"It was extremely difficult," he recalls. "You spend your entire life hearing that fat makes you fat and causes heart attacks and strokes. Now, all of a sudden, you're eating 200 grams of fat per day. There is a huge psychological component to conquer before you can become successful with the keto diet. In the beginning, it's like trying to convince people 1,000 years ago that the world is in fact round, not flat."
A ketogenic diet (also known as the keto diet) is typically lower in carbohydrates and higher in fats than a standard American diet. Once your body adapts to a ketogenic diet, it switches from primarily using carbohydrates and glucose to fat and ketones as fuel. This adaptation within the body increases fat breakdown and oxidation, which can improve body composition, general health, performance, and perhaps even longevity! The amount of fat, carbohydrates, and protein needed to achieve a well-formulated keto diet for beginners differs from person to person and is goal-dependent. Any dietary protocol in which you are lowering carbohydrates sufficiently enough to induce a state of ketosis can be considered a ketogenic diet. However, throughout this guide you will begin to understand how to construct a well-formulated ketogenic diet to meet your goals.
"Plenty of people jump right in, thinking all they have to do is cut carbs and increase fat. All of a sudden, they hit a wall and get 'keto flu.' They feel tired, lethargic, and experience headaches," Wittrock says. "The primary reason they get these symptoms is lack of the three primary electrolytes: sodium, potassium, and magnesium. If you're deficient in any of these, you'll suffer mentally and physically. This is the single biggest reason people fail on the keto diet."
"You can find a lot of "fat bomb" recipes on the Internet," Wittrock says. "These are very good at satisfying your sweet tooth, and are a great way to increase fat consumption without going over on protein. Also, I'm a huge fan of salted pumpkin seeds and salted sunflower seed kernels. Believe it or not, pork rinds are also a very good keto snack."
Your glycogen stores can still be refilled while on a ketogenic diet. A keto diet is an excellent way to build muscle, but protein intake is crucial here. It’s suggested that if you are looking to gain mass, you should be taking in about 1.0 – 1.2g protein per lean pound of body mass. Putting muscle on may be slower on a ketogenic diet, but that’s because your total body fat is not increasing as much.5Note that in the beginning of a ketogenic diet, both endurance athletes and obese individuals see a physical performance for the first week of transition.
For patients who benefit, half achieve a seizure reduction within five days (if the diet starts with an initial fast of one to two days), three-quarters achieve a reduction within two weeks, and 90% achieve a reduction within 23 days. If the diet does not begin with a fast, the time for half of the patients to achieve an improvement is longer (two weeks), but the long-term seizure reduction rates are unaffected. Parents are encouraged to persist with the diet for at least three months before any final consideration is made regarding efficacy.
The confusion between ketosis and ketoacidosis is a prominent reason why many individuals, particularly doctors, steer clear of the keto diet for beginners. It’s important to understand that these are two very DIFFERENT metabolic states. Ketoacidosis may occur in uncontrolled type 1 diabetics (DKA; diabetic ketoacidosis) due to insulin deficiencies. DKA is associated with both elevated blood glucose and ketone levels; due to little to no insulin production, blood glucose cannot enter insulin-dependent cells to be used for energy, and as such, cells become hungry, resulting in uncontrolled ketone production. In turn, a highly acidic environment is created that can have detrimental effects on an individual’s health, possibly resulting in death. It must be echoed that the ketogenic diet, which induces “nutritional” ketosis, is vastly different and should never be confused with DKA. To put this in perspective, a normal state of ketosis, as achieved via the keto diet for beginners may elevate ketones anywhere from 0.3–5mM, while DKA results in ketone levels of about 15mM or higher.
While it may be new to you, the keto diet has actually been around since the 1920’s, when the Mayo Clinic reported its effectiveness for helping epilepsy (that is still the case). Since then, there’s strong evidence that the keto diet helps with weight loss as well as type 2 diabetes, prediabetes, and metabolic syndrome, says Jeff Volek, Ph.D., RD, professor in the department of Human Sciences at The Ohio State University in Columbus, Ohio and co-author of The Art and Science of Low Carbohydrate Living.
A survey in 2005 of 88 paediatric neurologists in the US found that 36% regularly prescribed the diet after three or more drugs had failed, 24% occasionally prescribed the diet as a last resort, 24% had only prescribed the diet in a few rare cases, and 16% had never prescribed the diet. Several possible explanations exist for this gap between evidence and clinical practice. One major factor may be the lack of adequately trained dietitians who are needed to administer a ketogenic diet programme.
A systematic review in 2018 looked at 16 studies on the ketogenic diet in adults. It concluded that the treatment was becoming more popular for that group of patients, that the efficacy in adults was similar to children, the side effects relatively mild. However, many patients gave up with the diet, for various reasons, and the quality of evidence was inferior to studies on children. Health issues include high levels of low-density lipoprotein, high total cholesterol, and weight loss.
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