The Evolution Of Keto: Studied Science Or Fad?

The ketogenic diet has been studied for almost a century, with the first modern study of fasting as a treatment for epilepsy taking place in France in 1911. The ketogenic diet itself was introduced in the 1920s as a treatment for epilepsy, and its use continued for two decades until the advent of antiepileptic drugs. In the 1970s, the diet was popularised again and has since been widely studied as a potential treatment for various conditions. In recent years, the ketogenic diet has experienced a resurgence, particularly as a weight loss intervention, proving its efficacy in the short term.

The ketogenic diet's history as a treatment for epilepsy

The ketogenic diet has been used to treat epilepsy since the 1920s, but its roots go back much further. Ancient Greek physicians, including Hippocrates, advocated for dietary restrictions to treat epilepsy, and fasting was considered integral to a healthy lifestyle. In fact, it was the only epilepsy treatment recorded by Hippocrates and was standard practice for over two thousand years.

The first modern study of fasting as a treatment for epilepsy took place in France in 1911. Twenty epilepsy patients of all ages were put on a low-calorie vegetarian diet, combined with periods of fasting and purging. Two patients benefited enormously, but most could not maintain the restrictions. Around the same time, American osteopathic physician Hugh Conklin began recommending fasting to his epileptic patients, reporting a 90% cure rate in children.

In the 1920s, Dr Russell Morse Wilder at the Mayo Clinic coined the term "ketogenic diet" to describe a diet that produced a high level of ketone bodies in the blood. Wilder hoped to obtain the benefits of fasting with a dietary therapy that could be maintained indefinitely. His trial on a few epilepsy patients in 1921 was the first use of the ketogenic diet as a treatment for epilepsy. Wilder's colleague, paediatrician Mynie Gustav Peterman, later formulated the "classic keto" approach, which is still followed today. This approach advocates a 4:1 ratio of fat to protein and carbs, with 90% of calories coming from fat, 6% from protein, and 4% from carbs.

The ketogenic diet was widely used in the 1920s and 1930s, but its popularity waned with the introduction of effective anticonvulsant medications. By the end of the twentieth century, it was available in only a small number of children's hospitals. However, in the 1990s, there was a resurgence of interest in the diet, sparked by media reports of its successful use in treating severe epilepsy. Today, the ketogenic diet is available in almost all major children's hospitals and continues to attract scientific interest for its role in treating neurological disorders.

The diet's resurgence in the 1990s

The ketogenic diet was all but forgotten by the 1990s, with those who studied it relegating it to the realm of historical curiosity rather than medical fact. However, in October 1994, the NBC show Dateline aired an episode detailing the case of Charlie Abrahams, a two-year-old boy with severe epilepsy. Charlie's seizures were out of control until he started the keto diet, and the show triggered an explosion of scientific interest in the diet.

Charlie's father, Hollywood producer Jim Abrahams, subsequently created the Charlie Foundation for Ketogenic Therapies to further promote diet therapy. The foundation sponsored a research study, the results of which—announced in 1996—marked the beginning of renewed scientific interest in the diet. In 1997, a made-for-TV film called *First Do No Harm*, starring Meryl Streep, was aired on national television, and this further fuelled interest in the ketogenic diet.

The renewed interest in the diet's effects caused researchers to take a closer look at what it could offer otherwise healthy individuals, and the findings were impressive. By the early 2000s, the Atkins diet—a similar perspective on carbs—was dominating, and this renewed interest in the diet's effects caused researchers to take a closer look at what it could offer otherwise healthy individuals.

Today, most people who consider following the ketogenic diet do so for health reasons that go far beyond reducing seizures. The diet is now available at almost all major children's hospitals and continues to attract scientific interest for its role in neurological disorders.

The diet's efficacy in treating neurological disorders

The ketogenic diet was first introduced in the 1920s as a treatment for epilepsy. It was widely used until the 1930s, when anticonvulsant medications were introduced. The diet was then forgotten until the 1990s, when it was reintroduced as a treatment for epilepsy. It has since been studied for its potential to treat other neurological disorders, including Alzheimer's disease, Parkinson's disease, multiple sclerosis, and migraine.

The diet's potential health risks

The ketogenic diet, or keto diet, is a high-fat, low-carbohydrate eating plan that has been studied since its introduction in the 1920s as a treatment for epilepsy. While it has proven effective in reducing seizures, it also carries potential health risks, especially when used for weight loss or by otherwise healthy individuals. Here are the key potential health risks associated with the keto diet:

Nutrient Deficiencies: The keto diet restricts several nutrient-dense foods, including fruits, whole grains, and legumes. This may lead to deficiencies in vitamins and minerals such as calcium, vitamin D, magnesium, phosphorus, selenium, and vitamins B and C. Such deficiencies can have various negative health consequences.

Digestive Issues and Gut Health: The keto diet's restriction of carbohydrates can make it challenging to meet daily fiber needs. This may result in digestive discomfort and constipation. Additionally, fiber is essential for feeding beneficial gut bacteria, and a lack of it may negatively impact immunity, mental health, and inflammation.

Kidney Problems: The high intake of animal products on the keto diet can increase the risk of kidney stones. This is because animal foods can make the blood and urine more acidic, leading to increased calcium excretion in the urine. The keto diet may also reduce citrate levels in the urine, which normally helps prevent kidney stone formation.

Liver Problems: The keto diet's high-fat content can be challenging for the liver to metabolize, potentially worsening any existing liver conditions.

Low Blood Sugar: The keto diet may cause dangerously low blood sugar levels, especially in individuals with type 1 diabetes. This can lead to hypoglycemia, marked by confusion, shakiness, fatigue, and sweating. If left untreated, hypoglycemia can lead to coma and even death.

Bone Health: Several studies have linked the keto diet to impaired bone health, showing a decrease in bone mineral density. This may increase the risk of bone fractures and other issues.

Heart Disease: The keto diet is typically high in saturated fat, which has been linked to an increased risk of heart disease. It is also associated with an increase in "bad" LDL cholesterol, another risk factor for heart disease.

Social Isolation and Disordered Eating: The strict nature of the keto diet may lead to social isolation as it can be challenging to adhere to in social settings. Additionally, the restrictive nature of the diet could contribute to disordered eating patterns or an unhealthy relationship with food.

Other Health Conditions: The keto diet is not suitable for individuals with certain medical conditions, including those involving the pancreas, liver, thyroid, or gallbladder. It may also cause issues for people with multiple sclerosis, rheumatoid arthritis, Alzheimer's, or dementia.

It is important to note that the keto diet has been studied and used primarily as a treatment for epilepsy, especially in children. When used for weight loss or by otherwise healthy individuals, the diet may pose more risks than benefits. It is always recommended to consult a healthcare professional before starting any new diet, especially one as restrictive as keto.

The diet's efficacy in weight loss

The ketogenic diet has been studied for its efficacy in weight loss since the 1920s, when it was first introduced as a treatment for epilepsy. While its use declined with the advent of antiepileptic drugs, there has been a resurgence of interest in the ketogenic diet in recent years, particularly for its potential benefits in weight loss and improving metabolic health.

The ketogenic diet is a high-fat, low-carbohydrate dietary approach that induces a metabolic state called ketosis, where the body utilises fat as its primary fuel source instead of carbohydrates. This shift in metabolism leads to a reduction in overall body fat and improved metabolic health. Numerous studies have shown that the ketogenic diet can be highly effective for weight loss, with some research indicating that it may be as effective as a low-fat diet for long-term weight loss. One review of 13 studies found that individuals following a ketogenic diet lost an average of 2 pounds more than those on a low-fat diet. Another study in 34 older adults found that those on the ketogenic diet lost nearly five times as much total body fat as those on a low-fat diet.

The ketogenic diet has also been found to have additional health benefits beyond weight loss. It has been shown to reduce the risk of certain diseases, including type 2 diabetes, hyperlipidemia, heart disease, and cancer. Additionally, the ketogenic diet can improve insulin sensitivity and lead to significant health benefits for people with type 2 diabetes or prediabetes. The diet can also have a positive impact on neurological disorders such as epilepsy, Alzheimer's disease, Parkinson's disease, and traumatic brain injuries.

While the ketogenic diet has proven efficacy in weight loss, there are also some potential side effects and considerations to be aware of. The diet can be restrictive and may lead to inadequate intake of essential vitamins, minerals, and phytochemicals. It can also cause digestive issues such as constipation, diarrhea, and bloating. Additionally, the high-fat and low-carbohydrate nature of the diet can increase the risk of developing kidney stones. Long-term compliance with the ketogenic diet can be challenging, and more research is needed to understand its full range of potential benefits and risks.

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