Is the Ketogenic Diet a Fad?

Keto is all the rage these days. More and more people are giving it a shot. But does it live up to its hype?

What is Keto?

The ketogenic diet or "keto" is essentially a super low carb diet where you typically eat less than ~25-50 grams of carbs everyday (it varies between individuals how low of a carb intake you need to induce ketosis). By necessity, if you lower your carbs but keep your calories the same you will have to eat more fat and protein. Keto is typically known as a "high fat" diet, or at least a lot higher than your typical Western diet, which is more carb/grain heavy.

Keto dieters are famous for loving bacon, butter, heavy cream, and all the super high fat foods the medical establishment told us to avoid.

After a few days of eating super low carb your body should in principle switch from burning carbs (glycogen) to burning ketone bodies. When your body and brain is running efficiently on ketones you are said to be in a state of "ketosis".

The theory behind keto is that when you are in ketosis your metabolism will be super efficient at burning fat.

It should also be noted that the increased levels of saturated fat in the keto diet have not been shown to increase chances of mortality. A recent editorial from a top medical journal, the British Journal of Sports Medicine, writes that:

Coronary artery disease pathogenesis and treatment urgently requires a paradigm shift. Despite popular belief among doctors and the public, the conceptual model of dietary saturated fat clogging a pipe is just plain wrong. A landmark systematic review and meta-analysis of observational studies showed no association between saturated fat consumption and (1) all-cause mortality, (2) coronary heart disease (CHD), (3) CHD mortality, (4) ischaemic stroke or (5) type 2 diabetes in healthy adults.Similarly in the secondary prevention of CHD there is no benefit from reduced fat, including saturated fat, on myocardial infarction, cardiovascular or all-cause mortality

So we have reason to believe that the keto diet is safe. But is it actually more effective at fat loss than calorie-reduced diets?

But isn't it all about the calories?

Typically when people switch from the Standard Western Diet to a keto diet they also reduce their caloric intake. This could account for the success of keto. It works, but only as a method of managing hunger while being in a caloric deficit.

The keto enthusiasts want to say that the fat burning effect of ketosis goes beyond what you'd predict on a purely caloric model.

But is it true?

Unfortunately, this sort of question is very difficult to study in a controlled fashion. There has never been a study between people on keto diets vs. people on similarly-calorie restricted diets but where they also matched for protein intake.

The Importance of Protein

Some theorists believe that the reason keto is so effective is not because the metabolic effects of ketosis but rather because of the increased protein intake, which is almost inevitable switching to a keto diet.

Some benefits of increased protein intake for fat loss:

• Protein has the highest thermic effect of all the macronutrients. Eating 100 calories of protein your body has to burn about 30 calories to just digest the protein.
• Protein is the most satiating macronutrient i.e. it keeps you full longest. It's hard to binge on chicken breast. It fills you up. Compare that to free bread at the restaurant: you can just keep eating hundreds of calories worth of bread and still be hungry.
• Protein is used for building muscle. Muscle is highly metabolic i.e. it requires your body to burn calories to keep the muscle, increasing your metabolism when you add muscle. So couple increased protein intake with resistance training and you have a recipe for a faster metabolism
• Increased muscle-protein synthesis is important during weight loss because inevitably in the weight loss process you will lose both fat and muscle. You want to preserve as much muscle as possible during this process in order to keep your metabolism fast.

Conclusion

So given the importance of protein for fat loss - is it any wonder that keto diets work well for people? But the reason might not because the state of ketosis is making your body a super fat burning machine. It might just be because increased protein intake is great at managing hunger while being in a calorie deficit.

Does that make keto a fad? Yes and no.

First of all, it's not a fad because ketogenic diets have been around for over 100 years and doctors have used them to treat all kinds of illnesses including epilepsy in children. The scientific community is well aware of keto and it's been relatively well studied. In that sense it's not your typical "eating nothing but lemon juice detox" quack diet.

But most people claiming to be "doing keto" have probably no idea if they are actually in ketosis because they haven't gotten test strips or any way to objectively determine if they are in keto. Furthermore, to actually get into ketosis and stay there long enough to get the benefits you have to be super restrictive with your eating. This can make socializing or eating out difficult. It's not necessarily the easiest lifestyle to maintain.

So in my opinion, I think keto diets do work. They are effective and bodybuilders have used them to great effect. But it's very probable that the reason it works so well is not because the magic of ketosis but rather because increased protein intake makes it easier to be in a calorie deficit.

But you can get the benefits of increased protein intake without being so restricted with super low carb intake. Low-to-medium carb intake along with higher protein intake will also be effective even though you won't be in ketosis.

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