The ketogenic diet has been described as the biggest diet sensation of all time in the nutrition industry. So it’s worth looking into it 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 designed to put the body in 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 we typically hear about are weight loss, increased HDL (“good”) cholesterol, and improvement in type 2 diabetes, as well as reduced epileptic seizure activity and inhibition of cancer tumor growth.
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 reset insulin sensitivity.
Everything old is new again?
The current keto diet isn’t the first time we’ve targeted carbs as dietary villains. Medical trials of low-carbohydrate diets and/or fasting date back to the 1850s and even earlier.
In 1967, Stillman introduced The Doctor’s Quick Weight Loss Diet, which contained essentially nothing but low-fat protein and water.
Next came the Atkins diet in 1972, high in fat and protein, low in carbohydrates. It helped with weight loss and also with diabetes, high blood pressure and other metabolic diseases. It’s still popular today.
In 1996, Eades and Eades introduced Protein Power, a very low-carb diet that appeared to help patients with obesity, high blood pressure, high cholesterol, and/or diabetes.
So cutting back on carbs, like the keto diet does, has a long history of helping people lose weight and/or improve metabolic factors. Anecdotes prove that.
Does keto have any other benefits?
Probable benefits can be seen in neurodegenerative diseases such as multiple sclerosis, Alzheimer’s or Parkinson’s, probably because these brain diseases 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.
Based on research in rats, ketones also appear to improve traumatic brain injuries.
In the interests of full disclosure…
Initial weight loss on the keto diet is rapid. The body has used up its stored glycogen (carbohydrates stored in the muscles) and dumped the water stored with it. After that, weight loss can continue, but at a slower rate.
Metabolism shows an initial increase that seems to disappear within 4 weeks.
Keto doesn’t appear to provide any long-term benefits for either fat loss or lean mass gain.
In some people, keto appears to increase LDL (“bad”) cholesterol.
What about negative effects?
The most commonly cited “disadvantages” of a ketogenic diet are nutrient deficiencies due to missing food groups and an uncomfortable transitional state called “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 negative aspects include issues with gut health on such a low-fiber diet and difficulty in following it.
As far as training goes, the keto diet probably doesn’t offer any benefit for most people. In fact, the glycogen breakdown it causes can cause you to “bonk” against the wall. Without glucose and carbohydrates for fuel, athletic performance in terms of speed and power can be reduced.
The International Olympic Committee has urged athletes to avoid low-carb diets. They can lead to poor training adaptations and a decrease in both power output and endurance. A colleague of mine induced cardiac arrhythmias in rats fed a low-carbohydrate diet.
Due to the low-carb nature of the keto plan, my concern is how women may fare in terms of serotonin synthesis and function. Carbohydrates play an important role in transporting tryptophan (the precursor to serotonin) to the brain, so without these carbohydrates, serotonin levels could drop. How does this affect women in terms of mood, appetite, impulsivity and more?
What is the bottom line?
Keto appears to be suitable for short-term weight loss and the other health issues outlined above. Whether the approach is suitable in the long term is still controversial. Its benefits are also still debated. Critics cite possible kidney damage and the lack of long-term studies and scientific evidence.
Overall, keto doesn’t seem like a long-term cure, nor does it seem like the ideal solution for those who just want to “be healthier.” Last but not least, many people find it difficult to stick to their diet consistently.
A preferable long-term eating plan might be a more balanced one, low in sugar and “junky” carbohydrates, and emphasizing healthy, high-fiber foods, including vegetables.
Thanks to Joan Kent
