School of Amaranth: Keto Guide
Amaranth is committed to providing quality, accurate information that supports every individual health journey. With this in mind, we are happy to partner with local naturopathic doctor, Dr. Jatish Kaler. Dr. Kaler’s teachings have informed this article, he’s partnered with us to present keto workshops, and he’s available to answer questions in-person and help patients monitor their diet.
Amaranth’s goal is to provide information and support to set each individual up for success and help them eat well, live well, and thrive. We are focused on the ketogenic diet beyond a trendy quick-fix diet and want to establish it as a tool to use properly as part of a long-term plan to achieve optimal health.
What is the Ketogenic diet?
The ketogenic diet was introduced by modern physicians as a treatment for epilepsy in the 1920s, to mimic the metabolism of fasting. In the past few years the diet has exploded in popularity with people seeking to address various health issues, and among the scientific community.
The keto diet is primarily a high fat diet, moderate to low protein, and an extremely low carb diet (so low your body goes into ketosis). Ketosis is a metabolic survival mechanism that your body uses when you are not getting enough carbs (sugar) as a source of energy, it then switches to using fat in order to create and use ATP (energy). For macronutrients, those on the keto diet get 70-90% of calories from fats, about 20% from protein, and 5-10% from net carbs (dietary fiber and sugar alcohol).
How does the diet allow you to lose weight?
By switching your primary fuel source from carbs to fat, you are “training” your body to convert fat (from food and your body) into energy. A diet higher in fat, with good amounts of protein and fiber, will leave you feeling fuller. Lastly, any diet that promotes shifting towards a whole food-based diet and away from a processed, high sugar diet will tend to help weight loss and improve health and well being.
A special note on fibre: with a focus on fat and a movement away from carbs, there is a tendency to let fibre intake slip. We recommend keeping fibre front of mind and aiming to get an optimal amount of 30-50 grams in a day. Since the keto program subtracts fibre from carbs, this should have minimal impact on ketosis. Fibre will keep you regular, feeling full, and most importantly, it supports a healthy gut microbiome.
Technically a keto diet can be followed by just focusing on macronutrients. However, to encourage health and well being we recommend a “clean keto” approach. Clean keto for us means choosing whole foods, organic if possible and reducing processed foods. It also means choosing humane (organic/free range) meats sourced as locally as possible and fed a healthy diet (100% grass fed/free range). Choose healthy fats and use them appropriately. Generally, we recommend saturated fat for cooking, especially high heat (butter, ghee, lard, tallow etc.), monounsaturated for low eat and as dressings (avocado and olive), and polyunsaturated – the healthiest but the most sensitive to heat and light (fish oil, nuts and seeds).
Minerals and electrolytes
One common error is forgetting about minerals and electrolytes, which can lead to not feeling well or the “keto flu”. To mitigate this, make sure you increase your salt intake to counteract the water loss that commonly happens when starting the keto diet. Drink lots of water and get lots of rest as your body transitions. Bone broth is a a great whole food source minerals and electrolytes and you can even try coconut water (some people will be okay with the small amount of sugar). For more information on the keto flu and how to avoid symptoms, check out this great resource from Keto Academy.
Supplements are an easy and affordable way to get in those electrolytes, make sure to choose ones with minimal additives and artificial sweeteners. Ultima brand has a good line with minimal fillers and added minerals. Lastly, don’t forget your veggies! There are many low carb high mineral greens such as spinach, kale, swiss chard, collard greens bok choy, broccoli etc. that will also give you much needed fiber and vitamins.
What is Modified Keto?
Like the modified paleo or Atkins diets, the modified keto diet is a departure from the strict definitions of the original diet. In a sense it is “modified” to be more accessible, easy to follow, more in line with your unique needs, while delivering close to the same results.
You ARE able to train your body to use fat for energy without being in ketosis. This still means that your diet has to be low carb, just not low enough to put you in ketosis. Being on a modified ketogenic diet still allows you to use fat for energy (not as fast and efficiently as if in ketosis), enjoy the benefits of being in a low insulin state, better hormone regulation, a clearer mind etc.
Being in ketosis (regular keto diet) is harder to achieve and demands that you are on a strict ketogenic diet, meaning that your body is creating ketones. Ketones are the compounds that will turn on your brain, giving you energy and mental sharpness and allowing you to not only burn fat faster but also put on muscle much easier. Intuitively, it makes sense that this state takes more management, as any cheat meals or non-keto ingredients may push you out of ketosis and for the diet to work you should be in ketosis for most or all of the time. Even consuming more protein than what is recommended pushes you out of ketosis since your liver will be able to convert the extra amino acids into glucose (this is why the keto diet is NOT a high protein diet—only about 20% of your calories are supposed to come from protein).
A modified keto diet may be a great option after you lose the weight, as a break between full keto diets, when you are not looking to treat a particular medical issue, or even as a first step before the full diet.
FAQ: Ask the Doctor
Who is the diet for? What results can you expect?
The ketogenic diet can be used in healthy individuals interested in losing weight, increasing energy and improving blood sugar profiles. Under medical supervision, the ketogenic diet can be used safely and effectively to treat seizure disorders, diabetes, obesity, metabolic syndrome, PCOS (polycystic ovarian syndrome), certain genetic disorders (Glut-1 deficiency & PDH deficiency), and potentially certain cancers.
Is it a long term diet? For everyone? Are there any concerns that need to be addressed? How can we mitigate those concerns?
The ketogenic diet was designed in the early 1900s specifically for long-term use. Children with uncontrollable seizures were experiencing benefits from therapeutic fasting but in the process were not meeting the basic requirements of life. For this very reason the ketogenic diet was designed and formulated for day-to-day basis and to avoid malnutrition. That being said, there are considerations that may need to be made such as supplementation with carnitine, fibre, salt and a multivitamin.
The ketogenic diet can also cause major changes to your metabolic profile and for this reason it is important to consider baseline testing of blood sugars, cholesterol, blood pressure, kidney and liver function. Finally, if you are currently diagnosed with a medical condition or taking medications, the ketogenic diet can alter the need for these medications and you may need to adjust dosing with the help of a healthcare professional.
You lost the weight, what now?
Once you have achieved your desired body mass composition, it is important to identify a sustainable diet for long-term maintenance. If you are happy with the ketogenic diet, then you can continue for as long as you desire, but with a mild increase in fat and protein intake to prevent continued weight loss. Typically, it is recommended to eat low carb, moderate protein and eat fat to fullness. There are many other options, including intermittent fasting, adopting a more modest ketogenic diet with increased carb intake and also cycling through ketosis for part of the week and eating a more conventional diet on “cheat” days.
Who should not do the diet?
The ketogenic diet is suitable for almost all people from all walks of life. However, some individuals should strongly consider professional supervision while on the diet because of pre-existing medical conditions and the need for alterations in medications during the transformative process. Finally, children and adolescents should certainly seek advice from a healthcare professional because of the need to maintain adequate macro and micronutrient levels for growth.
What supplements support the keto diet?
There are many supplements on the market meant to promote ketosis or mitigate the side effects of adjusting to the diet. At the end of the day, eating the diet in the right proportions and with a focus on whole-foods is the best path to success. Below are examples of a few solutions for common issues with the diet.
Dizziness and light-headedness: Increased salt intake (ketosis causes the kidneys to increase salt excretion), adrenal support,
Fatigue: MCT oil (a readily available fat fuel source ready for burning), caffeine, Carnitine, adrenal/adaptogenic herbs
Constipation: Fibre supplement, probiotic, magnesium
Upset stomach: Digestive enzymes, chewable licorice, probiotics
What are some benefits beyond weight loss?
There are numerous benefits beyond weight loss on the ketogenic diet and many more being investigated by medical researchers. There is strong evidence that the ketogenic diet can benefit those with seizures/epilepsy, high blood pressure and diabetes. There is also much promise in the areas of Alzheimers and dementia, inflammatory disorders, neurological conditions (M.S. and Parkinsons) and certain cancers.
To find out more visit: www.calgarynaturopathicmedicine.com or email drjatishkaler [at] gmail [dot] com.
Bulletproof: ketogenic diet with more advanced concepts, including more individual specific food groups, toxin management, and timing of eating with periods of fasting.
Atkins: A low-carb but not necessarily ketogenic diet. It advises eating more fat and protein (unlike keto which is high fat, moderate protein). Atkins also recommends phases of implementation, ending with eating more healthy carbs (fruits and veggies) to achieve weight loss maintenance.
Intermittent Fasting: Related to Keto and used in the Bulletproof diet. Great for revitalizing the system and may prevent aging and assist with many other health areas .
Paleo: Strictly focuses on whole foods and excludes legumes, potatoes, butter, dairy, and all processed foods. A similar option may be a “modified” Paleo diet where you eat a similar diet based on the main principles, but are less strict and allow for your health goals to be met. (E.g., incorporating potatoes, kefir, sprouted grains and butter into your diet and the occasional treat).