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Wellness

Supplements to Consider When on the KETO diet

December 7 2018

By Eric Madrid, MD

The Ketogenic, or Keto, diet has become quite popular over the last several years. Many have experienced significant weight loss by adopting this eating style. The main premise of the Keto diet is that a person should consume 60 percent fat, 35 percent protein, and around 5 percent carbohydrates—in other words, it is primarily a plan high in healthy fats, moderate in protein and low in carbohydrates. The Keto diet recommends keeping carbs (which turn into sugar) to less than 50 grams ( or 20-25 net carbs) per day.

The Keto diet has not always been used for weight loss. The diet has its origins in the treatment of drug-resistant seizures—it was observed as far back as the 1920s that children with seizures who did not respond to the limited drugs available for the condition at the time, would respond favorably to a ketogenic diet. It is still used today for those with medication-resistant seizures with notable success. It was noted that those use started the ketogenic diet for seizure control also experienced weight loss. For this reason, its use expanded to those trying to drop the extra weight.

While many have found success with the Ketogenic diet, there is also a lot of confusion around this way of eating. As with any diet, consult with your physician prior to starting to make sure it’s right for you. Additionally, those who practice Keto need to stay hydrated as constipation frequently occurs—some have also reported fatigue and menstrual irregularities. However, others report feeling more energized, especially as excess weight begins to fall off.

Examples of Foods Allowed on the Keto Diet

  • Non-starchy vegetables, such as broccoli, cabbage, cucumber, kale, arugula, garlic, jalapeno, spinach
  • Low-sugar fruit: avocados, blueberries, strawberries, raspberries, cherries
  • Seafood:  bass, crab, salmon, tilapia, tuna
  • Poultry: chicken, turkey
  • Meat: beef, pork, veal
  • Dairy: almond milk, coconut milk, cheeses, Greek yogurt (unsweetened)

How We Process Sugar

The body’s cells use sugar (glucose) as their main energy source. However, sugar comes in multiple forms, and many people do not realize how much they actually consume on a daily basis, which may be more than the body needs or can manage. When the body is at capacity, it will immediately store excess sugar in the liver and muscles in the form of glycogen.

The human body can store a 24-to-72-hour supply of glycogen, allowing sugar to be available in the event one is hungry and needs a quick source of sugar. It provides an evolutionary advantage, allowing humans to survive during times of starvation. However, when starvation doesn’t occur, and a person consumes more sugar than the body can store, it will begin to convert it into fatty acids, which are then stored as fat. This excessive fat storage can lead to obesity, which has reached epidemic levels in many countries, including Russia, The United States, and Europe, and is now more prevalent than ever worldwide.  

It’s important to read food labels because sugar can be listed under various names. Keep in mind that the following are all “code” terms for sugar:

  • Brown sugar
  • Corn sweetener
  • Corn syrup
  • Fruit juice concentrate
  • High-fructose corn syrup
  • Honey
  • Molasses
  • Raw sugar
  • Sugar molecules ending in “ose”, such as dextrose, glucose, lactose, maltose, fructose and sucrose.

How the Keto Diet Works

The Ketogenic diet’s low carbohydrate and sugar intake cause ketone production in the liver, which results in the burning of fat tissue. The body is essentially tricked into thinking it’s starving and will use up all the liver’s glycogen stores in one to three days. Once that’s used up, the body goes into a state of ketosis and starts to degrade fat tissue for energy.

The main ketones formed by the body are β-hydroxybutyrate and acetoacetate. These molecules are then taken up by the body’s organs, muscles, and brain, where they enter the cells and are then used by the cells’ “powerhouses”, or mitochondria, to generate energy.

As long as a person continues to minimize carbohydrate intake to less than 50 grams per day (20-25 net carbs)  and stays physically active, he or she will remain in ketosis. If sugar or carbohydrates over the allotted amountare consumed, or if activity levels are reduced,  liver glycogen stores will be renewed, and fat burning will cease.

Total Carbohydrates (grams) – Dietary Fiber (grams) =   Net Carbs (grams)

Foods and Supplements to Help Support Those on the Ketogenic Diet

Nuts

There are many types of nuts, each containing a variety of different vitamins and minerals. Due to their high concentration of essential fatty acids, they are an excellent source of healthy fats and protein. Along with their cardiovascular and brain benefits, they are also an excellent snack to help ward off cravings.

Seeds

  • Chia Seeds: an excellent source of protein and omega-3 fatty acids and have been shown to have numerous health benefits. They may work well for those who want to lose weight as they appear to also help lower blood sugar. In fact, a 2010 study in the European Journal of Clinical Nutrition showed that chia seeds could help lower blood sugar and blood pressure in those with diabetes. A 2017 study showed that chia seeds, added to yogurt, could help improve satiety.
  • Hemp seeds:  an excellent source of nutrition that has been consumed for thousands of years. Adding hemp seeds to one’s diet is important, especially when on the Ketogenic diet. The seeds come from the same plant which produces marijuana, however, the seeds have little to no THC, the psychoactive ingredient in the marijuana plant. Hemp seeds contain over 30 percent fat and are rich in the omega 3 fatty acid, alpha-linolenic acid, and the healthy omega-6 linoleic acid.  According to studies, hemp seed also contains the important gamma-linolenic acid (GLA), which has vascular health benefits. They are also an excellent source of protein, and many add them to smoothies, salads and keto-bomb snacks.

Supplements

  • Multivitamin – On June 19, 2002, a study in the Journal of the American Medical Association recommended that all adults take a multivitamin. Additional assurance that the body is getting what it needs, a quality multivitamin provides extra nutrients when one eats a restrictive diet such as Keto and/or practices intermittent fasting.  Crucial for those on a ketogenic diet. Recommended dose: As recommended on the label
  • Raspberry Ketones – Some studies show that raspberry ketones can encourage fat burning while other studies using animal models show that they help prevent a fatty liver from forming when supplemented. In a 2013 study in Journal of the International Society of Sports Nutrition, those who took a supplement containing raspberry ketones (along with other herbal ingredients) demonstrated more weight loss than those who received a placebo. More studies are needed.
  • Whey Protein – A common supplement used by those who exercise routinely, whey protein is frequently used as a meal replacement by those trying to maintain or lose weight. Derived from cow's milk, it is also a popular source of protein among individuals attempting to build muscle. A whey protein shake can be used as a meal replacement for those on the Keto diet. Recommended dose: As recommended on the label
  • Pea Protein – A pea protein, meal replacement shake or plant-based protein powder should also be considered by those following a keto diet. Pea protein is advised for those who avoid dairy, like those who follow a vegan diet. One serving has less than one gram of carbohydrates. Recommended dose: As recommended on the label
  • Magnesium – This macro-mineral should be taken if muscle cramps develop during the diet. Magnesium chelate (magnesium aspartate, magnesium citrate, magnesium malate) should be considered and taken daily—125mg to 500 mg.  Since constipation is common for those on a Keto diet, magnesium use can help keep bowel movements regular.

Medium Chain Triglycerides

  • Medium Chain Triglycerides (MCTs) - can also play an important role for those trying to lose weight. Many on a ketogenic diet supplement with MCTs, which are used for energy and are less likely than regular long-chain triglycerides to be stored as fat. A 2015 study showed that MCTs could modestly help reduce body weight in those who consume them. In addition, there was no elevation in blood cholesterol levels. They can be taken by the teaspoon or simply added to smoothies. Suggest dose: as directed on the label.
  • Coconut Oil – This is one of most popular MCTs and is frequently used for its brain-health benefits and to help with weight loss. A 2009 study showed consumption for 12 weeks resulted in reduced weight around the waist. Coconut oil is an excellent option when cooking at low, medium, or high temperatures.
  • Protein Bars – Protein bars are an excellent snack or meal replacement for those on a Keto diet.  Ensuring they are low in net carbs is important to make sure to stay below your daily carbohydrate goal.

References:

  1. Trans-Resveratrol Content in Commercial Peanuts and Peanut Products Victor S. Sobolev* and Richard J. Cole Journal of Agricultural and Food Chemistry 1999 47 (4), 1435-1439 DOI: 10.1021/jf9809885
  2. Eur J Clin Nutr. 2010 Apr;64(4):436-8. doi: 10.1038/ejcn.2009.159. Epub 2010 Jan 20.
  3. Ayaz A, Akyol A, Inan-Eroglu E, Kabasakal Cetin A, Samur G, Akbiyik F. Chia seed (Salvia Hispanica L.) added yogurt reduces short-term food intake and increases satiety: randomized controlled trial. Nutrition Research and Practice. 2017;11(5):412-418. doi:10.4162/nrp.2017.11.5.412.
  4. Callaway, J.C. Euphytica (2004) 140: 65. https://doi.org/10.1007/s10681-004-4811-6
  5. Fletcher RH, Fairfield KM. Vitamins for Chronic Disease Prevention in Adults Clinical Applications. JAMA.2002;287(23):3127–3129. doi:10.1001/jama.287.23.3127
  6. Accessed October 5, 2018  https://pdfs.semanticscholar.org/4ac3/2d4f4fbb87e512b990d17b3b09cf6e74ae1e.pdf
  7. Wang L, Meng X, Zhang F. Raspberry Ketone Protects Rats Fed High-Fat Diets Against Nonalcoholic Steatohepatitis. Journal of Medicinal Food. 2012;15(5):495-503. doi:10.1089/jmf.2011.1717.
  8. Lopez HL, Ziegenfuss TN, Hofheins JE, et al. Eight weeks of supplementation with a multi-ingredient weight loss product enhances body composition, reduces hip and waist girth, and increases energy levels in overweight men and women. Journal of the International Society of Sports Nutrition. 2013;10:22. doi:10.1186/1550-2783-10-22.
  9. J Acad Nutr Diet. 2015 Feb;115(2):249-63. doi: 10.1016/j.jand.2014.10.022.
  10. Lipids. 2009 Jul;44(7):593-601. doi: 10.1007/s11745-009-3306-6. Epub 2009 May 13.

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