An Expert Nutritionist Discusses the Keto Diet
Nutritionist and Keto Expert L.J. Amaral MS, RD, CSO, specializes in teaching people about nutrition during cancer treatment, for survivorship, and for cancer prevention. She is currently a co-investigator on a phase one clinical trial for ketogenic diets and people newly diagnosed with glioblastomas, a type of brain tumor. She works at the outpatient Cancer Center of Cedars-Sinai in Los Angeles. We had the opportunity to discuss what you need to know about the keto diet with L.J.
Registered Dietician and therapeutic diet expert L.J. Amaral
Why are we hearing so much about the keto diet these days?
The keto diet has gained immense popularity due to a number of similar diets being popularized at the same time, specifically ones like the paleo diet.
Additionally, our country has a disproportionate amount of people who struggle with being overweight/obese and/or dealing with type 2 diabetes.
A lot of researchers have been trying to find ways to help address this epidemic, and more people are using low carb diets to treat these populations. People are seeing real results with low carb in a quicker amount of time than other diets. Most people who follow a well-planned keto diet can see weight loss within their first week, and/or their glucose/sugars almost normalize, which is very encouraging and implores people to continue with the lifestyle change.
What really makes a keto diet keto?
Ironically, there are a lot of different versions of Keto! According to the Charlie Foundation, which is one of the best and most reliable resources for ketogenic diets, there are several versions of the diet.
There’s a classic ketogenic diet, which is considered a very high fat diet, upwards of 80-90% of calories coming from fat. This ensures the body reaches a state of ketosis.
There are also versions of the diet that are more lenient with protein and fats, but still limits carbs, called the modified Atkins diet.
There’s one version that allows for a little more carbohydrate intake, but the diet is supplemented with MCT, or medium-chain triglyceride, oil to ensure they stay in ketosis.
The most important part is to ensure you reduce and avoid all refined carbohydrates (white flour products) and sugars, to ideally reach a state of ketosis, during which your blood glucose is low and your blood ketones are high. This allows the body to use ketones instead of sugar as a fuel source.
Some people have specific goals for their glucose and ketone values depending on their disease or what type of ketogenic diet they choose to follow.
Being keto is different from just eating a lot of meat, right?
Yes!!! It’s quite the opposite. I do not recommend anyone to just eat meat and call it keto. Cutting out all but one food group is dangerous and unbalanced.
Can you be vegetarian or vegan and follow a keto diet?
You can, but it poses extra challenges. I personally have not counseled anyone on a vegan keto diet, but I’m sure it could be done with a lot of planning, supplementation and likely eating a lot of the same foods.
We’ve heard that a keto diet can have positive medical or health benefits. What are some of the documented situations where this is the case?
There are randomized controlled studies that show how ketogenic diets help people with anticonvulsant resistant epilepsy or seizures that do not respond to medications, especially in children.
It has shown quite positive results for those with type 2 diabetes and normalizing blood glucose and helping to reverse insulin resistance. Some people are even able to get off their glucose-lowering medications or insulin with the right planning and exercise.
It is being studied in cancer, especially brain tumors, and showing some positive effects in mice and preclinical studies in reducing tumor burden.
Research is also being done to show if the ketogenic diet has any positive effects on those with Alzheimer’s and/or Parkinson’s diseases and cognition.
A few researchers across the country are also looking at the ketogenic diet and mental health like PTSD, anxiety, depression, bipolar disorder, and schizophrenia.
There are plenty of anecdotal stories out there where people have felt the difference in using a ketogenic diet such as decreased inflammation, increased mood, better sleep, increased cognition, and weight loss to name a few benefits.
Is the keto diet an all-or-nothing sort of scenario? Can a person follow this part of the time?
I think it depends on what they are following the diet for and what type of ketogenic diet they are following. If you want to occasionally modify your refined carbohydrate and added sugar intake—that’s great! I don’t recommend yo-yo dieting though, and do not recommend doing a classic ketogenic diet part-time.
Is this meant to be a long-term lifestyle or something to facilitate shifts, or a little of both?
It really depends on people’s goals. If someone has diabetes, then a low carb diet could be a lifestyle adaptation to continue to control your blood glucose and insulin and lead a long and healthy life!
For someone who wants to experience weight loss, they can use it as a tool to reduce their body weight. And then they can transition to a plant-based diet, or something more tenable.
The most important thing is to consider if this is a sustainable option. So if you’re struggling to follow the diet for a short amount of time, I would not recommend it long term.
If I’m thinking about following a keto diet, where should I begin?
Start to think of your goals. Why are you doing this? What is your motivation? You are going to need to come back to this constantly in order to continue.
Next, I would get rid of all temptation in your house that you can. This includes pasta, rice, crackers, cookies, sugars of all kinds, corn-based products, et cetera. Start to decrease your intake of these foods as well.
Are there some trusted resources for following a keto diet?
A few I recommend include: The Charlie Foundation. KetoNutrition.Org, and Max Love Foundation.
What are some things a person needs to know to stay healthy and on track on a keto diet?
Ideally, work with a dietitian/nutritionist who can guide you and keep you accountable! I would also download a food tracking app like Cronometer or Eat This Much and record your foods so you understand the ratios and amounts of macronutrients (carbohydrates, fats, proteins) you are eating daily. Always focus on healthy fats like olives, olive oil, avocados, nuts and seeds, and fatty fish. And do not forget to hydrate!! If you can find someone to do it with you, you’ll have more success.
Keto for Beginners
Check out LJ’s instructions on Keto for Beginners.
Felicia Tomasko has spent more of her life practicing Yoga and Ayurveda than not. She first became introduced to the teachings through the writings of the Transcendentalists, through meditation, and using asana to cross-train for her practice of cross-country running. Between beginning her commitment to Yoga and Ayurveda and today, she earned degrees in environmental biology and anthropology and nursing, and certifications in the practice and teaching of yoga, yoga therapy, and Ayurveda while working in fields including cognitive neuroscience and plant biochemistry. Her commitment to writing is at least as long as her commitment to yoga. Working on everything related to the written word from newspapers to magazines to websites to books, Felicia has been writing and editing professionally since college. In order to feel like a teenager again, Felicia has pulled out her running shoes for regular interval sessions throughout Southern California. Since the very first issue of LA YOGA, Felicia has been part of the team and the growth and development of the Bliss Network.