The keto craze

Why is everybody talking about the ketogenic diet? And what is it exactly? Good investigates the high-fat, low-carb lifestyle on everybody’s lips.

Words Nikki Birrell

The grapefruit diet, the cayenne pepper water diet, the liver cleansing diet… the cabbage soup diet – remember that one? All have had their moment in the spotlight. In more recent times, the raw food and paleo diets exploded on to the scene. Whether it’s for general wellbeing or more specifically about weight loss, “miracle” diets all have their advocates, espousing a trove of health benefits. But, there’s always two sides of the coin and it’s often difficult to sort fact from fiction. The latest trend making waves is the ketogenic diet, on which the body is starved of carbohydrates and burns a secondary source of energy: fat. What are its benefits? Is it good for you? Are there risks? And is it sustainable?

Weight loss and health benefits

Carbohydrates and fats have both been vilified and exalted in the world of nutrition, with medical supporters on both sides. The keto diet celebrates fats over carbs.

So how does it work? Normally, our bodies use glucose, typically derived from dietary carbohydrates, as the primary form of energy. If we deprive ourselves of these, the body will start to break down fat stores for energy instead, forming ketone bodies which are sent to the bloodstream for use as fuel. This is a metabolic process called ketosis. The ketogenic diet puts the body into this secondary state. Ketosis is what makes this diet different from other low-carb versions, such as Atkins. For it to occur, it is suggested carbs make up around five per cent of your calorie intake, with protein at 25 per cent and the majority of your intake coming from fat (avoiding hydrogenated oils and many vegetable oils). Following this ratio, ketosis can occur between two to seven days. Whether it is a lower calorie intake or ketosis itself that promotes greater weight loss is up for debate.

Along with the proven effectiveness of the keto diet on limiting seizures in those with refractory epilepsy, there is evidence to suggest it can help control type 2 diabetes, with instances reported of people being able to stop their diabetic medications. High blood pressure, high cholesterol and other cardiovascular disease risk factors have also been known to be lowered on a keto diet, with other health benefits also recorded. However, the results remain largely inconclusive. 

Those who have tried it

William Brooks (27) had been struggling with a condition called ulcerative colitis for a few years when his naturopath suggested trying the keto diet. His partner, Leticia (25) joined him. More than six months down the track and the pair have both noticed significant changes. Remarkably, Brooks says, “I’m fully in remission with no side effects from my condition. I’ve just been able to drop my meds down to the minimum dosage.” And both have more energy and sleep better. 

Adjusting to the diet, Leticia did experience some “keto flu” symptoms but, she says, “The biggest shock is how much more prep you need to do. It’s basically not eating anything processed, which means you can’t really quickly grab anything”. The pair have worked the diet to suit them. 

“We are lucky we’re just doing it to avoid certain foods rather than to be in proper ketosis all the time where you have to be very strict,” says Brooks. 

Mother of two, Catherine* (44) was more precise in her approach. She started the diet on an eight-week training programme and “followed it to the letter,” she says. “It involves monitoring calories in versus calories out, so as not to exceed daily calories and carbohydrates.” And while she did lose weight, she noticed “mostly cm changes. People often say they see changes in how their clothes fit, even when they are not losing off the scales, which is a whole new way of thinking. I found it quite difficult not to see the scales going down.” Even so, she plans to start the diet again and recommends it for energy.

Where did it come from? 

The ketogenic diet’s origins date back to the 1920s when it was used therapeutically on patients with epilepsy to help control seizures. With the advent of anti-seizure medications, it fell out of favour, although came back into focus in the past 20 years, particularly as a proven effective treatment for drug-resistant epilepsy. Its renewed use led to heightened interest in what other roles it could play for health, including helping reduce diabetes and cardiovascular disease. Documentaries such as Netflix’s The Magic Pill helped propel the diet into the limelight. Its widespread popularity, however, boils down to its effectiveness for rapid weight loss.

What can you eat?

The keto diet is not a licence to eat as much bacon, cheese and butter as you like. While there are reports of people not having to calorie count while losing weight on a keto diet, this could be because of the elimination of unhealthy high-calorie carbs, plus fats and protein are more filling. 

A typical day on a keto meal plan might be fried eggs for breakfast, a spinach salad with a cheese and avocado-topped grass-fed burger patty for lunch and grilled salmon with buttered broccoli for dinner. Oils, nuts, seeds, coconut, butter, meat, fish and low-starch vegetables such as zucchini, asparagus, cucumber, broccoli, cauliflower and capsicum are all high on the keto-friendly food list. 

The risk factors 

Nutritional deficiencies can be an issue when eliminating major food groups. Clinical nutritionist Ben Warren of BePure Health Clinics says, “There is a lot of research showing benefits for ketogenic diets. However, I believe it is quite hard on your system long term, it is a stress on your body, there are other key nutrients your body needs – [the keto diet is] not as nutrient-dense because you’re not eating the B vitamins from some vegetables and grains, so you have to make sure you’re supplementing essentially with a high-quality multi-vitamin.” 

People with kidney problems should avoid the diet and it is not recommended for pregnant or breastfeeding women. Certain conditions and medications, such as those of blood pressure and diabetes, may be risk factors and a doctor should be consulted. 

Is it for you?

With the full ketogenic diet being difficult to practice long-term, chef Pete Evans, well-known keto proponent (he was the executive producer of the doco The Magic Pill), has outlined other approaches in his cookbook, Easy Keto. These include cyclical ketogenic, in which you cycle in and out of ketosis, and his personal diet of “intuitive ketogenic” where you “tune-in to your body, responding to how you feel”. These less restrictive approaches may make it easier to adopt the diet as a lifestyle.

But even so, ultimately, the best diet is one that works for you. One you can stick with and one that makes you feel good, providing for all your personal nutritional needs. There is no one size fits all and it’s always recommended to work with a doctor or dietician before embarking on a new diet plan. 

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