When it comes to lifestyle and diet choices, there are a lot of options and a lot of opinions. The past 40 years the general advice has been low fat with high exercise, and this has resulted in the largest obesity epidemic in human history, yours truly included. And with that comes a lot of crazy fad diets such as different juice cleanses, card counting schemes, and weird tasteless frozen meals. But there have been a few fad diets that turned out to be successful and have long-term verifiable results, one of which is the ketogenic diet.

At the top level, there are basically three macros that most people concern themselves with: carbohydrates, fat, and protein. There are secondary items that people concern themselves with such as cholesterol and sodium intake, but those can be managed independently of the three primary macros. The typical diet focuses on carbs and cut fat, body builders tend bulk on protein, and keto cuts carbs and focuses on fats. When I say cuts carbs, I mean it cuts them out almost completely. With only 20g of net carbohydrates allowed per day (total carbs minus fiber), the body switches to a process called ketosis where most of the energy that your body uses comes from ketones bodies in the blood instead of blood glucose. Ketogenesis allows the body to generate ketone bodies and cells can generally use ketones as an alternative fuel source. At a metabolic level, cutting carbohydrates forces the body into ketosis which ends up converting fat into energy. Coupled with a caloric deficit, your body will first use up it’s glycogen stores (and associated water weight), then it will begin to use ketones as it’s energy source. With a caloric deficit, you will burn what you eat first, then you will begin to burn stored fat.

On a higher level, eating fat, proteins, and fiber ensures a full feeling at all times, making it easier to maintain a calorie deficit. By focusing on fat supplemented with fiber and protein it allows you to burn fat optimally without loss of muscle mass. By staying in ketosis, your body will opt to burn fat continuously and you will rarely feel hungry. Anecdotally, while in ketosis I slept more consistently, suffered fewer migraines (more on that in a future post), and enjoyed a consistent 5.1 mmol/L blood glucose level. At first I thought that eating all of these natural fats and healthy meats would cost me more money I found that the cost was offset by my reduction in eating out at restaurants.

Despite all the positives of a ketogenic diet, there are some negatives. A negative to ketosis is the lack of food variety. By eliminating all carbohydrates and not just refined sugars it is hard to eat fruits and root vegetables as both are high in natural sugars. Another negative would be the so-called “keto flu” that some individuals experience when their body transitions to using ketones. I have experienced this effect first-hand in the past, lasting about 3 days, during which I suffered from a headache, general weakness, and mild mental fog. This all immediately cleared up for me once I was in ketosis and didn’t return. Another thing to note is even though ketosis will burn fat preferentially, if you aren’t eating a deficit that means your calories will still mostly come from the food you eat, slowing weight loss. Another common feature of the ketogenic diet are plateaus - points where the body is no longer losing weight. While most are temporary, it can be discouraging, and sometimes require a brief change in diet to restart the process (fat-fast, cyclical keto diet, etc).

All said, I have tried numerous fad diets in the past, all had short-term small success, but ultimately lead to failure. I tried the traditional calories in, calories out ideology, but found that not all calories are created equal. There are better calories such as those tied to fiber and micro nutrients, and the body burns macro nutrients differently. I think the 3 months I followed a strict calorie-in, calorie-out diet were the most miserable months of my life. I then tried the ketogenic diet, and while the food restriction at first felt negative to me, I soon found it to be a positive. I could prepare meals days in advance, cook large batches and freeze them. Grocery shopping was simplified as I only stuck to fresh foods on the outer rim of the grocery store. Most important of all, it worked. That is why I am choosing the ketogenic lifestyle again.