Keto diet explained – one size doesn’t fit all

Lately, the ketogenic (keto) diet is having a resurgence, but there is still much confusion around this dietary regime.

First of all: what is a ketogenic diet? The ketogenic diet is a low-carbohydrate, high-fat eating approach designed to induce ketosis. In this metabolic state, the body primarily burns fat for energy. By restricting carbs (long chains of glucose, the cells' immediate energy source), the liver produces ketones from fatty acids, which can also be efficiently utilised for energy.

However, it requires careful planning to ensure adequate nutrient intake, as a keto diet doesn’t mean eating fatty foods 24/7! There are different keto styles for different health goals. Always consult a healthcare professional before starting to ensure the diet aligns with individual needs and stays balanced.

Types of keto diets

As we explore the nuances of various keto diets, it becomes evident that customisation, particularly in the proportions of fat, protein, and carbohydrates, is critical to addressing specific health concerns.

Standard ketogenic diet (SKD) for weight management

• Fat: 70-75%
• Protein: 20-25%
• Carbohydrates: 5-10%

The SKD, characterised by its high fat, moderate protein, and very low carbohydrate composition, is recognised for its effectiveness in inducing and maintaining ketosis. This metabolic state promotes fat burning, making it a popular choice for individuals aiming to support weight loss.

It is important to note that this is not the holy grail for weight management, as it is essential to understand the root cause of weight gain – hormonal imbalances and gut health also play a crucial role, and the ketogenic diet is not the best to address those issues.

Targeted ketogenic diet (TKD) for athletic performance

• Fat: 65-70%
• Protein: 20-25%
• Carbohydrates: 10-15% (consumed around workouts)

TKD introduces a targeted approach to carb intake, providing a small amount of carbohydrates strategically around workouts to enhance athletic performance. This slight deviation from SKD allows for improved energy availability during physical activity without compromising overall ketosis.

Cyclical ketogenic diet (CKD) for muscle-building

• Fat: 70-75%
• Protein: 15-20%
• Carbohydrates: 5-10% (higher on refeed days)

CKD involves cycling between strict ketosis and short periods of increased carbohydrate intake. Typically, individuals follow five days of SKD, followed by two days of higher carb consumption. This cyclical approach is favoured by those seeking to build muscle while maintaining the benefits of ketosis.

High-protein ketogenic diet (HPKD) for muscle maintenance

• Fat: 60-65%
• Protein: 30-35%
• Carbohydrates: 5-10%

HPKD is a modification of the traditional keto diet that places a greater emphasis on protein intake. This variant is suitable for individuals aiming to preserve or build muscle mass, making it popular among those engaged in strength training, but it can be detrimental to kidney health in certain individuals.

Keto diets for diabetes management

• Fat: 60-75%
• Protein: 15-30%
• Carbohydrates: 5-10%

For diabetes management, a well-formulated ketogenic diet focuses on minimising carbohydrate intake to stabilise blood sugar levels. The distribution of macronutrients may vary based on individual needs, renal health and insulin sensitivity.

Keto diet in kidney disease

• Fat: 60-75%
• Protein: 15-20% (controlled protein intake)
• Carbohydrates: 5-10%

In cases of kidney disease, a keto diet with controlled protein intake may be considered. The emphasis on healthy fats remains, with adjustments made to address specific renal health requirements.

Ketogenic diet for epilepsy

• Fat: 70-75%
• Protein: 20-25%
• Carbohydrates: 5-10%

The ketogenic diet was originally formulated to manage epilepsy, as inducing ketosis might positively impact brain function and reduce seizures.

Keto diet and neurological health

• Fat: 60-75%
• Protein: 20-30%
• Carbohydrates: 5-10%

For neurological health, including conditions like Alzheimer's and Parkinson's disease, some studies support that a keto diet emphasising neuroprotective fats and minimal carbohydrates can be supportive.

Potential detrimental affects 

While a professionally planned ketogenic diet alongside the support of a registered nutritional therapist can lead to great results, DIY options can have detrimental effects on the individual’s health, the most common being:

Nutrient deficiency

Due to the restrictive nature of the diet, individuals may be at risk of nutrient deficiencies of essential vitamins, minerals, and mostly fibre.

Digestive issues

Some people experience constipation or digestive discomfort when following a ketogenic diet. The low fibre content of the diet, coupled with potential changes in gut bacteria, can contribute to digestive issues.

 "Keto flu"

In the initial stages of adopting a ketogenic diet, individuals may experience symptoms known as the "keto flu," including fatigue, headaches, dizziness, and irritability. These symptoms are often transient but can be challenging for some.

Risk of nutrient overload

While the diet emphasises healthy fats, it may also lead to an overconsumption of saturated fats if not planned carefully. Relying on a nutritionist for advice on recipes and testing can help prevent this.

Kidney stones

Some individuals on a ketogenic diet may be prone to developing kidney stones due to increased excretion of calcium in the urine. Testing, constant monitoring and feedback from a healthcare professional are essential to avoid this potential issue.

Elevated cholesterol levels

The diet's impact on cholesterol levels is variable, with some individuals experiencing an increase in LDL cholesterol (considered the "bad" cholesterol). It's essential for those with cardiovascular concerns to monitor lipid profiles regularly.

If you are curious about this diet and believe it can help you reach your health goals, don’t hesitate to contact a healthcare professional for a tailored plan to help you thrive!