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The No Nonsense Ketogenic Article of Your Dreams

The ketogenic diet is probably the trendiest and most misunderstood diet ever. Marketers and influencers love to take advantage of it’s popularity by over exaggerating claims and taking science out of context to hype up ketogenic products.

On the contrary, many coaches love to overly bash the ketogenic diet because apparently, that’s the cool thing to do when you’re not fully knowledgeable about something.

Ultimately, you’re left wondering, is keto truly good or bad for you? Is it overrated or can it be useful? Let’s discover the answer by looking at unbiased science, shall we?

What is Keto? (pronounced key-toe not ket-toe)

So, what even is keto? The goal of the diet is to enter into a deep state of nutritional ketosis by severely restricting carbohydrate intake. This usually results in a moderate/high protein, high fat, and very low carb diet.

This carbohydrate limit is generally about 50 grams of net carbs a day (2,3). This is not a set in stone limit for everybody as mild ketosis has been seen in some people with slightly higher intakes, but generally speaking you’d want to stay under about 20-60g of net carbs daily to remain in deep ketosis. This means the only carbs you can eat are fibrous vegetables and minimal low sugar fruit.

Well, what about dessert? That’s cute. Most dessert dishes will easily blow you out of ketosis unless zero calorie sweeteners are used.

Wait, What the Heck is Ketosis?

Your body’s primary fuel source is glucose. With keto’s low carbohydrate intake, your body’s glucose is being depleted. Fortunately, your body can still run off of fat as a fuel source.

However, your brain in particular, can’t run off of fat because fat doesn’t cross the blood-brain barrier. Once your brain uses up a significant amount of your remaining glucose, your body then produces an alternative fuel source called ketones which do cross the blood-brain barrier.

Ketones are essentially your body’s way of saying, “Oh snap, the brain’s out of fuel. Let’s make some ketones so my human doesn’t go brain dead.”

Ketones while necessary as an alternative fuel source are not superior compared to glucose, especially for athletic performance, but we’ll talk more about that later (9,10,40).

Anyways, this entire process of officially converting to deep ketosis generally takes about 2-4 days and usually isn’t pleasant to adapt to (5). People often report what they describe as keto fog or keto flu within the first few days/weeks attempting the diet, describing symptoms of sickness or fatigue (16,62).

While on keto, it’s also common for people to report bad breath known as keto breath because of the presence ketone bodies in the blood (6). Hair loss is a slight potential as well (62).

These effects can be traced back to carb restrictions (45), but not the degree of carb restriction (53).

So regardless of how low carb you go, merely transitioning to carbohydrate restriction can reduce your glycogen stores (stored sugar), electrolyte levels and thus cause water loss (42).

The potential for dehydration and electrolyte loss increases which explains some of the early keto symptoms (41,42). Thus, the initial keto flu can be mitigated by increasing electrolyte, fiber, and water intake (46).

The exact electrolyte minerals you’ll need to increase in consumption or supplementation are potassium, sodium, and magnesium.

Lastly, ketosis can also occur with extended fasting, times of starvation, and even exercise (47). It’s not some new revolutionary metabolic state, but with a consistent ketogenic diet, you do stay in a deeper state longer (11).

How Keto Started

Even though your annoying co-workers on keto might make this diet sound new and flashy, it’s actually not new. The ketogenic diet has been frolicking around for an entire century. If you’ve been attentive, it spikes in popularity every couple of years, then dies down slightly before spiking up again.

And this might be shocking, but keto actually didn’t start as some flashy fat melting diet popularized by celebrities. It actually started way back in the 1920s where doctors used it to treat epilepsy (1).

Epilepsy is a neurological disorder associated with seizures. 1 in 26 people will develop epilepsy and fortunately, the ketogenic diet has been shown to help.

What About My Love Handles Bro?

You’re probably thinking, “that’s great and all that keto helps shaky kids, but what about my weight loss goals bro? Is keto good for that?”

Yes, keto can definitely be good for weight loss and is generally safe (57).

However, when people first learn about ketosis, many misunderstandings arise.

Because you do burn more fat than carbs while in ketosis, it leads many to believe you’ll lose more body fat on keto.

Unfortunately, what marketers don’t want you to know is that burning and losing fat are completely different. You can burn more fat, but not necessarily lose more fat off your body.

How Is This So?

Well, your body adapts to the fuel source you provide it. With extreme fat intakes and extreme carb restrictions, your body is obviously going to burn more fat and less carbs because that’s what you’re providing it (8,12).

Burning fat simply means your body is oxidizing it as fuel. On the other hand, to lose fat, you have to burn more total fat than you store or in other words, you have to be in a caloric deficit.

When tightly controlled studies compare low carb vs low fat diets, even though the low carb group burned more fat, it also stored more fat making the net outcome the same when calorie and protein intake are equal (7).

This is why despite ketosis sounding radically powerful, fat loss is never superior on a ketogenic diet compared to a diet of equal calories and protein. The fuel source you use might be different, but the end result is the same.

Net energy balance (calories in vs calories out) still determines fat loss not ketosis (14). In fact, ketosis doesn’t make you more metabolically flexible and has no correlation with fat loss (45,48,49).

This is also a good time to bring up the fact that ketosis doesn’t miraculously save you from fat gain.

Just like any other diet, if you eat more calories than your body can burn over time, you will still gain fat regardless if you’re in ketosis or not.

Why the Ketogenic Diet Might Be a Good Idea For Fat Loss.

Even though the ketogenic diet isn’t necessarily superior when compared with other diets given the same calories and protein, there are two advantages to the ketogenic diet you might want to consider if the goal is fat loss.

The first advantage is appetite suppression. Ketosis can suppress appetite for some people if maintained consistently for about 3 weeks (13,15). In fact, in many studies, the appetite suppressing effects are quite powerful and still have a strong effect after weight loss.

This can definitely be useful for people who want to ensure a deficit without having to track to calories.

The second advantage of the ketogenic diet is early weight loss (7). This applies to all low carb type of diet as restricting carbs causes additional losses in water and glycogen at the beginning (42). However, studies show long term body composition change is the same.

Even though the long-term effects are the same, practically speaking, the early weight loss of a low carb diet like keto can be deeply beneficial for impatient clients who want to see the scale drop fast early on.

This could ignite motivation in people who are easily discouraged when initial progress appears too slow.

And indeed, research shows people who lose more weight early on are more likely to lose more and keep the weight off better (54,55,56).

Keto and Adherence

Despite being a viable weight loss diet on paper, people forget in practice, you have to actually stick to a diet consistently to reap the rewards.

Some of the studies I mentioned earlier are metabolic ward studies or tightly controlled studies, meaning participants were housed and forced to eat the exact food instructed. This is great to study the effects of a diet with clarity, but this doesn’t tell us much about whether the diet is easy to stick to left to your own free will.

When you look at ketogenic studies where participants weren’t paid, housed, and forced to eat specific foods, it shows the ketogenic diet is not always easy to adhere to (17).

This can be confounded by population and study design. Most studies don’t implement good ketogenic diets to mitigate the keto flu symptoms, I mentioned earlier.

Furthermore, a recent meta-analysis showed overweight/obese people adhere to very low calorie ketogenic diets as well as other diets of the same calories (57).

In fact, while people say keto is harder than other diets, research is not conclusive on which diet is easier to stick to (17,58). This is important as many coaches automatically dismiss this diet even when clients insist on trying it.

So while carb restriction can make adherence harder, many people can still stick to a ketogenic diet for a short duration (43). Some people report feeling great on it. They likely enjoy higher fat foods, feel the appetite suppression, or prefer the simplicity of cutting carbs (59,60).

You ultimately have to ask yourself, do I know how to implement a proper ketogenic diet custom towards me and if so, is it something I can adhere to for a while? If you think cutting out an entire macronutrient is too restrictive, no worries, there are still many other viable diets that are more flexible.

What About Other Goals?

Even though, the ketogenic diet gained mainstream popularity for the sake of weight loss, many influencers are promoting it for other goals like hypertrophy or performance.

Let’s take a deeper look at these aspects.

Keto and Athletic Performance

When it comes to traditional sports performance, keto isn’t ideal both in terms of aerobic and anaerobic measures.

With a ketogenic diet, you lack carbohydrates (the most powerful fuel source for performance) and besides tasting really good, carbohydrates have other crucial benefits (28).

For starters, when carbs are burned for fuel, they produce more energy than fat (18). On top of this, a carb sufficient diet will allow the glycogen in your muscles to be full along with replenishing it faster. Both these factors are critical for maximum performance if you train multiple times a day (19).

Here’s a 2016 systematic review showing carbs are beneficial for performance particularly when exercising for longer than 90 minutes (20).

In actual competition, victories are attained thanks to carbohydrates because it’s a powerful fuel source. Race winning moves, sports of long durations, and bouts of high intensity all rely heavily on carbs (21,22,23,24,27).

Research has also indicated in concurrent training where both resistance and endurances styles of training occur, a ketogenic diet is not optimal (19).

For example, this CrossFit study, concluded that a moderately low carb diet might be ok for short durations of CrossFit, but a higher carb diet is likely needed to maximize performance especially for longer demands (25).

As far as pure anaerobic performance, this study showed keto isn’t as good either (26). You’ll lose power with keto because carbs are superior for sustaining power output.

Many keto fanboys will propose keto periodization. This is where you train keto and compete with higher carb. Well research has tested this and it’s a complete myth (51,52).

Keto and Lifting Performance

But surprisingly outside of traditional athletic sports and concurrent styles of training, the evidence behind keto’s effect on pure lifting is not as clear cut.

Most keto studies on strength training have major limitations like not controlling for equal protein as well as not testing for blood ketones to ensure ketosis is achieved and maintained.

Considering the glaring limitations, some studies do show the ketogenic diet can maintain strength comparable to the control groups (30,31,65).

This review article on carb’s effect on resistance training concluded it most likely depends on the volume, duration, and intensity (32). With more volume/time of lifting, carbohydrates can become increasingly important.

This lines up well with a study done on intermediate Olympic lifters, a sport in which volume and duration of intensity is fairly low compared to traditional sports (33). The Olympic lifters lost fat and muscle on a ketogenic diet, but was able to maintain performance. While Olympic weightlifting is considerably different than the recreational strength training most people do to get swole, this study at least shows the ketogenic diet can be viable for weight class restricted athletes looking to maintain performance.

So what’s the verdict on keto’s effect on strength training?

Considering the data we do have on traditional athletic performance and the limited data we have on keto’s direct relationship with strength training, my conclusion is that a ketogenic diet is likely fine for recreational lifting performance given volume and duration is low/moderate.

However, a higher carbohydrate diet would be beneficial for maximizing strength training if your workouts involve a lot of sets/reps surpassing 1 hour.

Keto and Muscle Building

Some people will say you can’t build much muscle on keto because you can’t eat much protein without going out of ketosis.

In theory, this is true because the body can convert protein into glucose which would stop ketosis, but when played out in practice, high protein intakes have been shown to not withdraw people from ketosis as long as carb intake remains very low (34).

Research has shown as much as 2.8g of protein per kg of bodyweight is still fine for keto. That’s way more than enough daily protein to build muscle.

As for not having sufficient carbs, we know that the muscle signaling enzyme mTOR is unaffected by carbohydrate restriction (35).

So this then begs the question if protein is equal, is there any muscle building drawback to eating a ketogenic diet?

Physiologically speaking, probably not, but practically speaking yes there is a drawback to keto for hypertrophy. This infamous study done by Vargas and colleagues shows that despite trained men being assigned a caloric surplus, the ketogenic group could not eat in a surplus and resulted in no muscle growth (39,64).

These results were replicated in women as well (61).

This does not mean you can’t build any muscle on a ketogenic diet, but it does indicate that it’s difficult to eat enough total calories on keto because of the appetite suppressing effects and perhaps the limited food variety. In other words, bulking on keto is totally doable, but probably harder.

In general, I don’t recommend the ketogenic diet for building muscle. While it is possible, it’s not optimal because it makes it harder to eat sufficient calories and overall gym performance is potentially compromised as discussed earlier (32).

Keto and Brain Power

Many keto fanboys claim how the ketogenic diet has cleared their head of distractions and is now turbocharging their brain into another dimension. This is a pretty big myth.

A recent study showed the ketogenic diet has no effect on cognitive function, memory, or sleep (37).

This is in line with another study comparing cognitive performance between high carb and low carb groups showing no advantage (38).

Anyone who feels improved brain power is most likely just placebo after recovering from the initial unpleasant symptoms mentioned earlier. Another likely explanation is the fact that the ketogenic diet often forces people to stop eating junk food and the inevitable increase in food quality improved brain power, but as of right now, science tells us the ketogenic diet doesn’t have any inherent brain-boosting effects in healthy individuals.

Keto and Micronutrients

With the ketogenic diet’s drastically low carb requirements, you miss out on fruits, starches, and grains, all of which have plenty of valuable vitamins and minerals.

One study found with a calorie matched diet, the ketogenic group had a much worse micronutrient profile than a standard low carb diet (36), which can cause hair loss (62).

It goes to show you two important things.

  • If you prefer a low carb diet, a simple low carb diet might be better than a pure ketogenic diet where carbs are practically banned. It’ll be easier to cover all micronutrient deficiencies.
  • If you do choose to do a ketogenic diet, selecting highly nutrient dense foods is important to prevent nutrient deficiencies given your limited food choices. Think fish and nuts, not bacon and cream cheese.

Implementing The Ketogenic Diet

While I’m not personally a fan of the ketogenic diet, I think many people blindly dismiss it based on poor implementation. If you do want to do the ketogenic diet, here are some guidelines I use with ketogenic clients to ensure optimal results.

  • Eat sufficient protein to support muscle growth or muscle retention.
  • Increase electrolyte intake especially within the first few weeks to mitigate keto flu. You’ll likely need to increase sodium intake temporarily and supplement with magnesium throughout the diet.
  • Eat mostly whole nutrient dense foods. This will prevent micronutrient deficiencies, crucially increase electrolyte intake, and allow for sufficient fiber.
  • For food choices, some keto friendly food people forget about are avocado, nuts, olives, coconut, dark chocolate, and fibrous vegetables.
  • Do a targeted ketogenic diet approach. A targeted ketogenic diet simply means eating the bulk of your carbs around your workout window. This allows you to better leverage the performance enhancing benefits of carbs especially when daily carb intake is low (44,50). It may even allow you more total carb intake while maintaining ketosis.

Keto Conclusions

I hate to sound like I’m bragging, but this is literally as comprehensive and unbiased of a ketogenic diet article as you’re going to get. Just like with all my other articles, I’ll be updating it when new evidence comes out.

To recap everything into adorable little bullet points, here are the key takeaways.

  • The ketogenic diet’s goal is to put you into a deep state of ketosis. This generally takes 2-4 days of carb restriction.
  • Most people are not able to stay in ketosis because of dieting inconsistencies, not to mention there are annoying side effects to adapting to ketosis.
  • Keto’s side effects can be mitigated by increasing water and electrolyte intake.
  • Regardless of attaining ketosis or not, the ketogenic diet is like every other diet when calories and protein are matched. It can make you lose weight if you eat low enough calories and it can make you gain weight if you eat too many.
  • The ketogenic diet can be a viable fat loss diet especially considering it’s appetite suppressing effects, but only if you can stick to it consistently which the research has shown can be easier or harder for some individuals.
  • The ketogenic diet is pretty subpar for athletic and traditional sport performance.
  • The ketogenic diet is fine for traditional weight lifting/strength training, but likely not optimal if your workouts are long or involve high volumes.
  • The ketogenic diet can build muscle just fine, but is not recommended as it’s hard to eat sufficient calories paired with the fact that lifting performance might be compromised.
  • Keto improving your brain power is a myth.
  • If you’re not careful, the ketogenic diet may leave you deficient in micronutrients as food choice is severely limited.
  • If you do implement the ketogenic diet, there are some key things to ensure a better outcome.

That’s all for this one folks. Shoot me an email ([email protected]) if you have any further questions tickling your brain.

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