SLU Nutrition and Dietetics Internship Blog: The REAL Keto Diet

By Ryanne Hill

The Keto Diet has become a hot topic and fat-loss fad diet within recent years. Everyone from CrossFit athletes to moms trying to lose the baby weight are giving the keto diet a try.

But does anyone actually know what the true keto diet is?

The ketogenic diet can be defined as a high fat, low carbohydrate, controlled protein diet. The ketogenic diet was created by Dr. Russell Wilder in 1923. Dr. Wilder was working at the Mayo Clinic at the time. He created the ketogenic diet as a treatment for individuals with epilepsy. The diet aims to reduce seizures through changing the fuel source of the body. Within healthy individuals, their bodies use glucose from carbohydrates as energy. However, the ketogenic diet switches the primary fuel source to fat. The body begins to produce ketones and ultimately lives in a state of ketosis. Recent studies have also shown that decanoic acid is also produced during this diet and may be a key factor in helping decrease the frequency of seizures in people with epilepsy.

The classic ketogenic diet follows a 4:1 ratio. This means that there are four parts fat for every one part protein and carbohydrate. This ends up being 90% of calories from fat, 6% from protein and 4% from carbohydrates.

The modified keto diet breaks down to 82% of calories from fat, 12% from protein, and 6% from carbohydrate. This variation allows a little bit more flexibility for diet choices.

Living the Keto Way

I personally have not experienced living on a strict ketogenic diet. However, I witnessed my younger brother follow a classic keto diet for two years during his stint of epilepsy. At age three my brother began having up to 8 tonic-clonic (convulsive) seizures a day. After intensive work ups and screenings, he was diagnosed with epilepsy and immediately placed on a slew of medications. These medications greatly altered his mood and attitude; he was angry, aggressive and moody most of the time compared to his previous kind demeanor. My parents made the decision to attempt the ketogenic diet to help mitigate the seizures and hopefully improving his mood. My brother was admitted to Children’s Hospital to begin the transition to a ketogenic diet. He was supervised for 24 hours to fast, then slowly increase calories to meet the 4:1 classic keto ratio. Supervision is completed in order to monitor for a potential increase in seizures. Fortunately, my brother handled the transition well and was able to stop taking most of his medications.

In order for the diet to be effective, he had to follow a strict 4:1 ratio diet. He got zero cheat meals, snacks or treats. Sweets and other carbohydrate rich foods were eliminated. A typical day for him included: Breakfast – Scrambled Eggs
38g (2.7 Tbsp) heavy cream
50g (1 large) egg
27g (1.9 Tbsp) Butter
Strawberries: 12g (1 medium)

Lunch – Quesadilla
20g (1.4 Tbsp) Heavy Cream
11g (2.3 tsp) Mayonnaise
23g Avocado
10g Butter
30g Egg Whites
5g Almond flour
12g (0.4oz) Cheddar Cheese

I remember babysitting and having to weigh every meal on a scale to maintain the perfectly portioned macronutrients. He would have to drink straight heavy whipping cream in order to meet the necessary fat content. He was a rockstar at school and only ate the food that was packed for him. During his last year on the keto diet he saved all of his Halloween candy and patiently waited a few months until he was cleared to stop the keto diet to eat the candy and celebrate! I am beyond proud of this stud for sticking to his ketogenic diet and now being 10 years seizure free!

Keto in the Spotlight

Comparatively, the Instagram keto translates to a high fat and high protein diet. This is better outlined as the Modified Atkins diet which composes of 65% of calories from fat, 30% protein and 5% carbohydrate. At this point, the body is most likely not producing enough ketones to be in ketosis and switch to utilizing fat as the primary fuel source. Most likely the Instagram fitness gurus and celebrities that you draw inspiration from are not following the strict meal plan required of the ketogenic diet. The transition into a ketogenic diet requires intensive supervision from a medical team who specialize in epilepsy and the ketogenic diet. The individual who you meet at the gym most likely did not undergo supervision and therefore is most likely not in ketosis.

So Remember…..

Ketogenic Diet