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What is ketosis? After 3-4 days of fasting or following a very low carbohydrate diet, the body, deprived of dietary sugar and starch, reduces its insulin secretion and switches to burning fat for fuel. The resulting overproduction of a co-enzyme for metabolism, known as acetyl-CoA, leads to the formation of ketones. Though the brain cannot use fatty acids for fuel, ketones can cross the blood-brain barrier, providing fuel to the typically glucose-hungry brain and to other tissues.
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The keto diet is a very lowcarbohydrate diet that essentially swaps out dietary carbohydrates for dietary fat. “For the diet, a person’s carbohydrate intake is typically less than 50 grams a day – that’s less than the amount in a medium, plain bagel!” Jeril Goss, MS, RD, LDN, CDE, Manager of PH DuBois Diabetes and Nutrition Wellness Center, said. If you compare average healthy eating to the keto diet: • Fat is normally 20-35 percent of your daily intake; keto requires 70-80 percent. • Protein is usually 10-35 percent daily; keto is 20-25 percent. • Carbohydrate is usually 46-65 percent of your intake; keto is 5-10 percent. “The protein amount on a ketogenic diet is kept moderate in comparison to other low-carb, high-protein diets - like Atkins - because eating too much protein can prevent ketosis,” Jeril said.
“This transition to physiological or nutritional ketosis usually takes a week. This type of ketosis does not raise blood levels of ketones as high as what occurs with diabetic ketoacidosis (DKA),” Joyce Kulick, RD, LDN, CDE of the Diabetes and Nutrition Wellness Center of PH DuBois, said. DKA is a life-threatening complication of Type 1 diabetes that lowers blood pH. But the diet isn’t perfect. “When you first make the shift from carbs to fats for energy, you can anticipate the ‘keto flu’ side effects of carb restriction that mirror the actual flu,” said Marie Michelini, MS, RD, LDN, CDE at PH Elk Diabetes and Nutrition Wellness Center. “These side effects include nausea, vomiting, diarrhea, fatigue, headache, cravings, muscle cramps and soreness, dizziness and trouble concentrating. This is a result of the body’s rapid excretion of sodium and fluids as carbohydrates are restricted.” Kelly Schreiber-Straub, RD, LDN, CDE at
PH Elk Diabetes and Nutrition Wellness Center added that “other side effects are increased risk of kidney stones, osteoporosis and increased blood levels of uric acid, a risk factor for gout. Nutrient deficiencies are possible if a variety of foods are not included to ensure adequate intakes of fiber, B vitamins and minerals, such as iron, magnesium and zinc.” “A ketogenic diet has been shown to provide short-term benefits in some people including weight loss and improvements in total cholesterol, blood sugar and blood pressure,” Bernie Clark, RD, LDN at PH Clearfield, said. “However, these effects after one year — when compared with the effects of conventional weight loss diets — are not significantly different. Eliminating several food groups and the potential for unpleasant side effects may make compliance difficult.” The bottom line: A ketogenic diet may be an option for some people who have had difficulty losing weight with other methods. If you choose to start a ketogenic diet, it is recommended to consult with your physician and a dietitian to closely monitor any biochemical changes after starting the regimen and to create a meal plan that is tailored to your existing health conditions and to prevent nutritional deficiencies.
Our outpatient dietitians are available to help you as you determine your best choice for weight management. Ask a provider to refer you to their services available in Brookville, Clearfield, DuBois, Punxsutawney and St Marys. The phone number for any questions or scheduling an appointment at any location is 814375-3890.
Need a doctor? — Visit us at www.phhealthcare.org/findadoc
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