Making Sense of Macronutrients: A Brief Look at the Ketogenic Diet

Photo credit: Kjokkenutstyr [CC BY-SA 4.0]

Macronutrients are the building blocks needed to maintain health. The seemingly simple concept is the source of debate among scientists, nutritionists, celebrities, and laypeople. The question of ratio, quantity, and combination of macronutrients is not new. At different points in recent years, we have seen advocates for a surplus of one over the other in most fad diets—making it nearly impossible to know what to eat.

One diet currently gaining popularity was created to treat childhood epilepsy in the early twentieth century. A ketogenic diet, recently rebranded as a “bio-hack,” has been proven to be effective in the treatment of childhood epilepsy—but is it safe for everyone?

Following a ketogenic diet means strictly limiting carbohydrates—starchy vegetables, grains, and fruits—that convert to sugar during digestion and are used to power the body. Instead of being fueled by sugar, the body is forced to burn fat for energy. The body enters a state of ketosis, a similar effect to fasting in which the presence of both acetone and beta-hydroxybutyric acid appear. Followers of ketogenic diets get up to 75 percent of their daily calories from fat, 5 to 10 percent from carbs. Remaining calories come from protein, typically 1 gram per kilogram of body weight.

In addition to epilepsy, researchers have studied the therapeutic effects of a ketogenic diet on obesity, headaches, neurodegenerative diseases, and endocrine, sleep, and psychiatric disorders. One study shows that benefits in obese patients included decreased body mass index, total cholesterol, triglycerides and blood glucose.

The ketogenic diet differs from other low-carb diets, like Atkins, because it is not broken up into phases. Unlike Atkins, carbohydrates are not slowly reintroduced to the diet; practitioners just continue with the drastically reduced carb consumption. Unfortunately, a prolonged sense of deprivation can lead to significant overindulgence.

One feared consequence of maintaining ketosis for a prolonged period is ketoacidosis, a state in which the blood acidifies from high-levels of ketones. So far, the level of ketones necessary to reach ketoacidosis has not been possible in nutritive ketosis. There are several real side-effects to consider, however, including digestive issues, dehydration, electrolyte imbalance, and micronutrient deficiencies. When choosing the ketogenic diet, it’s important to discuss supplementation with your doctor or nutritionist to avoid these types of issues.

With trends shifting from low-fat to low-carb/high-fat, high-protein to moderate-protein, deciding what to eat is challenging. If you grew up during the low-fat craze of the 1990s, you may find it difficult to add healthy fats to your diet. One benefit of a short-term ketogenic diet or a “low-ketogenic” plan is that it allows a higher number of carbohydrates and can act as a reset for the sugar-filled Standard American Diet. Once the curve from high to low blood sugar is stabilized, it can be easier to make choices based on true, biological hunger instead of cravings.

Ultimately, a balance of fresh, colorful fruits and vegetables, nuts, legumes, and animal or plant protein provide an accessible middle ground for most. By eating a varied diet, you are more likely to get all of the necessary nutrients without supplementation, and you are less likely to binge on forbidden food categories. If you have been limiting caloric intake for weight loss, adding a slice of avocado can be profoundly satisfying.

Resources

Scientific American

https://blogs.scientificamerican.com/mind-guest-blog/the-fat-fueled-brain-unnatural-or-advantageous/

Women’s Health Magazine

https://www.womenshealthmag.com/weight-loss/high-protein-diets

Scientific American

https://blogs.scientificamerican.com/mind-guest-blog/the-fat-fueled-brain-unnatural-or-advantageous/

National Center for Biotechnology Information (NCBI)

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2716748/