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At times, type 2 diabetes can feel like carrying around an incessant party pooper on your back. Anytime you want to treat yourself, he's there to swat that apple cider donut right out of your hands.
And while no one is calling T2 diabetes a party, there are plenty of ways to keep your condition from raining on your parade. One of the most promising? The Ketogenic diet.
You've probably heard a lot about it, some true, some false. So - does it help? Is it just another fad? Is it true that a keto meal plan includes deep-fried cheese sticks wrapped in deep-fried bacon? No.
Read on for everything you need to know about how going keto could get that party pooper off your back.
What is the keto diet?
It's that diet where you stuff your face with cheese and miraculously lose weight right? Sorry, no.
The keto diet was actually developed back in 1923 to help those suffering from drug-resistant epilepsy. It involves eating a high fat, moderate protein, very low carbohydrate diet to “starve” cells of traditional fuel (aka carbs), and in turn, reduce epileptic seizures.
Eventually, people discovered that the diet had other potential health benefits, such as helping people manage chronic conditions like Alzheimer's, Parkinson's, cancer, and - you guessed it - type 2 diabetes.
This part is important…
… as most people forget that the high-fat, low-carb part of this diet comes with precise specifications. To properly follow the keto diet, your food intake should break down to about 75 percent fats, 20 percent protein, and 5 percent carbs. Notice how this is a lot different than subbing bread with cheese and calling yourself keto. You gotta play by the rules for it to work!
Here's how the high-fat, low-carb shift works:
Carbohydrates are the primary fuel source for most of the body's processes. When carbohydrates are restricted or absent, your body is forced into a state of what it views as starvation. With fat being plentiful, your body begins to use fat as its primary fuel source.
This state is called ketosis (get it - keto?). In ketosis, fat is broken down into ketones to be used as fuel instead of the glucose (aka sugar) your body would normally get from carbs.
Because this diet promotes the burning of body fat, it frequently appeals to individuals hoping to lose weight. It's also been shown to have positive impacts on cardiovascular health, including increased HDL cholesterol (the good kind), improved blood pressure and reduced triglyceride levels.
Keto, T2, and you
Maintaining a healthy weight and keeping blood sugar levels in check are the hallmark recommendations for controlling diabetes. Going keto can help you kick things up a notch thanks to side effects like weight loss, improved insulin sensitivity, lower blood sugar levels, and reduced need for medication.
All you need to do is give your doctor a heads up - they can answer any questions you might have and refer you to a registered dietitian who can put together a meal plan that works for you - and follows the keto rules.
First up, carbs
5 percent of calories from carbohydrates translates to about 20-50 grams per day. Yikes!
For reference, one slice of bread contains between 15-20 grams of carbs and a medium apple has between 20-25 grams. One cup of broccoli, on the other hand, contains just 6 grams.
It's also important to remember that the amount of carbohydrates allowed per day is based on very personal, specific calculations based on a person's body fat percentage, which is why it's so important to consult with a medical pro BEFORE you hop on the keto train.
In addition to the amount of carbs you're permitted to eat, the keto diet also limits carb types. (We know - we're feeling personally attacked too.)
Bread, pasta, beans, legumes, and starchy vegetables (think corn, carrots, peas) are not recommended. The same goes for root vegetables, most fruits, alcohol, and processed foods in general. Sugar also gets the stanky boot (RIP Krispy Kreme).
On the plus side, lots of good stuff is permitted. Meat, poultry, fish, eggs, dairy (butter, cheese, cream), nuts, seeds, oils, avocados, non-starchy vegetables, and some fruits (mostly berries) are good to go. It's restrictive, but not totally impossible to follow.
What to expect when you're keto-ing
Needless to say, completely rearranging the way your body burns energy comes with a few side effects. Here's what you can expect:
- The Keto Flu. The primary side effect when beginning the ketogenic diet is affectionately known as the keto flu. For the first few weeks, your body is adapting to using this new energy source, and it needs a minute to figure out what the heck is going on. Symptoms can include brain fog, difficulty sleeping, gastrointestinal discomfort, intense food cravings, and fatigue. Initial weight loss is mostly from dehydration so be sure to drink extra fluids.
- Constipation. A significant decrease in fiber + a surge in fat = a lot of standstill traffic. Be sure to drink plenty of water and work in some high-fiber, low-carb foods like broccoli, cauliflower, Brussels sprouts, and nuts to get things moving again.
- Bad breath and general stinkiness. No one wants to be the smelly friend, but going keto will give you some extra work in the odor-control department. Ketones are released in sweat, urine, and your breath. You may notice a metallic-like taste in your mouth, due to the presence of a specific type of ketone called acetone. Combat these effects with a stash of mints, extra-strength deodorant, and a quick flush after you use the facilities.
Don't panic - side effects should dissipate within a few weeks as your body adjusts to its new fuel source. Keto is not for everyone though, and if symptoms persist, this may not be the best eating plan for you.
Risky business: The downside of keto
Very high intake of fat, particularly saturated or trans fats, has been linked to an increased risk of heart disease. This is bad news to begin with, but doubly so considering people living with diabetes are already at higher risk for cardiovascular disease.
Hypoglycemic episodes (aka low blood sugar), and worse, diabetic ketoacidosis are potential side effects of going keto, especially for people who take insulin.
Certain nutrient deficiencies are also commonplace given the drastic reduction in nutrient-dense foods like whole grains, fruits, and vegetables.
Keto vs. other common diets
With the overwhelming popularity of keto, it's easy to forget there are lots of other diets out there known to help people manage their type 2 diabetes. Here's how they stack up:
- Intermittent fasting. Thought to trigger a similar state of ketosis through cycles of fasting and eating, intermittent fasting is gaining a lot of traction as a beneficial long-term strategy to optimize health and reduce inflammation. During these fasting cycles our cells get really stressed out, and adapting to this stress helps to make them more resilient, and also better at fighting off disease. The focus in IF is on when to eat, not necessarily what to eat. Quality food sources are encouraged with no specific restrictions.
- Atkins. The Atkins diet is almost identical to the ketogenic diet, but focuses more on the grams of carbohydrates eaten per day (starting at 20 grams) and less on the specific amount of fat and protein. The diet is broken up into 4 phases, gradually increasing the amount of carbohydrates allowed until weight loss goals are reached.
- Mediterranean diet. The emphasis here is on whole, minimally processed, and mostly plant-based foods. Unlike the keto diet, it includes whole grains, some dairy, and moderate consumption of alcohol with minimal, if any, added sugar. It promotes a sensible, inclusive eating pattern, and is probably the most sustainable diet of the bunch.
- Paleo. This diet emphasizes foods theoretically consumed by our early ancestors. It includes lean meat, fish, eggs, berries, and nuts. While there is no limit on carbohydrates, grains are not allowed, nor is dairy, sugar, or refined foods of any kind. The paleo diet has been shown to support weight loss efforts for those who follow it, mostly due to the significant reduction in carbs.
- Low-Glycemic diet. The LGID (that's the low-glycemic index diet) involves eating foods that take longer to break down into sugar in your bloodstream. It was created specifically to help people with diabetes manage their blood sugar. The rules are simple: Eat foods that have a glycemic index of less than 55.
Is the keto diet right for you?
- Choosing to follow a ketogenic diet is a very personal choice, and one that should not be made without the input of a trusted healthcare provider.
- While it has proven to be effective at achieving significant weight loss and improving blood sugar, the jury is still out on the long-term benefits and risks. 11 12 13 Most longer term studies (2 years or so) show about the same amount of weight loss as other eating patterns.
- Working with a doctor and a registered dietitian can help to determine an eating plan that works best for your lifestyle while also supporting your health goals.