The Ketogenic Diet: A Detailed Guide
In the medical world, where new progress is made every day, obesity is still a big problem worldwide, despite all the technological developments. Excess weight, which forms the basis of chronic diseases such as cardiovascular diseases, diabetes and high blood pressure, arises from the combination of unhealthy eating habits and insufficient activity. Those who want to lose weight try new diet lists that are added every day and try to lose weight quickly. One of the popular slimming methods of recent years is the ketogenic diet, also known as the keto diet. The ketogenic diet, which has a very low carbohydrate and high fat ratio, consists of a special nutrition program that has been proven to have an effect on weight loss and is actually used in the treatment of certain diseases.

CONTENTS
What is the Ketogenic Diet?
If you are trying to lose weight, you may have heard of or even tried diets such as Paleo, South Beach and Atkins, which have low carbohydrate and high protein and fat content. Although these diets are sometimes called keto diets, a real ketogenic nutrition program is quite different from these diets and it may not be very healthy to use it to lose weight. 19. This diet, which was used in the blood sugar regulation of diabetic patients in the 19th century, began to be used in children with epilepsy that could not be treated with medication in the 1920s and was recognized for its positive contribution to the treatment of epilepsy. It has also been proven to be effective against diseases such as cancer, polycystic ovary syndrome and Alzheimer’s. In the 1970s, Atkins, a modified form of the ketogenic diet, took the whole world by storm with its effect on weight loss. The Atkins Diet, which has a higher protein content than the ketogenic diet, is also the starting point of the now popular Paleo, South Beach and Dukan diets[1][2][3].
The working principle of the ketogenic diet is based on the fact that almost 90% of daily calories come from foods containing fat. The remaining 10% consists of protein and carbohydrates. The main energy source for body cells is glucose, which you get from carbohydrate-containing foods. If you deprive cells of glucose-containing nutrients, the body provides the energy it needs from ketones obtained from stored fats. However, it is essential to consume a limited amount of carbohydrates in your diet since your brain only uses glucose as fuel. Your body first uses glucose stored in the liver for its energy needs on the ketogenic diet. It then turns to glucose, which is stored in your muscles as glycogen. At the end of a 3-4 day period, all glucose stores in your body run out and the level of the insulin hormone in the blood decreases. In this case, the liver produces ketone bodies from fat to obtain energy in the absence of glucose. Thus, a decrease in body fat percentage and an increase in weight loss are observed[4][5].
How to Do Ketogenic Diet?

Ketogenic diet types aim to have total daily carbohydrate intake below 50 grams. This amount may decrease to 20 grams on some keto diets. Your daily caloric intake should consist of 70–80% fat, 10–20% protein, and 5–10% carbohydrates on average. In this case, a 2000-calorie diet contains an average of 165 grams of fat, 40 grams of carbohydrates and 75 grams of protein. The most important thing when doing a ketogenic diet is not to consume more protein and carbohydrates than recommended. Otherwise, the body won’t be able to produce energy from fat in a state known as ketosis. If you consume too much protein for example, it turns into glucose with the amino acid in the protein and the body uses the protein as energy. If you are on a ketogenic diet, you should avoid the following carbohydrate-rich foods:
- Sugar and sugary foods (jam, honey, molasses, marmalade)
- Bread and pastries (all grain foods such as pastries, buns, cakes, cookies, cereals, pasta, rice)
- All vegetables containing starch, such as potatoes and corn
- All dried legumes such as beans, chickpeas, kidney beans, green lentils, red lentils and peas.
- All fruits, fruit juices, carbonated drinks, in short, all types of drinks containing sugar and alcohol
- You can consume the following foods on a ketogenic diet that aims for high fat intake:
- Cacao butter, olive oil, coconut oil
- Avocado, walnuts, almonds, peanuts, hazelnuts, Brazil nuts, cashews, sunflower seeds, pumpkin seeds
- Flax seeds, chia seeds
- Lactose-free dairy products, hard cheeses
- Fish species containing omega 3(sardine, mackerel, tuna, herring)
- Red meat, poultry meat such as chicken, turkey, goose
- Egg, bean curd
- Green leafy vegetables such as spinach, chard, parsley, lettuce and dill; non-starchy vegetables such as mushrooms, cucumbers, tomatoes, kale, white cabbage, brussels sprouts, onions, garlic, celery and zucchini.
- Dark chocolate (80% cacao), unsweetened coffee, tea, vinegar, mustard and all other spices, especially black pepper, red pepper, turmeric and ginger
There is no calorie limitation in the ketogenic diet. You should definitely not consume prohibited foods. You should also pay attention to the amount of fat, carbohydrates and protein in order for the body to enter ketosis. You can have the amount of ketone bodies in the blood checked or follow the ketone bodies excreted in the urine with urine strips to understand whether you are in ketosis. There are limited studies on the long-term effects of the ketogenic diet, which facilitates weight loss in the short term, on healthy people. When you reach your target weight, you can control your weight by following an adequate and balanced diet program suitable for you[4][5][6].
What are the Tips of the Ketogenic Diet?

Following a ketogenic diet may be challenging as the carbohydrate and protein content in the nutrition program is quite low. Planning may be necessary to get the body into ketosis. While on a ketogenic diet, you can make your diet easier by considering the following tips:
Prepare to Adapt to the Ketogenic Diet
It takes about 2 weeks for the body to adapt to the ketogenic diet. Minimizing sugar and carbohydrate consumption can cause the body to withdraw. During this process, you may experience symptoms called keto flu that make you feel weak, tired, reluctant and irritable. Get rid of all sugar and starch-containing foods in the kitchen and get yourself recipes suitable for the ketogenic diet. Plan your nutrition program in advance.
Drink Plenty of Water
While on a ketogenic diet, be careful to keep the blood levels of minerals such as magnesium sodium balanced and take supplements if necessary. Since excess water in the body will be removed during the diet, make sure you drink enough water and drink at least 8 glasses of water a day without waiting for thirst.
Don’t Compromise on Nutritional Quality
Being on a ketogenic diet does not mean eating whatever fat or protein you desire. Try to consume healthy oils such as avocado, coconut oil, walnuts, hazelnuts, almonds, olive oil and sunflower oil instead of oils such as margarine.
Be Disciplined
Going on a ketogenic diet can be really challenging, your body may react to drastic changes. After a few weeks of doing it, don’t reward yourself with a sugary drink or favorite foods like pasta. There are no breaks in this nutrition program, if you break your diet your body may go out of ketosis and you may have to start all over again. Do not give up discipline and control.
Exercise
Increasing your physical activity while following a ketogenic diet accelerates the body’s entry into ketosis. Ketone production may increase, especially during training on an empty stomach. Although your exercise performance may decrease when you first start the diet, don’t forget that this situation will improve over time[7][8].
Who Can Do Ketogenic Diet?

The ketogenic diet, which has become one of the favorite nutrition programs of athletes and those who aim to lose weight in recent years, can lead to serious problems such as kidney stone formation, as well as its positive effects on health. Anyone who wishes can follow a ketogenic diet, except for people in the risk group below:
Pregnants
It is recommended that the expectant mother follow an adequate and balanced diet that includes all food groups for the health of both herself and her unborn baby during pregnancy. The ketogenic diet is low in protein and carbohydrates that the expectant mother needs. In the ketogenic diet, which is an extremely restrictive diet, essential vitamins and minerals for the expectant mother are also low in addition to the fiber content.
Vegans
Vegans abstain from eating anything derived from animals and consume a diet high in fruits, vegetables, grains, and legumes. All foods containing carbohydrates are restricted in the ketogenic diet, and if you are vegan, the ketogenic diet is not suitable for you.
People with Digestive Disorders
One of the most common side effects of the ketogenic diet is constipation. Limiting the amount of high-fiber carbohydrates can cause slow bowel movements. You should not follow the ketogenic diet, if you have gastrointestinal problems such as irritable bowel syndrome, chronic constipation, stomach problems.
Those with Kidney Problems
The kidney works harder to remove excess fat from the body in the ketogenic diet program with high fat content. If you have a problem with your kidneys, this diet can put extra pressure on your kidneys and make the existing problem worse[9][10].
What are the Benefits of the Ketogenic Diet?

The most well-known effect of the ketogenic diet is on weight loss. Daily calorie intake may decrease as foods containing sugar and starch are prohibited in the diet. Besides, using fats as energy in the absence of carbohydrates reduces the fat stored in the body. Elevating ketone bodies in the blood can reduce appetite and help speed up metabolism. In addition, other benefits of the ketogenic diet include:
- Consuming foods high in processed and refined sugar negatively affects the balance of intestinal bacteria and the regulation of blood sugar, which can cause acne, especially on the skin. The ketogenic diet may reduce acne formation in some people by restricting carbohydrate intake.
- Choosing healthy fats such as avocado, olive oil, walnuts, hazelnuts, almonds, cashews and coconut oil during the ketogenic diet can help protect cardiovascular health.
- There are many studies showing that ketone bodies produced during the ketogenic diet strengthen and protect brain and nerve cells. A ketogenic diet can help reduce Alzheimer’s symptoms, particularly in those who have the illness[11].
Food List on Ketogenic Diet

The ketogenic diet list is based on low carbohydrate and protein and high fat food choices. It is important that the drinks you drink throughout the day are completely sugar-free. Ketogenic diet example; It should be rich in foods such as green leafy vegetables, eggs, cheese, avocado, fish, olive oil, coconut oil, walnuts, hazelnuts and almonds.
Ketogenic Diet Program Sample
1. Day:
- Breakfast: 2 eggs fried in coconut oil and greens such as parsley and arugula
- Lunch: Cheese, mushrooms and avocado slices on green vegetables
- Dinner: Green beans with chicken sauteed in olive oil
2. Day:
- Breakfast: Mushroom omelet with greens on the side
- Lunch: Tuna salad with celery and tomatoes on green vegetables such as arugula, parsley, dill, lettuce
- Dinner: Fried chicken with cream sauce and boiled broccoli with olive oil and garlic
3. Day:
- Breakfast: Omelette in olive oil prepared with cheese and parsley and 2 eggs
- Lunch: Boiled turkey, avocado and arugula salad with cheese and olive oil
- Dinner: Salmon with spinach sautéed in sesame oil[12].
References
- 1. https://pubmed.ncbi.nlm.nih.gov/30877806/
- 2. https://pubmed.ncbi.nlm.nih.gov/30867113/
- 3. https://pubmed.ncbi.nlm.nih.gov/30859652/
- 4. https://www.health.harvard.edu/staying-healthy/should-you-try-the-keto-diet
- 5. https://www.hsph.harvard.edu/nutritionsource/healthy-weight/diet-reviews/ketogenic-diet/
- 6. https://www.healthline.com/nutrition/ketogenic-diet-101#weight-loss
- 7. https://www.healthline.com/nutrition/7-tips-to-get-into-ketosis#1.-Minimize-your-carb-consumption
- 8. https://howtothisandthat.com/keto-diet-tips-6-must-know/
- 9. https://wellversed.in/blogs/articles/who-should-not-follow-a-keto-diet
- 10. https://timesofindia.indiatimes.com/life-style/health-fitness/diet/
- 11. https://www.medicalnewstoday.com/articles/319196#7-improves-pcos-symptoms
- 12. https://www.healthline.com/nutrition/keto-diet-meal-plan-and-menu#sample-menu
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