Keto diet for weight loss in women and men: the essence, list of products

The ketogenic or keto diet is not new: a hundred years ago, before the advent of effective anticonvulsant drugs, French pediatricians noticed that certain dietary restrictions reduced the frequency of seizures in children suffering from drug-resistant epilepsy.

Based on the research into metabolism, a therapeutic diet was developed – without starch and sugar, which became part of the complex therapy of epilepsy in the early 1900s. The name “ketogenic diet” is said to have been coined by the American doctor Russell M. Wilder, who used it to treat epilepsy in the 20-30s of the last century.

The keto diet involves a high fat diet, moderate protein intake, and very low carbohydrate intake. For most people, this nutrient ratio is considered safe for a limited period of time and not only helps you lose weight, but also has therapeutic applications.

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Indications

The low-carb keto diet for epilepsy, which has been widely used in foreign clinical practice, helped to reduce the frequency of seizures in children of different ages by 62-75% (after dietary treatment for 12 weeks). At the same time, children who are prescribed such a diet should be registered with doctors who monitor their normal growth and weight gain, and also make adjustments to the diet in accordance with the needs of each child.

Low-carb diets have also been used for other disorders. Researchers have shown that ketogenic diets are useful in treating patients with De Vivo disease, a syndrome of GLUT1 protein deficiency (which transports glucose across the blood-brain barrier), as well as some other congenital metabolic defects.

It is believed that this diet can slow the progression of amyotrophic lateral sclerosis (Charcot's disease); indications for the ketogenic diet also include neurodegenerative pathologies such as Alzheimer's and Parkinson's diseases. Clinical studies are underway to examine the effects of the ketogenic diet on patients with autism, depression, type 2 diabetes (insulin-independent), and polycystic ovary syndrome.

The most famous keto diet for weight loss is the Atkins diet for the treatment of obesity, modified and popularized by Dr. Robert Atkins (Dr. Atkins Diet Revolution, 1972). Although experts consider only the induction phase of this diet to be ketogenic. And, in fairness, it should be noted that many American doctors were studying the principles of the ketogenic diet long before him: Peter Huttenlocher, Alfred Pennington, Richard McCarnes, etc. For example, in 1958, R. McCarnes wrote the book Eat Fat and Grow Slim, and this is essentially the same low-carbohydrate diet, originally introduced to treat epilepsy.

Since the deposition of excess fatty tissue in the form of triglycerides concentrated in its cells occurs due to excessive consumption of carbohydrate foods (no one doubts this fact), then limiting carbohydrates in the diet to a minimum - a keto diet for a month - helps to reduce fat reserves, that is, lose weight.

In addition, it has been found that the keto diet in oncology - due to increased oxidative stress of cancer cells - significantly reduces the growth rate of malignant neoplasms localized in the colon, stomach, prostate gland and lungs. In addition, an increase in the sensitivity of some cancer tumors to chemotherapy has already been proven - due to the induced state of ketosis.

Over the past two decades, the ketogenic diet has been adopted by bodybuilders to reduce the fat layer under the skin: in their slang, this is called drying on a keto diet.

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General information keto diets

On a standard keto diet, your total daily calories should come from 70-80% fat, 15-20% protein, and 5% carbohydrates (less than 50g per day).

As a rule, the ratio of fat to protein and carbohydrates is 3:1 (that is, 3 g of fat for every gram of protein + carbohydrates). If the proportion is 4:1, then 90% of the energy comes from fats, 8% from proteins and only 2% from carbohydrates (about 20 g per day).

Despite a century of use, the mechanisms underlying the clinical efficacy of the ketogenic diet in epilepsy remain unclear. Several theories have been proposed, including modification of the Krebs cycle to increase GABA synthesis in the brain and increased energy production from ketone bodies, which is 70% consumed by brain tissue. The ketogenic diet induces adaptive changes in brain energy metabolism that increase energy stores; ketone bodies are a more efficient source of ATP for brain neurons than glucose.

The essence of the diet used to reduce excess weight is to introduce the body into a state of adaptive ketosis - when the body receives energy (ATP) mainly from ketone bodies in the blood, and not from glucose, which comes from eating foods containing carbohydrates.

Carbohydrates in food are transformed into glucose, but when a person consumes very few carbohydrates and a lot of fat, a chain of biochemical reactions is launched in the body. Schematically, this process looks like this. Firstly, due to a decrease in the level of glucose in the blood, the pancreas begins to produce more of the hormone glucagon, which stimulates the catabolism of glycogen stored in the liver into glucose and its release into the blood. Secondly, ketogenesis is activated, that is, the production of ketone bodies by the liver (acetoacetate, which is then transformed into β-hydroxybutyrate and acetone) and the conversion of fat from food into free carboxylic (fatty) acids. Thirdly, due to the increase in the level of glucagon, the activity of lipase, an enzyme that breaks down triglycerides (fats) accumulated in the cells of adipose tissue, is significantly increased.

In addition, in the first two weeks of the keto diet, significant weight loss occurs due to the removal of water from the body, which is also associated with increased production of glucagon. And therefore, a temporary side effect of a high-fat diet can be dehydration, which nutritionists advise to combat by drinking up to two liters of water daily.

Many people believe that the main advantage of the keto diet is the absence of hunger, the need to count calories and exercise for hours to burn off excess calories.

Keto Diet for Men

The keto diet is considered especially effective for men with abdominal obesity.

If the domestic therapeutic diet for obesity (No. 8 according to Pevzner) recommends reducing the caloric content of food to 2000 (2300) kcal per day, then the ketogenic diet does not control calories so strictly (but reducing them by at least 10-20% will not hurt). But carbohydrate consumption must be reduced fivefold: instead of 250 g to a maximum of 50 g per day.

Remember that the bulk of calories on the keto diet are foods with a high content of natural fats and a moderate amount of protein products. That is, this is not a "protein load", as some may think. And if a man is used to eating a lot of meat, then his body will enter the state of adaptive ketosis much more slowly. So you will have to limit protein: per day to 1-2 g of protein per kilogram of body weight that you want to achieve as a result of losing weight. Example: if the initial weight is 112 kg, and the desired is 85 kg, then the amount of protein during the day is 85-170 g.

The exact ratio of fats, proteins and carbohydrates in the diet (in grams) will depend on the age, goal, level of physical activity and health of each individual man. But everyone is recommended to do short-term fasting during the keto diet: in the first two days of switching to this diet system, you should drink a lot of water and limit yourself to one meal per day (in a very small amount). By the end of the first week, you should exclude carbohydrates as much as possible (below is a list of products for the keto diet), but the portion size is reduced very slightly.

Another nuance: they say that the keto diet does not lose its effectiveness without exercise, and to lose weight you do not need to go to the gym or just do some additional physical exercises. But, physical activity, as part of a healthy lifestyle, accelerates the burning of excess fat, so you should not lie on the couch. Moreover, you can take advantage of the moment and, following the example of bodybuilders, build muscle mass: gaining weight on a keto diet is possible only with muscle load, and then subcutaneous fat will go away, showing strong muscles.

Keto Diet for Women

The problem with the keto diet is that to date, the research into its effectiveness and safety has only focused on men. This raises the question of whether the keto diet is appropriate for women, given that women's hormones tend to be more sensitive to most dietary changes.

While opinions vary, most experts agree that the ketogenic diet has positive results, especially for women in perimenopause or menopause. It can help you lose weight, control your blood sugar, improve your sleep, and reduce menopausal symptoms like hot flashes and night sweats.

However, there are also negative reviews and even complaints of nausea, fatigue and constipation due to the diet (more details below - in the section Possible complications). It is also worth mentioning that in case of menstrual cycle disorders, thyroid pathologies, during pregnancy and lactation, switching to a keto diet is contraindicated.

Women are advised to combine the ketogenic diet with intermittent fasting, that is, simply skipping lunch and taking a 10-12 hour break between morning and evening meals, which after 50-55 years gives a rejuvenating effect (these are the data from a 2016 study published in the Journal of the American Medical Association). According to Western nutritionists, such a dietary regime allows the body to take a break from digestive functions and direct energy resources to restoring tissue cells and balancing hormones.

If a woman weighing 75 kg and 165-168 cm tall wants to lose weight to about 68 kg, she should switch from 2300 kcal per day to consuming no more than 1855 kcal. Protein should be 1-1.5 g per kilogram of ideal weight, that is, daily you can get about 68-102 g of protein, 240-350 g of fat and 18-20 g of carbohydrates (in pure water, without fiber).

How is the keto diet different from the high fat diet?

The high-fat or LCHF diet differs from the keto diet in the proportions of proteins, fats and carbohydrates in the diet, with the high-fat diet suggesting a ratio of 50% fat and 25% protein and carbohydrates.

In Europe, the high-fat (and low-carb) diet is called the Swedish diet. Apparently, this is due to the Swedish physician Annika Dahlqvist, who began recommending her patients with diabetes to consume more fat and limit carbohydrates, which contradicted the officially approved recommendations of Swedish endocrinologists.

The professional conflict was widely publicized, but a scientific study commissioned by the National Health Council (involving 16,000 patients) restored the doctor's reputation and recognized the benefits of the high-fat LCHF diet. Because it reduces insulin requirements, the diet was labeled as suitable for people with type 2 diabetes and obesity.

Among the modifications of the ketogenic diet system, starting with the Atkins diet and the LCHF diet, one can name strange dietary recommendations, for example, the egg fast on the keto diet - when for several days you need to eat only boiled chicken eggs with mayonnaise...

Cyclical Keto Diet and Other Modifications

In recent years, the standard keto diet (SKD) has undergone many modifications, including the high-protein ketogenic diet (HPKD), which gets 60% of calories from fat, 35% from protein, and 5% from carbohydrates.

The Targeted Ketogenic Diet (TKD) is more moderate, as carbohydrates can be eaten before and after training; it is considered athletic, so the amount of calories obtained from carbohydrate consumption is higher than in SKD.

The cyclical keto diet (CKD) or, according to another version, the rotational keto diet (alternating), is a low-carb diet with alternating periods of high or moderate carbohydrate consumption: 5-6 days - a minimum amount of carbohydrates, then a carbohydrate loading is carried out on the keto diet - one or two days of carbohydrates are consumed without limitation. Unknown authors of this version of the keto diet are trying to justify their innovations by the need to replenish glycogen reserves, restore hormone levels and thyroid activity, as well as ensure moral and psychological stability - to continue the diet. In fact, everything that is lost in six days immediately returns.

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Benefits

As foreign clinical practice shows, almost 20% of children with epilepsy after a ketogenic diet (followed from six months to two years, with a gradual return to normal nutrition) have much less seizures, and many of them can reduce the intake of anticonvulsants or completely abandon them.

Based on the results of two dozen randomized controlled trials, experts have concluded that the benefit of the keto diet is a significant and fairly rapid loss of excess weight, especially in severe obesity. Despite the large amount of fat, this diet over 24 weeks in a significant percentage of patients leads to a decrease in systolic blood pressure, blood sugar and insulin levels, plasma C-reactive protein levels, and an increase in high-density lipoprotein (HDL), that is, good cholesterol.

In 2008, the American Diabetes Association (ADA) revised its dietary guidelines and recognized low-carbohydrate diets as a fairly effective method of short-term dietary therapy for patients with non-insulin-dependent diabetes.

And yet, the skin on the keto diet reacts to the lack of carbohydrates in its own way, for example, acne may decrease. And this is confirmed by the results of a study published in the Journal of the American Academy of Dermatology.

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What can and what can not?

What can you eat? The list of products recommended for the keto diet includes: any meat and meat by-products; poultry; fish and seafood; eggs (in all forms); cream, sour cream, butter (butter and vegetable). Hard cheese is very useful on the keto diet. But be careful with regular milk, as it contains a lot of lactose - milk sugar, which is a disaccharide carbohydrate. But fermented milk products can be consumed without fear: in the process of lactic acid fermentation, lactose undergoes hydrolysis.

Instead of popcorn, candy or chips, walnuts (about 13 g of carbohydrates per 100 g) and sunflower seeds (10.5 g of carbohydrates per 100 g) are suitable. The number of calories, respectively, is 655 and 600.

It is recommended to include in the menu:

• mushrooms (except dried porcini and aspen mushrooms), the ideal option is champignons (only 0.5 g of carbohydrates per 100 g).
• All types of leafy greens and vegetables that do not contain complex carbohydrate starch: broccoli and kohlrabi; white cabbage, cauliflower and Brussels sprouts (3-6 g carbohydrates per 100 g); cucumbers, squash, zucchini, eggplant, bell peppers (green), tomatoes, radishes, leeks, rhubarb, green beans, and leeks (within 1.8-4.5 g carbohydrates per 100 g).

You can eat berries in small amounts: strawberries (100 g contains about 8 g of carbohydrates), cherries, raspberries, blackberries, cranberries (100 g contains 12 g of carbohydrates).

If you stick to moderation in their use, following a keto diet for weight loss, then 100 g of apricots, pineapple or grapefruit can be eaten occasionally: this is about 11.8-12.4 g of carbohydrates. But you should not eat bananas: in every 100 grams of carbohydrates there are almost 23 g.

What should you not eat? You will have to give up bread and all flour products; pasta; sugar, honey and confectionery sweets; any cereal porridges; potatoes, carrots, beets, celery root; pumpkin and all melons; legumes and most fruits.

Keto Diet Weekly Menu

A serious attitude to getting rid of excess fat reserves in your own body, of course, requires making a menu for a week of keto diet. And the information in the previous section will help with this.

For breakfast you can make scrambled eggs or omelettes – with onions, mushrooms and spinach, bacon and tomato. Coffee or tea, naturally, without sugar.

Lunches can consist of a salad (a recipe for one of them is below), vegetable soup or meatball soup (without potatoes, rice or vermicelli), chicken broth and boiled chicken, fried fish or pork stew with mushrooms.

For dinner, choose a protein such as turkey, beef, fish, or seafood, which goes well with broccoli, Brussels sprouts, green beans, or bell peppers topped with a creamy cheese sauce as a side dish.

Keto Diet Recipes

Considering the list of foods that are allowed in the ketogenic diet, you can cook so many different dishes that it is impossible to give even a tenth of the keto diet recipes. Try these three.

Chicken baked with vegetables

Ingredients for two servings: 500 g chicken (thighs, breast or fillet, cut into medium pieces), tablespoon vegetable oil, 1 green bell pepper (cut into medium cubes), half an onion (cut into small cubes), 500 g cauliflower (disassembled into florets), half a small hot pepper (finely chopped), 50 g butter, 100-150 g sour cream, 50 g hard cheese (grated on a coarse grater), salt and ground black pepper to taste, ground coriander (half a teaspoon).

Preparation:

• Preheat the oven to 180°, grease a baking dish or frying pan with vegetable oil;
• separately sauté the onion and pepper (sweet and hot) in vegetable oil;
• Blanch the cauliflower florets in salted boiling water for three minutes, drain;
• place the chicken in a pan (frying pan), add salt, pepper, onion and pepper and cabbage (distribute the vegetables evenly over the meat);
• Sprinkle with coriander on top, put butter (several pieces, over the entire surface), pour in sour cream, sprinkle with grated cheese and place in the oven for 40-45 minutes.

Quick salad with ham or brisket

Ingredients for two servings: 100 g ham or brisket, 250 g lettuce (dry well after washing), two fresh cucumbers, one tomato, two chicken eggs (hard-boiled), 60 g dill or parsley, 1 tablespoon olive oil and the same amount of mayonnaise, salt to taste.

Preparation:

• cut the brisket or ham into large strips;
• cut boiled eggs into quarters, vegetables into thin circles;
• Place the lettuce leaves on a plate, put the ham on top, then the eggs and vegetables on top of that, add salt;
• Mix vegetable oil with mayonnaise, add finely chopped herbs, stir and pour this sauce over the salad.

Pork stew with mushrooms

Ingredients for three servings: 300-400 g pork, 350 g fresh champignons, half an onion (finely chopped), 2 tablespoons vegetable oil, half a teaspoon nutmeg, one clove of garlic, 4 tablespoons sour cream or heavy cream, 2 tablespoons chopped herbs, salt and ground black pepper to taste.

Preparation:

• pour vegetable oil into a deep frying pan or saucepan with a thick bottom, add onion and chopped garlic, simmer for five minutes;
• put in pieces of meat and fry a little;
• add chopped mushrooms, stir, add nutmeg and ground black pepper, salt;
• cook over low heat for 15 minutes, then add sour cream (cream) and herbs;
• Cover the pan with a lid and simmer until done (about another 15 minutes).

Contraindications

Absolute contraindications for switching to a ketogenic diet include:

• diabetic ketoacidosis caused by insulin deficiency;
• congenital and secondary carnitine deficiency;
• pyruvate carboxylase deficiency;
• mitochondrial diseases caused by impaired beta-oxidation of fatty acids;
• porphyria;
• pronounced abnormalities in blood composition, iron deficiency anemia;
• pancreatitis;
• acute and chronic inflammation of the gallbladder (cholecystitis);
• liver dysfunction, primary or metastatic liver tumors;
• acute renal failure;
• bowel dysfunction, Crohn's disease;
• abdominal tumors;
• condition after cancer chemotherapy.

With special caution, you should treat the advice of bodybuilders to "spur" metabolism with the help of pharmacological agents: do not risk your health in pursuit of a super-effect. In fact, the ketogenic diet is incompatible with anabolics, for example, the keto diet and clenbuterol. Clenbuterol is an adrenomimetic drug for relieving bronchospasm and treating bronchial asthma - it is classified as anabolic, since, like norepinephrine, it stimulates beta2-adrenergic receptors and affects metabolism. The drug accelerates the breakdown of glycogen in the liver and triglycerides of adipose tissue, but can cause hyperglycemia, increased heart rate, headache, nausea, decreased blood pressure, hand tremors and other side effects.

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Possible risks

Risks associated with long-term dietary interventions for the treatment of childhood epilepsy include the risk of growth retardation (due to decreased levels of insulin-like growth factor 1), decreased bone mineralization (due to calcium deficiency), and nephrolithiasis (formation of kidney stones). Hyperlipidemia (high blood lipids) is seen in up to 60% of children, and cholesterol levels may increase by about 30%.

Rare side effects include cardiomyopathy, long QT syndrome (abnormal heart rhythm), vitamin, micro and macronutrient deficiencies.

The most common side effect is constipation, which is complained about by almost a third of those losing weight: the lack of fiber consumption has an effect. In addition, the ketogenic diet at the initial stages can be accompanied by increased fatigue, weakness, headaches, dizziness; in women - dysmenorrhea.

In most cases, low-carb ketosis causes mild acidosis, a condition in which the pH is slightly lower than normal, which is considered safe according to research. Signs that the body is in a state of induced ketosis include: an increase in the number of urinations; a feeling of dry mouth; bad breath (due to acetone escaping through the lungs); a decrease in hunger and a surge of energy.

Signs such as nausea on a keto diet, vomiting, dehydration, shortness of breath, rapid heartbeat, increased urine output, and thirst may indicate possible complications – the development of ketoacidosis. Any of these symptoms should prompt you to see a doctor immediately.

If you don't lose weight on a keto diet, then most likely there is too much protein in the diet, since more than half of the excess proteins are transformed into glucose in the body, that is, the process of induced ketosis is disrupted.

When muscles are very sore on a keto diet, the cause may be associated with either a disruption of gluconeogenesis – the synthesis of glucose from muscle lactate (lactic acid), or with the enzymatic breakdown of muscle tissue glycogen under ketosis.

At the beginning of the diet, reducing carbohydrate intake leads to the removal of fluid, and swelling of the legs during the keto diet can occur even with minor renal failure.

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Reviews and results of losing weight

Reviews from doctors who prescribe a ketogenic diet to patients with neurodegenerative pathologies come down to stating its absolute effectiveness: even with senile dementia and Parkinson's disease, patients experience increased attentiveness, significantly improved memory and adequacy of perception.

Usually, reviews and results of those losing weight are commented on by specialists. But significant contradictions regarding all low-carb diets also introduce disagreements in the assessment of specific results.

Thus, according to the American Journal of Clinical Nutrition, researchers found that men and women who switched to the keto diet, on average, lost 3.6-4 kg more in six months than those who limited their fat intake. British obesity experts (British National Obesity Forum) also note that low-carb, high-fat diets are superior to low-fat diets in terms of weight loss. Although their numerous colleagues claim that the results of the keto diet for weight loss are “contradictory to the available evidence.”