Recently, many of my patients are asking a few ketogenic diet. Is a ketogenic diet safe? Would you recommend it? Despite the recent hype, a ketogenic diet isn't something new. In medicine, we have been using it for almost 100 years to treat drug-resistant epilepsy, especially in children. In the 1970s, Dr. Atkins popularized his very-low-carbohydrate diet for weight loss that began with a really strict two-week ketogenic phase. Over the years, other fad diets incorporated an identical approach for weight loss.
What is a ketogenic (keto) diet?
In essence, it is a diet that causes the body to release ketones into the bloodstream. Most cells like better to use blood glucose , which comes from carbohydrates, because the body’s main source of energy. In the absence of circulating blood glucose from food, we start breaking down stored fat into molecules called ketone bodies (the process is named ketosis). Once you reach ketosis, most cells will use ketone bodies to get energy until we start eating carbohydrates again. The shift, from using circulating glucose to breaking down stored fat as a source of energy, usually happens over two to four days of eating fewer than 20 to 50 grams of carbohydrates per day. Keep in mind that this is often a highly individualized process, and a few people need a more restricted diet to start out producing enough ketones.Because it lacks carbohydrates, a ketogenic diet is rich in proteins and fats. It typically includes many meats, eggs, processed meats, sausages, cheeses, fish, nuts, butter, oils, seeds, and fibrous vegetables. Because it is so restrictive, it is really hard to follow over the long run. Carbohydrates normally account for a minimum of 50% of the standard American diet. One of the most criticisms of this diet is that a lot of people tend to eat an excessive amount of protein and poor-quality fats from processed foods, with only a few fruits and vegetables. Patients with kidney disease need to be cautious because this diet could worsen their condition. Additionally, some patients may feel a little tired in the beginning, while some may have bad breath, nausea, vomiting, constipation, and sleep problems.
Is a ketogenic diet healthy?
We have solid evidence showing that a ketogenic diet reduces seizures in children, sometimes as effectively as medication. Because of these neuroprotective effects, questions are raised about the possible benefits for other brain disorders like Parkinson’s, Alzheimer’s, MS , sleep disorders, autism, and even brain cancer. However, there are no human studies to support recommending ketosis to treat these conditions.Weight loss is the primary reason my patients use the ketogenic diet. Previous research shows good evidence of a faster weight loss when patients continue a ketogenic or very low carbohydrate diet compared to participants on a more traditional low-fat diet, or even a Mediterranean diet. However, that difference in weight loss seems to disappear over time.
A ketogenic diet also has been shown to enhance blood glucose control for patients with type 2 diabetes, a minimum of within the short term. There is even more controversy once we consider the effect on cholesterol levels. A few studies show some patients have increase in cholesterol levels in the beginning, only to see cholesterol fall a few months later. However, there's no long-term research analyzing its effects over time on diabetes and high cholesterol.