1. What is the ketogenic diet?
Low in carbohydrates with moderate protein and high in fat, a ketogenic diet prompts the body to burn fat for energy rather than glucose, which leads to the production of ketone bodies—molecules that can be used as a source of fuel. A typical ketogenic diet consists of ~70% fat, 20% protein, and 10% carbohydrates. Though this can vary slightly depending on the individual, this diet is specifically designed to induce nutritional ketosis.
2. What is ketosis?
When ketone bodies accumulate in the bloodstream (>0.5 mmol/L) due to low glucose availability, they cause a metabolic state called ketosis. The most efficient approach to induce nutritional ketosis is to lower dietary carbohydrate intake while increasing fat intake. This reduction in carbohydrate intake helps the body shift toward a state that promotes the breakdown of fats (from the diet and your body) to produce ketone bodies and enter ketosis.
3. How does the ketogenic diet differ from a paleo diet, Mediterranean, Atkins?
One diet does not fit all—the best diet is the one that you can stick with for long-term. As a lifestyle modification, it should be closely monitored and modified as needed.
4. What is intermittent fasting? How is this beneficial for someone on ketogenic diet?
Intermittent fasting (IF) limits the eating window to just a few hours a day. However, during this window, one simply eats to feel full. This practice allows the body to increase the amount of food intake at one time, and induce adaptive metabolic changes. There are many different variations of intermittent fasting,and many different reasons for doing so. Some people may experience mental clarity and focus as well as using intermittent fasting to get over a plateau.
5. What are ketones? How are they produced?
Ketone bodies production in the liver is a natural process when the body increases the use of fat as the main source of fuel. This occurs during a fasting state and/or prolonged exercise, or when dietary carbohydrates are very low. There are three endogenous ketone bodies. These are acetone, acetoacetate and beta-hydroxybutyrate (βHB).
When following a ketogenic diet, your brain, as well as other organs and tissues, depend on ketones as an energy source. Ketones can be measured in the blood, breath and urine, and measuring can be helpful when following a ketogenic diet or program to ensure that the desired level of ketosis is reached and maintained.
6. What is keto-adaptation? How long does it take to adapt?
Keto-adaptation is the process the body goes through during the ketogenic diet as it switches to using fat as an energy source rather than glucose. The length of time varies for individuals, but typically starts a few days after being on a ketogenic diet. Within a week to two weeks, many people report positive effects of keto-adaptation, and studies have shown that signs of keto-adaptation (such as increase in fat oxidation) occur within this time-frame.
7. What are exogenous ketones vs. endogenous ketones? Are there benefits to taking exogenous ketones?
Exogenous ketones are ketone bodies in either mineral or ester forms that can be ingested as a nutritional supplement, producing acute elevations in circulating ketone levels. Nutritional ketosis resulting from adherence to a ketogenic diet is often referred to as endogenous ketosis in contrast to peripheral ketosis induced by supplementation, referred to as exogenous ketosis.
8. Which patients or individuals would be excluded or not advised to follow a ketogenic diet?
While the ketogenic program can benefit a wide array of patients, it may not be suitable for patients with possible inborn metabolic disorders (CPTI or II deficiency; β-oxidation defects [LCAD, MCAD, SCAD]; and pyruvate carboxylase deficiency). Caution should also be used in patients with the following conditions:
Depending on the health goals, the practitioner may recommend a specific time period for the patient to be on the ketogenic diet. There are many people and cultures that go into ketosis and stay there for a long period of time without any negative effects.
10. Can someone just dabble in keto for a few days/weeks? Can they still get benefits?
While there is evidence to support the long-term use of ketogenic diets without serious side effects, there are also benefits to just doing a cyclical ketogenic diet. We encourage patients to stay on the ketogenic program for a period of 6-12 weeks as it takes some time for the body to be “keto-adapted” and for them to start seeing results.
11. During the keto-adaptation process, which noticeable changes are expected and what is the “keto flu”?
During the keto-adaptation process, many people may experience symptoms of the “keto flu”. These symptoms occur because the body, being used to utilizing carbohydrates as main source of energy, is going through a metabolic shift to burn fat instead. Some people describe this as a feeling of withdrawal. Symptoms one may experience include feeling drowsy, achy, nauseous, dizzy, and irritable. Some may even experience cramping, stomach pains, and muscle soreness.
12. How long do these symptoms last?
It varies for the individual, but the keto flu lasts typically a week or less for the average person and not everyone experiences the keto flu. However, below are some anecdotal ways to mitigate symptoms of the keto flu. Increase electrolyte intake, but avoid those electrolyte sports drinks with high sugar.
Ketones can be measured in a variety of ways via a breath meter, urine strips, or a blood meter. The blood meter is the most accurate way to measure the levels of ketones (primarily βHB) in the body. However, this method is more invasive than others, and can also be significantly more expensive. Your healthcare practitioner can advise you on commercially available blood meters to test ketone levels by looking at circulating levels of βHB measured in millimolar (mmol/L) units.
14. What levels should be achieved (millimolars)?
While variable among individuals, βHB ranges >0.5mmol are considered the beginning of the range of nutritional ketosis and a range at which clinical benefits (for example to body weight management) have been described. Work is ongoing to understand the optimal range of circulating ketones for different outcomes.
15. Why is it important to incorporate as we age?
The healthy young brain relies solely on glucose to obtain energy for its functional and structural needs. During healthy aging, brain glucose uptake is 10-15% lower and can be up to 35% lower in certain brain areas in neurological disorders such as Alzheimer’s Disease. In contrast, brain uptake of ketones appears to still be normal in the brains of Alzheimer’s disease patients. A common misconception is that the brain can only use glucose. Ketone bodies are the only alternative source of energy for the brain as it cannot utilize free fatty acids (FFAs). Both rodent and human studies have shown increase uptake of ketone bodies by the brain following peripheral infusion of ketones, prolonged fasting, or a ketogenic diet. They observed that up to 70% of brain’s energy demands were provided by ketone bodies available in circulation (blood) and taken up by the brain.
16. Why is it used for weight loss?
Ketogenic diets that are rich in fat and low in carbohydrate induce a decrease in blood sugar and insulin levels. A reduction of circulating insulin levels causes an increase in the metabolism of fatty acids (increased lipolysis-the breakdown of lipids) from adipose tissues for utilization as energy. The liver uses FFA derived from dietary source and release from adipose tissue to oxidize and generate ketone bodies in order to meet the energy demand. Ketone bodies in circulation provide a stable source of fuel for the body and the brain, thereby sparing the need to break down muscle protein into glucose as energy supplies. A ketogenic diet encourages the burning of body fat as fuel, as well as inducing satiety between meals. Additionally, a ketogenic diet may help suppress appetite and reduce cravings.
17. Why is it used to prevent cognitive decline?
With a ketogenic diet, the brain utilizes ketone bodies instead of glucose as its primary fuel source. This switch can help encourage more nerve growth factors and synaptic connections between brain cells, and result in increased mental alertness, sharper focus, and improved cognitive capabilities.
18. Why is it used for diabetes?
Studies have shown that low-carbohydrate diets help support insulin metabolism in the body. This is because the absence of carbohydrates in the diet can reduce circulating insulin concentrations and contribute to glucose control.
19. Will this affect cholesterol? Isn’t this diet is too high in fat for weight loss or CVD patients?
The ketogenic diet, as many diets, can positively influence body weight and cardiometabolic health and potentially improve dyslipidemia. Ketogenic diets are by design high in fat, and the type of fat is an important consideration as is the overall quality of the foods eaten within the diet. In terms of cholesterol levels, although there are studies to show that total cholesterol and total LDL cholesterol may increase on a ketogenic diets, more detailed analysis of cholesterol profile has shown the following:
20. Why do athletes use it?
Low-carbohydrate, high-fat and ketogenic diets are increasingly adopted by athletes for body composition and sports performance enhancements. There is not one diet that fits all or perhaps most. The literature on ketogenic diets in athletes is limited but variable with some studies showing no negative impact and others suggesting that a ketogenic approach may not be ideal. As the science evolves in this area, current thinking is that the health status of the individual athlete and type of exercise (endurance vs high intensity) they are performing is important. For example, a ketogenic approach has been discussed as being beneficial for those participating in endurance activities, or for those who need to increase power-to-weight ratio, however specific studies in these areas are currently lacking.
21. Isn’t glucose needed for energy for workouts?
Carbohydrates only go so far to sustain energy throughout the day, and especially during a workout. In ketosis, your body uses fat as fuel instead of glucose, to provide the brain with a consistent supply of the ketone bodies necessary to sustain physical performance.
22. Isn’t this diet too low in protein for my patients with sarcopenia or who are athletic?
Studies show that low carbohydrate ketogenic diet is effective in body weight reduction without inducing lean body mass loss, preventing the risk of sarcopenia. Consumption of approximately 25–30 grams of high-quality protein per meal maximally is recommended to stimulate muscle protein synthesis and slow sarcopenic muscle loss.
23. Doesn’t the brain need glucose to function?
A common misconception is that the brain can only use glucose. Ketone bodies are the only alternative source of energy for the brain as it cannot utilize FFAs. Both rodent and human studies have shown increase uptake of ketone bodies by the brain following peripheral infusion of ketones, prolonged fasting, or a ketogenic diet. They observed that up to 70% of the brain’s energy demands can be provided by ketone bodies available in circulation (blood) and taken up by the brain.
24. Will insulin resistant patients need to be on this diet the rest of their lives?
Modifying lifestyle behaviour including weight-loss and exercise are considered to be methods in restoring the ability of tissues to properly respond to insulin. Although a ketogenic diet with low carbohydrate intake can effectively improve insulin sensitivity, the duration of diet for which these patients should be on is of healthcare practitioner’s decision. As the patient makes other important diet and lifestyle changes and maintains these healthy behaviours, it may be possible to re-introduce dietary carbohydrates (with a focus on lower glycemic index/load sources) which may be tolerated with improved insulin sensitivity.
25. Isn’t this diet too acidic?
Diabetic ketoacidosis happens when extremely high levels of ketone bodies are presented in the blood (normally > 5 mM). Therefore, the blood can turn more acidic. However, during nutritional ketosis you might experience a small, transient decrease in serum bicarbonate in conjunction with mild ketosis which can be minimized by increasing electrolyte intake. Hence the need for following this dietary approach under the supervision of a healthcare practitioner and for periodic monitoring of biological parameters is recommended.
26. Do I have to restrict calories on the ketogenic diet in order to lose weight or just follow the macronutrient plan? What about if I am not trying to lose weight but just want to follow the keto diet?
A caloric deficit will allow your body to mobilize stored fat deposits for energy utilization. If weight loss is not a goal, there is no need for caloric deficit and you can still get the benefits associated with the keto-adapted state of nutritional ketosis.
27. I can’t recommend this diet because less than 25g of CHO’s would be impossible for my patients to adhere to.
The exact amount of carbohydrate intake to reach nutritional ketosis requires an individual assessment as several parameters need to be taken into account (gender, age, physical activity, insulin sensitivity, among others). Hence, the need for following this dietary approach under the supervision of a healthcare practitioner and for periodic monitoring of biological parameters (see question 19) is recommended. A carbohydrate intake of less than but close to 50 grams per day is acceptable for some individuals to reach a state of nutritional ketosis.
28. How do I count the carbs allowed per day? Are fibre included – do these count towards the total carbs allowed per day?
When following a ketogenic diet, it is important to consider the individual when determining the total amount of carbohydrates per day. Several factors will influence the ‘carb tolerance’ of an individual, such as gender, age, physical activity and insulin sensitivity among others. As a general recommendation, you will want to start with total carbohydrates intake below 50 grams per day. This number can be reassessed after the first two weeks to optimize your individual threshold for carbohydrate intake and maximize the benefits from reaching a state of keto-adaptation.
Please let us know if we can provide any further information
The Amipro | Metagenics Team
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You can’t beat the “meal in a cup” convenience of a smoothie or shake. A smoothie or a shake also provides built-in portion control, which can be so helpful. However, whether it’s Instagram-ready or a basic powder-water combo, your beverage should do more than just fill you up on the way out the door. So check out these seven smoothie upgrades—and become a shake master in the process.
About Maribeth EvezichMaribeth Evezich, MS, RD is a functional nutrition and therapeutic lifestyle consultant. Maribeth is also a graduate of Bastyr University and the Natural Gourmet Institute. Whether she is in her kitchen experimenting, at her computer researching, or behind the lens of her camera, she is on a mission to inspire others to love whole foods. as much as she does. She lives in Seattle and is the founder of Lifestyle Medicine Consulting, LLC and the culinary nutrition blog, Whole Foods Explorer. Maribeth Evezich is a paid consultant and guest writer for Metagenics.
The holidays involve taking time off work, travelling to see family, and picking out thoughtful gifts. For many, the final months of the year also require careful planning to stay in shape. According to a number of studies, including research from The New England Journal of Medicine, the average person gains one to two pounds between Thanksgiving and New Year’s Day.1
Fortunately, awareness and creativity will help you keep the momentum going on your fitness regimen. Consider the following workout tips to stay in shape over the holidays.
1: Make the airport your personal gym.Occupy your time at the airport by taking a long walk through the terminal. Use your phone to keep track of your steps—the ground you can cover may surprise you!
Engaging in light activity even for five minutes helps to increase your blood flow and heart rate, so make use of long wait times at the airport by pacing around at the gate. You can log thousands of steps before you board your plane. Celebrate the holidays in style by keeping active amid the chaos of air travel.
2: Stretch in your seat on the plane or in the car.Research reveals that you burn up to 30% more calories standing up than when you’re seated.2 If you’ve booked a long flight for the holidays, you probably know that getting up to stretch your legs isn’t always feasible. (The same goes for driving. While you should plan to stop at a gas station and get your blood flowing every few hours, extenuating circumstances—say, an impending December blizzard—might make this difficult.)
However, you can still stretch during transit. Does this sound counter intuitive? It’s actually quite simple. If you are seated in a small space, there are plenty of ways you can work your muscles. Consider the following exercises:
Go into this knowing that parking far is your choice. Those extra steps will add up, and the fresh air will do you good. Another benefit of parking far from the entrance is that you will no longer need to stress about snagging the perfect space.
4: Take advantage of slow times at the office.If your workload is lighter during the holidays, enjoy your downtime at the office. Step outside every few hours to stretch your legs and recharge. Go for a long walk during your lunch break. You could even encourage your colleagues to bundle up and join you for a walking meeting. This time of year is ideal for building healthy habits on the job.
5: Register for a holiday race.From Turkey Trots to Reindeer Runs, there is no shortage of 5 km and 10 km races around the holidays. Take your workout routine to the next level by registering for your local Jingle Bell Jog. There’s no need to fret if you’re not in running shape—many people sign up for these events with the aim of simply getting in the holiday spirit, and they still manage to break a sweat by walking the course.
These tips will help you maintain a workout routine during the holidays. In addition to working out regularly, make sure to relax and get enough sleep during this busy time of year.
You probably know about probiotics. They’re the tiny, “friendly” bugs that support a balanced and healthy gut. What you may not know is that their benefits go well beyond gut health!*
Your body is full of both good and bad bacteria, and when this delicate bacterial balance is out of whack, probiotics may be your most powerful ally to help restore your intestinal ecosystem.*
Before adding a probiotic to your daily routine, it’s important to consider the following factors:
With all the benefits probiotics have to offer, there are many reasons to consider probiotic supplementation. Talk to your healthcare practitioner today about which probiotic formula may be best for you.
*These statements have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure, or prevent any disease.
What’s Eating You?
Feeling overly tired, bloated, or achy? When dealing with these often stress-related concerns, there are a few questions you should ask yourself: Am I eating well? Am I getting enough sleep? Do I drink enough water and get enough exercise?
A healthy body handles daily stress better while an unhealthy lifestyle and daily stress can contribute to a deeper issue—chronic inflammation.
Inflammation is the body’s natural response to fighting off potential health threats, but unhealthy lifestyle choices can stunt the resolution of your immune response. In fact, chronic low-grade inflammation is often related to common chronic illnesses. But here’s the good news: There are a few ways you can help resolve your body’s inflammation response—starting today!
1. Ditch That Diet
Unfortunately, many of us do not receive our fair share of nutrients from food. You may feel tired and overworked, and rather than taking the time to prepare a healthy, well-balanced meal, you may often resort to convenient inflammatory trigger foods that are lacking in nutrients: refined starches, high-fat and processed red meats, fried foods, dairy, etc. These may cause an activation of the innate immune system and lead to excessive production of pro-inflammatory cytokines.
It’s time to break the cycle by incorporating anti-inflammatory foods into your day. A Mediterranean-style diet, for example, typically has a high ratio of monounsaturated fatty acids as compared to saturated fats, and more omega-3 to omega-6 polyunsaturated fatty acids. It’s also rich in fresh fruits, vegetables, legumes, and whole grains, which have shown anti-inflammatory effects in observational and intervention studies.
2. Stay Hydrated
This one is obvious. It’s always important to drink enough water throughout the day and ensure you are properly hydrated. Water makes up a large percentage of our bodies to keep all our physiological systems working together smoothly, and it helps flush out toxins and unwanted chemicals we may pick up from the environment.
Tip: Bored with plain water? Add in fresh fruit slices to liven up your H2O. Antioxidant-packed green tea is also great for afternoon sipping.
3. Put Stress to Rest
In our fast-paced modern culture, you may find yourself working too much and not getting enough rest. The initial stress response can be positive, but when left unchecked, it can lead to chronic stress and become pro-inflammatory. This is when getting extra sleep, practising yoga, or taking on leisurely activities you love can make a world of difference.
Catching those Zs at night is especially important because it’s your body’s time to rest and recharge. Lack of sleep can make you feel sluggish, unmotivated, and irritable, which only compounds a stress problem; and increased stress disturbs the quality of your sleep. Research has also linked higher levels of inflammatory proteins to getting fewer hours of sleep at night.
In addition to getting proper rest, taking time to move and exercising are helpful stress relievers, as they release “feel-good” endorphins and can reduce your body’s levels of adrenaline and cortisol (stress hormones).
It’s never too late to make positive life changes!Eating a nutrient-rich diet, ensuring proper hydration, and taking time for relaxation, exercise, and healthy sleep habits are some simple ways you can support your body’s best health today.
You try to eat well to feel good and stay healthy. While it’s optimal to get your nutritional needs from the foods you eat, it’s not always possible. There is conflicting information out there on the benefits of supplements, but the Dietary Guidelines for Americans 2015-20201 say that supplements may be useful for providing the nutrients you may be lacking from diet alone.
Still on the fence? Consider these top five reasons to add a multivitamin to your daily regimen.
Ready to add a daily multivitamin to your diet? Be sure to check with your healthcare practitioner to see if he or she has a recommendation and to ensure that any medications you’re currently on won’t interfere with their effectiveness.
†These statements have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure, or prevent any disease.References:
According to data from a recent study published in the Journal of the American Medical Association (JAMA), the more plant protein consumed, the lower your risk for mortality.1 This remains true even for those with unhealthy lifestyle habits, such as heavy drinking, obesity, physical inactivity, or smoking.
The study takeaway?
Look for ways to reduce the number of calories you consume daily from red meat and eggs. Substituting just 3% of daily calories derived from these animal proteins with plant protein was found to be associated with a 10% lower risk of death.
How does this translate to our forks?
Very easily! No major dietary overhauls are required to gain these life-extending benefits. For example, if you consume 2,000 calories daily, you would only need to swap out 60 calories. That’s just 15 grams of protein each day.
We’ve put together some delicious examples of plant protein meals.
Plant Protein Swaps:Breakfast
According to a recent study published in the British Medical Journal (BMJ), spicy food could help you to live longer.2
A seven-year Chinese health study examined spicy food intake of over 20,000 lives and revealed a reduced risk of total mortality, as well as death due to cancer, ischemic heart diseases, and respiratory diseases (independent of other risk factors).
Compared with eating spicy food less than once a week, eating it once or twice a week resulted in a 10% reduced overall risk for death. But eating spicy food six to seven times a week reduced the risk by 14%.
Nowadays, detoxing is on everyone’s mind, especially when living in increasingly toxic environments and experiencing negative health effects.
If you think that a detox might be right for you, there’s a way to do it right and ensure you are safely achieving the results you are looking for.
Here are three easy tips to keep in mind to make the most out of your detox:
In summary, if you feel tempted to try out the latest detox program, keep this checklist in mind. It’s designed to help you know how often to do a detox, the importance of targeted nutrients, and, most of all, how to ensure your chosen detox is safe and based on good science.
[i]Klein AV, Kiat H. Detox diets for toxin elimination and weight management: a critical review of the evidence. J Hum Nutr Diet. 2015 Dec;28(6):675-86. doi: 10.1111/jhn.12286. Epub 2014 Dec 18.
[ii]Lamb JJ, Konda VR, Quig DW, Desai A, Minich DM, Bouillon L, Chang JL, Hsi A, Lerman RH, Kornberg J, Bland JS, Tripp ML. Altern Ther Health Med. 2011 Mar-Apr;17(2):36-44.
[iii]Bland JS, Barrager E, Reedy RG, Bland K. Altern Ther Health Med. 1995 Nov 1;1(5):62-71.
When following a ketogenic diet, it is not uncommon for people to neglect eating quality sources of fiber in an effort to avoid any carbohydrate intake. There is a chance this can lead to constipation, poor digestion, and a lack of certain vitamins and minerals.
What is fiber?Dietary fiber is the indigestible plant material that passes through our digestive system either completely undigested, or broken down via microbial fermentation, in the large intestine.1 Fiber aids in the removal of waste via the colon and is important for maintaining healthy digestion. Fiber is categorized as either soluble or insoluble, and each is digested differently.
Soluble fiber: Soluble fiber dissolves in liquids and becomes gel-like in the digestive tract.1 It slows digestion, increases satiety, and when consumed with carbohydrates can slow intestinal absorption and can help minimize increases in postprandial blood glucose.2
Soluble fiber is predominantly found in fruits and legumes, which are not advised on a ketogenic diet, and small amounts are found in vegetables.3 Soluble fiber ingredients are also commonly found in low-carb packaged foods, such as isomalto-olidosaccharides (IMOs) and soluble corn fiber.
Insoluble fiber: Insoluble fiber does not dissolve like soluble fiber does. This type of fiber stays intact and is responsible for what people refer to as “roughage” when speaking of fiber. This type of fiber aids in digestion and promotes elimination of waste by the colon.4
Insoluble fiber is the predominant type of fiber found in vegetables, especially the low-carb, non-starchy options that are fitting for a ketogenic diet.
Taking in fiber on a ketogenic dietFollowing a ketogenic diet is easy when you stick to fatty meats, eggs, oils, and full-fat dairy. However, by a strict intake of these foods, there is very little consumption of whole-food fiber in addition to a lack of micro nutrient intake. Moreover, low-carb, “keto-friendly” packaged foods, although providing ease of entry into a ketogenic lifestyle, are typically filled with soluble fibers. These soluble fibers contribute toward the majority of the daily carbohydrate count and lead to a lack of insoluble fiber in the diet. Consequently, due to the attempt to meet daily macronutrient ratios, there is a tendency to neglect all vegetables, even low-carb options, and thus losing out on insoluble fiber intake. A well-formulated ketogenic diet should not be void of fiber; some may even argue it provides more fiber than other diets. This is because a well-formulated ketogenic diet includes regular amounts of low-carb vegetables on a daily basis, along with quality sources of fats and protein.
Intriguingly, the fermentation process of insoluble fiber during digestion can also contribute to ketogenesis (i.e. the production of ketones). Fiber is broken down by the gut microbiome into short-chain fatty acids, such as butyrate,5 a molecule that is very structurally similar to the ketone body, beta-hydroxybutyrate. Subsequently, butyrate can be converted to beta-hydroxybutyrate and has been shown to increase blood ketone levels in humans.6
Fiber sources on a well-formulated ketogenic dietLow-carbohydrate fibrous whole foods, such as those listed below, are recommended as part of a well-formulated ketogenic diet to allow for entering and/or sustaining nutritional ketosis (defined as an elevation of beta-hydroxybutyrate (BHB) above 0.5 mmol/L). Consider adding these examples to your diet:†
Tips for consuming more fiber on a ketogenic diet:SaladsThis may be an obvious solution to a lack of insoluble fiber in the diet, and you may even be experiencing flashbacks from traumatic dieting memories you just can’t shake. However, a ketogenic salad should be an exception to this bias. If you have ever had a good salad, you know salads are underrated; they only become boring when you take away the fat—not an issue on a ketogenic diet. Gone are the days when you ask for “dressing on the side.” When you find a high-fat dressing you enjoy, you will begin to enjoy your salads!
Recommended ingredients: leafy greens (all types), avocado, hemp seeds, boiled eggs, fatty cuts of beef, chicken thighs, fatty fish, olives, nuts & seeds, artichoke hearts, high-quality oils, high-fat dressings (see below)
Sautéed & roasted vegetablesWhile from a glycemic standpoint there is an advantage to eating vegetables raw (due harder access to carbohydrates stored inside plant cells), sometimes eating cooked vegetables can bring a sense of comfort, and could translate to better compliance to a ketogenic diet. The best oils for cooking that can handle heat contain saturated and monounsaturated fats such as butter, ghee, avocado oil, extra-virgin olive oil, MCT oil, and coconut oil. Use of fresh or dried herbs and spices such as garlic, parsley, cumin, chili, oregano, paprika, rosemary, coriander, etc. will add additional flavors.
Recommended ingredients for sautéing: spinach, onion, mushrooms, kale, zucchini, cabbage, Bok choy
Recommended ingredients for roasting: Brussels sprouts, broccoli, cauliflower, onion, mushrooms, celery (don’t knock it ’til you try it!)
Chia puddingYes, pudding! Ketogenic chia puddings are extremely easy, cheap, and convenient to make and, most importantly, are full of fiber. The carbohydrate content of chia seeds is primarily fiber, 86% to be exact, and most of it is insoluble fiber! When chia seeds are soaked overnight, they absorb the liquid and take on a pudding-like consistency. Spruce up the chia puddings with some of the recommended ingredients below to avoid a flavorless gel and make sure to include healthy fats!
Recommended ingredients: chia seeds, flax seeds, hemp seeds, low-carb nuts/nut butters, sugar-free chocolate chips, cocoa powder, cinnamon, vanilla extract, MCT oil/powder, full-fat coconut cream, coconut butter, shredded coconut, unsweetened nut-milks, coconut oil, sea salt, sugar-free/low-carb protein powders
Dressings & dips Dressings and dips are like smoothies in that you can easily sneak ingredients into them. Adding fiber into dressings and dips makes food taste better, as well as being an easy way to get in those healthy fats! Use a blender to make these, and include dressings and dips with any savory snack or meal!
Recommended ingredients: spinach, kale, steamed cauliflower, raw or steamed zucchini, high-quality oils, tahini, herbs & spices, garlic, lemon juice, apple cider vinegar, full-fat yogurt (or dairy-free alternative), MCT oil/powder, avocado oil- or olive oil-based mayonnaise
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If you have ever walked down a grocery or health food store aisle containing protein powders, you’ve likely found that the sheer volume and varieties of protein supplements can be overwhelming and confusing. How do you choose the right supplement? How much should you consume? Will you be able to absorb and tolerate it properly?
Let’s take a closer look at the importance and requirements of protein and best available sources of protein supplements.
How Much Do You Need?
Proteins are the building blocks of life. They are a class of molecules that are a key structural component of all cells in the body. Protein is needed for growth and repair of the body and maintenance of good health. Additionally, protein is required for energy metabolism, muscle synthesis, cell signalling, immune responses, and enzymatic reactions.
The amount of protein we need is varied and changes throughout our lifetime. The Recommended Dietary Allowance (RDA) for protein is 0.8g/kg of body weight per day for healthy individuals aged 19 and older.1,2 This equates to approximately 55g of protein per day for a person weighing 150 pounds. This is the minimum amount needed to maintain nitrogen balance and prevent protein deficiency.1,2 But recent research indicates that the RDA requirements are not adequate to maintain optimal health, and in fact more protein is needed for women who are pregnant or lactating, older individuals, active people, and athletes.3-5
Animal vs. Plant-Derived Protein is available in a variety of dietary sources. These include foods of both animal and plant origin. Both animal and plant-derived proteins are made up of 20 amino acids.1 Nine of these are not synthesised by humans and are considered essential.1 Therefore, these essential amino acids have to be obtained from the diet.
Proteins from animal sources (eggs, dairy, meat, and poultry) are considered high biological value protein because they contain all nine essential amino acids. Plant-derived proteins (from legumes, nuts, seeds, etc.), on the other hand, typically lack one or more of the essential amino acids and are considered a lower biological value protein.
But when these proteins are combined (e.g.: rice and beans), not only do they provide a complete source of protein, but they also offer a protein profile that is lower in saturated fats and cholesterol.
What Is a PDCASS Score?
Powder supplements offer an easy, convenient, and reliable source of high-quality protein. The most common sources of protein supplements include whey and casein (animal-derived) and soy and pea/rice blend (plant-derived). Depending on the source and purification methods used to manufacture the supplements, a consumer may or may not obtain a high-quality product. The quality and digestibility of a protein is vital considering the nutritional benefits it can provide. It is very important to determine this since the quality of the protein refers to the availability of amino acids that it supplies, whereas the digestibility considers how the protein is best utilised in the body. Therefore, in 1989, the Food and Agriculture Organisation (FAO) along with the World Health Organisation (WHO) in a joint statement recommended utilising the protein digestibility corrected amino acid score (PDCAAS) to determine the quality and digestibility of a protein.6
Anti nutritional factors such as trypsin inhibitors, lectins, and tannins may be present in some protein sources, such as soybean meal, peas, etc., and may cause reduced protein hydrolysis and amino acid absorption.⁶ These factors may be compounded by age, since the ability of the gut to adapt to environmental and dietary insults reduces as we age.6
The PDCAAS score for whey protein is the highest at 1.0 compared to other common protein sources, due to their high content of essential and branched chain amino acids.7 Soy protein isolate is also considered a high-quality protein source (containing all nine essential amino acids) and contains a PDCAAS score of 1.0.7 Pea protein concentrate has a PDCAAS score of 0.89 because it contains lower levels of the sulfur-containing amino acids cysteine and methionine.7
Whey proteins one of the most widely used protein sources for supplementation. Whey protein contains a high amount of the amino acid cysteine. Cysteine has been shown to enhance glutathione levels and has strong antioxidant properties that are capable of helping to prevent damage to important cellular components in the body.6 It also contains a high concentration of branched chain amino acids (BCAA). BCAAs are important for their role in the prevention of muscle breakdown during exercise and tissue maintenance.6
There are different forms of whey protein: Whey Protein Concentrate (WPC) and Whey Protein Isolate (WPI).
WPC is about 80% protein and is created by removing water, lactose, and some minerals. WPI on the other hand contain protein concentrations of 90% or higher since there is significant removal of fat and lactose making it the purest form of protein.6 Unfortunately, the manufacturing process often leads to some proteins breaking down and becoming denatured, reducing the effectiveness of the protein.6 Therefore, even though WPI contains higher protein concentrations than WPC, whey protein concentrate contains more biologically active components. People who are lactose intolerant are able to utilise WPI more readily without experiencing many negative side effects.
Both WPC and WPI can be further hydrolysed. Protein hydrolysates contain di- and tripeptides and therefore can be easily absorbed.
Soy protein contains beneficial phytonutrients such as phytosterols, saponins, and isoflavones. These nutrients have been associated with positive cardiovascular benefits, menopausal symptoms, and osteoporosis.6
Soy protein can also be found in various forms: soy protein concentrate and soy protein isolate. Concentrates have some fat and carbohydrate removed, providing about 70% protein content.6 They have a high digestibility and are usually found in nutrition bars, cereals, and yogurts. Isolates are further refined, lacking dietary fibre but provide 90% protein content.6 They are easily digestible and can be found in protein supplements and infant formulas.
Pea/rice protein blend is recommended if you have a milk protein allergy/sensitivity, are avoiding soy products, or consume a vegetarian diet. Including a pea/rice blend protein powder is an alternative to whey protein, has a high PDCAAS score, and provides all nine essential amino acids.
Pea protein also contains a variety of phytonutrients such as polyphenolics, which may have antioxidant activity; saponins; and galactose oligosaccharides, which may demonstrate beneficial prebiotic effects in the large intestine.8
Whether you are using these supplements as a meal enhancer, snack, or a post workout drink, adding a high-quality protein supplement will help meet your daily protein needs. Metagenics provides a variety of protein options; work with your healthcare provider to figure out the amount and type of protein you need for optimal health.
About Nilima Desai
MPH, RD, Metagenics Manager, & Medical Marketing Nilima Desai is a Registered Dietitian who received her undergraduate degree from California State University Long Beach in Nutrition and Dietetics and her Master’s in Public Health Nutrition from Loma Linda University. She has over 14 years of experience providing medical nutrition therapy in diabetes, renal disease, weight management, and vegetarian nutrition. She also served on the board of the Renal Practice Group of the Academy of Nutrition and Dietetics from 2012-2016 as the Membership Chair. Her passion about living and teaching a healthy lifestyle led her to collaborate with a nephrologist on creating the Pocket Dietitian app, which offers the user personalized, easy-to-use dietary prescription on conditions such as diabetes, hypertension, renal disease, weight management, etc. In her free time she runs half marathons and shuttles her two kids to their activities.