The Keto Diet from Miami Endocrinologist Dr. Richard Lipman offers fast, safe and healthy weight loss. The keto diet is a high protein moderately high fat, very low-carbohydrate diet that puts the body into a state called ketosis. Normally, the body gets most of its energy from ingested and stored carbohydrates. Reducing net carbs to less than 30 g/day forces the body to obtain its energy from stored fat cells for energy.
Pros and Cons of Dr Lipman’s Keto Diet
Advantages of Keto Diet:
The largest NIH review of the Keto Diet: “The ketogenic diet is significantly superior in the induction of weight loss in otherwise healthy patients with obesity and the induced weight loss is rapid, intense, and sustained until at least 2 year>”
1.Rapid weight loss: All evidence points to the fact that dieters who lose weight quickly are more successful in reaching their goal and then maintaining weight loss. There are NO healthy dangers with rapid weight loss.
2. Fewer plateaus and slowdowns: One of the key advantages of the Keto Diet is the lack of plateaus and slowdowns seen in most diets. This prevents significant frustration with the dieters and much greater compliance with the diet plan.
3. Artificial sweeteners can increase weight loss: Artificial sweeteners, especially Stevia and Monk Fruit are very helpful and make the almost total absence of carbs more tolerable. Since dehydration and water loss is a common occurrence, some of the artificial sweetened, zero sugar carbonated drinks may help weight loss by adding to the adherence to the Keto plan. These drinks help with the boredom of the plan, provide a lot of fluids and help with common carb cravings.
4. Vegetable-based rice and pasta substitutes can work with the Dr Lipman’s keto diet without adding too many carbs.
Disadvantages of the Keto Diet
1. Confusing the Paleo Diet and Atkins Diets with the Keto Diet. Although both emphasize protein and fat, the Paleo diet permits carbs and eliminates all prepared foods. This makes the Paleo diet very difficult to maintain, often because it involves a lot of shopping and recipes. There are fundamental difference between these plan making impossible to move from one to another quickly
2. “Weekend Cheating” The Keto Diet is very sensitive to “weekend cheating” involving carbs. I suggest individuals that need “cheat days” avoid this diet plan.
3. Water retention can occur with most weight loss plans. It may be even worse on the Keto Diet. While this does not lead to actual weight gain it can cause significant frustration and lack of compliance with the diet plan similar to the occurrence of plateaus.
4. Development of the Keto Flu: Often the normal development of ketosis is associated with the Keto Flu. The keto flu is a metabolically induced state with symptoms similar to a viral infection. The are many way to minimize symptoms of Keto Flu.
Measuring the Ketones in Your Breath
Stored fat breaks down into fatty acids which are then converted to KETONE BODIES. Ketones travel to the brain and increase energy while decreasing hunger. They also provide energy to our muscles and tissues, and are ultimately excreted in the urine as ketones. The ketones can be measured in your urine with a tiny dipstick, in your blood (similar to a blood sugar test), or now in your breath with a ketone breathalyzer. This gives you a way to directly measure the rate and degree of fat burning. A negative test implies a hidden carb in your diet and gives you a chance to reassess your food choices.
Keto Diet Macros
“Macros” is an abbreviated term for macro-nutrients in the Keto Diet. Important macros you must be mindful of while on the keto diet are “the big 3” nutrients: carbohydrates, fats, and protein. Consumption of these macros is dependent on your age, height, gender, and goals. During your first appointment with Dr. Lipman, he will assess your medical history, medical problems, metabolism, blood levels, thyroid function, and weight loss goals. If the keto diet is right for you, he will help determine the right macros for you, offer daily food menus, and provide appetite suppressants if needed and indicated.
On the keto diet we follow total calories (cannot be almost unlimited as Atkins often is), grams of protein per day (depends upon age, gender, height, physical activity), net carbs (should be as low as possible–about 20-25 grams per day) and fat grams. Here are items to consider in the keto diet when reading a label, as well as the calculation for net carbs:
You might be asking, “what’s a net carb?” It’s simple really! The net carbs are your total dietary carbohydrates, minus the total fiber, minus sugar alcohols (if present). These are the carbs that are quickly absorbed from the GI tract. They raise blood sugar and blood insulin levels, and quickly turn to fat.
In the beginning, I recommend keeping total daily net carbs below 30g, some studies suggest the ideal intake of net carbs is 20 grams. That number is severely limiting and adding 10 net carbs a day still maintains ketosis and fast weight loss without causing feelings of deprivation.
The benefit of eating a near very low carb diet like the keto diet is that you will never have to worry about cravings or hunger. This keto diet results in rapid weight loss as fat deposits are broken down to provide energy for metabolism. Carbs can cause a quick rise in sugar and insulin, only to fall leaving you hungry and looking for more sugar. To reach ketosis, you will need to reduce your net carb intake to 20 to 75 net carbs per day. Thirty net carbs per day may be a better maximum for faster weight loss. This forces your body to burn fat instead of carbs. The addition of the new cauliflower-based rice alternative with 1-2 net carbs per portion adds diversity to the often boring and limited Keto diet.
There are two ways to find your ideal net carbs intake:
Low to High Method
Start from a low level of net carbs to ensure you quickly enter ketosis (about 20 grams of net carbs per day). When you detect ketosis after about 2-3 days, start adding net carbs (about 5 grams each week) until you detect a very low-level or no ketones (using Ketostix, blood ketone meter, or ketone breathalyzer). This is usually the most reliable and quickest way to discover your net carbs limit. It could be a bit hard the first couple of days, as you have to give up almost all carbs from one day to another, but it will be worth it.
High to Low Method
Assuming you’re not in ketosis, start from a relatively high level of net carbs (about 50 grams per day) and keep reducing the amount (about 5 grams each week) until you detect the presence of ketones. This is a less difficult approach. However, it is not recommended because you may spend a long time out of ketosis before you find your net carbs limit.
If you can’t see any ketones, be patient. It typically takes 2-3 days for your body to deplete its sugar (glycogen) stores, so don’t expect to be in ketosis after just a day of low-carb. Remember, while ketosis is a favorable condition and an indication that your body is using fat for fuel, you can still lose weight even without being in ketosis. A diet high in fat, adequate in protein, and low in carbohydrates is naturally sating. This makes you less hungry and therefore helps you lose weight.
Protein Requirements on the Keto Diet
The body needs a certain amount of protein to maintain healthy tissues and to increase muscle mass if you are working out. Protein is the most satiating of the three macro-nutrients. Therefore, when you eat enough protein you’ll experience reduced hunger and cravings. Protein, especially at breakfast ensures control of hunger and cravings later in the day.
The accepted standard for the amount of protein you need to eat daily is 0.6 – 1.2 grams of protein per pound of lean body mass. Your lean body mass is your total body weight minus your fat. A standard that is commonly accepted in the keto community is 0.8 grams of protein per pound of lean body mass.
For example, if you currently weigh 180 lbs and your body fat is at 30%, your lean body mass is 126 lbs. In order to calculate your daily protein multiply 126 x 0.6 to 1.2, and you’ll get a range of 76g to 151g of protein/day. The minimum amount you need in order to maintain your bodily functions and muscle mass is 76 grams.
A simpler method is to take 1/3 or your bodyweight = required protein. For keto diets, 2/3 of your body weight equals faster weight loss. The 180 lb individual then needs 120 g of protein.
It comes down to about 100 grams of protein per day for most people and between 25-40 grams of protein per meal. (This depends on how many meals per day you’re eating.) Meeting this goal will make weight loss and muscle gain (or maintenance) much easier.
Fat Intake Needed for Weight Loss on the Keto Diet
Fats on the Keto Diet are the next most important macro-nutrient.. They help you feel full for longer periods of time, will give you energy, and are essential for maintaining your hormonal balance. However, there’s a catch: it’s possible to eat too much fat, to the point that you don’t burn off the excess body fat as quickly. Even when following a ketogenic diet, you still need to burn more energy than you consume in order to lose weight.
Fats have the highest amount of calories in all the macro groups. After taking into account the amount of protein you need to consume, fat is used to fill in the caloric gaps caused by removing the carbs from your diet. Fats typically consumed on a ketogenic diet include avocados, coconut oil, butter, avocado oil, olive oil, and llimited quantities of nuts and cheese. Some people tend to overdo some of these foods, and it can stall weight loss. If you know you’ll eat too much, cheese, nuts, or peanut butter, it might be safer to just avoid them. Much simpler is to add the fat in the form of coconut oils.
You can calculate ideal fat intake based on daily caloric allowance in the graph below:
Keto Diet Macros are Expressed as a Percentage of Daily Calories: 70% for Fat, 25% for Protein, 5% for Net Carbs
Total daily calories can vary in women from 1000 to 1200 calories/day and in men from 1400 to 1600 calories/day depending on age, weight, metabolism, and weight loss goals. The daily intake of each nutrient depends on its caloric content: fat = 9 cal./g, protein and net carbs are 4 cal./g Based on the daily calorie limit, healthy fats are increased to between 60 and 120 g/day, protein 65 to 125 g/day, and net carbs to 20 g/day or less. Here are the average Macros used for patients in my Keto Diet Plan. Short, older women might be slightly lower while active, tall, and overweight men might be slightly higher:
Alternative Testing For Ketosis in Dr. Lipman’s Keto Diet Plan
There are 3 techniques for measuring ketosis in dieters on the Keto Diet. The original method, used extensively in the Atkins diet, was dipping Keto Stix in the urine early in the morning (when it is the most concentrated). A color change from beige to pink or purple indicates the presence of ketones in the urine and consequently in the blood. A newer method has been the measurement of ketones directly in the blood by using a Blood ketone meter. This is the most accurate method. It is also the most expensive at $4-5/test strip. Its my feeling that all you really need to know is the absence or presence of ketosis and not necessarily an exact blood value.
The newest and most interesting addition is the ketone breathalyzer. Built to test your breath for alcohol, it also tests your breath for acetone, which is a byproduct of ketones in your blood. The device costs $8.00 to $15.00 from Amazon and provides unlimited testing that takes less than 15 seconds. Knowing the status of your ketosis helps you avoid mistakes and speeds up your weight loss.
Keto Boosts and Supplements: Keto “Boosts” are Products Containing Exogenous Ketones
You can raise you level of ketosis by adding ketones in the form of ketone BHB (beta-hydroxybutyrate). Usually, you’ll find exogenous ketones (ketones created outside the body) in the form of powdered ketone salts. Less common are ketone esters, which are expensive and have a bad taste. People also use medium-chain triglyceride (MCT) oil — or partially man-made fats — to put the body into a state of ketosis. A serving of exogenous ketones will set you back only 100 calories or less, but most people who’ve tried them say they taste awful. And they’re expensive. You can add MCT oils derived from coconuts to your food, or you can take MCT’s as oil-filled capsules.
Keto supplements are not a requirement of the keto diet. However, they can make your body’s transition to ketosis so much easier. When added to a well-balanced keto diet, keto supplements increase your chances of getting and staying in ketosis. Some keto supplements increase ketone levels, thus helping to alleviate symptoms of keto flu. Other supplements prevent nutrient deficiencies. Additional advantages to these supplements are that they can improve your health and well-being, as well as boost your workout results. These supplements are safe, natural, and scientifically proven to work.
Advantages of Exogenous Ketone Supplements Added to the Ketone Diet
- Ease Ketosis – It takes at least 3 days to get into ketosis and even longer for your body to become keto-adapted. When added to a keto diet, researchers believe that exogenous ketones can speed up keto-adaptation and ease the transition to nutritional ketosis.
- Correct Mistakes – If you accidentally took too many carbs or protein, taking exogenous ketones can help prevent you from being kicked out of ketosis. They do so by immediately boosting ketone levels, lowering blood glucose, and controlling insulin release.
- Keto Flu – The keto flu is a popular way of referring to carb withdrawal symptoms. These include fatigue, headaches, muscle cramps, and nausea among other things. The keto flu goes away as soon as your body starts making ketones. Exogenous ketones help by speeding up this process.
- Appetite Control – If your goal is to lose weight, exogenous ketones can help by suppressing your appetite. A very recent study shows that drinking exogenous ketones following an overnight fast suppresses appetite for at least 4 hours.
- Brain Boost– Ketone bodies are your body’s natural nootropics. But taking them in supplement form can have the same effect. One study even found that ketone supplements help reduce anxiety, likely by improving brain function.
Read About the First 3 Weeks on the Keto Diet: https://richardlipmanmd.com/diet-plans/keto-diet-beginners-start/