Keto And Metabolism: A Match Made In Heaven?

The ketogenic diet, or keto, is a low-carb, high-fat eating plan that has been used for centuries to treat specific medical conditions. In recent years, it has gained popularity as a potential weight-loss strategy. The diet involves depriving the body of glucose, its main source of energy, which is obtained by eating carbs. When the body doesn't have enough glucose, it burns stored fats instead, resulting in a buildup of acids called ketones. This metabolic state is called ketosis.

Keto diets are usually high in fat, with 70-80% of calories coming from fat, 10-20% from carbohydrates, and 10-20% from protein. The premise of keto for weight loss is that by depriving the body of glucose, it will start burning fat for energy, leading to weight loss.

There is some evidence to support the effectiveness of keto for weight loss and improving metabolic health. A 2021 review states that the keto diet could reduce the risk of developing metabolic syndrome, cardiovascular disease, and diabetes. Additionally, a meta-analysis of 13 randomized controlled trials found that the keto diet produced a greater reduction in weight, triglycerides, and blood pressure compared to a low-fat diet.

However, there are also potential downsides to the keto diet. It can be challenging to maintain due to the extreme restriction of carbohydrates, and it may have negative side effects such as increased risk of kidney stones, osteoporosis, and high blood levels of uric acid. It is also important to note that long-term effects of the keto diet are not well studied, and there is some evidence that it may not be sustainable for lifelong weight loss.

Overall, while keto may offer some metabolic benefits and promote weight loss, it is important to carefully consider the potential risks and challenges before starting this diet.

Ketogenic diets can help with weight loss

The ketogenic diet is a low-carbohydrate, fat-rich eating plan that has been used for centuries to treat specific medical conditions. In the 19th century, the ketogenic diet was commonly used to help control diabetes. In 1920, it was introduced as an effective treatment for epilepsy in children who did not respond to medication. The ketogenic diet has also been tested and used in closely monitored settings for cancer, diabetes, polycystic ovary syndrome, and Alzheimer's disease.

The premise of the ketogenic diet for weight loss is that if you deprive the body of glucose, its main source of energy, an alternative fuel called ketones is produced from stored fat. The brain demands the most glucose, about 120 grams daily, and cannot store it. During fasting or when very few carbohydrates are eaten, the body first pulls stored glucose from the liver and temporarily breaks down muscle to release glucose. If this continues for 3-4 days and stored glucose is fully depleted, blood levels of the hormone insulin decrease, and the body begins to use fat as its primary fuel. The liver produces ketone bodies from fat, which can be used in the absence of glucose.

Ketosis

When ketone bodies accumulate in the blood, this is called ketosis. Healthy individuals naturally experience mild ketosis during periods of fasting (e.g., sleeping overnight) and very strenuous exercise. Proponents of the ketogenic diet state that if the diet is carefully followed, blood levels of ketones should not reach a harmful level (known as "ketoacidosis") as the brain will use ketones for fuel, and healthy individuals will typically produce enough insulin to prevent excessive ketones from forming.

Weight Loss Benefits

The ketogenic diet has been shown to produce beneficial metabolic changes in the short term. Along with weight loss, health parameters associated with carrying excess weight have improved, such as insulin resistance, high blood pressure, and elevated cholesterol and triglycerides. There is also growing interest in using low-carbohydrate diets, including the ketogenic diet, for type 2 diabetes.

Appetite Suppression

Several theories exist as to why the ketogenic diet promotes weight loss, though they have not been consistently shown in research. These include a satiating effect with decreased food cravings due to the high-fat content of the diet, a decrease in appetite-stimulating hormones such as insulin and ghrelin when eating restricted amounts of carbohydrates, and a direct hunger-reducing role of ketone bodies, the body's main fuel source on the diet.

Increased Calorie Expenditure

Another theory is that there is an increased calorie expenditure due to the metabolic effects of converting fat and protein to glucose. Additionally, the ketogenic diet may promote fat loss versus lean body mass loss, partly due to decreased insulin levels.

Research Findings

A meta-analysis of 13 randomized controlled trials following overweight and obese participants for 1-2 years on either low-fat diets or very-low-carbohydrate ketogenic diets found that the ketogenic diet produced a small but significantly greater reduction in weight, triglycerides, and blood pressure and a greater increase in HDL and LDL cholesterol compared with the low-fat diet at one year.

A systematic review of 26 short-term intervention trials (ranging from 4-12 weeks) evaluated the appetites of overweight and obese individuals on either a very low-calorie or ketogenic diet using a standardized and validated appetite scale. Despite losing a significant amount of weight on both diets, participants reported less hunger and a reduced desire to eat compared with baseline measures. The authors noted the lack of increased hunger despite extreme restrictions on both diets, which they theorized were due to changes in appetite hormones such as ghrelin and leptin, ketone bodies, and increased fat and protein intakes.

Long-Term Effects

The available research on the ketogenic diet for weight loss is still limited. Most of the studies so far have had a small number of participants, were short-term (12 weeks or less), and did not include control groups. A ketogenic diet has been shown to provide short-term benefits in some people, including weight loss and improvements in total cholesterol, blood sugar, and blood pressure. However, these effects after one year, when compared with the effects of conventional weight-loss diets, are not significantly different.

Potential Drawbacks

Eliminating several food groups and the potential for unpleasant symptoms may make compliance difficult. An emphasis on foods high in saturated fat also counters recommendations from the Dietary Guidelines for Americans and the American Heart Association and may have adverse effects on blood LDL cholesterol. However, it is possible to modify the diet to emphasize foods low in saturated fat such as olive oil, avocado, nuts, seeds, and fatty fish.

A ketogenic diet may be an option for some people who have had difficulty losing weight with other methods. The exact ratio of fat, carbohydrate, and protein that is needed to achieve health benefits will vary among individuals due to their genetic makeup and body composition. Therefore, if one chooses to start a ketogenic diet, it is recommended to consult with one's physician and a dietitian to closely monitor any biochemical changes after starting the regimen and to create a meal plan that is tailored to one's existing health conditions and to prevent nutritional deficiencies or other health complications.

Ketogenic diets can reduce the risk of several health conditions

The keto diet can also be beneficial for people with type 2 diabetes. With this condition, the body still produces some insulin, but it does not work as effectively. The keto diet focuses on reducing a person’s intake of dietary carbohydrates, which can lower blood sugar levels.

The keto diet has also been shown to reduce the risk of heart disease. A systematic review published in the American Journal of Clinical Nutrition in 2019 found that a ketogenic diet can lower markers of inflammation, which is associated with a decreased risk of heart disease.

The keto diet can also be used to treat epilepsy, especially in children with epilepsy who do not respond to other forms of treatment.

Additionally, the keto diet can be beneficial for people with Alzheimer's disease. As Alzheimer's disease is associated with the brain's inability to efficiently utilise glucose, ketones can be used as an alternate fuel source.

The keto diet can also be beneficial for people with polycystic ovarian syndrome, as it can help lower insulin resistance and improve androgen levels.

Furthermore, the keto diet can be used to treat non-alcoholic fatty liver disease, as it can help reduce intrahepatic fat.

However, it is important to note that the keto diet may not be suitable for everyone and may have some side effects. It is always recommended to consult with a healthcare professional before starting any new diet.

Ketogenic diets can be used to treat medical conditions

Weight Loss

The keto diet can facilitate weight loss by creating a metabolic state where the body breaks down fat stores. A 2021 narrative review states that the keto diet could reduce a person's risk of developing health conditions such as metabolic syndrome. Additionally, a study by Dr. Andrew Freeman found that the keto diet led to initial weight loss, but it was not sustainable long-term, and people tended to gain back the weight.

Epilepsy

The keto diet is often used to help reduce the frequency of epileptic seizures in children. It has also been tried for weight loss in adults with epilepsy, although more research is needed to confirm these findings. The ketogenic diet reduces the excitability of neurons in the brain, which can help treat epileptic seizures.

Diabetes

The keto diet may be beneficial for people with type 2 diabetes. By reducing the intake of dietary carbohydrates, people with type 2 diabetes can lower their blood sugar levels. However, it is important to carefully monitor ketone levels to prevent ketoacidosis, a severe and dangerous condition.

Mental Illness

A pilot study by Stanford Medicine found that the keto diet improved severe mental illness in patients with schizophrenia or bipolar disorder. The diet not only restored metabolic health but also improved psychiatric conditions. The ketogenic diet may provide an alternative fuel source for the brain, improving its metabolism and energy dysfunction.

Alzheimer's and Dementia

Although more research is needed, there is some evidence suggesting that the keto diet may have potential benefits for Alzheimer's and dementia.

Multiple Sclerosis (MS)

Ketogenic diets have been explored as a potential treatment for Multiple Sclerosis (MS), but more research is needed to confirm their effectiveness.

It is important to note that while ketogenic diets can be used to treat medical conditions, they also come with certain risks and side effects. These include nutrient deficiencies, liver and kidney problems, constipation, fuzzy thinking, and mood swings. Therefore, it is crucial to consult a doctor and a registered dietitian before starting a ketogenic diet.

Ketogenic diets can help with diabetes

The ketogenic (keto) diet is a high-fat, low-carb diet that can be beneficial for people with type 2 diabetes. The keto diet was originally created in the 1920s as a treatment for epilepsy, but its effects are now being studied for type 2 diabetes.

When the body does not have enough glucose for energy, it burns stored fats instead, resulting in a buildup of acids called ketones. The keto diet encourages this process, called ketosis, by forcing the body to rely on fat for energy, rather than carbohydrates.

Benefits for Type 2 Diabetes

The keto diet may improve blood glucose (sugar) levels while also reducing the need for insulin. It can be an effective way to manage type 2 diabetes by lowering blood sugar and promoting weight loss. Additionally, following a keto diet may lead to reduced dependence on diabetes medication and insulin.

Risks and Considerations

While the keto diet can be beneficial for some people with type 2 diabetes, it is not suitable for everyone. There are several risks and considerations to keep in mind:

• Hypoglycemia: Low blood sugar can be dangerous, especially for those with diabetes, and may be a risk if medication and insulin levels are not properly adjusted.
• Ketoacidosis: If ketones build up too much, they can turn the blood acidic, leading to a dangerous condition called ketoacidosis. This is more common in type 1 diabetes but can also occur in type 2.
• Nutrient deficiencies: The keto diet may be low in certain nutrients, such as fiber, and require supplementation.
• Constipation: Keto diets are often low in fiber, which can lead to constipation.
• Sustainability: The keto diet is very restrictive and can be difficult to stick to in the long term.
• Heart health: The keto diet may not distinguish between "good" and "bad" fats, which is important for people with diabetes who are already at risk for heart disease.

Alternative Diets

For those who find the keto diet too restrictive or unsustainable, alternative diets such as the Mediterranean diet have been found to be similarly effective in controlling blood glucose and aiding weight loss in people with type 2 diabetes. The Mediterranean diet emphasizes heart-healthy foods such as fruits, vegetables, whole grains, legumes, nuts, and fish.

The ketogenic diet can be a helpful tool for managing type 2 diabetes, but it is not a one-size-fits-all solution. It is important to consult with a healthcare professional to determine the best diet plan for your individual needs and goals.

Ketogenic diets can help with epilepsy

The ketogenic diet is a high-fat, low-carbohydrate, controlled-protein diet that has been used since the 1920s to treat epilepsy. The diet is usually considered for children whose seizures have not responded to several different seizure medications. It is also beneficial for adults with epilepsy, although the restricted food choices make it harder to follow. The ketogenic diet is a medically supervised treatment that must be carried out with the guidance of trained medical specialists.

The ketogenic diet works by producing ketones in the body. Usually, the body uses glucose from carbohydrates as its primary source of energy. However, with the ketogenic diet, the body uses fat as its main energy source, resulting in the production of ketones. Ketones are not dangerous and can be detected in the urine, blood, and breath.

The ketogenic diet has been shown to be particularly helpful for various epilepsy conditions, including infantile spasms, Rett syndrome, tuberous sclerosis complex, Dravet syndrome, Doose syndrome, and GLUT-1 deficiency. It can lead to a significant reduction in seizures, with some children even becoming seizure-free.

The diet can be adapted to suit different ethnic diets and those with dairy allergies. It is important to note that the ketogenic diet is very specialised and requires careful monitoring by a medical team, including a neurologist and a dietitian. The diet may have side effects such as constipation, hunger, vomiting, and lack of energy at the beginning of the treatment.

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