Education

Bachelor of Science in Human Nutrition

Master of Dietetics

Accredited ISAK level 1

Member of Dietitians NZ

Associate member of Sports Dietitians Australia

© 2017 by Cushla Holdaway. 

  • Cushla Holdaway

Keto diet - what the fat?!

Keto diet, what the fat?!


Ah, the famous ketogenic diet, or more commonly known as the ‘keto diet’. The keto diet is the current trend taking the nation by storm. Said to be initially discovered in the early 1900’s, it was found to aid patient’s suffering from epilepsy. However, more recently it has become incredibly popular for its apparent health benefits and weight loss effects.


If you are already pretty clued up on the keto diet, then skip this paragraph and jump to the next. The ketogenic diet gets its name from ketones, a metabolic by-product made when our body is starved of glucose and is forced into ketosis. Our brain can only function from glucose, so when we run out of a supply of glucose, like in starvation, fasting, or someone on the keto diet, our brain has to rely on another means of fuel. Ketones are made in place of glucose as they can cross the blood-brain barrier. The keto diet is not for the faint hearted. To strictly be following keto, you need to be consuming <20g/day of carbohydrates. To give you an idea, the carbohydrate quantity in one medium red apple is 22g, one glass of trim milk 12.4g, and one slice of white bread 17g. To make this worse, you have to also moderate your protein intake, because too much protein can be also be made into glucose. In the perfect keto world, about 5% of your energy intake should be from carbohydrate, 20% from protein and 75% from fat. So not only are you having virtually no carbs, you have to restrict protein too.




Being a science geek through and through, I always love a bit of self-experimentation. Through my training and professional career I have jumped at any every opportunity to put myself in the patient’s shoes, or try out the latest fad. It is the best means of having a more thorough understanding and can sometimes be fun. To clarify with you all, the keto diet was not in the fun category. For one week recently (OK, honestly it was 5.5 days) I pushed my body into ketosis through the ketogenic diet. I know this is not very scientific and was a short time, but here is my experience in a nutshell:


· I REALLY missed consuming unlimited amounts of fresh vegetables, moderate amounts of fruit, and my daily milky coffee. A lot. Fruit is basically a complete no-no on this diet, with occasional small quantities of berries being OK. I really missed having fresh, juicy fruit.

· My appetite was sometimes suppressed. However, it was suppressed no more than usual when consuming a healthy, balanced diet including wholesome, high fibre carbs. To be completely honest, I think my appetite was primarily suppressed from an underlying nausea from consuming so much fat.

· I had to become crazy obsessive, weighing out every single gram of whatever I prepared, cooked, and consumed down to every last half of a walnut. It not only took the enjoyment out of eating, it also took over being mindful of how I was truly feeling in terms of hunger signals. I was overriding natural intuition with pre-measured ‘x’ amounts of fat, protein, and carbs because that was the rules and my focus was remaining strictly in ketosis.

· My diet was made up of cheeses, eggs, spinach, oily fish, meats, avocado, olive oil, pecan nuts, walnuts, macadamias, and some lower carbohydrate vegetables which equates to basically anything that was leafy green (spinach, lettuce, kale) or mushrooms.

· Going out for dinner was stressful, and again, took the enjoyment out of something that should be one of life’s simple pleasures.

· My weight fluctuated about 1kg. The science in me knows this was solely water weight. When you don’t eat carbohydrates, your body will slowly use up the stored sugar (known as glycogen) in your muscles and liver. For every 1g of glycogen your body stores, it has to store 3g of water. For example, if I had 350g of glycogen stored, that’s 1050g increase of total weight (temporarily). Thus, on the keto diet, I don’t have any carbohydrate in my diet to have any stored glycogen, leading to an instant loss of water weight. On a side note, this is one of the reasons our weight can so quickly fluctuate over the course of a day.

· I didn’t get any blood tests done, but I didn’t feel great about eating so much fat. Although I tried to maximise healthy unsaturated fats, there is naturally going to be a greater amount of unhealthy saturated fat in a higher fat diet. It would have been interesting to do the diet over a longer period of time and get blood tests done, particularly looking at blood cholesterol markers. Current evidence suggests there have been mixed findings in terms of blood markers on high fat diets, some beneficial and some detrimental.

· My HIIT gym sessions felt more challenging; the struggle was real. My lactate threshold felt reduced and the muscle burn came on more rapidly. My body was not as acclimatised to running solely off fat for such high intensity, and it certainly made that clear and my performance was negatively affected.

· It was really expensive. Protein foods are always the most expensive of any grocery shop, and I can’t say that avocados now at $6 each are the cheapest means of dietary intake. Also taking into account salmon, cheeses and nuts….

· I often felt quite sick, especially after such a fat-laden breakfast, and my breath smelt of fruity ketones. Feeling nauseous in the mornings prior to going to deal with gastroenterology patients was sometimes not the wisest choice.

· A fresh, crisp, juicy apple has never tasted as delicious as after the keto diet.


How do I know I got into ketosis? Besides feeling like rubbish, I purchased keto urine sticks. These are not ‘gold standard’ in comparison to a blood sample, but a good crude measure nonetheless.


Would I recommend the keto diet to my clients? It depends. If they had a medical condition and the keto diet was improving their health, then yes, I would absolutely encourage them if that’s what they believed in and it was improving their health. I always work using a patient-centered approach and that includes working with their beliefs and needs.


For most other people, I believe it’s a fast track to disordered eating, obsession over food, and an unbalanced diet. In our current society, I don’t believe we need any more societal pressure to eat a certain way, or have anything else to make us more confused about the foods we are eating. The more we restrict a food, the more we crave it, and the more likely we are to binge and begin that unhealthy yo-yo dieting cycle that such a huge proportion of the population struggle with. It seems everyone these days needs to be doing some crazy diet to feel accepted or healthy. No one wants to just eat a healthy balanced diet with moderate amounts of all foods. Is it because this sounds so boring and simple? Why are we constantly trying to over complicate eating?!



If you are considering trialing the keto diet, go for it, I would love to hear your experience…but my personal opinion? Carbohydrates aren’t harmful. Healthy fresh fruit, wholegrain high fibre sources of carbohydrates and unlimited amounts of fresh vegetables contain endless health benefits when consumed as part of a balanced diet. The keto diet is very extreme and totally unrealistic in the long-term. Are you really just going to live off avocados (at $6 each), some nuts (not all nuts though as some are too high in carbs), meats, fish, and spinach for the rest of your life? No thanks.


I truly believe a large proportion of the population could greatly enhance their health by simply cutting back on alcohol consumption, increasing fresh fruit and vegetables, and limiting refined and processed foods. This will likely give you greater health benefits than any form of the keto diet.

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