus can’t do exercises in ketosis :

Carbs may be essential in all exercises. But as your body gets keto adapted, the muscle learns to burn fat and ketone bodies too. Your body simple learns how to use an alternate fuel.

But high intensity cardio or weight training is not easy to do in ketosis. Hence, for advance keto dieters, there is something called TKD or targeted keto diet. Here you take some carbs just before exercise and then go for the grind. Thus the glucose from that carbs, taken before exercise, is utilized to replete the glycogen store (used up in intense training). Even there is a kind of keto variation called CKD or cyclic keto diet. In CKD, the idea is to increase carb intake at weekends, to replenish glycogen stores.

For little bit advanced keto dieters, TKD is the way to go. As the body is keto adapted, it quickly goes back to ketosis. Thus you get the best of both worlds,diet and exercise!

But just remember one point, don’t stop working out, even if you can’t reach that intensity. Without exercise, free fatty acid mobilization is not that effective. This can raise triglycerides and even cholesterol in the body and is bad for your lipid profile (as described already).

But one point should be kept in mind. Due to the lack of glucose and depleted glycogen stores, muscle building is not easy in ketosis. But you can preserve those muscles for sure. Remember, ketosis has a protein sparing effect, even more than standard low carb diet.

Keto diet lacks glucose and thus causes dizziness, weakness and lack of energy:

These symptoms are not uncommon for first few days. This is popularly known as ‘keto flu’. And most dieters experience it.

As you start keto diet, glycogen stores are depleted quickly. This occurs as very less carbs can compensate the loss. As brain can’t use fatty acids like most other tissues, it takes some time to adapt. Slowly brain learns to utilize beta hydroxybutyrate (one of the 3 ketone bodies) as fuel.

This may lead to dizziness, weakness, muscle cramps, cravings, brain fog, confusion and other flu like symptoms. For details, please read my post on keto flu.

Please keep in mind that the principal 3 causes behind the ‘keto flu’ symptoms are:

1.Fighting to become “keto-adapted.”
2. Electrolyte loss and dehydration.
3. Withdrawal from carbohydrates and sugary foods.

But they are all temporary. Salt, water and electrolyte replenishment can easily cure keto flu symptoms in most people. Within few days, the brain learns to use ketone bodies. That becomes the permanent end of ‘keto flu’ symptoms.

Brain activity and clarity decreases as brain runs on glucose only:

This is not true. Studies show that many subjects experience better mental clarity and improved cognition. But this occurs after the body supersedes the initial ‘keto flu’ symptoms.

Ketone bodies, produced during ketosis, reduce free radicals in the brain. It also acts by improving the efficiency and energy levels of the mitochondria in the nerve cells of brain. It even improves memory functions, as per some literatures. Read this for details:

https://www.perfectketo.com/use-ketogenic-diet-productivity-mental-performance/

Ketone bodies, mainly the beta-hydroxybutyrate, are a more efficient source of energy per unit oxygen than glucose. Moreover the increased GABA, (inhibitory neurotransmitter in the brain) helps to fight against Parkinson and Alzheimer disease. Use of keto diet in childhood epilepsy is already established, that too in refractory cases.

Due to very low carbs and low glucose in blood, you can’t do exercise in ketosis. Exercise is not needed also in ketosis:

As your body gets keto adapted the muscles learn to use fat as fuel. This has to occur as glycogen stores get completely depleted. But they hardly get enough glucose from external carb source for replenishment. Hence, body (mainly the muscles, being metabolically most active tissue of our body), has no other choice but to burn the fat.

But exercise is almost a must for long term health in ketosis. Why? Read on…

In keto diet, the high fat diet contributes to lots of fatty acids. Moreover free fatty acids are easily released from cells. Please remember, low glucose in blood leads to low insulin level. This helps in releasing more free fatty acids in blood (normally this is done by hormone sensitive lipase, an enzyme inhibited by insulin).

In such low insulin environment, these lots of free fatty acids must be mobilized for long term health. This is exactly what exercise does. Without exercise, these will pile up and cause higher triglycerides and cholesterol in the body with all its complications and consequences.

Keto acidosis is a dangerous and life threatening conditions in diabetes, which can occur in keto diet too:

These are two totally different terms. In the diet induced ketosis, the concentration of Ketone bodies in blood is 1-3 mmol/lit. This does not cause acidosis and is not at all dangerous. The insulin in the body acts as feedback mechanism to prevent extreme increase in the Ketone bodies to any morbid level.

In ketoacidosis the scenario is different. This occurs in poorly controlled type 1 diabetes mellitus patients. Ketone body level may exceed 15 mmol/l. Here the lack of insulin (pancreatic beta cells in type 2 DM can’t secrete any insulin – patients may need insulin injection for life), leads to no check in ketone body production. This leads to uncontrolled, runaway ketosis to dangerous levels and lead to severe acidosis in the body. This may be fatal and needs treatment in a hospital setup.

So don’t client confused between these two terms. Ketosis is a diet induced condition for effective fat burning whereas diabetic ketoacidosis is a near fatal condition which needs urgent treatment.

good diet for fat loss

Conclusion:

So there you go… If you are overweight and your nutrition consultant and doctor gives green signal, go for keto diet. Don’t listen to the various keto diet myths and get distracted. But never forget one dictum, it is all or none type of diet. Either you are in ketosis or not. There is no middle path. If you are strict in your diet, this can really be that magic diet for you.

 

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