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What Is the Ketogenic Diet and How Does It Work?

Article ID 06-ND-LI-00290

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What Is the Ketogenic Diet?

The ketogenic diet, often called the keto diet, is a way of eating that contains very few carbohydrates and a high proportion of fat.

Carbohydrates are nutrients found in foods such as bread, rice, pasta, potatoes, fruit and sugar. The body breaks many carbohydrates down into glucose, which provides energy for our cells.

On a ketogenic diet, carbohydrate intake is usually reduced to approximately 20–50 grams per day. Fat becomes the main source of dietary energy.

However, not all fats are the same. They can come mainly from saturated fats, found in butter, cream and fatty meat, or unsaturated fats, found in olive oil, nuts, avocado and fish.

This distinction creates two very different ways of following a ketogenic diet.

How Does the Ketogenic Diet Work?

When carbohydrate intake becomes very low, the body’s available glucose supply decreases.

The liver begins producing substances called ketones from fat. Ketones provide an alternative source of energy for several organs, including the brain.

This metabolic state is called ketosis.

Ketosis is a change in how the body obtains energy. It does not automatically mean that a diet is healthy or that the body is burning more stored fat than it otherwise would.

What Are the Two Main Ways of Following Keto?

Although these are not two officially defined medical types of ketogenic diet, they represent an important difference in food quality.

1. Keto Rich in Saturated Fats

This approach relies heavily on foods such as butter, cream, fatty red meat, bacon and cheese.

These foods contain little carbohydrate and can help maintain ketosis.

However, consuming large amounts of saturated fat may increase LDL cholesterol, which contributes to the development of atherosclerosis.

2. Keto Rich in Unsaturated Fats

This approach emphasizes olive oil, avocado, nuts, seeds and fish, together with low-carbohydrate vegetables.

It provides a more favourable balance of dietary fats and may have a different effect on blood cholesterol.

However, even this version requires careful planning to ensure adequate fibre, vitamins and minerals.

Is Keto the Same as a High-Protein Diet?

No. A ketogenic diet is primarily high in fat, very low in carbohydrates and usually moderate in protein.

It is also different from a general low-carbohydrate diet, which does not necessarily produce ketosis.

Based on Research

Malinowska D, Żendzian-Piotrowska M. Ketogenic Diet: A Review of Composition Diversity, Mechanism of Action and Clinical Application. Journal of Nutrition and Metabolism, October 2024.

https://pmc.ncbi.nlm.nih.gov/articles/PMC11511599/

Author

Monika Mikulicz-Pasler, MD, PhD

Monika Mikulicz-Pasler, MD, PhD

Specialist in Cardiology

Specialist in Internal Medicine

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