The ketogenic diet has been described as the biggest diet sensation ever seen in the nutrition industry. So it’s worth investigating for that reason alone.
A ketogenic diet is very high in fat (about 75%), moderate in protein (about 20%), and very low in carbohydrates (about 5%). It is meant to put the body into a state of ketosis. In ketosis, the body breaks down fat to create ketones for energy, instead of burning glucose.
Benefits of Keto?
The benefits of ketosis that we commonly hear about are weight loss, increased HDL (“good”) cholesterol, and improvement in type 2 diabetes, as well as decreased epileptic seizure activity and inhibition of growth of cancerous tumors.
Small studies have shown promise for women with PCOS (polycystic ovary syndrome), an insulin-related condition. This may be due to its possible (inconclusive) ability to restore insulin sensitivity.
Is everything old new again?
The current Keto diet isn’t the first time we’ve targeted carbs as a dietary villain. Medical trials of low-carb and/or fasting date back to the 1850s and even earlier.
In 1967, Stillman introduced The Doctor’s Rapid Weight Loss Diet, which contained essentially nothing but low-fat protein and water.
Then came the Atkins diet in 1972, high in fat and protein, low in carbohydrates. It helped with weight loss and also with diabetes, hypertension, and other metabolic conditions. It is still popular today.
In 1996, Eades and Eades introduced Protein Power, a very low-carbohydrate diet that seemed to help patients with obesity, hypertension, high cholesterol, and/or diabetes.
Therefore, reducing carbohydrates, as the Keto diet does, has a history of helping people lose weight and/or improve metabolic factors. Anecdotal evidence supports that.
Does keto have other benefits?
Likely benefits can be seen with neurodegenerative conditions, such as multiple sclerosis, Alzheimer’s or Parkinson’s, probably because these brain disorders are linked to metabolic disorders. In fact, Alzheimer’s is now called type 3 diabetes.
Care for these conditions is best done under medical supervision.
Ketones also seem to improve traumatic brain injuries, according to research done on rats.
In the interest of full disclosure…
Initial weight loss on the Keto diet is fast. The body has used up its stored glycogen (carbohydrates stored in muscle) and discarded the stored water with it. After that, weight loss can continue, but at a slower rate.
The metabolism shows an initial increase that seems to disappear in 4 weeks.
Keto does not appear to offer long-term advantages in either fat loss or lean mass gain.
In some people, Keto seems to increase LDL (“bad”) cholesterol.
What about the negative effects?
The often mentioned “cons” of a ketogenic diet are nutrient deficiencies due to missing food groups and an unpleasant transition state called the “keto flu” that can last for days. It includes hunger, dehydration, headaches, nausea, fatigue, irritability, constipation, brain fog, sluggishness, poor concentration, and lack of motivation. Because these symptoms are so similar to those of people who give up caffeine, Keto has been postulated as a “detox” plan.
Other negatives include problems with gut health on such a low-fiber diet and difficulties with adherence.
When it comes to workouts, the keto diet probably doesn’t offer any advantages for most people. In fact, the glycogen depletion it induces can lead to bonking. Athletic performance involving speed and power can be diminished without glucose and carbohydrates for fuel.
The International Olympic Committee has urged athletes to avoid low-carb diets. They can lead to poor training adaptations and decreases in both power output and endurance. A colleague of mine induced cardiac arrhythmias in rats that exercised on a low-carbohydrate diet.
Due to the low carb nature of the Keto plan, my concern is how women fare with regards to serotonin synthesis and function. Carbohydrates play an important role in transporting tryptophan (the precursor to serotonin) to the brain, so serotonin levels may drop without those carbohydrates. How does that affect women in terms of mood, appetite, impulsiveness, and more?
What is the end result?
Keto appears to be viable for short-term weight loss and the other health issues outlined above. Whether the approach is adequate in the long term is still debated. Its benefits are still up for debate, too. Critics cite possible kidney damage and a lack of long-term studies and scientific evidence.
In general, Keto does not seem to be a long-term cure or the ideal solution for those who just want to “get healthier.” Not least, the diet is difficult for many people to follow consistently.
A preferable long-term eating plan might be a more balanced one that is low in sugar and “junk” carbohydrates and emphasizes healthy, high-fiber foods, including vegetables.
