Is a ketogenic diet effective for weight loss?
Intro
The ketogenic diet is certainly an effective tool to lose excess body fat. However, there are both poorly formulated ketogenic diets and well-formulated ones. So the state of ketosis itself isn’t a guarantee of fat-loss, but it is conducive to it.
There are ketogenic diets where, despite the person being fat-adapted – meaning they rely on fat rather than sugar for most of their energy – they’re still not losing fat. Let’s dive into the importance of being fat-adapted and how it plays into fat-loss.
Does being ‘fat adapted’ guarantee fat loss?
Being fat-adapted does not guarantee fat-loss. These are two different things.
Fat-loss depends on mechanisms that govern the balance between fat entering and fat leaving fat cells.
Being fat-adapted is about your metabolic state, specifically about your reliance on fat for energy. It doesn’t tell you anything about the fat balance of fat in a fat cell. Fat or lean people can be fat adapted, as can people doing keto or just standard low-carb. The quickest way to becoming fat adapted, so to speak, is to fast. This effectively forces you to rely on stored body fat for the vast majority of your energy needs.
Losing fat however, is different. It requires removing things that make you more likely to store fat, called adipogenic factors, as well as addressing food addiction issues if these play a role in your case. For the latter, this means not eating fast absorbable sugars (e.g. bread, pasta, noodles, sodas, candy) or high omega-6 seed oils (e.g. soybean oil, pizza).
Then there’s the addiction side of fat-loss. Sugar cravings and addiction more generally have to be addressed if this is part of the obstacle in someone’s fat-loss journey.
The sensitivity of your own fat cells to the hormone insulin also matters a great deal, since this hormone specializes in storing rather than expending energy.
What is keto-adaptation?
Keto adaptation is basically fat adaptation, with the difference being that keto adaptation happens on a ketogenic diet and fat adaptation can happen on or off a ketogenic diet – like by fasting.
Keto adaptation usually happens when a person eating a standard American diet transitions to a ketogenic one. A ketogenic diet is a diet where a certain level of blood ketones is achieved, say above 0.5 or 1 mmol/L of beta-hydroxybutyrate.
What is electrolyte loss?
Electrolytes are atoms from the periodic table of chemical elements that we call minerals. These minerals are sodium and chloride, like the sodium and chloride from table salt, potassium, calcium, bicarbonate, magnesium and phosphate.
We can lose electrolytes, via sweat and urine most commonly. When someone transitions from a standard high carb diet to a ketogenic one, they are likely to lose electrolytes. This happens because when you go keto you starting burning off your filled-to-the brim carb (glycogen) stores in your liver and muscle. This glycogen is stored with water which contains electrolytes.
When you burn through the glycogen you lose the water and electrolytes too. This is the keto adaptation process, which also compensates by giving you greater access to fat (fat adaptation) and ketones (keto adaptation). Ketone bodies, the molecules produced on a ketogenic diet, are made from fat. That’s why you make ketones on a low-carb high-fat diet.
How many pounds of fat can I lose on keto in a week?
At best you can hope to lose 1.5 lbs of fat a week over the first few weeks (equivalent to 2 to 4 lbs of body weight) [1]. However, losing 0.5 to 1 lb of fat per week is already an accomplishment.
One of the advantages of a ketogenic diet is that the nutritional state of ketosis seems to be particularly filling, over the short and long term (satiation and satiety, respectively). This certainly can help with spontaneously skipping meals or limiting caloric intake.
Spontaneously skipping meals or limiting one’s caloric intake both lower the hormone insulin. This grants much greater access to fat cells and their stored fat in the form of triglycerides. Burning lots of fat at rest, rather than carbs, is a good metabolic state to be in. It’s efficient and good for your energy generating organelles called mitochondria.
How can I lose fat faster on keto?
Ketogenic diets are a fantastic way to lose excess body fat. By definition, however, their focus is limited to macronutrient distribution, specifically to a very low-carb intake – simply because it’s the major dietary factor allowing blood ketone levels to rise.
Addressing other factors influencing fatness (adiposity) beyond a low-carb macronutrient pattern is really important for good, long-term fat-loss results. These factors vary in their importance and many of them overlap, but here are 5 worth exploring:
- Food quality
- Food order
- How often you eat (fasting/feeding windows)
- Sleep
- Stress
Food quality
There are many aspects to food quality. The two most important ones are, first, excluding flour, added sugars and high omega-6 seed oils. Second, it’s obtaining generous amounts of high-quality animal protein every day (e.g. > 1.5 g of protein per kilogram of body weight) [2,3,4,5,6,7,8,9].
Food order
Understanding the order in which food is eaten allows you to do ‘less with more’. What does this mean in practice? It means that for a given amount of fat, protein and carbs, depending on the order in which you eat it your body will secrete more or less insulin to metabolize it.
Say you’re eating a meal with chicken, a salad, a sweet potato and a handful of berries. Are you better off eating your carbs (sweet potato and berries) first or last? The rule of thumb is that it’d be best to have your carbs after the chicken and veggies [10].
Eating frequency (fasting/feeding windows)
How often you eat, as well as when you eat, also matters to fat-loss. A lot of the negative effects of ‘overeating’, like gaining liver fat, can be mitigated by just eating less often [11]. So if you’re already on a ketogenic diet but want further improvements, try going from 3 to 2 meals a day, which is in effect the intermittent-fasting pattern.
You could also try most of your calories earlier in the day, as far from bedtime as feasible, especially if you notice larger evening meals correlating with worse sleep [12]. However, the science is far from settled on the matter. If getting down from 3 to 2 meals a day means you will have most of your calories later in the day rather than earlier, that’s still a win. To have or not have breakfast is not a settled question, but 3 meals instead of 2 is certainly a healthier eating pattern for the vast majority of people to aim for.
Sleep
What doesn’t sleep affect? It’s amazing how much benefit people are missing out on by all but ignoring good sleep hygiene as a fat-loss tool.
When people are losing body weight but doing so in a sleep restricted state they will lose proportionally less fat and more muscle than people losing the same amount of body weight but without restricting their sleep [13].
Stress
Chronic stress is well accepted as a factor contributing to heart attacks. It’s also being convincingly linked to increased belly fat [14].
Furthermore, coping with stress by drinking sugary drinks full of fructose is an even worse combination. Fructose increases the activity of an enzyme called 11β-HSD1 whose job it is to turn the inactive version cortisone into the active stress hormone cortisol [15].
This probably explains the common association seen between fructose intake and people with metabolic syndrome, a cluster of conditions happening all at once, such as increased risk of heart disease, stroke and type 2 diabetes, with symptoms like high blood pressure, high blood sugars and excess body fat (especially around the waist).
5 fat-loss mistakes on keto
The five main reasons people tend to not lose fat on a ketogenic diet are as follows.
Snacking
The first is pretty understandable: who doesn’t snack at least a little nowadays? Everyone does. So that makes it common, nearly universal, but not necessarily normal. It’s not normal in fact for a highly carnivorous species like humans to continuously graze on little bits of food, in near perpetual digestion.
Humans are adapted to digest and metabolize calorie dense, nutrient dense foods such as beef, salmon or eggs. This is further reflected in our metabolic profile, showing a healthier fat burning state when eating once or twice a day (intermittent-fasting) rather than three or four [16].
You can also fast to really learn to appreciate food and gain insight into your snacking psychology; simply go without food for 16, 24 or more hours. If you can’t, try a fat fast. This low-calorie high-fat temporary measure can help you ease into the real thing, namely water fasting. This is rare in modern times, and simply not eating for a while is a simple, safe experience that can make you realize some basic facts about your behavior around food.
Low quality keto
You can, technically, still do a ketogenic diet with lots of baked almond flour products that have a high inflammatory potential. They’re also dense with delicate oxidized omega 6 oils, which is not generally advisable. Furthermore, you may also be mistakenly consuming unstable inflammatory oils like canola oil, soybean oil and rice bran oil, instead of the healthy stable fats like butter, coconut oil, lard and olive oil.
Low protein and plant-based
People are not typically used to eating adequate amounts of high-quality animal protein on a regular basis. Standard diets focus on starch, sugars and plant protein sources. The latter have a low bioavailability and have skewed amino acid ratios.
It is crucial to rely instead on high-quality animal sources on a daily basis, aiming for at least 1.5 g of protein per kilogram of body weight. That’s quite a few eggs and a respectable rib-eye or a large fillet of salmon, at least…
Mis-counting carbs
Hidden carbs are everywhere, in sauces, in supposedly low-sugar, high-fiber bars, in smoothies, in creamers and in a variety of lower quality processed meats. It’s also easy to get confused:
- Total carbs = indigestible carbs (like fiber) + digestible carbs (like sugar or starch)
- Net carbs = indigestible – digestible carbs
To be on the safe side? Make your net carbs limit your total amount of carbs. This makes you likely to overestimate (rather than underestimate) what your net carbs are.
Not sleeping
What do sleep and diet have to do with fat-loss? Shouldn’t this all be about calories anyways?
Not at all.
Sleep is an essential process your body needs to go through over 7 – 9 hours every 24 hours to maintain the cellular ‘orchestra’ playing in harmonious synchrony. It’s hard to identify a process, tissue or condition not affected by sleep.
Without proper sleep, your body fails to adequately partition food calories to the various tissues in the correct manner, resulting in loss of lean mass, increased fat mass and poor glucose control.
Think of it this way, a comfortable digestion, not being too cold or too hot after meals, not eating too close to bedtime… all of these factors commonly affect one or more of the four pillars of sleep:
- A regular schedule, going to bed at the same time every night
- Depth, quality
- Length, really getting in the hours
- Timing, before midnight and in line with natural light rhythms
Eat well to sleep well. It will be easier to make smart food choices and not fall prey to your cravings when your mind is sharp and well rested, not foggy and short tempered.
You can also use the methods above but do make sure that you see this page on keto diets and supplements to maximize your efforts and get the best results.
Other factors affecting fat-loss on keto?
If you’re not doing resistance training, meaning the lifting weight of some sort, you’re doing your general health a disservice. Resistance training does get you burning calories, but its real value is in increasing your lean mass, which independently contributes to a better composition: a (lower) ratio of fat-to-lean mass. It would also help if you considered adding a dietary supplement like Lactobacillus gasseri into your diet to help your body maintain muscle mass while on a low-calorie diet.
Improving that ratio is known as improving your body composition, which not only makes you look sexy, it’s also good for staying alive longer and with vigor. It also happens to maintain or increase your basal metabolic rate and give you more muscle mass capable of ‘sponging up’ glucose, thus disposing of any carbs you may eat.
Conclusion
Ketogenic diets are excellent tools to lose body fat as they normalize many of the immunometabolic problems that cause our bodies to store fat rather than to efficiently use it as fuel. Furthermore, they lower and normalize appetite to surprising extents when well-formulated with generous intakes of high-quality animal protein.
Despite the fact that ketogenic diets can be formulated in better or worse ways, and that a considerable number of important factors besides macronutrients impact fat-loss, ketogenic diets are a foundational strategy worthy of a try for virtually anyone.
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Written by Raphael Sirtoli MSc in Molecular Biology and currently a neuroscience researcher pursuing a PhD in Health Sciences. He is also the co-founder of Nutrita, the world’s first keto & low-carb food search engine giving a Keto score, Insulin index and Nutrient density score for thousand of foods.