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Changing lifestyle and food habits exposed people to chronic diseases like diabetes, hypertension and heart complications. Most of them are related to obesity complaints which has grown up being a major health issue on globe. There are many measures that have been adopted to fight obesity. Following a strict diet regimen, sticking to perfect exercise schedules, depending on weight loss commercial products have all stocked up in the lane of weight loss process. Ketodiet is one such effective diet proven for providing efficient results in obese individuals. 




What is Ketodiet? 

Ketodiet primarily consists of very low carbohydrate diet, medium protein and a rich fat diet. The concept is to provide healthy fats for body and make it less dependable on body’s sugar depots. 

Concept behind Ketofoods 

Basically, humans digest the polysaccharides (long chain sugars) into monosaccharides (mostly glucose) with the help of digestive enzymes. There are certain metabolisms that can convert the simple sugars (glucose) into pyruvate which is later converted to ATP, the prime fuel molecules of human body. 
This entire process is reset in people feeding on ketodiet. Ketodiet plan ensures that body utilizes stored fats. This is attained by maintaining a very low availability of carbohydrates. 
The purpose of keto diet is not to provide fat and calorie to the body, but to make body switch over to fat metabolism by burning consumed fat and stored fat simultaneously. 

Physiology in consuming ketogenic diet 

Consuming ketogenic diet pushes the body equilibrium towards a low carbohydrate diet. Hence it is similar to physiological state of fasting where the low glucose availability is accompanied with high fats. 
During fasting, low glucose availability prevails in body. The human body adapts two mechanisms. One is gluconeogenesis where body synthesizes its own glucose from lactic acid or glycerol. When these depots are also used up, ketosis takes into action. Low blood sugar is already prevailing in the body and thus there is low insulin secretion. All these physiological situations trigger the metabolic pathways that breakdown stored fats. Finally, ketone bodies replace glucose as central molecule and the situation is termed as Nutritional Ketosis. Butahydroxybutyrate, acetone and acetoacetate are the three most common organic molecules that are referred all together as ketone bodies. A small proportion of ketone bodies does not pose any threat since the blood pH is not disturbed. 
So, during ketogenic diet, when the body is supplied with high fat diet having a low carbohydrate proportion, body’s stored carbohydrate reserves become insufficient to provide enough glucose molecules for energy needs. Then the body reaches a stage of utilizing the available fats for providing ketone bodies which are new energy currency. 
Ketogenic diet however has shown few adverse effects on a short time base. Dizziness, nausea, fatigue, headache, vomiting, insomnia, constipation. Few people suffer from excessive fatigue during workouts and exercise. All together it is called as “keto flu”
Maintaining the hydration balance of body and providing enough electrolytes can help subjects to overcome these issues. However, the side effects get resolved in a maximum period of few weeks. 

From being an apprehension to special diet 

Ketosis gained a level of apprehension because it is the main mechanism behind acid ketosis where the number of ketone bodies produced is quite large having a direct impact on blood pH. 
Its use in treating epilepsy by Russel Wilder and recent advances in nutritional research have changed the opinions regarding ketosis. 
After the glucose deposits deplete in human body, the energy demands of brain are met by ketone bodies. Ketone bodies are the sole molecules that can cross the blood brain barrier and reach brain cells avoiding them to starve. 
This logic has been used by Russel Wilder in treating epilepsy. Epilepsy is characterized by sudden electrical disturbances in brain which lead to uncontrollable behavioural changes. In epilepsy patients, glucose is an immediate energy providing source for seizures. So, cutting of glucose availability makes brain dependant on ketone bodies and seizures are supplied with less energy and hence reduced. 
Ketogenic diet occupied crown in therapeutic diets until antiepileptic agents have been discovered and replaced it. Currently it became a weight loss diet and gained good response in very short run.

The Diet 

There is no specific or standard ketogenic diet with proper ratio of macronutrients. The diet typically decreases the total carbohydrate uptake to less than 50 grams a day. Generally, popular ketogenic diet has aspect ratios of 70-80% fat from total daily calories, 5-10% carbohydrate, and 10-20% protein. The protein content in the ketodiet is kept moderate because eating too much protein prevent ketosis. 
Ketogenic diet pushes the body to another edge of utilizing fats as fuels and must ensure a least carbohydrate range in the diet. 
There is fixed nutrient chart for people following ketodiet. A minimum range of 3-6 grams of *net carbohydrates in 100 grams of food is better. It is even accurate if subjects can follow least carbohydrate of 3 grams in 100 grams of food. 
Green leafy vegetables are one best source of low carbohydrate and reserve of essential micronutrients. They are rich in fibre making the stomach full and simultaneously have a low carbohydrate and calorie levels.

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Vegan Ketofoods 

Kale, mustard greens, spinach, broccoli, sprouts, lettuce and arugula are popular greens recommended for ketodiet. Vegetables like tomatoes, cucumbers, egg plant, zucchini, radishes, asparagus, turnips, fennel, kohlrabi, green beans, snow peas better choices if ketodiet is followed. 

Meat and sea foods 

Lobsters, crabs, chicken, big fatty sea fishes, lamb, beef are all good options for meat based ketodiet. 
Apart from the above, dairy items are also recommended Ketofoods. Milk based products like ghee, full cream, cream cheese, cottage cheese, yoghurt, parmesan, mozzarella cheese, cheddar cheese, whole milk are all rich fats dietary products having enough quantity of proteins too. 
Oils are an entirely different category in ketogenic diet since they are richest source of fats and some are having special vitamins too. Coconut oil, avocado oil, olive oil, cocoa butter, sesame oil, walnut oil, hazelnut oil is used in ketogenic platter preparation. 
Taking enough care while choosing oil for particular preparation is needed to ensure the essential nutrients are not lost. This is because different oils have different evaporating (smoke) points and cooking beyond that particular temperature can make the nutrients to degrade. For example, avocado oil has a relatively high smoke point so it can be used to ketogenic platter based on grilling, roasting, frying and even as dressing and dipping’s. While sesame oil has a medium smoke point, so beyond cooking it can destroy the nutrients and also the degraded constituents can cause inflammation in subjects as they are already on special diet with a diverted metabolism. 
Coconut oil is rich in saturated fats and medium chain fatty acids. It is extracted from coconut palms and has high smoke point. 
Extra virgin olive oil is rich in flavour having high amount of monounsaturated fatty acids and antioxidants. It has a very low smoke point and so can be used in dressings and marinades. 
Avocado oil is rich in monounsaturated fatty acids and antioxidants like olive oil having an extra dose of proteins, vitamin A and E. It ensures a better absorption of nutrients and maintains cholesterol levels. Hazelnut oil is a pack of rich flavour and essential fatty acids while walnut oil is blende of monounsaturated fatty acids with omega 3 fatty acids. It is a power pack of manganese, zinc, potassium and niacin. 

Medium chain triglyceride diet (MCT)

A dominance in ratio of fats to carbs and proteins make the ketogenic diet less palatable. In 1970’s Medium Chain Triglyceride (MCT) diet has been introduced which is comparatively palatable than the classic ketogenic diet. 
MCT diet contains medium chain fatty acids along with proteins and carbohydrates. Medium chain fatty acids produce ketone bodies more easily in comparison to the long chain fatty acids. this tendency to produce ketone bodies easily makes room for carbohydrates and proteins making the diet more palatable than the classic ketogenic diet. 
A supportive point in favour of MCT diet is that medium chain fatty acids do not require carnitine shuttle. So, people with impaired carnitine levels can rely on MCT diet under clinical supervision. 
It is planned and supplemented such that 30% energy needs are supplied with MCT oil and rest 30% from long chain fatty acids. The balance of energy needs is supplied by carbohydrate and proteins. Though some side effects may pop up differently in different subjects the supply of diet may be variable during short run and can be inculcated on advent of normal conditions. 
The MCT diet is more flexible than the classical ketogenic diet since it expands the diet chart by adding lot many items into the proteins and carbohydrates columns. This makes a variety of items into platter making its comparatively delicious. Specially in case of children where they turn resistant to the classic diet, inculcating MCT can make the diet relatively attractive with a room for fried bread, potatoes and mushrooms. MCT oils can be used in salad dressing and be given directly to children fed on tube in gastrostomy. 
Liquid food is a quite satisfactory point in MCT which can be least availed in case of classic ketogenic diet. MCT shakes can be made out of milk, MCT oil, and protein powders which make the children find interest in adapting to the diet chart. 
If the subject is acclimating to the ketogenic diet chart either MCT or the classical one, a close monitoring of the ketone levels in urine blood are to be monitored. An eye watch on blood sugar levels, fluid intake and body weight is a mandatory point to be kept in mind while in the starting stage.

Be cautious before you choose 

Since ketogenic diet shifts the body metabolism to another physiological edge, being cautious before adopting the diet pattern is a minimum essential. 
Ketone body generation is entirely confined to liver. The enzymes associated with fat metabolism are main switches in ketosis. Hence patients with liver disorders, pancreatic failures are restricted to depend on ketogenic diet. 
Pancreatitis is an inflammation of pancreas where its function and enzyme production are impaired. Pancreatic enzymes like pancreatic lipase, cholesterol esterase is chiefly associated with lipid digestion in small intestine. And hence pancreatitis patients are restricted from taking ketogenic diet. 
Carnitine is an amino acid derivative compound which has a very important role in fat metabolism. Carnitine is the basic molecule synthesized from two amino acids lysine and methionine and involved in long chain fatty acid translocation into mitochondria. It carries fatty acids across inner mitochondrial membrane and returns back for the next cycle. The entire process is called as carnitine shuttle. 
Carnitine shuttle is an essential step in fat metabolism because it facilitates the fatty acids with an exposure to inner mitochondrial membrane. The enzyme action causes an oxidation reaction in with a step wise removal of two carbons at a time and finally forming acetyl CoA molecules. The acetyl CoA either enters Krebs cycle to produce ATP or are converted to ketone bodies. 
So, deficiency in fat metabolism enzymes like carnitine palmitoyl transferase, carnitine translocase, primary carnitine deficiency can have a direct impact on ketone body synthesis. So, if patients continue to take ketodiet, there occurs a situation of low energy levels. 
Long term usage of anticonvulsant drugs like sodium valproate can deplete the carnitine stores of body. So, patients who had a long-term treatment based on anticonvulsants are advised not to follow ketodiet. The logic is that already the body is fed with long chain fatty acids and a prevailing low carnitine levels can have a direct impact on fat metabolism and adequate ketone bodies are not formed. Finally, the body suffers from low energy supplies which can pose severe threat to vital organs. 
In some subjects, acetone in body becomes isopropanol by the reduction action of alcohol dehydrogenase of liver. Isopropanol gives false positive results in alcohol breath tests. 
In healthy subjects too ketogenic diet can only be introduced on a slow and gradual base with a periodical observation on kidney functioning. Healthy subjects were reported with dehydration, hypoglycaemia and electrolyte imbalance when fed a ketogenic diet. Staying hydrated while on ketogenic diet have shown effective results for weight loss cases. 
Other approaches for weight loss like reduced calorie intake and low-fat diet have been reported with long term effects. Though the long-term effects of Ketogenic diet are not known due to limited literature. However ketogenic diet has shown efficient results in rodent studies. Any short-term symptoms like ketoflu have sustained for only a short time period. 

Withdrawing the diet plan 

In case of individuals who are fed with ketogenic diet for treatment of medical ailments like epilepsy, sudden abruption in ketodiet immediately is not recommendable. There should be a gradual increase in carbohydrate content along with simultaneous decreasing MCT oil by 10% for three months. If the individual abruptly stops ketogenic diet and shifts to normal diet there can be sudden seizures. For this reason, as the way ketodiet has been inculcated in a step wise manner, withdrawing the diet in a step wise manner is also essential for balancing the health and is strictly recommended under the surveillance of doctor and a dietician.

FAQs

Keto word is primarily taken from word ketosis, a metabolic mechanism in our body to use fat or digest fat and fatty acids. Ketodiet primarily consists of very low carbohydrate diet, medium protein and a rich fat diet. The concept is to provide healthy fats for body and make it less dependable on body’s sugar depots. For diabetic people low carbohydrate diet is recommended, having good amount of protein and low fat. Whereas in ketodiet, the fat consumption is focused by reducing the carbohydrates in diet.

The ketogenic diet has been shown to produce beneficial metabolic changes in the short-term. Along with weight loss, health parameters associated with carrying excess weight have improved, such as insulin resistance, high blood pressure, and elevated cholesterol and triglycerides. There is also growing interest in the use of low-carbohydrate diets, including the ketogenic diet, for type 2 diabetes. Several theories exist as to why the ketogenic diet promotes weight loss, though they have not been consistently shown in research. However, if all the things implemented perfectly it may have beneficial effects on health. /To check your keto plan kindly consult your healthcare professional, do not take the diet with yourself, healthcare professional consult is recommended before you go for keto diet/

Yes, below is the list of organic foods you can eat to maintain your ketodiet. (For consumption values consult your healthcare professional.)

 Bell Peppers Zucchini   Avocado Cucumber 
 Onion  Cabbage Spinach   Nuts and Seeds
 Olive oil Coconut oil   Soya/Almond milk Tofu 
 Paneer Ghee   Cauliflower  Fruits
Non-Vegetarian can have Eggs, Fish, Chicken along with the vegetarian diet.

Yes, but first you must check their label claim what amount of Carbohydrate is added. The super dark chocolate. 72% dark has 4 net carbs in it, 86% dark has 3 net carbs.

Some signs are: decreased appetite, bad breath, dry mouth, short-term fatigue, increased focus and energy, digestive issues. For acute diagnosis kindly consult your healthcare professional as these symptoms might be due to irregularities in your meal.

It depends what type of diet chart you have, if you cannot get your dietary requirements then you should get supplements. MCT is the most important fat source, and it is also available online. Make sure you check the carbohydrate level before using the ketofoods as per your diet. For more assistance consult your healthcare professional.

It’s hard at first. Looking at labels is important. There are brands out there that are keto friendly.

In starting you have to slowly increase the fat amount and decrease the carbohydrate amount. For further assistance consult your healthcare professional.

You can not withdraw once you have started your keto diet, because your metabolism is switched in to fat instead of carbohydrate. Sudden withdraw is risky and may lead to multiple organ failure. So, to withdraw, increase the carb slowly and reduce fat slowly in diet. Kindly consult your healthcare professional if you are willing to withdraw.

“Net carbs” and “impact carbs” are similar terms in ketogenic diets also in diabetic diet. These terms are introduced by food manufacturers as a marketing strategy, appearing on food labels to claim that the product contains less “usable” carbohydrate than is listed. Net carbs or impact carbs are the amount of carbohydrate that are directly absorbed by the body and contribute calories. They are calculated by subtracting the amount of indigestible carbohydrates from the total carbohydrate amount. Indigestible (unabsorbed) carbohydrates include insoluble fibres from whole grains, fruits, and vegetables; and sugar alcohols, such as mannitol, sorbitol, and xylitol commonly used in sugar-free diabetic food products. However, these calculations are not an exact or reliable science because the effect of sugar alcohols on absorption and blood sugar can vary. Some sugar alcohols may still contribute calories and raise blood sugar. The total calorie level also does not change despite the amount of net carbs, which is an important factor with weight loss..

/Disclaimer: The information provided in this article is just for having knowledge and information on General Health. Science Arena Does not claim any health benefits nor its authors in any form, all the data and information shown are based on the personal experience and reference health data taken from Health practitioner. [Not For Medicolegal Purpose]Educational Purpose Only/
To check your keto plan kindly consult your healthcare professional, do not take the diet with yourself, healthcare professional consult is recommended before you go for keto diet

Author Details

  • Gautam Singh Rathore 
  • Prathyusha Naresh

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