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Anyone who knows me, will know that I am super passionate about helping women lose weight. I love being able to help someone lose those excess kilos in a way that feels easy and maintainable. I get extreme joy from empowering my patients with more knowledge about their body and supporting them in understanding their personal road-blocks to achieving long term weight loss. In the work I do, I find that a more holistic approach to weight loss is desirable. I ultimately want to be able to help a woman reverse the hidden drivers.
But…
In saying all that, I get it, there are those times when I have a woman in my office that is desperate to just start the ball rolling with some more rapid weight loss. They don’t want to dilly dally. They have a goal and they want it now (or yesterday in reality). They want to harness some immediate motivation and get some serious results straight away, with the intention of then dealing with the ‘big-picture-health-stuff’ down the road.
If you have been on the weight-loss-block for a while, you would have heard about ketogenic or keto diets for rapid weight loss results. Let me start by establishing, that in my mind, there is a ‘keto’ approach, and then there is a ‘healthy keto’ approach. These two versions can result in very different health benefits. The first (and most common) type of keto that I see, adheres strictly to the low carb: high fat: moderate protein, but fails to deliver those macronutrients in a health promoting way. It may endorse rashers of bacon washed down by a bulletproof coffee for breakfast, which is NOT your body’s idea of adequate nutrition. I very often see women develop or worsen issues with their stress hormones, thyroid function and menstrual cycles after participating in this type of ketogenic diet.
What I am suggesting is a more holistic view that supports your hormones and health while you lose the weight. While I totally appreciate that a “keto way of eating” is not for everyone, I have found clinically that a nutritionally sound, healthy ketogenic approach is a winner with the vast majority of my patients who are craving more rapid weight loss.
So, if you have tried keto before and hated it – I want you to hang in there with me and see if the approach I am suggesting is different to what you tried.
One of the most well-recognized benefits of following a ketogenic diet is its ability to help reduce stubborn fat while maintaining lean muscle mass. This happens because a ketogenic diet can virtually ‘re-awaken’ your body’s ability to use fat as its primary energy source. It pulls your cells away from relying on carbohydrate/glucose utilisation and encourages your body to tap into stored energy sites that come in the form of stored fat.
A ketogenic diet can help regulate your appetite by normalizing your hunger hormones. Ghrelin (one of these hunger hormones) is released from the stomach and intestines, with the highest levels produced during a fasted state. After consuming a meal, ghrelin levels decrease in response to circulating nutrients. Ghrelin levels also increase significantly after weight loss, which is the reason why weight can be difficult to keep off — your hunger is raging and rebound eating is challenging! But being in ketosis helps to suppress the increase in ghrelin that is experienced after losing weight. Studies have shown that a ketogenic diet leads to decreased amounts of circulating ghrelin and therefore decreased feelings of hunger.
With the ketogenic diet, insulin requirements are dramatically lowered (which can mean normalized for individuals with skyrocketing insulin levels) and insulin signalling is improved. This may effectively reverse your chances of developing type 2 diabetes.
Dietary carbohydrates raise insulin levels more than the other macronutrients - protein and fat. When a meal consisting of fast-to-digest-carbohydrates is consumed (for example bread, pasta, rice etc.), your pancreas is forced to secrete insulin to reduce your blood glucose level. This sets up an environment that favours fat storage over fat burning and can also result in a chronic inflammatory state – neither is great for fat loss.
When carbs only form a small part of the diet, as in a ketogenic diet, insulin levels do not fluctuate as drastically as they would if you were consuming a higher carbohydrate diet. The keto diet doesn’t prevent the production of insulin outright – instead it decreases it enough to allow the body to get stuck into using fat as a source of energy.
This can be a big reason why a ketogenic approach works well for women with PCOS (polycystic ovary syndrome) who commonly have underlying issues with elevated insulin and testosterone.
Metabolic flexibility is the ability of the body to switch between burning carbs and burning fat. Having metabolic flexibility means that your body is able to use different fuel sources to power different activities. Mitochondria are the structures that ultimately turn most of your food into useable energy (ATP). So naturally, being metabolically inflexible means that you have an issue with your mitochondrial function.
Metabolic inflexibility can be caused by a few different things, but the top three reasons are:
· Dysfunctional mitochondria
· Too few mitochondria
· Insulin resistance
A nutritional ketogenic diet, however, can improve your metabolic flexibility by helping to resolve these drivers. It can improve your insulin sensitivity and reduces your oxidative stress, which in turn will improve your mitochondrial function.
Your brain is hard-wired to seek out calories and the reward centres in your brain will light up in response to you eating hyper-palatable, calorie dense food – specifically food that contains a combination of fat, carbohydrates and salt. This means that junk food like pizza, chocolate, ice cream and chips are highly rewarding – which explains why they are some of the most common food cravings. Your brain literally gets trained to seek and ingest these foods.
A ketogenic approach gives your brain a chance to retain itself. By eliminating these highly palatable foods from your diet, you will soon find that your cravings for those foods subside and you find more joy in the naturally existing flavours of ‘real’ whole food.
Research has suggested that the genetic make-up of your microbiome can be affected by many lifestyle factors which include how you sleep and exercise, your antibiotic use, and even your diet. The bacteria in your gut can alter your body’s response to different food sources and impact how your body extracts energy from food or the impact that food has on your glucose levels.
A healthy ketogenic diet can potentially increase the genetic diversity of your gut microbiome and increase the ratio of Bacteroidetes to Firmicutes, which is a positive thing when it comes to improving your gut health and function. Much more research is needed in this area to determine the effect of the ketogenic diet on the microbiome, but so far it is looking promising.
I believe that some of the benefit to gut health, may also be due to the removal of some common gut destroying and inflammatory grains. This is my own clinical hypothesis, as I see a rising number of patients who benefit from the removal of grains (especially the gluten-containing ones) from their diet.
Your brain has an unusually high need for glucose in comparison to other tissues/organs in your body. When your brain is forced to switch from glucose to ketones to fuel its function there can be some profound neurological benefits. Studies have suggested that ketosis can help with mood disorders such as bipolar disorder, anxiety, and depression. Naturally occurring free radicals are produced when ketones are broken down and ketones are known to have anti-inflammatory actions – which can be a win-win for your brain and mood regulation.
Some people approach keto purely focused on the macronutrient composition. The goal with any ketogenic diet is to lower your carbohydrates and increase your fat intake while maintaining a decent protein amount. As a general rule, I like to work on a 50% fat: 30% protein: 20% carbohydrates. Some keto diets will work more towards a 60-75% fat: 15-30% protein: 5-10% carbs, which I find too low in carbs from the ladies I support (coz your thyroid gland needs at least 50-75grams of carbohydrates every day to keep working optimally).
What can go wrong when you focus on the macros, is that you miss out on ‘healthy’ being of importance. All of a sudden, rashers of bacon with a bulletproof coffee seems like the best breakfast, and you ditch common sense in favour of a short-term weight loss goal.
What I want to introduce you to, is a more balanced view on the whole keto scenario. I want you to hold onto some health promoting concepts and tweak them to fit in with a keto approach. I want vegetables to form the base of your diet (aiming for at least 2-3 handfuls at every meal) – providing you with phytonutrients, vitamins, minerals and fibre for optimal gut health. I want you to use free range, wild caught, and clean protein sources like fish, chicken, turkey, beef, kangaroo, lamb, seafood and eggs, along with plant-based protein options like tofu, tempeh, nuts and seeds. I want you to not shy away from healthy fats from avocado, nuts, seeds, coconut oil and olive oil. I encourage you to use a large variety of low-sugar fruits to promote greater alkalinity in your body. And I really want you to enjoy the food you eat so that you don’t feel hungry or deprived.
Forever weight loss can happen when you do it in the right way. There will never be one perfect diet out there for everyone, but I have found that a healthy keto approach works for a large majority of my patients really wanting to be motivated by some rapid results.
I am here to support you every step of the way.
- Love Melissa
