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Beginners Guide to Keto: Cut the Carbs

Learn how to start eating a ketogenic diet with this beginners guide to keto. In this guide, you’ll learn about the different types of macros, the foods to eat, how to cut the carbs from your diet and how to tell if you are in ketosis.

What is a ketogenic diet?

A ketogenic diet consists of a food intake that is high in fats, contains moderate protein content, and very low carbohydrate content. The dietary macronutrients are divided into approximately 55% to 60% fat, 30% to 35% protein intake, and 5% to 10% carbohydrates. Specifically, in a 2000 kcal per day diet, carbohydrates amount up to 20 to 50 g per day. (Masood, 2022).

In the Standard American Diet, refined carbohydrates (such sugar and flour) are the primary source of energy in the body. It is estimated to comprise around 55% of the typical Standard American Diet (200 to 350g/day). Excess consumption of low-quality carbohydrates may displace and leave no room in the diet for healthier foods like nuts, unprocessed grains, fruits, and vegetables.

These carbohydrates are absorbed into the body in the form of sugar. This triggers an insulin response which helps the sugar make it’s final journey into the cell where it is burned for fuel. The key take-home message is that insulin, not only transport sugar into the cells, but it stimulates the fat cells (adipose tissue) to store any excess energy by the production of more fat seen around the abdomen in the form of the expanding waist-line.

What is Nutritional Ketosis?

The aim ketogenic diets is to reduce the insulin response, and to switch the body from using over from carbohydrate burning to burning fat as the primary energy source. Fat is broken down into ketone bodies as a replacement from sugar. These are the basic ketone bodies that accumulate in the body as a ketogenic diet is sustained.

This metabolic state is referred to as “nutritional ketosis.” As long as the body is deprived of carbohydrates, the metabolism remains in the ketotic state. The nutritional ketosis state is considered quite safe, as ketone bodies are produced in small concentrations without any alterations in blood pH.

The keto diet greatly differs from ketoacidosis, a life-threatening condition where the body produce ketones in extremely larger concentrations, altering blood pH to an acidotic state.

Research suggests, people on a standard ketogenic diet initially lose weight rapidly by up to 5kg in 2 weeks or less. This diet has a diuretic effect, and some early weight loss is due to water weight loss followed by fat loss. Interestingly with this keto diet plan, lean body muscle is largely spared. As a nutritional ketosis state sustains, hunger pangs subside, and an overall reduction in caloric intake can help with further weight loss.

Beginners guide to keto

1. Limit your carbohydrate intake to 50 grams or less per day as part of your food intake.

2. Focus on eating high fat diets, such as avocados, olive oil, and nuts.

3. Make sure to get enough protein each day, especially if you are exercising regularly.

4. Drink plenty of water, avoid sugary beverages an focus on high fat diet.

5. Test your ketone levels regularly to make sure you are in ketosis.

6. Consult with a doctor or registered dietitian before starting any new keto eating plan.

By following these quick tips, you can successfully follow a ketogenic diet and reap all the benefits that come with it!

Ketogenic diet benefits

Some of the benefits of keto diets are as follows:

  1. Weight loss, improved BMI and abdominal circumference

  2. Improved mental clarity

  3. Decreased inflammation

  4. Improved blood sugar levels with Type 2 diabetes

  5. Reduced symptoms in neurological disorders such as epilepsy

  6. Hypertension control (high blood pressure)

  7. Improved cardiovascular health

Common keto mistakes

Inadequate fat for keto diet

One of the most common keto mistakes when following a ketogenic diet is not getting enough fat. The goal of a ketogenic diet is to train your body through eating a high fat diet to burn fat for fuel, it’s important to make sure you’re consuming enough healthy fats each day such as:

  1. fatty fish,

  2. avocado,

  3. nuts and nut butters,

  4. coconut and extra virgin olive oil.

Another consideration to make in your keto meal plans is when you eat too much protein. The main reason is that the body can convert high protein foods into sugar, which increases insulin secretion and in turn, slows the transition into ketosis (Melkonian, 2022).

Failing to Monitor ketones

Additionally, another common keto mistake people make is not monitoring their ketone levels. Ketone levels can be measured through urine, breath, or blood tests. It helps you to understand which foods are helping your to stay in nutritional ketosis and which foods bring you out of it.

Drawbacks of a ketogenic diet

There are a few potential drawbacks to following a ketogenic diet, such as the need to monitor your low carb high fat intake meticulously. The symptoms will improve after 2 to 3 days and the constipation will improve with dietary fiber.

These side effects typically go away once your body adjusts to burning fat for fuel. Overall, the ketogenic diet, when looking at the health benefits vs the drawback, for most people it is a safe and effective way to lose weight, improve mental clarity, and decrease inflammation.

Also for some people the dietary restrictions needed to sustain ketosis may lead to it being hard to sustain in the long term.

Long-term effects of keto diet

At present there is a lack of long term evidence regarding the long-term cardiovascular implications of a keto diet. However some studies have made the following findings:

  1. There is an increase in LDL cholesterol, which is associated with development of accelerated hardening of arteries and increased risks of heart disease (Bueno, 2013).

  2. While other studies have mentioned “favourable” lipid profile associated with the ketogenic diet, which included an increase in favorable HDL which is associated with removal of cholesterol deposits

  3. Possible low sustainability of long-term weight loss (Stern, 2004).

  4. Research suggests, symptomatic relief from polycystic ovary syndrome

Short term side effects of keto diet

There are a number of common short term side effects when converting to a keto diet. These include

  1. Dehydration

  2. Hypoglycemia

  3. Lethargy (Keto flu)

  4. Halitosis (bad breath)

  5. Gastrointestinal side effects such as nausea, vomiting, diarrhea, and constipation.

To manage this transition and to reduce the effects of the keto flu symptoms, start by staying hydrated, replacing electrolytes, getting plenty of sleep, avoiding strenuous activities, and eating enough fats and slowly reducing your carb intake over time.

Who should not do the keto diet?

If you have any of the following conditions you should really seek medical advice regarding a ketogenic diet. Anyone with these conditions who utilize a keto diet needs close medical supervision to avoid serious complications.

  1. Pregnancy and lactation;

  2. History of mental disorders and behavioral problems, abuse of alcohol and other substances;

  3. Hepatic or renal failure;

  4. Type 1 Diabetes;

  5. Porphyria, unstable angina, recent myocardial infarction

How do you follow a ketogenic diet?

If you want to follow a ketogenic diet, the first step is to limit your carbohydrate intake to 50 grams or less per day. Focus on fruit and vegetables that are naturally low in sugars such as;

  1. mushrooms

  2. leafy greens such as spinach, kale and swiss chard

  3. brassicas such as cauliflower, broccoli,

  4. lettuce

  5. berries

Next, focus on eating healthy fats, such as avocados, olive oil, and nuts.

Make sure to get enough protein each day, especially if you are exercising regularly.

Drink plenty of water and avoid sugary beverages.

Food list for keto diet

There are a variety of foods that you can eat on a keto diet, including:

  1. Meat: Beef, pork, lamb, chicken

  2. Fatty fish: Salmon, tuna, trout, and mackerel

  3. Eggs: Whole eggs with the yolk are best.

  4. Low carb vegetables/non starchy vegetables: Spinach, broccoli, cauliflower

  5. Healthy oils: Olive oil, coconut oil, avocado oil

  6. Nuts and seeds: Almonds, pistachios, walnuts, flaxseed, chia seeds, chia seeds

  7. Butter and cream: Grass-fed butter and heavy cream

  8. Dairy: Cheese, unsweetened yogurt

  9. Beverages: Water, coffee, tea

  10. Avocados: whole avocados, or freshly made guacamole

Reducing the net carb intake can be done without sacrificing the nutritional benefit. Given the right menu, low carb diets can be a sustainable diet. The drawback is that under a Standard American.

Foods to avoid on a ketogenic diet

The main food group to avoid in your keto journey are those high in carbs, especially those that are highly processed foods. These foods increase insulin levels, increase the number of highs in your blood sugar and do not help you to lose weight.

There are a few food groups that are not allowed on a keto diet, including:

  1. Grains or starches: Wheat, rice, oats, etc.

  2. Fruit and fruit juice: All fruit except for small portions of berries.

  3. Starchy vegetables: Potatoes, sweet potatoes, carrots, etc.

  4. Sugary foods: Honey, agave, maple syrup, etc.

  5. Unhealthy fats: Margarine, vegetable oil, shortening, etc.

  6. Alcohol: Beer, wine, spirits, etc.

  7. Junk foods: processed foods, and foods with added sugar.

  8. Sugar -free diet foods: Any food that uses artificial sweeteners, including Stevia

  9. Beans or legumes: Peas, kidney beans , lentils, chickpeas

  10. Condiments or sauces: Low fat mayonnaise, salad dressing and condiments have high levels of added sugar

These lists of foods are broad, however the goal of being successful on a keto diet is to eliminate or reduce the carb intake.

How long should you stay on a ketogenic diet?

There is no one-size-fits-all answer to this question. Some people may need to stay on a ketogenic diet for months or even years, while others may only need to follow the keto diet for a few weeks. It ultimately depends on what is your keto journey and health needs. Consult with your doctor or registered dietitian to create the right keto diet regime.

How do you know if you’re in ketosis?

There are a few ways to measure nutritional ketosis, including:

  1. Urine test strips: These test for the presence of ketones in your urine.

  2. Blood test: This measures the level of ketones in your blood.

  3. Breath test: This measures the level of ketones in your breath.

Additionally some people may experience symptoms of ketosis, such as:

  1. Increased energy levels 

  2. Decreased hunger or appetite

  3. Increased thirst and dry mouth

  4. Frequent urination

Image from dietdoctor.com

Above is some ketone values for a targeted ketogenic diet to consider:

  1. Anything below 0.5mmol/L is not considered ketosis

  2. Nutritional ketosis is achieved when ketones reach 0.5 -3mmol/L

  3. Over 3mmol/L is higher than necessary and does not confer additional benefits.

  4. Over 8-10mmol/L means that something has gone wrong. The most common cause would be Type 1 Diabetes and immediate medical review is required. Symptoms of type I diabetes include: feeling very unwell, nausea and vomiting, abdominal pain, confusion

Keto and gut bacteria

The high fat, high sugar Western diet negatively impacts gut health (Zinöcker, 2018).

The ketogenic diet has complex effects on the composition and diversity of the gut microbiome (Paoli 2019). There are a number of outstanding issues as to the effects of the ketogenic diet on the gut microbiome including:

  1. A diet high in saturated fats has a negative effect on the gut microbiome, so what is the optimal ratio of polyunsaturated and monounsaturated fats to saturated fats for people following a keto diet?

  2. Using artificial sweeteners in keto diet is controversial (seen as cheating) and these non-nutritive sweeteners have been shown to disrupt the structure and function of gut microbiota and gut mucosa.

  3. Are fermented foods sufficient to provide prebiotics, probiotics and maintain a balanced gut microbiome for people eating a probiotic diet?

  4. How does plant versus animal protein modify microbiome? This appears to alter the abundance and composition of the gut microbiome but further research is needed in this area.

Tips for a healthy gut microbiome while on keto diet

  1. Introduce the use of whey and plant proteins (i.e. pea protein);

  2. Reduce the intake of animal protein;

  3. Implement fermented food and beverages (yoghurt, water and milk kefir, kimchi, fermented vegetables);

  4. Introduce prebiotics and specific probiotics (if needed);

  5. Reduce omega 3 to omega 6 fatty acids ratio (increase omega 3 and decrease omega 6);

  6. Introduce an accurate quantity and quality of unsaturated quality fats;

  7. Avoid artificial sweeteners (such as stevia) and processed foods;

  8. Test your microbiome if needed (analysis of 16S rRNA to identify biodiversity and richness). A pre keto sample would be helpful to compare with.

Frequently asked Questions

What is the difference between a keto diet and low carb diets?

A keto diet is a specific type of low carb diet (called a very low carbohydrate ketogenic diet or VLCKD in the medical literature) that is focused on training your body to burn fat for fuel. Research suggests, keto diets improves metabolic health, gives better blood sugar control and helps in weight loss

The main difference between a keto diet and a traditional low carb diet is the macronutrient ratios. A typical keto diet consists of 70-80% fat, 10-20% protein, and 5-10% carbs, while a traditional low carb diet consists of 50-60% carbs, 30-40% protein, and 10-20% fat.

A low carb diet is similar to a keto diet in that it eliminates refined carbs such as sugars and refined grains such as flour and breakfast cereals. A low carb diet attains it’s carbohydrates from fruit and vegetables and is much less restrictive in terms of which fruit and vegetables can be consumed.

Hopefully this beginners guide to keto has been useful as you start your keto journey and helps you to cut the carbs.

References

Bueno NB, de Melo IS, de Oliveira SL, da Rocha Ataide T. Very-low-carbohydrate ketogenic diet v. low-fat diet for long-term weight loss: a meta-analysis of randomised controlled trials. Br J Nutr. 2013;110(7):1178-1187.

de Wit N, Derrien M, Bosch-Vermeulen H, Oosterink E, Keshtkar S, Duval C, de Vogel-van den Bosch J, Kleerebezem M, Müller M, van der Meer R. Saturated fat stimulates obesity and hepatic steatosis and affects gut microbiota composition by an enhanced overflow of dietary fat to the distal intestine. Am J Physiol Gastrointest Liver Physiol. 2012 Sep 1;303(5):G589-99.

Dhamija R, Eckert S, Wirrell E. Ketogenic diet. Can J Neurol Sci. 2013;40(2):158-167.

Masood W, Annamaraju P, Uppaluri KR. Ketogenic Diet. [Updated 2022 Jun 11]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-.

Melkonian EA, Asuka E, Schury MP. Physiology, Gluconeogenesis. [Updated 2022 May 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-

Muscogiuri G, Barrea L, Laudisio D, Pugliese G, Salzano C, Savastano S, Colao A. The management of very low-calorie ketogenic diet in obesity outpatient clinic: a practical guide. J Transl Med. 2019 Oct 29;17(1):356.

Nettleton J.E., Reimer R.A., Shearer J. Reshaping the gut microbiota: Impact of low calorie sweeteners and the link to insulin resistance? Physiol. Behav. 2016;164:488–493.

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