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  • Writer's pictureBrian Dooreck MD

Keto Diet, Weight Loss, and Balance

Updated: Jul 27, 2023


IBS, gas bloating, health, microbiome, gastrointestinal gi system, see your gastroenterology doctor or gastroenterologist
A ketogenic (keto) diet is high in fat and protein and low in carbohydrates.

What happens if you eliminate carbs?


Here are some thoughts 💭 from a Gastroenterologist...not to upset anyone.


If you eliminate carbs, your body will look for energy from other sources — like fat. Fat produces ketones when broken down for energy (or fuel). Thus, the ketogenic (keto) diet name.


The long-term sustainability of the ketogenic diet is unlikely to work for most people, and the long-term benefits, or adverse effects on health, are not yet known.


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The point is that consuming both carbs and fat is OK for a sustainable, balanced, healthy approach to eating and weight. Focus on portion control and avoiding processed foods.


For a sustainable, balanced, healthy approach to eating and weight — it is OK to consume both carbs and fat

Now you have a sense of my opinion. Read more below if you are still OK with me.


A patient asked me about going on a keto diet for weight loss. What did I say?


  1. "I do not eat with the ketogenic (keto) diet."

  2. "The keto diet is a diet that is high in fat and protein—and low in carbohydrates."

  3. "Our body usually looks for glucose (sugar) from carbohydrates for energy. If you eliminate carbohydrates with the keto diet—your body looks for a different energy source. It goes to the liver to break down stored fat into molecules called ketones in a process called "ketogenesis."

  4. "The true ketogenic diet model is that 90% of your daily calories come from fat. That is neither sustainable nor a healthy approach to weight loss — even though you will lose weight in the short term."


Does the keto diet work?


Yes. It does work...but that can be misleading.


Compared to the "calorie-reduction" diet, you can achieve a faster rate of weight loss with a keto diet. Faster is not always better.


I do not endorse quick fixes or solutions to weight loss, nutrition, diet, and lifestyle choices. Think long-term. Think sustainable, healthy, lifelong decisions.

What happens in my body with the keto diet?


The premise or goal of the ketogenic (keto) diet is to use stored fat as fuel.


To do this, you need to limit your daily carbohydrate intake — typically, it is limited to 20 to 50 grams of carbohydrates daily. This depends on body size, and some people need a more restricted diet to reach "ketosis."


For ketosis, you need to limit your daily carbohydrate intake to 20 to 50 grams of carbohydrates

For a perspective...


22 to 30 grams carbohydrates = 1 sports bar
22 to 30 grams carbohydrates = 1 large banana

22 to 30 grams carbohydrates = 1 large banana

How long does it take to get to a state of "ketosis" with the ketogenic (keto) diet?


Typically will take only two to four days to reach a state of "ketosis." Ketosis is when fat becomes your body's primary fuel or energy source.


Is it safe?


In the short term, a keto diet is probably safe. But over time, it's tough to keep off your weight this way. Ask yourself what your goals are. Are they short or long-term?


Is it sustainable for long-term weight loss?


No.


Check out this video from Cedars-Sinai, "What Do We Know About the Keto Diet?"



What about "keto breath"?


Many people on ketogenic (keto) diets find their breath has a "fruity" smell. This is because of the elevated ketone levels — specifically, the ketone called acetone. Acetone is a ketone in both your urine and your breath. So higher levels of ketone and acetone cause the famed "keto breath."


I want to try the keto diet. What should I do?


If you want to try the keto diet (some famous examples are the Atkins, South Beach, and less so the Paleo diet) — I suggest making the best choices in the foods you consume.


What are the healthiest sources of fat?


  • Olive oil

  • Avocados

  • Nuts (almonds, walnuts)


What should I do after a few weeks if I try the keto diet?


I suggest you shift to a more sustainable, balanced, long-term lifestyle choice. Focus on a well-established and proven effective diet — such as the "reduced-calorie" Mediterranean-style diet. Drink plenty of water. Make healthy choices. Focus on portion control. Increase your physical activity.


What is the takeaway from the keto diet?


For fast results, it will work. You will see weight loss. Your breath will change. It is probably safe for the short term — ideally under the guidance of a dietitian or nutritionist.


It is not a sustainable, healthy, or sound dietary choice in the long term. Keeping the weight off with the ketogenic (keto) diet will be challenging and unhealthy.


IBS, gas bloating, health, microbiome, gastrointestinal gi system, see your gastroenterology doctor or gastroenterologist
This looks more "balanced" to me- just an opinion of a Gastroenterologist.

Recently, many of my patients have been asking about a ketogenic diet. Is a ketogenic diet safe? Would you recommend it? Despite the recent hype, a ketogenic diet is not something new. In medicine, we have been using it for almost 100 years to treat drug-resistant epilepsy, especially in children. In the 1970s, Dr. Atkins popularized his low-carbohydrate weight-loss diet, beginning with a strict two-week ketogenic phase. Over the years, other fad diets incorporated a similar approach to weight loss.


What is a ketogenic (keto) diet?


A diet causes the body to release "ketones" into the bloodstream.


IBS, gas bloating, health, microbiome, gastrointestinal gi system, see your gastroenterology doctor or gastroenterologist

Personally


I eat a high-fiber, mostly plant-based 🌱 diet, no red meat, drink 4 liters of water a day, exercise, and am focused on keeping nutrition simple. I am sharing what works for me and what I routinely recommend to my patients.


"Balance. Portion control. Keep nutrition simple. Eat Smart. Eat Healthy. 🌱 🌾 🌿"

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