QUESTION: “Is the Keto diet good for a person in their 80’s? Thank you.”
DR. NEAL: For over 100 years, the Ketogenic diet has been used to help treat certain health conditions. Epilepsy is probably the most notable of these.
But since world record-setting endurance athletes began swearing by the Ketogenic diet and insisting that it played a large role in their athletic achievements, the diet’s popularity grew like crazy.
So, what’s so special about the Ketogenic eating pattern?
American vs. Keto Diet
The typical American diets consist of about:
- 60% of one’s daily energy (or, calories) coming from carbohydrates
- 15% from protein
- and 25% from fat
Contrast this with the Ketogenic diet which requires a person to eat:
- 10% of one’s daily calories from carbohydrate
- 20% from protein
- and 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.
What Are Ketones?
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.
Now 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?
Studies on the Keto Diet
The majority of published studies on the health effects of the Ketogenic diet have recruited elite athletes as participants. Results showed 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.
We know that in the short-term, when otherwise healthy individuals follow this eating style, it appears to be relatively safe. But when switching from a standard American diet, which consists mostly of carbohydrates, to one of mostly fat, there will be some side effects. Individuals often complain of:
- feeling fatigued (which could be the result of having low blood sugar due to the decreased intake of carbohydrates)
- constipation (also due to the reduced carbohydrate intake) diarrhea (because of the increased fat intake) gallstones vitamin deficiencies
The Ketogenic meal pattern may not provide dieters with enough B-vitamins, Vitamin C, calcium, zinc, phosphorus, and dietary fiber.
There are some recent findings that reveal that following a Ketogenic diet may influence the type and number of good bacteria in our gut. More specifically, it might limit the numbers of these good bacteria. As a result, it can change our bowel habits and possibly increase our risk for other chronic conditions.
We're also learning that in some folks, eating a high-fat diet may increase the number of these things called lipid peroxides in the body. Lipid peroxides can form as byproducts when our bodies metabolize fat. In turn, they may damage healthy cells, so we really don't want these in the body. Hopefully, we'll have results of longer-term studies in the near future to give us a better picture of what's really going on.
And if we follow a high fat diet like Keto, then there’s the chance that the body will create more lipid peroxides, which in turn, may increase risk for disease.
What About the Ketogenic Diet for Older Individuals?
Back to your question, specifically. There are only a few small studies that have looked at the health effects of the Keto diet on older individuals. Most of these looked at whether this diet helped with lowering a person’s risk for developing dementia. Other studies looked at whether it improved symptoms of Alzheimer’s. The diet has shown promise when it comes to preventing dementia and improving the symptoms of Alzheimer’s.
I was also able to find one study that looked at the effects of the Keto diet on weight loss and insulin sensitivity in older adults. The study found that when older individuals followed a Keto diet, they were able to lose body fat and preserve muscle. Sounds amazing, right? But if you know me, you know there’s a catch coming…
All of these studies were performed in the short-term – meaning, 2 months or less. When other studies have tried to keep people on the Keto diet for longer, they found that people tend to drop out. Some find it challenging to follow the diet even within this short time frame. So, it becomes really difficult to make health recommendations when so few are in the study sample and so few actually complete the study.
I should also mention that because many of the more recent studies examining the health effects of the Ketogenic diet used elite athletes as participants, this is 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. Even those that are active on a regular basis are already changing their metabolisms. The higher your level of cardiovascular and muscular fitness, the more likely you are to burn fat ALL the time, independent of what you eat!
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.