The Ketogenic Diet: UNTANGLED (Part 1)

Updated: Jan 11, 2021

So you are thinking of "going keto".

The most asked about topic from our clients right now is definitely the keto diet! There is a lot of information on the internet about it, but we are here to give you the straight facts.

Before we get into the nitty gritty of the keto diet, we want to take you back to where it came from. The keto diet has actually been around for a long time, despite it feeling like a new idea because influencers and celebrities are talking about it all over their social medias. When we say “long time” we mean it! The ketogenic diet has been used since the early 19th century and has a very interesting history. It's origin actually comes from the use of starvation and fasting as a means to treat epilepsy in children. It was found however, that the same beneficial outcomes of starvation could be achieved by following a high fat, very low carb, moderate protein diet. Thus the ketogenic diet was born (at the Mayo Clinic in 1921). "For two decades this therapy was widely used, but with the modern era of antiepileptic drug treatments, it's use declined dramatically" after the 1940s (Wheless, 2008). "With fewer children being placed on the diet, this resulted in fewer dietitiains being trained in the use of the diet. Without properly trained dietitians, the ketogenic diet was often implemented incorrectly, leading to the impression that the diet was ineffective" (Wheless, 2008). The ketogenic diet popped back up again in the 1970s when a young boy named Charlie (2 years of age) was featured on NBC-TV's Dateline. The episode described how his intractable generalized seizure disorder resolved after initiation of the ketogenic diet was implemented at the John Hopkins Hospital (Wheless, 2008). In the 1970s, the familiar Atkins Diet was published; a similar approach in that this diet suggested high fat, low carb, HIGH protein and involved different phases of the diet for weight loss. It remained popular throughout the 1990s.

We are now seeing the ketogenic diet (high fat, low carb, moderate protein), and again it is being marketed to people with a weight loss goal but also to people with chronic diseases such as diabetes. It’s important to remember that, while the diet is based in science, what you see online isn’t always the full truth.

We recently published a keto-themed trivia game on our Instagram stories (check out our highlight if you missed it), and while we were prepping the questions we thought, “this is complicated and totally deserves more attention.” To be honest, we see A LOT of misinformation out there so we are going to untangle the info-mess about keto and support our explanations the best way dietitians know how…with SCIENCE!

What IS the ketogenic diet?

Most people know the keto diet as a low carb/high fat diet, but technically there is more to it than just cutting carbs. If you are under the care of a dietitian, they will explain that “low carbohydrate” means LOW. This isn’t just cutting pasta on the regular, it means that carbohydrates make up less than 5-10% of your total daily calorie intake (Paoli, 2015). This is about the equivalent of 2 slices of bread for a person eating approximately 2000 calories per day (an average person’s recommended intake...ish).

Once you’ve mastered the LOW carbohydrate element, we move onto the “high” fat part. In keto “high” in fat means VERY high: about 80% of your daily calorie intake (Paoli, 2015). Sticking with our average person, this means eating about11 avocados, 4.5 cups cream OR two sticks of butter per day!

Now we can’t forget about the third important macronutrient, protein -- the keto diet is MODERATE in protein, about 15% of your calorie intake (Paoli, 2015). This piece of the keto diet is confusing and where many people go “out of keto” without realizing it. Technically speaking, if the dieter eats too much protein, then some of the amino acids from the protein foods can be converted into glucose (or sugar), which would prevent ketosis, the goal when following a keto diet. Effectively, this undoes all the work the dieter has done in cutting carbs and upping fat, without even knowing it.

We recommend that, before you attempt “going keto” it’s important to have a basic understanding of macronutrients. Check out our blog post “Should I be watching my macros? - The Ketogenic Diet: UNTANGLED (Part 2)” to get the basics.