What are Ketones and Keto Diet- Is it confusing?

By Dr Harold Gunatillake - Health Writer

Is KETO diet though popular as a weight reduction method, is it superior to other standard weight management plans?

Are there health risks involved including nutritional deficiencies in a keto diet?

That's what we are going to discuss today.

Sri Lankans eat rice and curry as the staple diet. This is a balanced diet consisting of a large amount of carbs as rice, or a few slices of bread and spicy curries to accompany. Curries such as the veggies, fish, meat or the salty dried fish with an occasional egg curry, provide the required proteins, fats and other micronutrients.

The answer to the Western salad, Mallum'. It is a bevy of greens wilted, spiced and combined with shredded coconut amongst other spices. Onion pickle is always there on the dining table as a 'rice puller' that feed the microbiota in your gut.

This would be the ideal diet for the hard-working labour class of person who need much sugar to provide quick energy to burn, required for the heavy physical work they perform.

They have no weight problem as such, and the majority remain skinny.

When it comes to the affluent sedentary class of people, having a weight problem need to seek dietary restrictions to reduce their body weight. Then, they think of starting on a fancy weight loss diet.

The new keto diet seems to be catching up and considered to be the most beneficial way to quickly lose weight.

Now let's find out the nitty gritty of this slimming diet.

Ketosis and ketone bodies

We need to know what ketosis is, to understand how the keto diet works. Ketosis is a normal process that happens when your body doesn't have enough carbs to burn for energy. Instead the fat reserves in your body starts mobilising to provide energy through a substance called ketones.

This is a life-saving natures method or call it a 'survival kit' when you get lost in the jungle for many days deprived of food or during starvation.

Ketosis is a popular weight loss strategy where you reduce your carbohydrate intake to 50 gams daily. Usually in your normal balanced diet you do consume as much as 200 grams of carbs mainly as rice or bread. Keto diet is a low carb diet like the eating plan which was propagated by Atkin and in the Paleo diet which stress proteins and fats for fuelling your body. The idea is for you to get more calories from protein and fat and less from carbohydrates.

The low carb, high fat keto diet causes the metabolic state known as ketosis, in which substances known as ketones or ketone bodies accumulate in your blood.

When you start on this low carb diet ketosis kicks off in after 3 to 4 days of eating less than 50 grams of carbs per day.

50 Grams of carbs is 3 slices of bread, or two tablespoons of boiled rice, a cup of low-fat fruit yogurt and two small bananas.

So, when you cut back on your carbs, fat in your fat cells stored as triglycerides, seem to mobilise and used for energy through ketone body formation in the liver.

The liver produces three ketone bodies. They are: Acetoacetate, beta hydroxy butyrate and acetone. To go further, these ketone bodies are formed from acetylCoA found in the mitochondrial matrix of liver cells when carbs are scarce that energy must be obtained from breaking down of fatty acids.

In addition to recommending the keto diet for weight loss, it is also recommended by doctors for children and adults having epilepsy- a special high fat diet which seems to prevent seizures.

Keto diet may help people with heart disease, and certain brain diseases and acne, but there needs to be more research in those areas.

Some researchers suggest that keto diet might help lower the risk of heart disease, though the intake of fats is high. Other studies show that this diet with low carbs can help people with metabolic syndrome, insulin resistance as among type 2 diabetics

When you start on a low carb diet, especially Sri Lankans who indulge in large quantities of rice in their daily consumption, may feel bad and restless during the first week on this diet. This is due to sugar and carbs withdrawal.

Keto diet includes high fat foods where one can eat up to 70-80% fat, and proteins and restrict carbs. Most keto diets include processed meats, fatty cuts of meat, including red meat, lard and butter. Unsaturated fats like oily fish, nuts and seeds and plant oils are also included.

Keto diet avoids all carbs sources including both refined and unrefined products. Foods to avoid include all breads, including whole grain, cereals, pasta, cookies and baked goods, rice, starchy veggies like corn, and potatoes, and fruits and their juices.

The side effects of keto diet could be - headache, fatigue, brain fog, irritability, constipation and so on.

Low carb diets can lead to kidney stones or high levels of acid in your body called acidosis.

If you have uncontrolled diabetes, ketosis can become dangerous when the ketone body build-up is high. It may lead to dehydration and change in the body chemical balance of your blood becoming acidic may result in a coma or death.

This condition is called diabetic ketoacidosis (DKA), when your sugar level is very high in your blood when you don't take enough insulin to control your blood sugar level.

So, please control your blood sugar levels before you plan to start on a keto diet, if you are a diabetic.

Some people without diabetes can get ketoacidosis, too., due to heavy alcohol intake, starvation, or an overactive thyroid.

Should diabetics go on a keto diet because of the forced low carb intake? Mice experiments have revealed that keto diet may increase the insulin resistance, i.e. poor glucose tolerance, and yet it does seem to question the safety of excess fat that is consumed on the keto diet.

So, presently, the advice given to the diabetics is to be vary of going on a keto diet because of the low carb intake.

Red Meat: Eating more red meat may shorten your life

People who increased their red meat intake by just half a serving a day boosted their risk of dying over the next eight years by 10%, the study authors said.

Processed meats are dangerous

Processed meats are smoked, cured, salted, canned, dried, or preserved. Cold cuts, hot dogs, bacon, sausage, salami, beef jerky, ham, corned beef, and other processed meats are linked to a variety of health problems. In several studies, people who ate the most processed meat had higher rates of diabetes, heart disease, and some types of cancer. Excess salt, preservatives, and fat in the products are to blame. Eat more meatless meals, cut back on the amount of processed meats you eat, and up your intake of fruit and veggies to protect your health. It is important that you need to take enough dietary fibre for gut health and wellbeing. Fibre itself is a carb that the human gut cannot digest. The

recommended daily intake is 25 grams for women and 38 grams for men

Sri Lankans get more fibre from tropical fruits like jack and breadfruit and the veggies. Jack provides in one serve 2.5 g of fibre. Jack fruit is also rich in antioxidants eliminating the toxins produced by the body as well as the free radicals which harm for us. Such toxins and free radicals formed in the body daily is known to cause cancer.

Breadfruit has 4.9 g of dietary fibre i.e. 13% of your daily requirement.

It is a starchy fruit and you are deprived if you are on keto diet.

High protein and high fatty foods have no fibre. Red meat has no fibre.

Fibre is a prebiotic that the microbes in your gut feeds on and produces butyrate and other short chain fatty acids that protects your gut inner lining from chronic debilitating diseases like Crohns, ulcerative colitis, and cancer.

In keto diet the fibre intake is low, and that may be detrimental to your health and wellbeing.

It is sound advice to eat a balanced low calorie low dense diet, exercise daily at least walk 10,000 steps a day and limit your alcohol consumption. Focus on eating unprocessed carbs like brown rice and multigrade bread

That would be the long-term regime to control our weight.

Just imagine you are carrying a sack of potatoes on your shoulder and walking about. If you have put on that amount of weight, your body must carry that amount daily. That would put a strain on your heart, joints and more.

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