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Ketogenic Diet (Keto)

Overview:

The ketogenic diet (or “keto”, for short) is a low-carb, high-fat diet. It involves drastically reducing carbohydrate intake and replacing it with fat. This reduction in carbs, according to experts, puts the body into a metabolic state called ketosis. When this happens, your body becomes incredibly efficient at burning fat for energy. It also turns fat into ketones in the liver, which can supply energy for the brain. Ketogenic diets can cause massive reductions in blood sugar and insulin levels. This, along with the increased ketones, has numerous health benefits.

Ketogenic diet (keto):

A low-carb, high-fat, moderate-protein diet that involves a drastic reduction in the carbohydrate intake (to less than 50 grams per day), and replacing it with fat and protein. This reduction in carbs, according to experts, puts the body into a metabolic state called ketosis.

How does keto work?

Keto is a high-fat, moderate-protein and a very low-carb diet, with no more than 50 grams of carbohydrates per day, which is opposed to most recommendations and guidelines for healthy nutrition. That is because most of the foods rich in essential nutrients are sources of carbohydrates. These include fruits, vegetables, whole grains, milk and leben. Besides, carbohydrates are the main source of energy. When no sufficient carbohydrates are available, the body will start to break down fat into ketones. Whereupon, fat will serve function as the main source of energy, from which the heart, the kidneys, and the rest of the muscles, shall derive the energy necessary for their functioning. Besides, ketones will function as an alternative source of energy for the brain—which is why this diet is called “ketogenic” in the first place.

The ketogenic diet (keto):

Standard ketogenic diet (SKD): It is a very low-carb, high-fat, moderate-protein diet; at a daily macronutrient ratio of 70% fat, 20% protein, and 10% carbs.
Cyclical keto diet (CKD): This diet involves increasing carbohydrates at certain times. For example, one can follow keto for five days, and enjoy a more balanced diet, with higher carbohydrate intake, for two days.
Targeted keto diet (TKD): TKD allows increasing the carbohydrate intake at the times of vigorous physical activity.
High-protein keto diet (HPKD): HPKD involves increasing the protein intake, and adjusting the macronutrient ration to: 35% protein, 60% fat, and 5% carb.

Advantages and disadvantages of the ketogenic diet:

Advantages:

Starting in 1924 as a treatment for epilepsy, the keto diet was subsequently associated with other advantages, including: fast weight-loss, control of type 2 diabetes, lowering the level of glycated hemoglobin, reducing the dose of sugar-lowering medications, and lowering the level of triglycerides in the blood.

According to the American Diabetes Association, several comparative studies have compared between the levels of glycated hemoglobin in individuals on a low-carb diet (e.g. keto), and individuals following a high-carb diet. The findings of those studies showed that the level of glycated hemoglobin is lower in the low-carb group than the high-carb group over a span of 3-6 months only, and is more or less the same over longer periods of time (one year or more).

Another study compared between the levels of glycated hemoglobin in individuals on a low-carb diet (e.g. keto), and individuals following a low-fat diet over a time span of six months. The findings showed that the level of glycated hemoglobin in the low-carb group is lower than the low-fat group.

Disadvantages:

Keto is not recommended for individuals with any of the following medical conditions:

Pancreatitis
Liver diseases
Thyroid disorders
Eating disorders, or a history of eating disorders
Cholecystitis
Chronic kidney diseases
Pregnancy

Besides, there are short-term and long-term health risks associated with the ketogenic diet. The short-term health risks associated with keto include: Flu-like symptoms (e.g. gastric disorders, headache, fatigue, dizziness (the so-called keto-flu), and sometimes sleep disorders.

Lowering the intake of vegetables, fruits, and the whole grains rich in fiber increases the risk of constipation. Sometimes, a person on keto will have to take fiber supplements, after consulting with a healthcare professional. The keto diet may also be diuretic, and lower the level of glucose in the blood. Therefore, it is essential to consult a nutritionist before following the keto diet, to avoid dehydration, and reduce the dose of insulin and other diabetes medicines, and hence to avoid too low blood sugar.

The long-term risks associated with keto, on the other hand, include: the risk of kidney stones, liver diseases, and deficiency of vitamins and minerals (e.g. folate, Vitamin A, Vitamin K, Vitamin H, etc.)

Final conclusions:

A balance of all nutrients should be stricken and with appropriate proportions. A too little intake of any nutrients can be harmful. All nutrients should be taken in amounts that are healthy and useful.
The research recommends the keto diet for treating epilepsy, under medical supervision; it is a very complicated treatment. As for treating obesity, losing weight, among other health benefits, keto remains under study.
For long-term diets, moderation should be maintained. However, studies have shown that the keto diet may be useful for achieving fast benefits, such as short-term weight-loss. On the long run, though, keto may increase the risk of diseases or death.
For a useful and convenient diet, consult with a nutritionist, who will design a programme that is appropriate for your body and health status, helps you lose weight, without prejudice to other health considerations.

Clinical Education General Department

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