Ketogenic diet: pros and cons

Ketogenic diet: pros and cons

You know, fashions come and go and new ones are continually created.

In the food and dietary field, however, this is a problem: interest shifts cyclically on this or that diet, on one nutrient rather than another, or on a food that is initially considered ” good ”, then“ bad ”and then again“ good ”.

Other times concepts of clinical dietetics, used in specific illness situations, are translated into generic indications that anyone could decide to follow in an arbitrary way.

This last case is a bit like the ketogenic diet or keto diet (from the English keto diet ): although many people are currently practicing it as a “diet of the moment”, it is a dietary protocol originally created and applied for very specific reasons (not those that most people think).

What is the ketogenic diet and what are the scientific assumptions

Ketogenic or simply “keto” is a diet low in carbohydrates and high in fat, inserted in a certain ratio with proteins.

Normally the body produces energy from glucose, which it obtains from simple and complex carbohydrates introduced with our diet.

However, when we decide to drastically cut the introduction of carbohydrates, our body will be forced to use other sources, in this case proteins and fats.

The use of fats as an energy source is not an immediate and linear mechanism, but if the ketogenic diet is well conducted, the body will begin to use them to produce ketone bodies and will enter a state called “ketosis” .

This type of diet was born in the 1920s (and is still used today) for the treatment of drug-resistant epileptic subjects, i.e. those people who, despite the use of drugs, continue to have convulsions, especially in children .

It also appears to have some benefit in neurodegenerative diseases such as Alzheimer’s disease and Parkinson’s disease, but although individual studies have shown some positive effects, some objections have been raised regarding gastrointestinal symptoms. , the reduced sense of hunger and the low attractiveness of this diet from the organoleptic point of view derive facts that could worsen the risk of malnutrition of such people.

In short, it was not born as a diet to lose weight.

However, the ketogenic diet has also found use in this sense, again in the clinical setting, but with the variant of a substantial caloric reduction.

It is called Very Low Calorie Ketogenic Diet (VLCKD) and is an option used for the loss of a lot of weight in a short period of time, which is necessary for example in the case of surgery bariatric.

VLCKD is supported as an effective strategy in the management of overweight and obesity and appears to lead to weight losses that remain stable over time, as well as other positive effects such as the reduction of BMI, waist circumference, glycated hemoglobin, total cholesterol, triglycerides and blood pressure.

How it induces weight loss

Given the conditions, it is easy to understand why the principles of this diet have been transferred to “common life”: many in fact use them to lose weight, even if not always in a consistent way.

As we said, the process is not immediate and is extremely variable depending on the person.

When you eat drastically reduced amounts of carbohydrates, say around 20 to 50 grams per day, your body quickly runs out of the fuel it usually uses, both the glucose present in the blood and the glycogen stores, i.e. the glucose stored in the liver and muscles.

Generally after 3 or 4 days of regimen you enter ketosis, with the body that begins to break down proteins and fats and produces ketone bodies : this metabolic shift induces a change in the organism and a resulting in weight loss .

A ketogenic diet is consequently high in protein and fat and typically includes lots of fresh and processed meats, eggs, cheeses, fish, nuts, butter, oils, seeds and fibrous vegetables.

The downside is that it is restrictive and difficult to follow in the long run , as carbohydrates normally make up at least 50% of the typical Western diet.

A ketogenic meal plan may also require the use of very expensive supplements and meal replacements: are you sure it is extremely necessary in your case?

If the answer is yes, however, rely on an experienced nutrition professional to follow you precisely and on time.

What can you eat on the ketogenic diet

The goal of the keto diet is to reach a weight goal by decreasing your carbohydrate intake, increasing your fat intake by adding protein. The final goal is within reach as the few sugars introduced, especially in the context of a sedentary or almost sedentary lifestyle, will not be converted into fat reserves. It is a subtle balance. Here, however, a non-exhaustive list of foods that are typically part of the ketogenic diet.

Low-sugar vegetables

Vegetables are rightly praised for their intake of fiber, vitamins and minerals and should be part of the daily diet, being one of the main foods. The point is, however, that many are unaware that vegetables contain a lot of sugar. Which should lead us to eliminate all unnecessary.

Rocket, spinach, cauliflower, courgettes, broccoli, celery, Brussels sprouts (read about the properties of crucifers).


Eggs are an excellent nutritional meal because they provide a mix of proteins and fats to be consumed both in breakfast and during regular meals. I have already talked about the benefits of eggs and why they should not be demonized in “Benefits and nutritional properties of eggs”, which I invite you to read.

Quality meats

The keto diet emphasizes the consumption of meat as it is rich in protein and fat. You have to be careful how you cook it, I have elsewhere stressed the importance of cooking food at a low temperature, ideal for keeping the nutritional values ​​intact and keeping the food intact. You can choose between beef, turkey and chicken. Less frequently the pig. Avoid industrial preparations and cured meats (they can be fine from time to time, but should not be mistaken for “meat”).

Dairy products

Italy is a country that has a rich tradition of regionally-based cheeses, known throughout the world, derived from both cow’s and sheep’s milk. Milk production is also important and there are high quality pastures that provide nutritious and healthy products. Dairy products should not be consumed in excess, but in the ketogenic meal plan they help provide the right mix of fats and proteins. It is also known that they are rich in minerals important for development. I have already mentioned butter above.

Not just cheese, fruit-flavored yogurt is a good breakfast meal and the basis for half-day snacks made with protein-rich seeds.

Not too sweet fruit

Fruit is rich in sugars so you should never overdo it regardless, even if it must be part of a balanced diet. Fruits with a lower glycemic index are wild berries (blueberries, mire and raspberries) which alternate with strawberries, kiwis and clementines. Better if in season. In general, however, those on a strict keto diet tend to avoid fruit .

Coffee and dark chocolate

Dark chocolate is known for its more bitter and less inviting taste than milk, but it can still satisfy the sweet tooth. Always without exaggerating.

Unsweetened drinks such as tea and coffee.


Rich in protein and good fats, fish can be eaten in many variations. The most nutritious meats are those of the Salmonidae family, tuna and all blue fish (mackerel, sardines, herring, anchovies).

Vegetable oils

Oil of vegetable origin is very present in our kitchen. A real cure-all is extra virgin olive oil of Mediterranean origin, to be used as a condiment. Also used seed oil.

Use unsweetened condiments to enrich dishes.

Because it can’t fit in the long run

Although the Italian Standards for the Treatment of Obesity also indicate ketogenic diets as effective in short-term weight loss (within 3-6 months), they specify that they do not show any net long-term advantage over diets with controlled carbohydrate content.

For this reason, in addition to the fact that very low carbohydrate diets may not be sustainable for the medium to long term, they recommend the use of ketogenic diets only in the short term., favoring in fact moderate carbohydrate intakes even in the treatment of overweight and obesity. An extraordinary and not ordinary intervention (ie weight maintenance).

One thing not to be underestimated in the implementation of this type of regimen are the side effects , especially at the beginning: the most common are usually not serious and can include headaches, weakness , irritability, bad breath, fatigue, constipation, nausea, vomiting and sleep problems.

There are some situations where this diet is contraindicated , such as pregnancy, medication, diabetes or kidney problems, where it could cause serious health problems.

Like any diet that involves restrictive behaviors, ketogenic can induce the onset of eating disorders, given that the absence of carbohydrates drives us to feed the desire to eat and then translate into unmanageable binges.

One of the main criticisms of this diet is that many people, in an attempt to self-manage it, tend to eat too much protein and poor quality fats from processed foods, with very little fruit and vegetables.

It is also important to note that the ketogenic diet focuses only on immediate weight loss and does not provide any basis for a balanced diet and any health benefits (essentially: eating better in balanced way based on a healthy diet).

Importance of the role of carbohydrates

I have often spoken of the importance of introducing the right amount and quality of carbohydrates in the diet, also depending on the level of physical activity and training practiced every day.

In the article on the importance of carbohydrates I will explain how to distinguish the various types of carbohydrates, what effects they have on your metabolism and how to best introduce them into your eating day.

The basic rules, however, can be summarized as follows:

  • add a portion of complex carbohydrates to each meal;
  • prefer whole grains, rich in beneficial fibers;
  • limit refined grains;
  • avoid the simple sugars of processed products as much as possible.

To feel good, you don’t have to engage in complicated diets. The more risk you want to take, the more medical advice you need. In the medium to long term you are interested in a balanced diet that allows you to eliminate superfluous fat, maintain lean mass and promote psychophysical well-being (which a life giving up could put in crisis).

The functioning of the body follows precise scientific rules, although the effects vary from person to person.

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