The ketogenic diet, hailed for its potential in weight loss and disease management, has garnered attention across various health spheres. Initially employed to combat drug-refractory epilepsy in children, this high-fat, adequate-protein, low-carbohydrate regimen has evolved to claim its place as a popular dietary trend. However, amidst the success stories, a closer inspection reveals a complex landscape of benefits and risks that demand a thorough understanding before embracing this dietary approach.
Unveiling the Mechanisms: How Does Ketogenic Diet Work?
At the core of the ketogenic diet lies a fundamental shift in the body’s energy source. By drastically reducing carbohydrate intake and emphasizing fats, the body enters a state of ketosis. Ketones, produced in the liver from fatty acids, become the alternative fuel source when glucose availability is limited. This metabolic shift prompts the body to burn fats for energy instead of relying on glucose.
Keto Diet Composition
5% carbohydrate
25% protein
70% fat
High-fat foods: high-fat meats, oils, eggs, high-fat dairy - cheese, nuts and seeds, avocado, coconut.
Leafy greens and low-carbohydrate vegetables, some berries in moderation.
NO: bread, pastas and other grains, added sugar, milk (because of the carbohydrate content), alcoholic drinks, starchy vegetables (corn, potato, rice, beans) and most fruit.
Weight Loss and Muscle Gain: The Keto Conundrum
Studies showcasing the diet’s efficacy in weight loss often overshadow the intricacies involved. While short-term studies indicate rapid weight loss on the keto diet, a deeper analysis reveals a trade-off: significant loss of water and muscle mass. Comparisons with low-fat, plant-based diets unveil contrasting outcomes, with the latter showing increased fat loss and beneficial impacts on various health markers.
Understanding the Risks: Short and Long-term Concerns
The allure of rapid weight loss often masks the risks associated with prolonged adherence to a ketogenic diet. Short-term risks, ranging from digestive issues to reduced athletic performance, may alleviate over time, but long-term concerns raise critical alarms. These include nutrient deficiencies, impaired artery function, increased risk of cardiovascular disease, and even potential adverse impacts on kidney and liver health.
Safety Concerns and Limitations
The safety of the ketogenic diet becomes a focal point of discussion. Studies indicate that prolonged adherence, exceeding two years, may lead to adverse events such as cognitive decline, nutrient deficiencies, gastrointestinal upset, and potential cardiovascular risks. Certain populations, including pregnant women, children who have not been medically advised to lose weight, and individuals with specific health conditions, such as people with certain types of cancer, heart disease, kidney or liver conditions, and high-performing athletes are advised against following this dietary regimen.
The Verdict: Balancing Potential Benefits and Risks
The ketogenic diet’s allure in weight loss and disease management must be considered against a backdrop of potential risks. Its short-term effectiveness in shedding pounds and managing certain health markers is juxtaposed against the possible long-term implications on overall health and well-being. Thus, a comprehensive evaluation of individual health status, careful monitoring, and professional guidance become imperative before considering a ketogenic journey.
The ketogenic diet stands as a testament to the complexities of dietary interventions. While it might offer short-term benefits, its long-term implications necessitate a cautious approach. Before embarking on any dietary regimen, consulting healthcare professionals and considering individual health conditions remains the cornerstone for making informed and holistic lifestyle choices.
For more information about the keto diet, click here KETO Diet: Can You Lose Weight and Gain Muscle on the Keto Diet?
References:
Kwiterovich PO. “Effect of a high-fat ketogenic diet on plasma levels of lipids, lipoproteins, and apolipoproteins in children.” JAMA. 2003 Aug 20;290(7):912-20.
Martin K, Jackson CF, Levy RG, Cooper PN. Ketogenic diet and other dietary treatments for epilepsy. Cochrane Database Syst Rev. 2016;2:CD001903. Published 2016 Feb 9. doi:10.1002/14651858.CD001903.pub3
Jéquier E. Carbohydrates as a source of energy. Am J Clin Nutr. 1994;59(3 Suppl):682S-685S. doi:10.1093/ajcn/59.3.682S
White H, Venkatesh B. Clinical review: ketones and brain injury. Crit Care. 2011;15(2):219. Published 2011 Apr 6. doi:10.1186/cc10020
Hall KD, Chen KY, Guo J, et al. Energy expenditure and body composition changes after an isocaloric ketogenic diet in overweight and obese men. Am J Clin Nutr. 2016;104(2):324-333. doi:10.3945/ajcn.116.133561
Yancy, William S Jr et al. “A low-carbohydrate, ketogenic diet versus a low-fat diet to treat obesity and hyperlipidemia: a randomized, controlled trial.” Annals of internal medicine vol. 140,10 (2004): 769-77. doi:10.7326/0003-4819-140-10-200405180-00006
Paoli, Antonio. “Ketogenic diet for obesity: friend or foe?.” International journal of environmental research and public health vol. 11,2 2092-107. 19 Feb. 2014, doi:10.3390/ijerph110202092
Grandl, Gerald et al. “Short-term feeding of a ketogenic diet induces more severe hepatic insulin resistance than an obesogenic high-fat diet.” The Journal of physiology vol. 596,19 (2018): 4597-4609. doi:10.1113/JP275173
Juraschek, Stephen P et al. “Effect of glycemic index and carbohydrate intake on kidney function in healthy adults.” BMC nephrology vol. 17,1 70. 8 Jul. 2016, doi:10.1186/s12882-016-0288-5
Czyżewska-Majchrzak, Łucja et al. “The use of low-carbohydrate diet in type 2 diabetes - benefits and risks.” Annals of agricultural and environmental medicine : AAEM vol. 21,2 (2014): 320-6. doi:10.5604/1232-1966.1108597
Roehl, Kelly, and Sarika L Sewak. “Practice Paper of the Academy of Nutrition and Dietetics: Classic and Modified Ketogenic Diets for Treatment of Epilepsy.” Journal of the Academy of Nutrition and Dietetics vol. 117,8 (2017): 1279-1292. doi:10.1016/j.jand.2017.06.006
Numao, S et al. “Short-term low carbohydrate/high-fat diet intake increases postprandial plasma glucose and glucagon-like peptide-1 levels during an oral glucose tolerance test in healthy men.” European journal of clinical nutrition vol. 66,8 (2012): 926-31. doi:10.1038/ejcn.2012.58
Jornayvaz, François R et al. “A high-fat, ketogenic diet causes hepatic insulin resistance in mice, despite increasing energy expenditure and preventing weight gain.” American journal of physiology. Endocrinology and metabolism vol. 299,5 (2010): E808-15. doi:10.1152/ajpendo.00361.2010