{"id":248211,"date":"2020-06-26T06:00:05","date_gmt":"2020-06-26T05:00:05","guid":{"rendered":"https:\/\/formnutrition.com\/us\/?p=248211"},"modified":"2021-08-26T04:26:08","modified_gmt":"2021-08-26T08:26:08","slug":"what-is-the-keto-diet-and-how-does-it-work","status":"publish","type":"post","link":"https:\/\/formnutrition.com\/us\/inform\/what-is-the-keto-diet-and-how-does-it-work\/","title":{"rendered":"What Is the Keto Diet and How Exactly Does It Work?"},"content":{"rendered":"<p>The keto diet broke through into the public consciousness in 2018 (it was that years most searched diet trend according to Google), and since then has surpassed the buzz to cement its position as one of the most popular and talked-about diets around. In fact, a <a href=\"https:\/\/www.nytimes.com\/2020\/01\/02\/style\/self-care\/keto-diet-explained-benefits.html\" target=\"_blank\" rel=\"noopener noreferrer\">2020 survey of registered dietitians<\/a> named the low-<a href=\"https:\/\/formnutrition.com\/inform\/nutrition-myths-carbs-make-fat\/\">carbohydrate<\/a> keto diet as the most popular diet in the United States.<\/p>\n<p>But how did keto make it to the top of the\u00a0<span class=\"il\">dietary<\/span>\u00a0podium? What exactly even is it? And can it really be relied on for healthy, long-term nutrition?<\/p>\n<p>A high fat, low carb\u00a0<span class=\"il\">diet<\/span>\u00a0touting benefits beyond body composition alone, in this short course, we\u2019ll take a microscope to the increasingly-popular\u00a0<span class=\"il\">diet<\/span>, touching on everything from its hailed metabolic advantage to its criticisms. To begin, though, let\u2019s take a look at how it all began.<\/p>\n<h2>What Is The Keto Diet?<\/h2>\n<p>The keto\u00a0<span class=\"il\">diet<\/span> was first developed as a treatment for epilepsy, with trials recorded in the 1920s. These early incarnations were extremely strict with 90 percent of total energy coming from fat and only 10 percent coming from carbohydrate and protein combined. In absolute terms, this translated as a ratio of 4:1 fat to carbs and <a href=\"https:\/\/formnutrition.com\/plant-based-nutrition\/form-superblend-plant-based-vegan-protein\/\">protein<\/a> \u2013 essentially a very low carb, low protein, high-fat <span class=\"il\">diet<\/span>. Meeting this ratio was deemed therapeutic for epileptics but only feasible for in-patients, under strict supervision and with supplementation.<\/p>\n<p>Fast-forward a few decades and in the early 70s, Dr Atkins began to apply aspects of keto <span class=\"il\">diets<\/span> to weight loss, leading to the development of the Atkins <span class=\"il\">diet<\/span>\u00a0characterised by low carbohydrate but without limits on protein or fat. This low carb, high protein, high-fat\u00a0<span class=\"il\">diet<\/span>\u00a0became hugely popular as a <a href=\"https:\/\/formnutrition.com\/inform\/why-diets-dont-work\/\">weight loss<\/a>\u00a0<span class=\"il\">diet<\/span> as you could still eat as much fatty foods as you liked. But where the Atkins <span class=\"il\">diet<\/span> received so much criticism is that it by-and-large didn\u2019t limit protein.<\/p>\n<p>The modern <span class=\"il\">ketogenic<\/span>\u00a0<span class=\"il\">diet<\/span>\u00a0(outside of a clinical setting) is typically a modified Atkins\u00a0<span class=\"il\">diet (MAD).<\/span>\u00a0This MAD\u00a0<span class=\"il\">diet<\/span> restricts carbohydrate more prescriptively to 20 grams per day, with limits to protein, but more achievable for people by recommending a ratio of 1:1 fat to carbohydrate and protein. In essence, it\u2019s a very low carb, moderate protein, high-fat <span class=\"il\">diet<\/span>. That is not to say this MAD\u00a0<span class=\"il\">diet<\/span> is easy to follow though. Limiting carbohydrate to 20g per day is a challenge. The evolution from here was the <span class=\"il\">ketogenic<\/span>\u00a0<span class=\"il\">diet<\/span> as we more commonly know it.<\/p>\n<h2>Carbs Vs. Fat<\/h2>\n<p>When we think of\u00a0<span class=\"il\">ketogenic<\/span>\u00a0<span class=\"il\">diets<\/span> not in their clinical sense, but as a way to optimise health and alter body composition, it really all comes down to the ongoing nutritional feud between pro-fat and pro-carb camps. This binary way of thinking is not at all helpful, but is a key catalyst for increasing promotion of the keto <span class=\"il\">diet<\/span>.<\/p>\n<p>Fronted by American physiologist <a href=\"https:\/\/www.thelancet.com\/pdfs\/journals\/lancet\/PIIS0140673604175788.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">Ancel Keys<\/a>, the low-fat model has been the public health message since the 1960s. But regardless of this, there has been little evidence to show for this message in terms of a change in obesity levels. If anything, obesity has increased, and though death from cardiovascular disease has dropped, the prevalence has remained high.<\/p>\n<p>A keto\u00a0<span class=\"il\">diet<\/span>\u00a0proposes a polarising view, prioritising fat. Where conventional\u00a0<span class=\"il\">diets<\/span>\u00a0tend to look at reducing energy (calorie) intake (and consequently see a reduction in fat, the most energy-dense macronutrient, alongside carbs and protein) on the surface the keto\u00a0<span class=\"il\">diet<\/span> is not necessarily concerned with calories at a top-line level, but reducing carbohydrates specifically and replacing the with fat as your main fuel. In doing this, you\u2019re sold the notion that your metabolism is forced to reorganise to burning more fat and to supplement where you can via ketones, despite not necessarily eating less.<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-248629 size-large\" src=\"https:\/\/formnutrition.com\/us\/wp-content\/uploads\/sites\/4\/2020\/06\/AdobeStock_217792721-1200x675.jpeg\" alt=\"no carbs in keto diet\" width=\"1200\" height=\"675\" \/><\/p>\n<h2>How Does The Keto Diet Work?<\/h2>\n<p>There\u2019s more to the <span class=\"il\">ketogenic<\/span>\u00a0<span class=\"il\">diet<\/span> than just a demonisation of carbs and an embrace of fat though. Knowing exactly how a <span class=\"il\">ketogenic<\/span>\u00a0<span class=\"il\">diet<\/span>\u00a0affects functions of the body and brain is key to understanding its metabolic, mental and behavioural impact.<\/p>\n<h3>Keto Biochemistry 101<\/h3>\n<p>The dramatic reduction in carbohydrate intake when following a\u00a0<span class=\"il\">ketogenic<\/span>\u00a0<span class=\"il\">diet<\/span> will naturally trigger a reduction in insulin. Insulin is released in response to an import of carbohydrate in the system; you take it and utilise it in muscle and sequester it away in adipose tissue (fat stores). But it\u2019s important to note that while people often talk about the carbs we eat going straight to adipose tissue, it\u2019s actually muscle that uses the bulk of carbohydrate in the body. Plus, carbs cannot store significant amounts of fat in adipose tissue single-handedly.<\/p>\n<p>If you haven\u2019t got carbohydrate coming in, then insulin response is minimal, meaning muscle uptake is equally minimal. This is deliberate so you can maintain a steady supply of carbohydrate in the blood in order to fuel the brain.<\/p>\n<p>Without insulin, you aren\u2019t utilising as much carbohydrate in the muscle or storing triglyceride in adipose tissue. Of course, you still need fuel, though. The carbohydrate you have still gets used: muscle may still use stored carbohydrate when needed, and your liver stores of glycogen can be used to keep blood glucose topped up. In turn, to continually maintain blood glucose, you stop using carbohydrate where you can and start manufacturing it.<\/p>\n<p>To preserve carbohydrate for the brain, your other tissues start using an alternative fuel to preserve carbohydrate: fatty acids. The lack of carbohydrate in your system forces the body to begin liberating fatty acids from stored fat, but don\u2019t forget the fatty acids from the <span class=\"il\">diet<\/span>-derived lipids circulating around your blood which you\u2019ve taken in from your high-fat\u00a0<span class=\"il\">ketogenic<\/span>\u00a0<span class=\"il\">diet<\/span>.<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-248628 size-large\" src=\"https:\/\/formnutrition.com\/us\/wp-content\/uploads\/sites\/4\/2020\/06\/Screen-Shot-2020-06-22-at-17.31.17-1200x675.png\" alt=\"keto diet\" width=\"1200\" height=\"675\" \/><\/p>\n<p>Carbohydrate stores are limited, and eventually you\u2019ll have all but exhausted carbohydrate stores (glycogen stores don\u2019t ever go down to actual zero). Naturally, you start supplementing for that carbohydrate by making more of it, using amino acids and glycerol from the circulating fatty acids you have used. But you can\u2019t do this forever because it&#8217;s energy costly and you can\u2019t sustain a supply of building materials as you will soon compromise muscle protein.<\/p>\n<p>And here\u2019s where we begin to produce ketones in the liver (predominantly). Ketones, unlike lipid, can cross the blood-brain barrier and can be used as another substrate of energy in the brain, taking the pressure off of having to solely supply glucose. From this, you achieve a state of <span class=\"il\">ketosis<\/span>\u00a0\u2013 the significant build-up of ketones in the blood.<\/p>\n<h3>The Metabolic Advantage<\/h3>\n<p>From a <a href=\"https:\/\/formnutrition.com\/inform\/body-composition-course\/\">body composition<\/a> point-of-view, the fact that on a\u00a0<span class=\"il\">ketogenic<\/span>\u00a0<span class=\"il\">diet<\/span>\u00a0you\u2019re not storing fat in adipose tissue, but releasing it, is its major draw. You\u2019re training your body to utilise its good-as-unlimited stores of energy from fat, breaking down fat stores for fuel.<\/p>\n<p>The other advantage is if you\u2019re glucose intolerant (such as in diabetes), then you\u2019ve removed one of the problems.\u00a0<span class=\"il\">Ketogenic<\/span>\u00a0<span class=\"il\">diets<\/span>\u00a0have been used historically for type 1 diabetes, because if you don\u2019t have any insulin, you can deal with that by simply removing carbohydrate. Of course, modern management of type 1 diabetes involves injecting insulin and moderating carbohydrates in a much more sophisticated way, but 100 years ago it proved relatively effective.<\/p>\n<p>By preferentially breaking down body fat and using that to fuel the body, there will be improvements in insulin sensitivity, too. This is because body fatness (in adipose tissue but also ectopic fat in organs) is intrinsically linked to insulin resistance. If you force the body to liberate fat, it in turn alleviates insulin resistance.<\/p>\n<p>Also linked to this <a href=\"https:\/\/formnutrition.com\/inform\/everything-you-need-to-know-about-your-basal-metabolic-rate\/\">metabolic effect<\/a> are possible increases in energy expenditure, which could help energy balance. The carbohydrate-insulin model suggests a move to a\u00a0<span class=\"il\">ketogenic<\/span>\u00a0<span class=\"il\">diet<\/span>\u00a0might drive up energy expenditure because you might be alleviating \u201cinternal starvation\u201d (due to too much uptake of fuel in adipose tissue), purportedly conducive to a conventional\u00a0<span class=\"il\">diet<\/span>.<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-248627 size-full\" src=\"https:\/\/formnutrition.com\/us\/wp-content\/uploads\/sites\/4\/2020\/06\/AdobeStock_254682964.jpeg\" alt=\"keto diet runners\" width=\"1050\" height=\"600\" srcset=\"https:\/\/formnutrition.com\/us\/wp-content\/uploads\/sites\/4\/2020\/06\/AdobeStock_254682964.jpeg 1050w, https:\/\/formnutrition.com\/us\/wp-content\/uploads\/sites\/4\/2020\/06\/AdobeStock_254682964-768x439.jpeg 768w, https:\/\/formnutrition.com\/us\/wp-content\/uploads\/sites\/4\/2020\/06\/AdobeStock_254682964-680x389.jpeg 680w, https:\/\/formnutrition.com\/us\/wp-content\/uploads\/sites\/4\/2020\/06\/AdobeStock_254682964-400x229.jpeg 400w, https:\/\/formnutrition.com\/us\/wp-content\/uploads\/sites\/4\/2020\/06\/AdobeStock_254682964-600x343.jpeg 600w\" sizes=\"auto, (max-width: 1050px) 100vw, 1050px\" \/><\/p>\n<h3>Mental And Behavioural Effects<\/h3>\n<p>Another key effect of this change of fuel takes place in the brain. Here\u2019s where we can take the\u00a0<span class=\"il\">ketogenic<\/span>\u00a0<span class=\"il\">diet<\/span>\u00a0back to its roots as an epilepsy treatment, because it creates a central effect in the brain thanks to the circulating ketones in your cerebral fluid. Think of it as you effectively burning nail polish remover (acetone) as a fuel. Anecdotally, how this manifests most profoundly is through appetite suppression, and people reporting an increase in perceived energy.<\/p>\n<p>But perhaps one of the most underplayed upshots of a\u00a0<span class=\"il\">ketogenic<\/span>\u00a0<span class=\"il\">diet<\/span> is behavioural, (this is explored in more depth in our keto diet course, details of which you can find at the bottom of this article). On a <span class=\"il\">ketogenic<\/span>\u00a0<span class=\"il\">diet<\/span>, people may feel fuller and despite any notion of cutting calories in the literature\u00a0actually end up eating less food.<\/p>\n<p>Moreover, people following a\u00a0<span class=\"il\">ketogenic<\/span>\u00a0<span class=\"il\">diet<\/span>\u00a0become more conscious of what they\u2019re eating; more so than when you simply tell them to reduce calorie intake, because you\u2019re asking them to do it in a specific food group. Cutting carbohydrates is particularly effective in this case, because this macronutrient tends to cover those foods which people most often overindulge \u2013 palatable treats such as cakes, crisps, biscuits, chocolate, pizzas, fast food and so on. Hence, people are far less likely to passively overeat. The end result is that people will consciously and unconsciously eat less food.<\/p>\n<p>People forget about this effect, but it makes up a big part of why\u00a0<span class=\"il\">ketogenic<\/span>\u00a0<span class=\"il\">diets<\/span>\u00a0are both popular and effective. We\u2019ll look more at this idea of a wholesale change to the\u00a0<span class=\"il\">diet<\/span>\u00a0in tomorrow\u2019s instalment, along with other proven benefits.<\/p>\n<hr \/>\n<p><em><strong>This article is an adapted excerpt from our short course on the keto diet. The course encompasses five emails on the topic explaining the benefits and criticisms, to where the future of the diet lies, all sent daily to your inbox. To find out more or sign up click <a href=\"https:\/\/formnutrition.com\/inform\/keto-diet-short-course\/\" target=\"_blank\" rel=\"noopener noreferrer\">here.<\/a><\/strong><\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>In this excerpt from our short email course on the topic, Dr. Adam Collins explains what the keto diet is and details its effects on our mind and body.<\/p>\n","protected":false},"author":11386,"featured_media":248626,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[13],"tags":[],"class_list":["post-248211","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-nutrition"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v22.1 (Yoast SEO v27.6) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>What Is the Keto Diet and How Exactly Does It Work? - Form - US<\/title>\n<meta name=\"description\" content=\"In this excerpt from our short email course on the topic, Dr. Adam Collins explains what the keto diet is and details its effects on our mind and body.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/formnutrition.com\/us\/inform\/what-is-the-keto-diet-and-how-does-it-work\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"What Is the Keto Diet and How Exactly Does It Work?\" \/>\n<meta property=\"og:description\" content=\"In this excerpt from our short email course on the topic, Dr. Adam Collins explains what the keto diet is and details its effects on our mind and body.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/formnutrition.com\/us\/inform\/what-is-the-keto-diet-and-how-does-it-work\/\" \/>\n<meta property=\"og:site_name\" content=\"Form - US\" \/>\n<meta property=\"article:published_time\" content=\"2020-06-26T05:00:05+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2021-08-26T08:26:08+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/formnutrition.com\/us\/wp-content\/uploads\/sites\/4\/2020\/06\/AdobeStock_177726497.jpeg\" \/>\n\t<meta property=\"og:image:width\" content=\"1200\" \/>\n\t<meta property=\"og:image:height\" content=\"800\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"author\" content=\"Dr. Adam Collins PhD\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Dr. Adam Collins PhD\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"8 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/formnutrition.com\\\/us\\\/inform\\\/what-is-the-keto-diet-and-how-does-it-work\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/formnutrition.com\\\/us\\\/inform\\\/what-is-the-keto-diet-and-how-does-it-work\\\/\"},\"author\":{\"name\":\"Dr. Adam Collins PhD\",\"@id\":\"https:\\\/\\\/formnutrition.com\\\/us\\\/#\\\/schema\\\/person\\\/20f054eb62a583dd478b64ca1885528a\"},\"headline\":\"What Is the Keto Diet and How Exactly Does It Work?\",\"datePublished\":\"2020-06-26T05:00:05+00:00\",\"dateModified\":\"2021-08-26T08:26:08+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/formnutrition.com\\\/us\\\/inform\\\/what-is-the-keto-diet-and-how-does-it-work\\\/\"},\"wordCount\":1657,\"commentCount\":0,\"publisher\":{\"@id\":\"https:\\\/\\\/formnutrition.com\\\/us\\\/#organization\"},\"image\":{\"@id\":\"https:\\\/\\\/formnutrition.com\\\/us\\\/inform\\\/what-is-the-keto-diet-and-how-does-it-work\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/formnutrition.com\\\/us\\\/wp-content\\\/uploads\\\/sites\\\/4\\\/2020\\\/06\\\/AdobeStock_177726497.jpeg\",\"articleSection\":[\"Nutrition\"],\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"CommentAction\",\"name\":\"Comment\",\"target\":[\"https:\\\/\\\/formnutrition.com\\\/us\\\/inform\\\/what-is-the-keto-diet-and-how-does-it-work\\\/#respond\"]}]},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/formnutrition.com\\\/us\\\/inform\\\/what-is-the-keto-diet-and-how-does-it-work\\\/\",\"url\":\"https:\\\/\\\/formnutrition.com\\\/us\\\/inform\\\/what-is-the-keto-diet-and-how-does-it-work\\\/\",\"name\":\"What Is the Keto Diet and How Exactly Does It Work? 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A qualified nutritionist for 20 years, Dr. Collins holds an MSc in Nutrition &amp; Metabolism and a PhD focusing on energy expenditure and body composition. He is Director of MSc and BSc Nutrition at the University of Surrey. 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