What You Need to Know About the Ketogenic Diet

Today, the production processes of food, from the field to the table, have been altered by unnatural interventions such as the use of hormones, the addition of preservatives, and food processing. As a result, people's eating habits and patterns have become disrupted and unhealthy.

As a result of these unnatural interventions in food production, there has been an increase in obesity, and consequently, a rise in various health problems such as diabetes, cancer, and cardiovascular diseases. This has led to many unanswered questions about what constitutes proper nutrition. When we look at diets, we encounter a wide variety of types. One of the most popular diets in recent years is the ketogenic diet. Originally used in the treatment of neurological disorders like epilepsy and Alzheimer's, ketogenic eating has recently become popular as a method for weight loss. So, what exactly is the ketogenic diet?

What is the Ketogenic Diet?

The ketogenic diet is a modified version of the standard diet, altering the macronutrient distribution of carbohydrates, proteins, and fats. In dietary guidelines published in our country, the recommended macronutrient distribution for healthy individuals is 50-60% carbohydrates, 12-15% protein, and 30% fat. However, in the ketogenic diet, carbohydrate intake is reduced to as low as 5%, while protein (1 gram per kilogram of body weight) is kept at a moderate level, and fats make up 75-80% of the diet.

Since carbohydrate intake is limited, glucose, which is the main energy source for the brain, becomes insufficient in the body, and the liver starts producing ketone bodies to provide energy for the brain. This process leads the body into the state of ketosis, which is the goal of the ketogenic diet. Ketone bodies repair mitochondrial damage in nerve cells, reducing the need for insulin. Various scientific studies have shown positive effects, especially in epilepsy, insulin resistance, cancer, and mild cognitive disorders.

There are certain signs to identify if the body has entered ketosis. These include:

• Increased urination due to the excretion of excess ketone bodies through urine.
• Increased fluid loss leading to dry mouth.
• The presence of acetone (a type of ketone body) in the breath, causing a distinct odor.
• Increased energy levels.

Additionally, ketone strips that measure the level of ketone bodies in urine can also provide an indication of whether the body is in ketosis.

Types of Ketogenic Diets

The ratio of fats to other nutrients in the ketogenic diet can be adjusted based on the individual’s needs. The ratios are typically expressed as 5/1, 4/1, 3/1, 2/1, and 1/1. The numerator represents fats, and the denominator represents the total of carbohydrates and proteins. As the fat ratio increases, the feasibility and sustainability of the diet decrease. The fat ratio should be adjusted by a dietitian and doctor based on the individual's health condition, blood values, and existing illnesses. Due to potential health risks associated with the ketogenic diet, it may not be suitable for everyone and should be followed under the supervision of a healthcare professional.

What Are the Risks of the Ketogenic Diet?

The ketogenic diet is quite different from the dietary recommendations in nutrition guides, and its long-term use may have negative effects on health. Some of these effects, which have been proven in studies, include:

• Because the ketogenic diet has a very high fat content, it may negatively affect the lipid profile in the blood. The increase in fat intake, particularly saturated fats, can raise cholesterol, triglycerides, and apolipoprotein levels in the blood, which increases the risk of cardiovascular diseases.
• The ketogenic diet generally provides less energy than the body needs. Therefore, the individual's general health should be closely monitored by a professional.
• During the adjustment period to the diet, individuals may experience symptoms such as muscle cramps, palpitations, fatigue, chills, shoulder pain, constipation, back pain, abdominal pain, bloating, headaches, and tension. The duration and monitoring of the diet are crucial at this stage.
• If followed for an extended period without control, the diet may lead to unhealthy outcomes. It should be planned according to the disease treatment process and monitored by a specialist.

How Does Ketogenic Nutrition Help with Weight Loss?

The golden rule of weight loss is that the energy expended must be less than the energy taken in, creating an energy deficit. Ketogenic diets contain fewer calories than the body needs, thus creating an energy deficit. Additionally, fats stay in the stomach longer compared to carbohydrates and proteins. This longer duration in the stomach means longer digestion time. Because fats are digested more slowly, they cause blood sugar to rise more gradually compared to carbohydrates and increase feelings of fullness. As a result, those following a ketogenic diet experience weight loss.

Health Benefits of Ketogenic Nutrition

The only disease for which the benefits of ketogenic nutrition are well established is epilepsy. In patients whose symptoms cannot be controlled with medication, it has been shown that following a ketogenic diet under the supervision of a doctor and dietitian improves the course of the disease. Research has also been ongoing regarding its effects on diseases such as autism and Alzheimer's. Recent studies suggest that because it slows the rise of blood sugar, it reduces diabetes complications and can be used in the treatment of obesity due to its effect on weight loss. Although it may increase blood cholesterol levels, there are studies showing that it does not lead to cardiovascular diseases and may even have a protective effect against them. Despite all these studies, the positive effects on epilepsy patients are the only health benefits that have been definitively proven, and further research is needed for other conditions.

What Should a Ketogenic Diet Menu Include?

The ratio and grams of the nutrients in the diet are very important. Therefore, the portion sizes should be clearly determined by a specialist. Animal products are generally not restricted in a ketogenic diet, but plant-based foods, especially those that are carbohydrate sources, are limited. The ketogenic diet menu includes protein sources along with high-fat dressings and salads for flavor. To reduce carbohydrates and increase fat intake, the following foods and restrictions should be followed:

Foods Allowed in the Ketogenic Diet:

• Meat Products: All types of beef, lamb, goat, chicken, turkey, fish, eggs.
• High-fat Dairy Products: Cream, clotted cream, kasseri cheese, full-fat hard cheeses (the firmer the cheese, the lower the carbohydrate content), butter.
• Leafy Green Vegetables: Swiss chard, spinach, arugula, cabbage, watercress, etc.
• Above-ground Vegetables: Cauliflower, broccoli.
• Nuts and Seeds: Almonds, cashews, walnuts, hazelnuts, sunflower seeds, etc.
• Berries with Low Glycemic Index: Blueberries, blackberries, raspberries, mulberries.
• Avocado: Due to its high-fat content.
• Oils: Olive oil, sesame oil, black seed oil, coconut oil (should not be used in excessive amounts due to high saturated fat content).
• Sweeteners: Low-carb sweeteners such as Stevia.

Foods Restricted in the Ketogenic Diet:

• Cereal Products: Wheat, barley, rye, oats, corn, rice.
• Products Containing Simple Sugars: Honey, molasses, maple syrup, agave, packaged products containing sugar.
• Fruits: All fruits and fruit juices, except for the ones listed as allowed, due to their high carbohydrate content.
• Root Vegetables: Potatoes, sweet potatoes.
• Legumes: Chickpeas, kidney beans, lentils, etc.

Frequently Asked Questions About the Ketogenic Diet

1. What does "ketogenic" mean?

"Ketogenic" refers to something that produces or creates ketones.

2. How is the ketogenic diet followed?

The ketogenic diet is followed by restricting carbohydrates and increasing fat intake, based on recommendations from a dietitian or doctor.

3. What can you eat on the ketogenic diet?

On the ketogenic diet, you can eat all animal meats, high-fat dairy products, hard cheeses, eggs, leafy or above-ground vegetables, fatty nuts, avocados, berries, sweeteners, and oils like olive oil and black seed oil.