Cutting carbs and fueling the body with fat is a popular diet strategy called the ketogenic diet, or keto for short. But if you’ve already found weight loss success using this approach, you may be thinking of taking things up a notch and combining keto with intermittent fasting to bust through a plateau or improve your results. Is this something you should try?
The short answer is maybe, though you should know up front that there is a lack of rigorous research on this combined approach, and it hasn’t been proven to work for weight loss. Experts say it could make sense, though the lack of research means you may want to think twice before delving into this eating approach.
Combining the two diets gained popularity when intermittent fasting expert Jason Fung, MD, author of The Obesity Code, recommended using keto as a foundation with fasting, explains Lori Shemek, PhD, a nutrition and weight loss expert in Dallas and the author of How to Fight FATflammation. Celebrities including Halle Berry and Jennifer Aniston have been reported to use both diets together, says Dr. Shemek.
Let’s talk about what each diet is.
What Are the Basics of the Ketogenic Diet?
Scientists originally designed a keto diet in the 1920s to help control seizures in children with epilepsy, research shows. This version, called the classic ketogenic diet or the long-chain triglyceride diet, specifies eating 3 to 4 grams (g) of fat for every 1 g of carbs and protein, according to the Epilepsy Foundation.
The version of keto many are using for weight loss today is a little different in that it is a high-fat, moderate-protein, and very-low-carb plan. Fat makes up about 80 percent of the daily calories, and you’ll aim to consume between 20 g and 50 g of net carbs (carbs minus fiber) each day, depending on your personal needs.
A typical keto diet food list ditches most carbs, even healthy foods such as fiber-rich whole grains and most fruits, while prioritizing fats, such as avocados, olive oil, grass-fed beef, and even bacon occasionally.
The idea with this eating plan is to transition your body from one that burns glucose (or carbs) for fuel to one that relies on fat for energy. This state is called ketosis or being keto-adapted.
While the keto diet appears to lead to quick weight loss in the short term, critics say that much of that is water weight and point out that long-term research (more than two years) on people using keto for weight loss is lacking. Some available research shows that keto is no more effective than other diets for weight loss.
It is also important to note that many of the claims that keto can treat health conditions other than epilepsy — such as cancer, high blood pressure, polycystic ovary syndrome, diabetes, and neurological diseases like Alzheimer’s disease — need more research, per a review.
How Does Intermittent Fasting Work?
Intermittent fasting is a diet approach in which you plan specific times when you are not eating. There are several ways to do intermittent fasting, which some people simply call IF.
For instance, some people may follow the popular 5:2 IF, for which five days are normal eating and two are extremely low-calorie (around 500) fast days. Other plans call for not eating for a 24-hour period, and still others involve what is known as time-restricted eating, such as eating for 8 hours and fasting for 16 each day.
When it comes to IF, exciting research is emerging, including the role that the approach may play in treating obesity and insulin resistance (the hallmark of type 2 diabetes), according to a review. Yet the authors of that review concluded that there’s a lack of high-quality evidence on the health effects of IF and that it’s still unclear which type of IF is best to follow.
In addition, IF can be an effective way to lose weight — in fact, it’s been shown to be just as effective as traditional calorie restriction. For people who have obesity, when it came to losing weight or body fat or improving metabolic risk factors after one year, combining intermittent fasting with calorie restriction was just as good as simply restricting calories, according to a randomized trial. The IF group consumed 1,200 to 1,800 calories between 8 a.m. and 4 p.m., while the calorie-restricted group had the same number of calories but without the time limit. The takeaway? There are numerous ways to lose weight, and finding one that suits your preferences and eating style — which may or may not be IF — is key to creating lasting weight loss.
One major limitation is that many of the studies of IF (for weight loss or otherwise) have been in animals, not humans, or have been short term.
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