Understanding the Keto Craze

Pam George

Can cutting carbs and boosting fat cure what ails you? Some say so, but proceed carefully.

Will Minster had a love-hate relationship with fad diets. “I have always been 20-to-30 pounds overweight and tried everything from the cookie diet to starvation,” says the Wilmington real estate agent. “Early success was followed by the standard weight gain.” But he had a reason other than weight to find a lifestyle diet. Minster has widespread cancer. “I became determined to be healthy,” he says.

Minster’s wife, meanwhile, was searching for a migraine cure. “She is an incredible researcher, and we found ourselves helping each other to find solutions to our health problems,” he says.  With that goal in mind, he went on the keto diet last year. His weight dropped from around 210 to a steady 180. Minster has been in three protocols at the National Institutes of Health for cancer, and his NIH doctors were impressed with his quick recovery from surgery and the physique he’s gained from daily two-hour gym sessions.

JulieAnne Cross has also benefited from the keto diet. In 2018, while vacationing in Dewey Beach, she was impressed with several housemates’ carb-cutting abilities. “One had lost 40 pounds already,” recalls Cross, who was nearly 80 pounds heavier than her lowest adult weight. What’s more, statin drugs were barely controlling her high cholesterol, and she was prediabetic.

After going on a keto diet, she’s currently at her driver’s license weight—a 20-year-old number—and her cholesterol is half of what it was before medication. Her triglycerides and “HDL cholesterol levels are excellent.” And she’s no longer prediabetic. “My addiction to bread and sugar is under control—which I never thought would happen,” says Cross, who organizes the popular Delaware Burger Battle.

Minster and Cross are among the many Delaware-area residents who praise the keto—short for ketogenic—diet. But as with any eating plan, there can be pitfalls.

What is Keto?

The goal of the ketogenic diet is to put you in ketosis, during which the body turns to fat—not glucose—for energy. (Ketosis is your body’s defense mechanism against famine.) To do this, you need to get about 75 percent of your calories from fat, compared to the usual 20-30 percent.

So, wave goodbye to carbs like soda, sugar, bread, and pasta and hello to good fats like ghee, grass-fed meat, and grass-fed butter (made from cows that feed on grass). When the body runs out of the quick fuel it typically gets from carbs—a three-to-four-day process—it breaks down ketone bodies, which are produced from fat. Congratulations, you’re in ketosis. If you want to be sure, look no farther than your nearest CVS, which sells strips that check the ketone levels in your urine.

In the past, the keto diet was used to manage epileptic children’s seizures. “It works quite well for this population,” says Liz Abel, a licensed functional nutritionist with First State Health and Wellness. She has also recommended the diet to people with a traumatic brain injury.

Research on the diet’s effect on other diseases, such as diabetes, is limited. But people who’ve seen results sing its praises. Cyndy Pyle, a former nurse practitioner near Media, Pa., is one of them.

Pyle and her husband, Harry, were previously on the paleo diet, which embraces mostly low-carb ingredients. He was losing weight; she wasn’t. Looking back, she realizes that she was overdoing the permitted sweeteners, such as honey.

Pyle was worried about more than her weight. She had high blood pressure, diabetes, and fibromyalgia. Painful arthritis in her knees often required frequent cortisone injections. Her doctor chalked it up to her age: she was 65 when she was diagnosed. But since going on the keto diet in April 2018, she’s lost 55 pounds. She no longer has high blood pressure, diabetes, high cholesterol, fibromyalgia, or painful knees.

“The idea of giving up sugar and bread was hard for me, but actually doing it is not hard at all,” she says. “The elimination of sugar takes away the craving.”

Former Delaware resident V Capaldi has also seen remarkable benefits from the keto diet. Capaldi, who was diagnosed with multiple sclerosis at age 24, previously tried Atkins, Pritikin, vegan, vegetarian, and blood-type diets. “Other than helping me lose weight, they did nothing for my MS,” says Capaldi, who now lives in California.

Going keto was “the missing puzzle to my healing journey,” maintains Capaldi, who has built the brand Paleo Boss Lady and spoke at TEDx in Wilmington. “Today, I’m potentially the most healed [person] with MS using only diet and lifestyle. I take no drugs and see no doctors.”

Sticking to the Plan

Keto buffs like Pat Farrell of North Wilmington appreciate the diet because it’s easy to follow. “There are so many recipes and alternatives available these days,” says Farrell, who lost 30 pounds. “I make a keto snickerdoodle cookie and coconut flour muffins.”

The cost of going keto, however, can be expensive. The program embraces higher-end products such as grass-fed beef and dairy products and wild-caught salmon. And most followers eat organic.

For a sweet treat, Cross purchases 85 percent dark chocolate. “You get what you pay for, so skip the average stuff from the grocery store,” she recommends. “I eat a half a serving every night, sometimes with nuts. Macadamia nuts are expensive but worth it. Smoked salmon costs as much as steak, but when I eat it for breakfast with cream cheese and cucumber, I feel like a millionaire and certainly not deprived.”

More recently, she’s focused on plant-based foods over dairy, which she says is too high in calories. Capaldi would approve. She eats six-to-nine cups of fruits and vegetables a day. That might surprise those who view keto as nothing but cheese and meat, she acknowledges. “I eat more vegetables than anything else and limit my fruit to one cup of berries a day and still remain keto,” she says. “No dairy at all—so pizza is never on my plate.”

Admittedly, making sure you get most of your calories from fat rather than carbs and protein requires some skill—and fortitude. To get enough fat, some devotees swear by “fat bombs.” Despite the name, these high-fat morsels can be nutrient-dense. They’re typically made with “good” fats, such as grass-fed butter, ghee, avocado, or coconut.

Grass-fed meatballs stuffed with cheese and served with spinach and cream, from Healthy Meals Supreme. Photo courtesy of Healthy Meals Supreme

Convenient Keto

To take the guesswork out of eating keto, Healthy Meals Supreme sells fresh, packaged meals delivered to your door. (You can order a la carte or by meal plan.) Selections might include grass-fed meatballs stuffed with cheese and served with spinach and cream; Salisbury steak topped with mushrooms and served with cauliflower-cheddar mash; and boneless chicken with pesto sauce and sundried tomatoes served with beans.

Currently, keto is the Princeton, N. J., company’s most popular meal selection, says founder Joe Martinez, a pharmacist who has diabetes. “Many friends and colleagues asked me how I controlled my weight and diabetes so well. When I told them, they asked how to buy the meals,” says Martinez, who launched his company in December 2018.

Healthy Meals Supreme, which delivers to Delaware, added keto selections in June. “It was a hit,” he says, “and the rest is history.”

Want ready-made keto foods at a moment’s notice? Head to HoneyBee Seasonal Kitchen & Market in Trolley Square, where Chef Lisa Scolero whips up keto-friendly foods that might feature chicken sautéed in butter, salmon cooked with olive oil, cauliflower mash, and steamed vegetables.

“There has been an upswing in the number of customers wanting ketogenic foods, low-carb items and healthy options,” she says. Her meals are inspired by comfort foods—“something customers recognize or relate to a childhood memory.”

Prepared meals and recipe books are a boon if you’re like Farrell and mostly eat at home. But depending on any additional dietary restrictions, the keto diet is not hard to follow if you eat in restaurants. Credit all the diners in the past 10 years who’ve made special requests a regular occurrence.

“We do hear about the keto diet but not as much as we did the old Atkins diet in the early ’90s when I was at Toscana,” says Paul Bouchard, managing partner of Tonic Bar and Grille in Wilmington. “I may hear about keto from a table once a week.”

Perhaps that’s because chefs no longer flinch if diners nix the potatoes in favor of more vegetables. “We get a lot of people doing that,” says Bouchard. “They could be keto people, and they’re just not announcing it.”

That’s also the case at Platinum Dining Group’s five restaurants, which include three Italian eateries. “Most keto dieters are making their own modifications without really telling us their reasons why, and we just accommodate their requests,” says owner Carl Georigi. “Now, gluten-free? That’s a whole different story.”

Home Grown Café in Newark does not design keto dishes, but many on the menu are low in carbohydrates. Plus, keto dieters can usually adapt. “A lot of items taste good without a roll or bread, such as burgers and sandwich” ingredients, notes owner Sasha Aber. ?

Melissa Ferraro of the Sonora at The David Finney Inn in New Castle is catering to customers with the new “Keto Skillet.” “It’s already becoming very popular,” she says. “It has four eggs, sausage, wild mushrooms, avocado, tomato, and scallions.” Surprisingly, mostly women order it.

Pyle, who is down 55 pounds and off nine medications, finds it fairly easy to order out. At an Italian restaurant, for example, she ordered a steak instead of pasta and had two vegetables. “I put oil on a salad and butter on vegetables,” she says.

Do Your Keto Homework

Some keto dieters are flexible. Cross, for instance, calls herself a “semi-lazy” keto. She took a six-week break before the Delaware Burger Battle, during which she gained up to 11 pounds. She dropped most of the weight when she slipped back into ketosis. Farrell plans to stay on a low-carb diet but will add items like beets and sweet potatoes after she reaches her goal weight.

If you are thinking of going keto, do your homework, Capaldi says. “There is a healthy version and an unhealthy version. Consider adopting a lifestyle that is plentiful in vegetables.”

Work with your healthcare team. Your cholesterol may initially spike. “I’ve seen cholesterol levels rise too high,” Abel says. For diabetics, high levels of ketones can poison the body, according to the American Diabetes Association. If you have a thyroid condition, the diet might not be for you.

Remember, too, that diet does not change behavior, Abel adds. You need to look at lifestyle factors other than eating to manage weight. She says the hyper-diligence required of going full-tilt keto often works in the short term. But like any fad diet, it could lead to yo-yo dieting. Once people go off the diet, they gain weight.

Those who are looking to manage chronic health conditions as well as lose weight may have more incentive to stay on a diet. Minster, for one, is sticking to it as long as he feels good, looks good, and his doctors like his test results. Says he: “I love this quote: ‘Cancer will kill me, but you will never see me dying.’”

So, what do you think? Please comment below.