The following are general guidelines
for ketogenic diets:
Carbohydrate - Most of what
determines how ketogenic a diet is how much carbohydrate is eaten, as
well the individual's own metabolism and activity level. A diet of
less than 50 or 60 grams of net (effective) carbohydrate per day is
generally ketogenic. However, athletes and people with healthy
metabolisms may be able to eat 100 or more grams of net carbohydrate
in a day and maintain a good level of ketosis, while an older
sedentary person with Type 2 diabetes may have to eat less than 30
net grams to achieve the same level.
I personally do well on 30 to 50 grams
of carbohydrates per day. A nutritionist supports me in planning the
carbohydrates to not overdo the total and take me out of ketogenic.
Protein - When people first
reduce carbohydrates in their way of eating, it doesn't seem as
though the amount of protein they eat is as important to ketosis as
it often becomes later on. For example, people on the Atkins diet
often eat fairly large amounts of protein in the early stages and
remain in ketosis. However, over time some (perhaps most) people
need to be more careful about the amount of protein they eat as the
bodies of many people seem to "get better" at converting
protein into glucose (gluconeogenesis). At that point, each
individual needs to experiment to see if too much protein is throwing
them out of ketosis and adjust as necessary.
Fat - Most of the calories in a
ketogenic diet come from fat, which is used for energy. The exact
amount of fat a person needs to eat will depend on carbohydrate and
protein intake, how many calories they use during the day, and
whether they are losing weight (using their body fat for energy).
Depending on these factors, somewhere in the range of 60-80% of
calories will come from fats on a ketogenic diet (even up to 90% on,
for example, the Ketogenic Diet for Epilepsy). People tend not to
overeat on diets this high in fat, so calorie counting is rarely
necessary.
When eating this large amount of fat,
you can imagine that the types of fats consumed are very important.
Many authors advise steering clear of oils that are high in
polyunsaturated omega-6 fats (soy, corn, cottonseed, safflower, etc).
Dr. Stephen Phinney, who has been doing research on ketogenic diets
since the 1980's, has observed that people don't do as well when they
are consuming a lot of these oils (mayonnaise and salad dressings are
a common source). This could be because omega-6 fats can be
inflammatory, especially in large amounts, or some other factor, but
people didn't feel as well or perform as well athletically in his
experiments.
On the other hand, fats high in
medium-chain triglycerides, such as coconut oil and MCT oil are often
encouraged, as these fats are easily turned into ketones by the body.
In general, people on the ketogenic way of eating tend to consume a
lot of foods high in monounsaturated and saturated fats such as olive
oil, butter (often butter from grass-fed cows is recommended),
avocado, and cheeses. The "high oleic" types of safflower
and sunflower oils (but not the regular forms of these oils) are also
good choices, as they are high in monounsaturated fats and low in
polyunsaturates. This way of eating also avoids canola, soybean
oils, and other vegetable oils.
I would seriously urge everyone to stop
using the term diet to refer to ketogenic way of eating. Call it a
food plan or better yet name it “way of eating” because this is
something you need to do if you have type 2 diabetes. Diets often
fail and are short-term at best and with the problems discussed in
'Part 1' (yesterday's blog), you will need to use this for the
long-term.
