The Keto Diet: A Healthy Option for Meat Eaters?
"This diet that is really high in fats, low in carbohydrates, can be beneficial for some people, but maybe not for others."
On today’s Inside Health with Dr. Keller Wortham, MD, we’re talking about the Keto diet, a diet that is high in fat, low in carbs, and can be controversial! We'll talk about what the diet is, the health benefits and potential health risks, and you'll get some tips for the healthiest way to follow this diet — including what foods to eliminate, and which ones to indulge. You'll even get to see the doctor's perfect Keto meal.
- 00:20: What is a Keto Diet?
- 01:00: How the Keto Diet Affects the Body
- 04:33: Benefits of Keto
- 08:41: Things you can’t eat on a Keto Diet
- 11:16: What you can eat on a Keto Diet
- 13:39: What a Keto plate might look like
- 15:03: Top Keto Diet Health Risks
- 18:10: Wrap-Up
What is a Keto Diet?
The keto diet is a little more controversial than some of the other popular diets. It is a diet that’s very, very high in fats and very low in carbs. There are studies out there that claim that the keto diet can help reduce things like cancer, diabetes, heart disease, epilepsy and even Alzheimer’s.
How the Keto Diet Affects the Body
Keto is short for ketogenic diet. It involves reducing carbohydrates to the point that you start to burn other sources of fuel. Our body runs on carbs and glucose but if these aren’t around, we start to look to other things — and fat is a primary source of fuel. As you burn down fat, you start to make something called a ketone. This diet — so low in carbs and high in fats — starts to generate a lot of these ketones.
The question is: is generating a lot of these ketones and using fat primarily as a source of energy a good thing? Well, the secret might lie in the molecule called insulin. Insulin is a hormone that helps regulate our sugars. If you have a diet that’s very low in carbohydrates, you don’t have much of a need for insulin to help regulate sugars (basically moving them around and storing them). Insulin is very inflammatory and one of its primary functions is to store calories as fat. So if you don’t have a lot of sugar calories coming into your blood in the form of carbohydrates, you’re not going to raise insulin, and therefore you’re not going to store calories as fat. Instead you’re going to be burning things as fat, and as you start burning fat, you can start to lose weight.
The standard keto diet is about 75% fat, 20% protein, and 5% carbohydrates. For the typical person, this means you only get about 15 grams of carbohydrates per day in your meal. Keep in mind, just a banana already about 27 carbohydrate grams — so the keto diet really does not give you a big allowance of carbohydrates. If you eat this way, after a few days with a limited amount of carbs, you start to build up ketones and go into a state called ketosis. At first, that can feel terrible; you can feel anxious, and hungry, and feel like your productivity is going down both in your thoughts and your physical activities. After a while, this ketogenic diet that’s build up of ketones can make you start feeling actually pretty good. You might feel more energetic, more sharp and alert, and some of that is thought to be because you have such a high level of ketones that they start to have a metabolic effect there — both because of the high ketones, which can be stimulating, and the low levels of insulin, which have some negative effects.
Insulin, as we mentioned previously, is pro-inflammatory, it leads to weight gain, it can lead to increased appetite, and increased fatigue. So with really rock bottom insulin levels, you might start to get some of the benefits of this very fat-heavy ketogenic diet.
Benefits of Keto
The ketogenic diet is great for weight loss. It’s been shown that people who go on a ketogenic diet can lose up to two or three times more weight than people doing other diets. It’s great for burning fat, reducing insulin, and increasing satiety, which is the feeling of fullness, because you’re getting tons of fats and proteins, which can make you feel very full. For all these reasons you start to eat fewer calories than you would in a normal diet, you don’t have big sugar swings, and as your insulin is reduced, you start storing less fat. Therefore, for weight loss it is great.
Keto and Diabetes
Diabetes is a problem with insulin and the way that insulin moves sugar around. Diabetics have really high levels of insulin, and that’s usually because of really high levels of carbohydrates in their diet. If you cut out the carbohydrates then you’re going to reduce that need for insulin. Your insulin levels are going to plummet and as they plummet, you’ll start to lose weight, to feel more full from the other things you’re eating, and then you won’t experience all those negatives effects of insulin. Your blood sugar is going to come down too. In fact with a ketogenic diet, insulin sensitivity has been shown to improve up to 75%. So it can be a great diet for people with diabetes.
Reduced Risk of Cancer
Keto has been studied as a possible way to reduce the risk of Cancer. So the question is, how can eating all these meats and fats reduce cancer risks? This could come down to insulin. Insulin is a growth hormone, and cancers love growth hormones. Diabetics and people with high insulin are at a higher risk for certain cancers like prostate cancer, colon cancer and some metabolic cancers. So if you can lower insulin levels, you might be able to reduce the risk of certain cancers.
In some people, Keto has been shown to actually improve their lipid panels. The lipids are the fats in your body, and a lipid panel shows you your levels of good cholesterol vs. bad cholesterol. For some people, when they switch to a ketogenic diet, their cholesterol panel ends up being better. They get higher levels of good cholesterol and lower levels of bad cholesterol. It’s a little bit of a paradox because you’re adding a lot of fat to your diet, but again one of the theories is that the lower levels of insulin and lower carbohydrates that actually reduces the effect that insulin can have on your cholesterol. High levels of insulin can shift cholesterol to a poor good/bad ratio, with higher levels of the bad cholesterol and lower levels of the good cholesterol.
So there are a lot of potential benefits for the ketogenic diet:
- Weight loss
- Regulating blood sugar
- Reducing bad cholesterol levels
- Reducing cancer risk
- Lowering risk for things like heart disease, stroke, and high blood pressure
Things you can’t eat on a Keto Diet
- Keto diets are very, very low in carbohydrates. So the first thing you’re going to cut out is fruit. You basically cannot have any fruits — no oranges, no mangoes, no bananas. You can have very limited amounts of low glycemic fruits like a small handful of berries.
- Grains — You can’t have processed grains, including Farro, wheat, cake, and rice. All these are out if you’re going keto.
- Legumes — You are also not allowed to have legumes like black beans, peanuts, and lentils.
- Root vegetables — sweet potatoes, carrots, and turnips are out as well.
- Unhealthy fats, like vegetable oil.
- Certainly no processed sugars or foods that have a lot of processed sugar in them like cookies, cakes, candies, and bread.
- Alcohol — This means no wine, beer, or any other kind of alcohol. Alcohol is a carbohydrate and it’s very high in calories, so on a keto diet you cut out all alcohol.
- No artificial sweeteners — You’re not allowed to have Splenda, Equal, or other artificial sweeteners like those found in diet sodas.
What you can eat on a Keto Diet
After that list, Keto might seem like a quite restrictive diet. So now let’s talk about what you can eat! We’re talking about a diet that is 75% fats, so you want to get fats any healthy way possible. These include:
- Healthy oils like organic oil, avocado oil, fat from nuts like almonds, fats from dairy products like butter, cheeses like goat cheese and Manchego. These are some great, healthy fats you can add to your diet.
- Certainly, you can add proteins from animals, including eggs, whole dairy, seafood like salmon, and any other kind of fatty meat like steak and chicken. It is important to note that these need to be unprocessed.
- When it comes to carbohydrates, you really need to look at the carbs that have a minimal glycemic index score. So you’re looking at primarily vegetables that are really low in carbohydrates, like bell peppers, broccoli, celery, lettuce, and leafy greens like spinach. You’ll get some carbohydrates, and they’ll be slow carbs that take a while to break down.
What a Keto Plate might look like
- Salmon, which contains a lot of healthy fat
- Avocado, another source of healthy fat
- A low-carb veggie like some spinach dressed in olive oil and squeezed lemon
- Spices like salt
- Some cheese like goat cheese
- When it comes to snacks, you’re looking at fatty spreads, such as nut butters, on top of low-carb things like celery. You can eat hard-boiled eggs or a handful of nuts.
Top Keto Diet Health Risks
In a diet that is very high in saturated fats, such as those found in cheese, animal products like steak and eggs, you’ll be consuming a lot of cholesterol. Even though there are some studies that show that eating a keto diet can actually help your lipid profile or your cholesterol levels, there are some populations of people that might already have a tendency toward high cholesterol that might not benefit from this. If you’re adding that much saturated fat to your diet, there is a potential that you increase your risk for cardiovascular disease. So basically the high cholesterol levels that can start to corrode the inside of your arteries.
A lot of our vitamins come from fruits, like oranges and mangoes, and vitamin C or vitamin A that you get in root vegetables like carrots and sweet potatoes. If you’re limiting those, you can really suffer from not getting enough vitamins. There are not a lot of vitamins in fats. There are certain vitamins in proteins, but you do run a risk of the limited amount of vegetables or fruits turning into a vitamin deficiency.
To process a lot of fat and protein, you need your kidneys, and if you’re someone who has kidney issues to begin with (for example a lot of diabetics have kidney issues), then it’s possible that you can put too much strain on your kidneys, as they’re having to filter more than they normally would, so this is another thing to be aware of.
Constipation is a less serious issue (although it can lead to more serious issues) but it’s still consideration. We’re really getting rid of a lot of fiber in the vegetables, fruits, and whole grains that are eliminated on the keto diet. So if you’re on a keto diet, you might start feeling like things are just not moving along very well.
If you’ve ever tried the keto diet, you may have experienced this. It’s those first couple of days when you cut out all the carbs and your body is just feeling bad — it could include fatigue, and mental cloudiness among other symptoms. It’s very unpleasant, but it will wear off in time.
When it comes down to it, this diet that is really high in fats, low in carbohydrates, can be beneficial for some people, but maybe not for others. So is keto right for you? It comes down to you and your body and your other health concerns. If you’re looking for a fast way to lose weight, the keto diet is certainly a viable option. You’re going to be reducing the amount of carbohydrates, reducing your insulin levels, and therefore reducing fat storage, so you’ll start to burn your fat stores pretty quickly.
If you’re diabetic and your kidneys are still pretty good, the keto diet is also an option. You’re crushing your insulin levels and this can really help reverse the strain on your pancreas, which is the organ that makes insulin.
There are studies that show keto diets are very good for people with epilepsy, helping to reduce their seizures, and even for people with Alzheimer’s to help promote mental clarity. If you or a family member suffers from autism or epilepsy, that’s another consideration.
In general, for the normal population, there are many other diets out there that provide a healthy balance of carbs and proteins, that aren’t adding a ton of saturated fat and you can find some healthy balance in them. For example, a Mediterranean diet, a paleo diet, or one that reduces some of the processed foods and refined sugars, but doesn’t go as far in terms of high fats.
As with any diet, have a conversation with your physician or healthcare provider about whether it’s right for you.