Dear Doctors: I’ve been doing keto for a few months to lose weight. I’ve almost reached my goal, and I’m ready to go back to eating more carbs. Is there a good way to switch from keto back to a regular diet? I’m worried that when I eat carbs again, I’ll gain back the weight I lost.
Dear Reader: When someone follows a keto diet, it means that they are severely limiting their intake of carbohydrates. These are the building blocks from which the body manufactures glucose, which is its preferred source of fuel. With carbohydrates mostly removed from the diet, the body is forced to switch to Plan B, which is burning fat for energy. This is a metabolic process known as ketosis, which gives the keto diet its name.
In a ketogenic diet, carbohydrate intake drops to about 10% of total food intake. The remaining 90% of the diet is made up primarily of either fat or protein. The proportions depend on which type of keto plan you are following. There’s a high-fat and moderate-protein approach, which currently is the most popular form of keto. Another way to put the body into ketosis is with a high-protein and low-fat diet, which many people know as the Atkins, paleo or Zone diets. Whichever version of keto you choose, it’s the limits on carbohydrates that lead to the fat-burning state of ketosis.
Keto can be a good way to jump-start weight loss, but it has its drawbacks. With such strict limits on carbohydrates, eating a nutritionally balanced diet takes careful planning and sustained effort. And whenever you follow a restrictive diet for a period of time, returning to “normal” eating can be daunting. For the best results, it’s a good idea to make the switch gradually. Plan on taking several weeks to slowly add more carbohydrates — and also more calories — back into your daily diet.
It’s also important to pay attention to the two different categories of carbs — simple and complex. Complex carbohydrates have more nutrients than simple carbs. They are also higher in fiber. Because they are made up of long chains of sugar molecules, they take longer to digest. Complex carbs are found in whole, unprocessed foods, including vegetables, whole grains, legumes, nuts, seeds, leafy greens and fruits.
Simple carbs, by contrast, are short chains of sugar molecules that absorb quickly. They include table sugar and sugar syrups. Simple carbs deliver calories but lack nutrients. They can cause a spike in blood sugar and leave you feeling hungry. Fruits, vegetables and other whole foods do contain simple carbs. However, the effect is mitigated by their higher fiber content.
As you move away from keto restrictions, steer clear of simple carbs. This includes sugar, soda, candy and other sweets, and highly processed foods. Instead, concentrate on a diet that is rich in lean proteins, healthy fats and complex carbs. A good model to follow is the Mediterranean diet. Call on the same discipline that allowed you to stick to keto, and choose high-quality carbs, lean proteins and healthy fat.
Eve Glazier, M.D., MBA, is an internist and associate professor of medicine at UCLA Health. Elizabeth Ko, M.D., is an internist and assistant professor of medicine at UCLA Health. Send your questions to firstname.lastname@example.org, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10960 Wilshire Blvd., Suite 1955, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.
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