The Keto Diet and Nutrients

    1. Does the keto diet starve the body off essential nutrients?

    Before this question can be addressed, we need to delineate what “keto” means. Keto is a four-letter word with no precise meaning anymore. It implies in a broad sense that carbs are kept low and proteins moderate, and healthy fats relatively high so that beneficial ketone bodies (KBs) can be produced as they always have throughout human evolution. On the notion that we are starving our bodies of essential nutrients, namely carbohydrates, this is incorrect biochemically and physiologically. Humans easily synthesize sufficient glucose (and in turn, other types of more complex carbs) via gluconeogenesis and other pathways. If consuming a so-called “dirty keto” diet, in which carbs are kept low, but the diet is otherwise of poor quality, one could starve the diet of essential nutrients, but the same could be said for any other poor-quality diet.

    2. If so, what are the side effects /dangers of this?

    Provided the low carb diet includes high quality foods rich in vitamins and minerals, for the general population there are no concerns.
    3. If you are doing keto, how can you ensure you're getting the right nutrients?

    Relative to a standard American diet (SAD) in a “keto diet”, we are consuming fewer simple carbs, less protein, and more fat (typically, by calories, 75% fat, 20% protein, 5% carb). So, the carbs that are consumed will be complex and higher in fiber; the protein intake will be adequate for the general population, and the fats should be of high quality containing the essential fatty acid (linoleic acid and linolenic acid) and the marginally essential fatty acids (EPA, DHA). Thus, the only real concern with Keto done poorly, is that one would consume high amounts of poor-quality fats, like deep fried fats, and too much saturated fats like coconut article (I have an article devoted to the less than miraculous properties of this fat) to achieve the high fat goal. The issue of eating too much poor-quality fats can be overcome with a solid education from an accredited nutritionist.

    4. Can you describe what 'macro nutrients' are?

    Macronutrients are our nutritional building blocks, and consist of classes of nutrients consumed in larger quantities, and consist of carbs, proteins, and fat. Micro nutrients consist of nutrients consumed in small amounts, such as vitamins and minerals.

    5. Do you agree that a well-balanced diet is superior to the keto diet? Why or why not.

    No, as discussed above, it can be argued that “keto” is closer to what our bodies need physiologically and evolutionarily and is already balanced. The exception would be in some sporting activities, in infants, and in those with medical conditions, where higher carb may be desirable.

    6. Michaels says carbs aren't evil -- but make a point to go whole grain/organic when you do want carbs. Thoughts on this?

    Whole grain foods can also be ridden with added simple sugars, as is the case with almost all packaged cereals, so one should not automatically consume foods advertised as having “whole grains”. Generally, though, a whole grain, with an intact hull, will contain more beneficial fiber. Organic is preferable.
    7. Any other thoughts on the keto diet + the dangers, risks, benefits of it?

    Words like “danger” should be used with caution when describing a simple dietary change as going low carb or keto. In a true classical ketogenic diet, such as that used in epileptics historically, the fat content was 95% by calories. This type of extreme diet, led to problems with palatability and could be lacking in essential nutrients without supplementation. So, it is important to put some delimiters around what “keto” means, in any conversation around keto. That should be the starting point. Also, there are a variety of flexible low carb regimens, such as alternating days of low carb and medium carb, or days where carbs are high to satisfy carb cravings. The addition of oils such as Medium chain triglycerides and exogenous ketone bodies, make it possible to reenter the ketogenic state easily on these mixed regimens, and make going “keto” easier to maintain.


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