fats-and-meats-lg-1

the most ketogenic diet foods

  • Ketosis occurs when glucose stores and insulin levels are low which causes the body to switch to the use of fat for fuel.
  • Our insulin response is related not just to carbohydrate, but also the protein and fibre content of our food.
  • This understanding can help us to prioritise foods with a lower insulin load that will help us improve our blood glucose control.

food insulin index

The initial research into the food insulin index was detailed in a 1997 paper An insulin index of foods: the insulin demand generated by 1000-kJ portions of common foods by Susanne Holt, Jennie Brand Miller and Peter Petocz who tested the insulin response to thirty eight different foods.

insulinindex

The food insulin index score of various foods was determined by feeding 1000kJ (or 239 kcal) of different foods to non-diabetic participants and measuring their insulin response over three hours.   This was then compared to the insulin response of pure glucose (which is assigned a value of 100%) to arrive at a “food insulin index” value for each food.

FII versus time chart.jpg

Considering how significant this information could be for people trying to manage their insulin levels (e.g. people with diabetes, “low carbers” or “ketonians”) I was surprised that there hadn’t been much further research or discussion on the topic.  I found a few references and mentions in podcasts, but no one was quite sure what to do with the information, mainly due to the fact that only a small small number of foods been tested.

more food insulin index data

Digging a bit further I came across a recent PhD thesis from the University Of Sydney titled Clinical Application of the Food Insulin Index to Diabetes Mellitus (Kirstine Bell, September 2014) which contained a more extensive list of foods that had been tested since the original study.

With this additional data perhaps we can make more sense of the various factors that affect insulin, the master regulating hormone of our metabolism?

In the chart below I have plotted the carbohydrates versus the insulin response of foods for more than one hundred foods.  Although insulin is loosely correlated with the carbohydrate content of our food, we can see that high protein foods such as steak, tuna and fish still require a significant amount of insulin.

food insulin index - fresh start 9052016 52737 AM.bmp

I ran some analysis on the data and found that we secrete about half as much insulin in response to protein compared to carbohydrate.  And we get the best correlation when we assume that indigestible fibre does not raise insulin.  Interestingly, fructose only requires about a quarter of the insulin as carbohydrate.

Once we account for protein and fibre we get a much better prediction of the insulin response to food compared carbohydrate alone.

food insulin index - fresh start 9052016 52727 AM.bmp

[Check out this cool interactive visualisation of all the FII test data here.]

Using this understanding we can calculate insulin load of our food using the following formula:

insulin load = total carbohydrate – fibre + 0.56 x protein

We can also calculate the proportion of the energy in our food that requires insulin to metabolise (i.e. “the percentage of insulinogenic calories”).

image016

If you have the nutritional properties for a food or a meal you can calculate the percentage  of insulinogenic calories using this calculator created by Dr Ted Naiman.

insulin load, the common denominator

You may have noticed that the internet is full of groups of people passionate about seemingly contradictory dietary approaches that seem to work.

image02

You have the vegans, vegetarians and the longevity crowd who advise that you should minimise animal proteins because they provide excess amino acids which raise IGF-1 and insulin.  People like Joel Fuhrman, T Colin Campbell and Ron Rosedale advise that we should prioritise high fibre unprocessed plant based foods.   This approach, with lower levels of protein, minimal processed carbohydrates and high levels of fibre will have a low insulin load compared to the typical diet.

insulin load = total carbohydrate – fibre + 0.56 x protein

Seemingly on the other end of the spectrum you have the low carbers following an Atkins type diet emphasising higher levels of fat and avoiding carbohydrates.  Similarly, such an approach will also have a relativity low insulin load.

Part of the magic of all of these approaches is that they all manage insulin levels.

possible applications

Insulin is not bad at normal levels, but we are understanding more and more that excess insulin (i.e. hyperinsulinemia) is highly problematic, perhaps as much or more than high blood glucose levels.

Understanding how to calculate our insulin response to food could enable us to better manage our diet to avoid elevated blood glucose and hyperinsulinemia.

The biggest challenge for someone with Type 1 Diabetes (like my wife) occurs when you require a large dose of insulin to address a high blood glucose level that is caused by eating non-fibre carbohydrates and large amounts of protein.  As you can see in continuous glucose monitor plot below, once you’re on the “blood glucose roller-coaster” it’s hard to get off.

It’s much easier to manage your blood glucose levels when the insulin load of your diet is lower (i.e. less non-fibre carbohydrates and moderate protein).

The plot below is from the same person with type 1 diabetes a few weeks later after modifying their diet.  The amplitude of the swings are smaller which makes it easier to manage blood glucose levels with smaller doses of insulin.

A more accurate understanding of insulin load can also help people with diabetes more accurately calculate their insulin dose or people trying to manage conditions like cancer or epilepsy through a therapeutic ketogenic diet.

For the rest of us who are somewhere on the insulin resistance scale, being able to calculate the insulin load of our diet will enable us to design a diet that will enable our pancreas to keep up and maintain normal blood glucose levels.

the most ketogenic foods

Listed below are the foods that will require the least amount of insulin.  I have included a number of other parameters that may be of interest:

  • nutrient density (ND) – high nutrient density foods will help you avoid cravings and achieve satiety with less calories.
  • energy density – foods that contain high levels of fibre and water have a low energy density (i.e. calories per 100g) and will tend to make us full with fewer calories.
  • percentage of insulinogenic calories – this is the proportion of the energy in the food that will require insulin to metabolise.
  • insulin load – foods such as non-starchy vegetables have a higher proportion of insulinogenic calories, but because of their low energy density will have a very low insulin load per 100g of food, meaning that you will need to eat a lot of that particular food for it to affect your blood glucose or insulin significantly.
  • net carbohydrates – these are the digestible carbohydrates that will affect your blood glucose levels and insulin that remain after you account for the indigestible fibre.

The amount you need to prioritise each of these parameters depends on a range of considerations including your blood glucose control and your weight loss goals.   Along with the insulin response to different foods, nutrient density and energy density are other important parameters we can use to optimise our food choices.

2016-07-06 (11)

The table below contains links to separate blog posts and printable .pdfs detailing optimal foods for a range of dietary approaches (sorted from most to least nutrient dense) that may be of interest depending on your situation and goals.   You can print them out to stick to your fridge or take on your next shopping expedition for some inspiration.

dietary approach printable .pdf
weight loss (insulin sensitive) download
autoimmune (nutrient dense) download
alkaline foods download
nutrient dense bulking download
nutrient dense (maintenance) download
weight loss (insulin resistant) download
autoimmune (diabetes friendly) download
zero carb download
diabetes and nutritional ketosis download
vegan (nutrient dense) download
vegan (diabetic friendly) download
therapeutic ketosis download
avoid download

If you’re not sure which approach is right for you and whether you are insulin resistant, this survey may help identify the optimal dietary approach for you.

image02

 

I have sorted the foods below by insulin load which will be useful if you are looking for foods to help you manage the insulin load of your diet.  If you’re interested, the most ketogenic foods article has these foods sorted by their proportion of insulinogenic calories.

Focusing on foods with a low percentage of insulinogenic calories will be useful if you are aiming for a high fat therapeutic ketogenic diet.  Focusing on foods with a low insulin load may be more useful if you want to lose weight and use some of your body fat for fuel.

eggs

Eggs are a staple for low carbers, ketogenic dieters and diabetics.  Not only are they nutritious they are also low in carbohydrates.

 Fried-Egg-Wallpaper-5

food ND % insulinogenic net carbs/100g insulin load  (g/100g) calories/100g
egg white -0.08 74% 1 9 48
whole egg 0.16 29% 1 10 138
egg yolk 0.17 19% 4 15 317

The egg white is higher in protein and hence more insulinogenic.  At the same time the energy density (calories/100g) of the egg white is lower and hence the insulin load per 100g for the egg white is lower.

dairy

Some people believe that red meat and dairy are uniquely insulinogenic, however my reading of the food insulin index data is that there is nothing special about these foods that isn’t explained by their carbohydrate, protein and fibre content.

Dairy foods typically have a high energy density.  This is great if you’re a growing baby, an athlete trying to replenish energy or a bodybuilder trying to spike insulin for hypertrophy. High palatability and high energy density are not a good combination if you’re trying to lose weight.

cheese

food ND % insulinogenic net carbs/100g insulin load  (g/100g) calories/100g
cream cheese 0.09 10% 4 8 348
cottage cheese -0.01 38% 3 9 93
ricotta cheese 0.08 25% 3 11 174
feta cheese 0.15 22% 4 14 265
Limburger cheese 0.16 18% 0 15 327
Camembert cheese 0.16 20% 0 15 299
brie cheese 0.14 19% 0 16 334
Muenster cheese 0.15 20% 1 18 368
blue cheese 0.16 20% 2 18 354
mozzarella 0.15 23% 2 18 318
Monterey 0.15 20% 1 19 373
cheddar cheese 0.15 20% 1 20 403
Colby 0.15 20% 3 20 394
Edam cheese 0.17 22% 1 20 356
Gouda cheese 0.17 23% 2 20 356
provolone 0.17 24% 2 21 350
Gruyère cheese 0.17 21% 0 22 412
goat cheese 0.17 22% 2 25 451
Swiss cheese 0.17 26% 5 25 379
parmesan cheese 0.18 30% 3 31 411

milk and cream

Milk has a higher proportion of insulin calories compared to cheese.  Butter and cream have a lower insulin load and proportion of insulinogenic calories.

36959895мляко

food ND % insulinogenic net carbs/100g insulin load  (g/100g) calories/100g
butter 0.09 0% 0 1 734
cream 0.08 5% 4 5 431
goat milk -0.05 40% 4 7 69
full cream milk -0.10 44% 5 7 65
low fat milk -0.12 58% 5 7 50
human milk -0.14 43% 7 8 71
reduced fat milk -0.13 59% 5 8 51

yoghurt

Full fat plain Greek yoghurt has the lowest percentage of insulinogenic calories while the sweetened and low fat options are extremely insulinogenic.

greek-yogurt

food ND % insulinogenic net carbs/100g insulin load  (g/100g) calories/100g
Greek Yoghurt 0.01 27% 6 9 130
plain low fat yoghurt -0.02 69% 7 11 63
skim milk yoghurt -0.02 86% 8 12 55
low fat fruit yoghurt -0.00 93% 19 22 95

fruit

It’s interesting to note that there are only a handful of fruits with a low percentage of insulinogenic calories (i.e. olives and avocados).  However some fruits like oranges have a lower insulin load because of their low energy density and therefore may not spike your blood sugar as much as dates or raisins which have a high proportion of insulinogenic calories as well as a high insulin load.  If in doubt, get a blood glucose metre and compare how much your favourite foods raise your blood glucose levels.

spanish-olives

food ND % insulinogenic net carbs/100g insulin load  (g/100g) calories/100g
olives 0.02 15% 3 3 90
strawberries -0.15 52% 4 5 36
avocado 0.01 18% 5 6 131
raspberries 0.09 42% 6 6 58
watermelon -0.04 88% 7 7 34
nectarines -0.04 68% 8 8 49
limes 0.05 69% 8 8 47
plum -0.06 74% 9 9 51
peaches -0.23 84% 9 9 44
honeydew melon 0.30 88% 8 9 40
apricots -0.21 74% 9 10 54
apples 0.48 77% 10 10 53
blackberries -0.01 79% 8 10 48
grapefruit -0.30 97% 10 10 42
mango 0.10 66% 10 11 67
pear 0.14 69% 11 11 64
orange 0.49 77% 10 11 55
cherries 0.72 84% 10 11 54
apple juice -0.22 95% 11 11 47
pineapple 0.06 84% 12 12 57
mandarin oranges 1.11 85% 11 12 55
kiwifruit -0.02 76% 12 13 67
currants -0.21 83% 12 13 63
apples -0.15 91% 13 13 58
mango nectar -0.20 98% 13 13 53
grape juice -0.06 92% 14 14 62
passion fruit 0.24 54% 13 15 109
guava -0.13 79% 14 15 76
litchis 0.20 80% 14 15 73
grapes 0.45 80% 15 15 77
boysenberries 0.40 66% 15 16 94
blueberries 0.32 72% 16 16 91
figs 0.37 81% 16 17 82
canned peaches -0.14 93% 18 18 77
bananas -0.02 87% 21 21 99
plantains 0.37 79% 25 25 129
dates 0.17 72% 54 56 308
raisins 0.20 84% 68 70 336
prunes 0.11 97% 89 91 378

vegetables

There aren’t many dietary approaches that don’t advise you to eat more vegetables.  It’s also hard to overeat non-starchy veggies because they have a very low calorie density and are high in fibre.  Again, due to the low energy density the net carbohydrates are low in a lot of the non-starchy veggies and hence won’t significant raise your blood glucose levels.

vegetable-03

food ND % insulinogenic net carbs/100g insulin load  (g/100g) calories/100g
chicory greens -0.25 27% 1 2 28
pickled cucumber -0.99 48% 1 2 13
butter head lettuce -0.98 49% 1 2 16
celery 2.63 49% 1 2 17
radishes 0.70 50% 2 2 19
lettuce 1.34 52% 2 2 17
Chinese cabbage 1.02 60% 1 2 16
chives 0.27 34% 1 3 37
cilantro -0.44 36% 1 3 28
spinach -0.54 41% 1 3 29
mustard greens 0.27 45% 2 3 30
mung beans 0.33 46% 1 3 26
asparagus 1.12 46% 2 3 27
endive -0.60 52% 2 3 20
rhubarb 1.46 57% 3 3 21
summer squash 1.00 65% 2 3 19
artichokes 0.83 33% 3 4 54
turnip greens 1.31 39% 1 4 37
alfalfa (sprouted) -0.54 46% 1 4 31
bamboo shoots 0.90 52% 3 4 28
cabbage 0.81 53% 3 4 30
arugula -0.02 54% 2 4 31
cauliflower -0.60 57% 3 4 28
turnips -0.13 64% 3 4 24
chard (cooked) -0.68 68% 3 4 25
pumpkin -0.04 73% 4 4 23
cucumber -0.03 78% 3 4 18
seaweed (kelp) 0.74 43% 4 5 50
beets 0.34 44% 4 5 48
collards 0.44 46% 2 5 40
snap green beans 0.74 47% 4 5 40
parsley 0.15 49% 3 5 44
jalapeño peppers 0.52 54% 4 5 35
carrots 0.20 55% 5 5 39
okra 0.94 57% 4 5 37
mushrooms 0.65 70% 2 5 30
broccoli 1.21 57% 4 6 42
parsnip 0.73 38% 7 7 76
Brussels sprouts 0.24 54% 5 7 52
peas 0.69 58% 5 7 51
shiitake mushrooms -0.22 60% 5 7 48
bell peppers 0.86 64% 6 7 43
eggplant 0.39 67% 7 7 41
leek 0.13 79% 6 7 36
onions 0.52 77% 7 8 41
winter squash 1.22 80% 7 8 39
kale 0.75 74% 8 10 56

nuts and seeds

Most nuts and seeds have a low percentage of insulinogenic calories though they have a higher energy density are possible to overeat.

food ND % insulinogenic net carbs/100g insulin load  (g/100g) calories/100g
coconut water 1.51 66% 3 3 20
coconut milk 0.03 8% 4 5 246
macadamia nuts 0.12 5% 5 9 769
pecans 0.15 5% 4 9 762
Brazil nuts 0.09 9% 4 15 704
flaxseed 0.08 12% 2 16 568
pine nuts 0.16 11% 9 18 647
coconut meat 0.09 11% 16 20 703
chia seeds 0.10 16% 8 21 511
sunflower seeds 0.18 20% 11 24 491
walnuts 0.10 15% 7 25 683
tahini 0.17 16% 13 26 633
hazel nuts 0.10 16% 15 27 692
almonds 0.11 16% 15 27 652
sesame seeds 0.12 18% 14 27 603
cashew nuts 0.11 22% 24 33 609
pistachio nuts 0.16 23% 19 34 602
pumpkin seeds 0.12 27% 36 53 777

seafood

Seafood is a great source of essential fatty acids which are heard to find in plant based foods.

seafood-salad-5616x3744-shrimp-scallop-greens-738

food ND % insulinogenic insulin load  (g/100g) calories/100g
crayfish 0.21 64% 12 78
perch 0.16 59% 13 91
crab 0.26 69% 13 78
oyster 0.31 57% 14 98
lobster 0.30 69% 14 84
sturgeon 0.26 47% 15 129
salmon 0.28 50% 15 122
snapper 0.25 64% 15 94
haddock 0.21 69% 15 85
halibut 0.27 63% 16 105
swordfish 0.28 41% 17 165
rainbow trout 0.28 43% 17 162
mackerel 0.28 45% 17 149
tuna 0.30 50% 17 137
whiting 0.21 63% 17 109
Pollock 0.27 66% 17 105
white fish 0.27 67% 17 102
orange roughy 0.08 67% 17 99
cod 0.17 67% 17 99
herring 0.26 34% 18 210
sardine 0.24 36% 18 202

animal products

7450703_orig

food ND % insulinogenic insulin load  (g/100g) calories/100g
frankfurter 0.10 14% 11 322
bratwurst 0.05 25% 11 171
beef ribs 0.11 13% 12 349
salami 0.12 29% 12 166
foi gras 0.11 11% 13 459
pate 0.13 16% 13 315
turkey heart 0.16 39% 13 130
duck (with skin) 0.12 17% 14 331
pepperoni 0.13 14% 17 487
polish sausage 0.11 26% 17 259
duck (meat only) 0.17 36% 17 195
lamb 0.14 24% 18 308
chorizo 0.15 17% 19 448
ground turkey 0.19 37% 19 203
veal (sirloin) 0.18 38% 19 195
ostrich 0.19 46% 19 168
chicken liver 0.43 48% 20 165
ham 0.26 55% 20 146
sirloin steak 0.16 28% 21 305
goose 0.17 37% 21 230
pork 0.18 46% 21 182
chicken drumstick 0.17 36% 22 238
turkey breast 0.22 70% 22 127
beef liver 0.46 58% 24 169
chuck steak 0.22 50% 25 197
chicken breast 0.22 56% 25 178
veal (leg) 0.25 56% 25 174
emu 0.24 63% 25 159
bacon 0.18 23% 30 522

154 thoughts on “the most ketogenic diet foods”

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s