

The ketogenic diet or Keto-diet for short has gained immense popularity in the last decade, primarily because of its successful short term effect on weight loss.
What is the ketogenic diet?
Low carbohydrate diet with moderate amount of protein restrictions and no restrictions on fat intake.
5-10% carbohydrate, 30-35% protein and 55-60% fat.
- Carbohydrate intake of less than 50g per day = 3 slices of bread or 1 serving of plain pasta or rice.
- Restriction of protein intake to 1-1.5g per 500g body weight = 70kg in weight equates to 140-200g of protein intake a day. That is about 30 boiled eggs or 6 pieces of grilled chicken breast.
- No restriction on your fat intake
Typical keto diet includes plenty of meat, eggs, fish, nuts, seeds, oil and fibrous vegetables.
How the Ketogenic Diet Works
When your body is starved of carbohydrate intake, a metabolic change occurs where stored carbohydrates in the body will start to be utilised for approximately a span of 3 days.
After which, the body will start to switch to stored fats as the primary source of energy by producing ketones and ketoacid to fuel the body.
Keto-diet has been shown to effectively :
- reduce weight and BMI
- abdominal circumference
- blood pressure and blood triglyceride , fasting blood glucose and HbA1c
- increase High density lipoprotein (Good cholesterol )
- reduce hyperinsulinemia
- improvement in insulin sensitivity.
Read our article here to learn more about Keto diet.
Is the Ketogenic Diet for Everyone?
Common side effects of the keto-diet :
- Collectively we can term them “ Keto-flu “ : fatigue, headache, dizziness, nausea, vomiting, constipation and low exercise tolerance.
- Symptoms typically resolve after few days to weeks as the body adjust to the low carbohydrate ketogenic state.
- Ensuring adequate fluid intake can help counter some of these symptoms.
- Long term adverse effects include hepatitis steatosis ( fatty liver ) , overall lack of protein in the body, kidney stones and vitamin and mineral deficiencies.
There are also a few groups of patients that should not be on Keto diet.
- diabetic on insulin or oral medications
- liver or renal failure
- pancreatitis
- rare cases of inborn disorders of fat metabolism
To ensure a successful Ketogenic diet plan
- Discipline and compliance. Good results are often seen in patients who stick to it for 3-6 months or beyond. Because it is a restrictive diet, it might be hard to follow over the long run.
- As it is a major shift in body metabolism, frequent monitoring with a doctor is necessary, and close monitoring of renal function is crucial. There are cases where patients do run into problems with hydration and electrolyte imbalances which could potentially be dangerous.
- Because this diet is heavy on meat , there are also health concerns with regards to high consumption of red meat and processed meat.
- Always ensure the transition from a ketogenic diet back to a standard diet should also be a gradual and well controlled one.
Conclusion
Instead of going 100% into a ketogenic diet, perhaps it may be better for you to move towards a reduced carbohydrate diet with a balanced meal plan that includes lots of fruits and vegetables with minimal processed food.
Most importantly, exercises help in the fight against obesity. Again, weight loss is 70% diet and 30% exercise
By : Dr Chen Yiming
Family Physician, MBBS (Singapore), GDFM (NUS), GDFP Dermatology (NUS)