So the keto diet really was used primarily
to reduce the frequency of seizures in kids with epilepsy.
So we still-- even inpatient, when patients come in,
pediatric patients with a seizure disorder,
they are a lot of times already on a ketogenic diet.
So we have specific diet parameters for that,
and a lot of times it is a diet that we get delivered, not
so much that we're providing.
So the benefit claims in general are weight loss
and improving heart health.
So what the ketogenic diet is, is
by basically greatly decreasing your carbohydrate intake--
and the CHO next to it is an abbreviation for carbohydrate.
So you greatly decrease your carbohydrate intake,
and you really force your body to burn fat.
Meaning, it's going to rely on ketones,
which are in the liver.
So you're going to start producing all these ketones.
If anyone in this audience has diabetes,
this is not necessarily-- a lot of people
with poorly controlled diabetes go into ketosis
because basically your body can't get
the energy from carbohydrate.
And so it's looking, it needs that energy,
and it starts dumping out some of the fat
and converting that into energy, into carbohydrate.
So that's really what the ketogenic diet is,
is cutting your carbohydrate intake
to force your body to use fat as energy.
So low carb, high fat, and your fat
is going to really provide up to 90% of your calories every day.
So 10% of those calories would be carbohydrate, about 80%
would be from fat.
What is not allowed are your starchy
carbs-- so bread, most of your starchy vegetables, oats,
and fruit even.
So reaching ketosis really takes a few days.
So you really have to deprive your body of carbohydrate,
and what that means is less than 20 to 50 grams per day.
The one thing I don't like, for people
that have never done this before,
they really need to plan a lot.
You need to research a lot because what happens
is you need some sort of source for certain carbohydrate foods.
Because if you read 20 to 50 grams a day,
your gut instinct is to just look
at a food label or a package because that already
has it all written right there for you.
It's much less work.
So a lot of those foods, the ones that come in packages,
aren't the ones that we would, as a health care
professional, nutrition professional,
really be recommending anyway.
So you really want to have more whole foods with any diet
or eating pattern.
So eating too much protein actually
can interfere with ketosis.
So remember ketosis is basically fat.
You're thinking fat, that's the majority of my intake,
and that's what I really need to focus on.
So your keto friendly foods-- if you were just
estimating about a 2,000 calorie a day diet,
and this might be for a man that is a little bit overweight.
So for 2000 calories a day, what that equals
is 165 grams of fat, 40 grams of carbohydrate,
and 75 grams of protein.
So your fat intake is actually more than double what
your protein intake would be.
So a lot of these healthy unsaturated fats
are what I would promote more so than anything else--
nuts, so almonds, walnuts, seeds, avocados, tofu,
which comes from soybeans, and olive oil.
Your saturated fats, they promote in high amounts--
so palm or coconut oil, lard, butter, cocoa butter.
And then protein, lean or high fat.
So it doesn't matter what the protein source is, it's fine.
But typically the higher fats, like beef, pork, and bacon,
because, remember, you have to get to that recommended
higher fat intake.
So keto friendly foods, fruit in very small amounts,
because, remember, you're going to stick to probably way
less than 50 grams of carbohydrates.
So if you're having fruit, berries
are usually the safest option.
So you get a better bang for the buck,
you can eat a little bit more berries.
And then berries really are at least
a really good source of antioxidants,
so you're still getting some.
There are a lot of vegetables allowed on the keto diet.
So these are all-- this is a list right here.
The dark green leafy--
so kale, spinach, Swiss chard, any of the ones in that group.
So even beet greens, mustard greens, collards, broccoli,
Brussels sprouts, cauliflower, asparagus, bell peppers,
onions, mushrooms, garlic, cucumbers, celery,
summer squash.
So a lot of these you could even do a stir fry.
So you could cut a lot of these vegetables up,
stir fry them with some fresh garlic,
with some olive oil, which is allowed.
And then with your high fat protein,
you could have a pretty decent meal.
The risks with the keto diet is it
is extremely high in saturated fat, which is associated
with an increased LDL.
So the LDL cholesterol is what is these bad cholesterol.
And so you also get-- if you think
about removing diet groups or certain groups of foods,
you then are at risk of a nutrient deficiency,
and it could be various.
So with the keto diet, you really run the risk of--
your carbohydrate foods are your B vitamin foods,
so if you're not eating those foods,
you really are at risk of a lot of vitamin and mineral
deficiencies.
And even the selenium, the magnesium, phosphorus,
like I just said, the B vitamins, vitamin C,
because vitamin C is in broccoli,
but it's in also a lot of fruit.
And so if you're having berries, it's
not really a great fruit source, unless you're
having strawberries.
So you really want to be careful with how long you're
doing these things and for what purpose.
So liver issues, if anyone has a pre-existing liver condition,
keto diet really is not indicated.
It really could worsen any of those liver conditions,
and really by increasing the fat metabolism.
So your kidneys, as well, one of its primary functions
is to filter nitrogenous waste, which when you eat protein,
your body breaks it down to amino acids.
The amino acids are broken down to nitrogen,
and so your kidneys are working to filter all of that out.
So a lot of people that do already high protein diets are
in a way making your kidneys work harder than they need to.
So if you have healthy kidneys it's not necessarily an issue,
you really just want to make sure
you're drinking adequate amounts of non-caffeinated fluids,
water to filter out that waste.
But if you have a little bit of kidney dysfunction
to begin with, not a great idea to tax them even more,
making them work a little harder.
So constipation is another one because a lot
of people that are doing keto--
anecdotally speaking, I don't know one person
that does keto, but makes sure they get enough
of their roughage every day by making
sure they're getting enough broccoli and dark green leafy.
Most people are just having the fat and the protein,
which is extremely low fiber, and really then
can cause constipation just because there's not
a lot of waste product in those foods.
Mood swings, fuzzy thinking--
my friends and I used to always have a joke in college,
college students with their erratic sleep patterns,
and they're always studying, they're
always in the library is food for thought
because everyone's bingeing on carbohydrate foods typically.
Mostly because carbohydrate is what your body's primary fuel
source is.
So fuzzy thinking, mood swings-- if you're
cutting a lot of carbohydrate out of your diet,
it could sometimes lead to a little bit of confusion
and fuzzy thinking.
And so you're not really giving your body
the nutrients that it actually needs to function well.
So the bottom line with keto, it's extremely restrictive.
It is really difficult to sustain.
So a lot of people will do this.
And whether any of you out there have done this,
or you probably know someone who has,
they are likely not still on it.
Most people cannot sustain it for any more than a couple
of weeks.
It's really, really restrictive.
And again, it might not be safe.
There aren't a lot of long term studies, if any.
And so in terms of the safety, it's really unknown.