I discussed the Ketogenic diet earlier this year, but I am still getting questions about it, which is great! There’s still so much you all want to know, so, I am happy to talk more about this. Let’s dive right in…
A Ketogenic-type diet has been used since the early 1900s to treat epilepsy. Fast forward to today and this diet is being used to help treat a number of health conditions. But it doesn’t always mean it’s effective. Is it even effective at all? If not, then, why the sudden jump in popularity? Let’s discuss…
Part of the Ketogenic diet’s recent popularity isn’t necessarily because it is effective for the treatment of health conditions or that it’s useful for weight loss in the long term. Instead, we can attribute much of its popularity to athlete and celebrity endorsements. A handful of world record-setting endurance athletes swear by the Ketogenic diet and insist that it played a large role in their athletic achievements.
What’s so special about this eating pattern? Typical American diets consist of about:
- 60% of one’s daily energy (i.e. calories) coming from carbohydrates
- about 15% from protein
- about 25% from fat
Contrast this with the Ketogenic diet which requires:
- 10% of one’s daily calories from carbohydrate
- 20% from protein
- a whopping 70% from fat
Essentially, it’s a lower carbohydrate, high-fat diet. It’s called a Ketogenic diet because this lowered consumption of dietary carbohydrate leads to the build of things called “ketones” in the body.
You all are familiar with one type of ketone: nail polish remover (aka acetone). Acetone is just one type of ketone, and yes, when our bodies are in a state of “ketosis,” meaning the body is creating ketones, one of the ones produced is acetone. If you were to follow this diet over a period of 2 weeks or longer, you would be in a state of ketosis – meaning your blood levels of ketones have increased to a higher than normal level.
You’re probably thinking: “Is being in a constant state of ketosis bad? Is it possible that following such an extreme diet could be beneficial?”
Based on observational case studies performed in the 1920s, explorers observed Inuit populations consuming large amounts of dietary fat and not a whole lot of carbohydrates. At the same time, they did not appear to suffer from the chronic diseases commonly seen in Western societies. Fast forward to today and we find a renewed interest in this diet – much of this can be attributed to athlete endorsements. More studies are being conducted to test the effects of the Ketogenic diet, but we need to keep in mind that many of these studies have recruited elite athletes as participants. When we examine the results, we find that during activity, these athletes burned more fat as fuel and were able to improve their endurance. It is often assumed that the ketones are what help this extra fat burn.
What happens when the rest of us follow a Ketogenic diet? We know that in the short-term, it appears to be relatively safe for otherwise healthy individuals. But when switching from a standard American diet, which consists mostly of carbohydrates, to one of mostly fat, there will be some side effects. Complaints range from:
- feeling fatigued (which could be the result of having low blood sugar due to the decreased intake of carbohydrate)
- constipation (also due to the reduced carbohydrate intake)
- diarrhea (because of the increased fat intake)
- some may develop gallstones
- there’s the risk of developing vitamin deficiencies
Let’s talk about cancer patients and the Ketogenic diet. There are a few small studies that examined this very question. The theory is that since cancer cells love carbohydrates, by severely restricting carbohydrates, you might be able to kill the cancer cells by starving them. Some very small studies have been conducted–think under 20 patients. One study started with 16 patients, but by the end, only had 5 left. Here’s what happened, I will quote the study’s authors:
“One patient did not tolerate the diet and dropped out within 3 days. Among those who tolerated the diet, two patients died early, one stopped after 2 weeks due to personal reasons, one felt unable to stick to the diet after 4 weeks, one stopped after 6 and two stopped after 7 and 8 weeks due to progress of the disease, one had to discontinue after 6 weeks to resume chemotherapy, and five completed the 3 month intervention period.”
So even though this study only lasted 3 months, some found it challenging to follow the diet within this short time frame. Plus, it becomes really difficult to make health recommendations when so few are in the study sample.
Moving on to ADHD and autism: the majority of the studies examining the Ketogenic diet on these conditions were performed in lab animals like mice, rats, and dogs. One small study was conducted back in 2003 and found improvements in the behavior of autistic children when they followed a Ketogenic diet. The problem is that about 23% of the children dropped out because they couldn’t stand the diet.
Going back to the more recent studies examining the health effects of the Ketogenic diet on elite athletes, we have to be careful interpreting these results because this is also a very unique subset of individuals. Elite athletes have very different nutritional needs when compared to those of us that do not possess these superhuman-like abilities. Also, as mentioned before, the majority of the studies were performed over the short-term (<6 months).
I recently attended an academic conference and happened to speak with one of the leading Ketogenic diet researchers Marlia Braun, PhD, RDN and asked, “We have all of this data on the short-term effects of following a Ketogenic diet, but what happens when otherwise healthy individuals follow this diet for a year or more?” Her response: “We don’t know.”
It is possible that over the long-term, individuals may not experience these same benefits. Plus, this diet is very strict. I am not so sure that long-term adherence is realistic for most folks.
If this type of eating pattern appeals to you, it would be wise to discuss the Ketogenic diet with your physician to be sure that it is safe given your current health status and prior health history. I would also recommend that you incorporate this pattern of eating very slowly to prevent any uncomfortable side effects.