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Keto diet for weight loss in women and men: the essence, the list of products

, medical expert
Last reviewed: 16.10.2021
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Ketogenic or keto diet is not a novelty: a hundred years ago, before effective anticonvulsants appeared, French pediatricians noticed that certain dietary restrictions reduced the frequency of seizures in children suffering from drug-resistant epilepsy.

On the basis of metabolic studies, a therapeutic diet was developed - without starch and sugar, which in the early 1900s became part of a comprehensive therapy for epilepsy. It is claimed that the authorship of the name "ketogenic diet" belongs to the American doctor Russel M. Wilder (Russel M. Wilder), who used it in the treatment of epilepsy in the 20-30's. Last century.

Keto diet involves a high content of fat in the diet, a moderate intake of proteins and a very low - carbohydrates. For most people, this ratio of nutrients for a limited period is considered safe and not only helps to lose excess pounds, but has therapeutic use.

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Indications

Low-carbohydrate keto diet with epilepsy, which was widely used in foreign clinical practice, helped to reduce the frequency of attacks in children of different ages by 62-75% (after dietary treatment for 12 weeks). At the same time, children who are prescribed such a diet should be registered with doctors who monitor their normal growth and weight gain, and also make adjustments in accordance with the needs of each child.

Dietary nutrition with a minimal amount of carbohydrates has also been used in other disorders. Researchers have proven that ketogenic diets are useful in treating patients with De Vivo disease - a protein deficiency syndrome GLUT1 (transporting glucose across the blood-brain barrier), as well as some other congenital metabolic defects.

It is believed that this food system can slow the progression of amyotrophic lateral sclerosis (Charcot's disease); indications for the appointment of a ketogenic diet include such neurodegenerative pathologies as Alzheimer's and Parkinson's. Clinical studies of the influence of a ketogenic diet on the condition of patients with autism, depression, type 2 diabetes (non-insulin-dependent) and polycystic ovary syndrome are conducted.

The most known keto diet for weight loss - in the form  of the Atkins diet  for obesity, modified and popularized by Dr. Robert Atkins (Dr. Atkins Diet Revolution, 1972). Although ketogenic specialists consider only the phase of induction of this diet. And, for the sake of justice, it should be noted that long before him, many American doctors were engaged in the principles of the ketogenic diet: Peter Hattenlocher, Alfred Pennington, Richard McCurnes, etc. For example, R. McCarnes wrote the book Eat Fat and Grow Slim in 1958 ("Eat Fats and become slimmer "), and this, in fact, is the same low-carbohydrate diet originally introduced for the treatment of epilepsy.

Since the deposition of excess adipose tissue in the form of triglycerides concentrated in its cells is due to excessive consumption of carbohydrate food (this fact is not in anyone's doubt), then restriction of carbohydrates in the diet to a minimum - keto diet for a month - helps reduce fat stores , that is, losing weight.

In addition, it was found that the keto diet in oncology - by increasing the oxidative stress of cancer cells - significantly reduces the growth rate of malignant tumors localized in the large intestine, stomach, prostate and lungs. In addition, the sensitivity of some cancers to chemotherapy has been proven to be due to the induced state of ketosis.

Over the past two decades, bodybuilders have begun to use a ketogenic diet to reduce the fatty layer under the skin: on their slang, this is called keto-diet drying.

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General information of the keto diets

With a standard keto diet, the total number of daily calories by 70-80% should be provided by fats, 15-20% by proteins and 5% by carbohydrates (less than 50 g per day).

Typically, the ratio of the weight of fats to the weight of protein and carbohydrates is 3: 1 (that is, 3 grams of fat per gram of protein + carbohydrates). If the proportion is 4: 1, 90% of the energy yields fats, 8% - proteins and only 2% - carbohydrates (about 20 g per day).

Despite the centenary use, the mechanisms underlying the clinical effectiveness of the ketogenic diet in epilepsy remain largely unknown. Several versions have been proposed, including a modification of the Krebs cycle to increase the synthesis of gamma-aminobutyric acid in the brain and increase energy production from ketone bodies, which is consumed 70% by the brain tissue. The ketogenic diet leads to adaptive changes in the energy metabolism of the brain, which increase energy reserves; ketone bodies are a more efficient source of ATP for brain neurons than glucose.

The essence of the diet used to reduce excess weight is the introduction of the organism into a state of adaptive ketosis - when the energy (ATP) the body receives primarily from ketone bodies of blood, rather than from glucose, when using products containing carbohydrates.

Carbohydrates of food are transformed into glucose, but when a person consumes very little carbohydrates and many fats, a chain of biochemical reactions is triggered in the body. Schematically, this process looks like this. First, because the blood glucose level decreases, the pancreas begins to produce more glucagon hormone, which stimulates the catabolism of the glycogen stored in the liver into glucose and its release into the blood. Secondly, ketogenesis is activated, that is, the production of ketone bodies by the liver (acetoacetate, which is then transformed into β-hydroxybutyrate and acetone) and the conversion of fat from the food into free carboxylic (fatty) acids. Thirdly, due to the increase in the level of glucagon, the activity of lipase, an enzyme that cleaves triglycerides (fats) accumulated in cells of adipose tissues, significantly increases.

In addition, during the first two weeks of adherence to the keto diet, a significant loss of weight occurs due to the excretion of water from the body, which is also associated with increased production of glucagon. And so the temporary side effect of a high-fat diet can be dehydration, which nutritionists advise to fight, using up to two liters of water daily.

Many believe that an important advantage of keto diet is the lack of hunger, the need to count the number of calories and hours of training to burn their surplus.

Keto diet for men

Particularly effective is the keto diet for men who have  abdominal obesity.

If the domestic therapeutic diet for obesity (No. 8 in Pevzner) recommends reducing the calorie intake to 2000 (2300) kcal per day, then the ketogenic diet does not strictly control the calories (but to reduce them by at least 10-20% does not hurt). But the consumption of carbohydrates should be reduced five times: instead of 250 g to a maximum of 50 g per day.

Remember that most calories on a keto diet are foods high in natural fats and a moderate amount of protein products. That is, it is not a "protein load", as some may think. And if a man is accustomed to eating a lot of meat, then in the state of adaptive ketosis his organism will enter much more slowly. So you have to limit the protein: a day to 1-2 grams of protein per kilogram of body weight, which you seek to achieve as a result of weight loss. Example: if the initial weight is 112 kg, and the desired weight is 85 kg, then the amount of proteins during the period is 85-170 g.

The exact ratio of fats, proteins and carbohydrates in the diet (in grams) will depend on the age, the goal, the level of physical activity and the health status of each particular man. But everyone is recommended to fast for a short time with a keto diet: in the first two days of switching to this food system, one should drink plenty of water and limit oneself to one meal a day (in very small quantities). By the end of the first week should be the maximum exclude carbohydrates (below will be a list of products for the keto diet), but the size of portions decreases very slightly.

Another nuance: they say that a keto diet without sports does not lose its effectiveness, and you do not need to go to the gym or just do some extra physical exercises to lose weight. But, fiznagruzka, as part of a healthy lifestyle, accelerates the burning of excess fat, so do not lie on the couch. Moreover, you can take advantage of the moment and build muscle mass by the example of bodybuilders: mass gain on the keto diet is possible only with muscular load, and then the subcutaneous fat will go away, showing strong muscles.

Keto diet for women

The problem with the keto diet is that to date, studies aimed at studying its effectiveness and safety, concern only men. There is a logical question: is keto-diet suitable for women, considering that female hormones are, as a rule, more sensitive to most changes in nutrition.

And although opinions are divided, but most experts argue that a ketogenic diet gives positive results, especially for women in perimenopause or menopause. This power system allows you to lose weight, control blood glucose levels, improve sleep quality and reduce the symptoms of menopause, such as hot flashes or night sweats.

However, there are also negative reviews, and even complaints about nausea, fatigue and constipation due to diet (more details in the section Possible complications). It is also worth mentioning that in case of violations of the monthly cycle, pathologies of the thyroid gland, during pregnancy and lactation, it is contraindicated to switch to keto-diet.

Women are recommended to combine periodic starvation with a ketogenic diet, that is, simply skip lunch and do a 10-12 hour break between morning and evening meals, which after 50-55 years gives a rejuvenating effect (this is the 2016 study published in the Journal of the American Medical Association). According to Western experts on nutrition, this diet regime allows the body to relax from the functions of digestion and direct energy resources to restore tissue cells and balance hormones.

If a woman with a body weight of 75 kg and a height of 165-168 cm seeks to lose weight to about 68 kg, she should go from 2,300 kcal per day to consumption no more than 1855 kcal. Protein should be 1-1.5 g per kilogram of ideal weight, that is, you can get about 68-102 g of protein daily, 240-350 g of fat and 18-20 g of carbohydrates (in pure water, without fiber).

How does the keto diet differ from high fat?

The high fat or LCHF diet differs from the keto diet by the proportions of proteins, fats and carbohydrates in the diet, with the high fat diet assuming a ratio of 50% fat and 25% protein and carbohydrate.

In Europe, a diet high in fat (and the minimum amount of carbohydrates) is called Swedish. Obviously, this is due to the Swedish therapist Annika Dahlqvist, who began to recommend her patients with diabetes to consume more fat and restrict carbohydrates, which contradicted the officially approved recommendations of Swedish endocrinologists.

The conflict on the professional ground was widely publicized, but as a result of a scientific study conducted at the initiative of the National Health Council (with the participation of 16,000 patients), the reputation of the doctor was restored, and the benefit of the LCHF diet with a high fat content was recognized. Because of the reduced need for insulin, this diet was noted as suitable for people with type 2 diabetes and obesity.

Among the modifications of the ketogenic food system, starting with the Atkins diet and the LCHF diet, we can name strange dietary recommendations, for example, an egg post on a keto diet - when a few days you should eat only boiled eggs with mayonnaise ...

Cyclic keto diet and other modifications

In recent years, the standard keto diet (SKD) has not been modified. So, there was a high-protein ketogenic diet (HPKD), in which 60% of calories are derived from fats, 35% from proteins and 5% from carbohydrates.

Target (targeted) ketogenic diet (TKD) is more moderate, since carbohydrates can be eaten before and after training; is considered sports, therefore the quantity received from the use of carbohydrates of calories is higher, than in SKD.

The cyclic keto diet (CKD) or, alternatively, the rotational keto diet (alternating) is a low-carbohydrate diet with alternate periods of consumption of high or moderate amounts of carbohydrates: 5-6 days - the minimum amount of carbohydrates, then carbohydrate loading is performed on keto- diet - one or two days carbohydrates are used without restriction. Unknown authors of this variant of keto-diet try to justify their innovations with the need to replenish glycogen stores, restore hormone levels and thyroid activity, and provide moral and psychological stability - to continue the diet. In fact, everything that is lost in six days, instantly comes back.

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Benefits

As foreign clinical practice shows, almost 20% of children with epilepsy after ketogenic diet (observed from six months to two years, with a gradual return to normal diet) are much less likely to have seizures, and many of them can reduce the use of anticonvulsants or completely from them to refuse.

Based on the results of two dozen randomized controlled trials, experts concluded that the benefit of the keto diet is a significant and fairly rapid loss of excess weight, especially with severe obesity. Despite the large amount of fat, this diet for 24 weeks in a significant percentage of patients leads to a decrease in systolic blood pressure, sugar and insulin levels in the blood, plasma c-reactive protein level, as well as an increase in high-density lipoprotein (HDL) that is, good cholesterol.

In 2008, the American Diabetes Association (ADA) revised its nutritional recommendations and recognized low-carbohydrate diets as a fairly effective method of short-term diet therapy for patients with non-insulin-dependent diabetes.

And more, the skin with keto-diet reacts to the lack of carbohydrate food in its own way, for example, acne can be reduced. And this is confirmed by the results of the study published in the Journal of the American Academy of Dermatology.

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What can and what can not?

What can you eat? In the list of products recommended for keto-diet, appear: any meat and meat by-products; bird; Fish and seafood; eggs (in all kinds); cream, sour cream, butter (cream and vegetable). Hard cheese on a keto diet is very useful. But with conventional milk, be careful, so there is a lot of lactose - milk sugar, which is a carbohydrate-disaccharide. But sour-milk products can be consumed without fear: in the process of fermented fermentation, lactose is hydrolyzed.

Instead of popcorn, sweets or chips, walnuts (about 13 g of carbohydrates per 100 g), and sunflower seeds (10.5 g of carbohydrates per 100 g) are suitable. The number of calories, respectively - 655 and 600.

It is recommended to include in the menu:

  • mushrooms (except for dried white and boletus), the ideal option - champignons (only 0.5 g of carbohydrates per 100 g).
  • all kinds of leafy greens and vegetables that do not contain complex carbohydrate starch: broccoli and kohlrabi; white, colored and Brussels sprouts (3-6 g of carbohydrates per 100 g); cucumbers, zucchini, zucchini, eggplant, bell pepper (green), tomatoes, radish, leek, rhubarb, string beans, and leeks (within 1.8-4.5 g of carbohydrates per 100 g).

Little by little you can eat berries: strawberries (100 g contains about 8 g of carbohydrates), cherries, raspberries, blackberries, cranberries (100 g contains 12 g of carbohydrates).

If you adhere to the moderation in their use, observing keto diet for weight loss, then 100 g of apricots, pineapple or grapefruit can occasionally eat: this is approximately 11.8-12.4 g carbohydrates. But bananas are not worth: in every 100 grams of carbohydrates almost 23 g.

What you can not eat? I will have to give up bread and all flour; macaroni products; sugar, honey and confectionery sweets; any cereal cereal; potatoes, carrots, beets, celery root; pumpkin and all melons; legumes and most fruits.

Menu for a week of keto diets

Serious attitude to getting rid of excess fat reserves in your body, of course, requires making a menu for a week keto diet. And help in this information of the previous section.

For breakfast, you can cook scrambled eggs or omelets - with onions, mushrooms and spinach, bacon and tomato. Coffee or tea, of course, without sugar.

Dinners can consist of salad (a recipe of one of them - further), vegetable soup or soup with meatballs (without potatoes, rice or vermicelli), chicken broth and boiled chicken, fried fish or pork ragout with mushrooms.

For dinner, choose a protein, for example, turkey, beef, fish, seafood, with which - as a side dish - perfectly combine broccoli, Brussels sprouts, green beans or Bulgarian pepper, flavored with creamy cheese sauce.

Keto diet recipes

Taking into consideration the list of products that are allowed for ketogenic nutrition, it is possible to prepare a lot of various dishes, so that it is impossible to cite even a tenth of the keto diet recipes. Try these three.

Chicken meat baked with vegetables

Products for two servings: 500 grams of chicken (thighs, breast or fillets, cut into medium pieces), a tablespoon of vegetable oil, 1 green bell pepper (sliced with an average cube), half of a bulb (cut into small cubes), 500 g of cauliflower on the inflorescence), half a small bitter pepper (finely chopped), 50 g butter, 100-150 g fatty sour cream, 50 grams of hard cheese (grated on a large grater), salt and black ground pepper to taste, ground coriander (half teaspoon ).

Preparation:

  • heat oven to 180 °, baking dish or frying pan with vegetable oil;
  • separately add onion and pepper (sweet and bitter) in vegetable oil;
  • inflorescence of cauliflower blanch in salted boiling water for three minutes, drain water;
  • put in the pan (pan) chicken, salt, pepper, add onion with pepper and cabbage (vegetables spread evenly over meat);
  • sprinkle with coriander, put butter (several pieces, over the whole surface), pour sour cream, sprinkle with grated cheese and put in the oven for 40-45 minutes.

Quick salad with ham or brisket

Products for two portions: 100 grams of ham or brisket, 250 grams of lettuce (after drying well dry), two fresh cucumbers, one tomato, two chicken eggs (hard-boiled), 60 g of dill or parsley, 1 tablespoon of olive oil and the same amount of mayonnaise, salt to taste.

Preparation:

  • brisket or ham cut into large straws;
  • cut boiled eggs with quarters, vegetables - thin circles;
  • lettuce leaves on a dish, spread the ham from above, and over it - eggs and vegetables, salt;
  • mix the vegetable oil with mayonnaise, add finely chopped greens, mix and sauce it with this sauce.

Stew of pork with mushrooms

Products for three servings: 300-400 g of pork pulp, 350 g of fresh champignons, half of onion (finely chopped), 2 tablespoons of vegetable oil, half a teaspoon of nutmeg, one clove of garlic, 4 tablespoons of sour cream or fatty cream, 2 tablespoons chopped greens, salt and black ground pepper to taste.

Preparation:

  • in a deep frying pan or stewpot with a thick bottom pour the vegetable oil, put onion and chopped garlic, let it sit for five minutes;
  • put pieces of meat and fry a bit;
  • add chopped mushrooms, mix, put nutmeg and black ground pepper, salt;
  • cook over low heat for 15 minutes, then add sour cream (cream) and greens;
  • closing the dishes with a lid, stew until done (about another 15 minutes).

Contraindications

Absolute contraindications for switching to a ketogenic diet include:

  • diabetic ketoacidosis caused by insulin deficiency;
  • congenital and secondary deficiency of carnitine;
  • deficiency of pyruvate carboxylase;
  • mitochondrial diseases caused by a violation of beta-oxidation of fatty acids;
  • porphyria;
  • pronounced anomalies in the blood, iron deficiency anemia;
  • pancreatitis;
  • acute and chronic inflammation of the gallbladder (cholecystitis);
  • abnormal liver function, primary or metastatic liver tumors;
  • acute renal failure;
  • impaired bowel function, Crohn's disease;
  • abdominal tumors;
  • condition after cancer chemotherapy.

With special forethought, one should refer to the advice of bodybuilders to "spur" the metabolism with the help of pharmacological agents: do not risk chasing your health in the pursuit of a super-effect. In fact, a ketogenic diet is incompatible with anabolics, for example, keto-diet and clenbuterol. Clenbuterol - an adrenomimetic drug for the removal of bronchospasm and the treatment of bronchial asthma - is attributed to anabolic, since, like norepinephrine, it stimulates beta2-adrenoreceptors and has an effect on metabolism. The drug accelerates the breakdown of glycogen in the liver and triglycerides of adipose tissue, but can cause hyperglycemia, increased heart rate, headache, nausea, lowering blood pressure, hand tremors and other side effects.

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Possible risks

Risks associated with a diet that has been used for a long time in the complex treatment of epilepsy in children are threatened by a slowdown in growth (due to a decrease in the level of insulin-like growth factor 1), a deterioration in the mineralization of bones (due to a lack of calcium), and nephrolithiasis (formation of kidney stones). Hyperlipidemia (high blood lipids) occurs in almost 60% of children, and the cholesterol level may increase by about 30%.

Rare side effects include cardiomyopathy, QT interval elongation syndrome (heart rhythm disturbance), deficiency of vitamins, micro and macroelements.

The most common side effect is constipation, to which almost a third of those who lose weight complain: the lack of fiber intake affects. In addition, ketogenic diet at the initial stages may be accompanied by increased fatigue, weakness, headaches, dizziness; in women, dysmenorrhea.

In most cases, ketosis on a low carbohydrate diet causes mild acidosis - a condition in which the pH is somewhat below normal, which, according to studies, is considered safe. The fact that the body is in a state of induced ketosis is indicated by: an increase in the number of urination; a feeling of dryness in the mouth; unpleasant smell from the mouth (because of the acetone coming out through the lungs); reducing hunger and energy.

Possible complications - the development of ketoacidosis - can indicate such symptoms as nausea on the keto diet, vomiting, dehydration, shortness of breath, heart palpitations, increased diuresis and thirst. Any of these symptoms should make you immediately consult a doctor.

If the weight does not go away with the keto diet, then, most likely, too much protein in the diet, since more than half of the excess proteins are transformed into the body in glucose, that is, the process of induced ketosis is disrupted.

When the keto-diet is very painful to the muscles, the cause can be associated with both a violation of gluconeogenesis - the synthesis of glucose from muscle lactate (lactic acid), and with the enzymatic cleavage of muscle glycogen in ketosis.

At the beginning of a diet, a decrease in the intake of carbohydrates leads to the elimination of fluid, and the edema of the legs with keto-diet can be even with a slight renal failure.

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Reviews and results of slimming

The comments of doctors who prescribe a ketogenic diet to patients with neurodegenerative pathologies are reduced to ascertaining its unconditional effectiveness: even with senile dementia and Parkinson's disease, patients pay attention, memory and adequacy of perception is significantly improved.

Usually reviews and results of losing weight experts comment. But significant controversy over all low-carbohydrate diets is also divisive in the evaluation of specific results.

Thus, according to the American Journal of Clinical Nutrition, the researchers found that men and women who switched to a keto diet, on average, lost 3.6-4 kg more in six months than those who restricted fat intake. British experts on obesity (British National Obesity Forum) also note that in terms of effectiveness in terms of weight loss, diets low in carbohydrates and high in fat exceed skim diets. Although their numerous colleagues argue that the results that gives keto diet for weight loss, "contradict the available evidence."

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