Keto Diet: Does It Work And How Well?

The ketogenic or keto diet is a low-carb, high-fat eating plan that has been used to treat specific medical conditions since the 19th century. While it is advertised as a weight-loss strategy, it is a strict and drastic diet change that comes with serious risks. The keto diet is based on depriving the body of glucose, which is the main source of energy for all cells in the body, and instead forcing it to use ketones, which are produced from stored fat. This state is called ketosis. While the keto diet can lead to rapid weight loss, it is challenging to maintain and can have negative impacts on health, including an increased risk of heart disease and nutrient deficiencies.

Weight loss

The keto diet is a low-carb, high-fat eating plan that has gained popularity in recent years. It has been shown to offer several health benefits, including weight loss.

Higher protein intake

Some keto diets lead to an increase in protein intake, which has many weight loss benefits.

Gluconeogenesis

The body converts fat and protein into carbs for fuel. This process may burn many additional calories each day.

Appetite suppression

Ketogenic diets help you feel full. This is supported by positive changes in hunger hormones, including leptin and ghrelin.

Improved insulin sensitivity

Ketogenic diets can drastically improve insulin sensitivity, which can help improve fuel utilization and metabolism.

Decreased fat storage

Some research suggests that ketogenic diets may reduce lipogenesis, the process of converting sugar into fat. When there is minimal intake of carbs, fat is used for energy.

Increased fat burning

Several studies have found that ketogenic diets may slightly increase the amount of fat burned during rest, daily activity, and exercise, although more research is needed.

There is evidence that ketogenic diets can help with weight loss. They may help you lose fat, preserve muscle mass, and improve many markers of disease. Some studies have suggested that a ketogenic diet may be more effective than a low-fat diet for weight loss, even when matching the total calorie intake.

However, it is important to note that the keto diet may not be sustainable in the long term due to its restrictive nature. Additionally, there is a lack of long-term studies supporting its effectiveness for weight loss. While it may lead to weight loss in the short term, the loss is unlikely to continue, and it can be hard to follow the diet for an extended period.

Health risks

The keto diet is a low-carb, high-fat diet that is used to reduce the frequency of epileptic seizures in children. It is also used for weight loss, but it is best to make this only a short-term dietary change to help jump-start weight reduction.

The keto diet is associated with several health risks:

• Nutrient deficiencies: The keto diet restricts several foods, including nutrient-dense fruits, whole grains, and legumes. It may fail to provide recommended amounts of vitamins and minerals, such as calcium, vitamin D, magnesium, and phosphorus. Over time, this may lead to nutrient deficiencies.
• Liver problems: With so much fat to metabolize, the keto diet could make any existing liver conditions worse.
• Kidney problems: The kidneys help metabolize protein. The keto diet may overload them, especially in individuals with chronic kidney disease (CKD). The diet's high intake of animal foods can cause blood and urine to become more acidic, leading to increased excretion of calcium in urine and a higher risk of kidney stones.
• Constipation: The keto diet is low in fibrous foods like grains and legumes, which can lead to digestive discomfort and constipation.
• Fuzzy thinking and mood swings: The brain works best when it uses sugar from healthy carbohydrates as an energy source. Low-carb diets may cause confusion and irritability.
• Low blood sugar: Low-carb diets like keto can help manage blood sugar levels in people with diabetes. However, individuals with type 1 diabetes may be at a high risk of more episodes of low blood sugar (hypoglycemia), which can lead to coma and death if not treated.
• Bone health: The keto diet is associated with impaired bone health. Several studies in animals link the keto diet to decreased bone strength, likely due to losses in bone mineral density.
• Chronic diseases and early death: The keto diet's effect on the risk of chronic illness, such as heart disease or cancer, is hotly debated and not entirely understood. Some evidence suggests that high-fat, low-carb diets that focus on animal foods may lead to poor health outcomes, while diets emphasizing vegetable sources of fats and proteins provide benefits.

Ketogenic diet and Alzheimer's

The ketogenic diet has been used to treat specific medical conditions for centuries. In the 19th century, it was used to control diabetes, and in 1920, it was introduced as a treatment for epilepsy in children. The diet has also been tested and used in closely monitored settings for cancer, diabetes, polycystic ovary syndrome, and Alzheimer's disease.

The ketogenic diet is a low-carbohydrate, fat-rich eating plan. The original ketogenic diet derived 70-75% of all calories from fat, 20-25% of calories from protein, and 5-10% from carbohydrates. The diet works by changing the way the body burns energy. Instead of relying on glucose from carbohydrates, the body draws its energy from dietary fat and the body's fat storage, which produces ketone bodies.

There is evidence that the ketogenic diet can improve cognitive function in people with Alzheimer's disease. A 2021 randomized crossover study found that subjects following a modified ketogenic diet had significant improvements in quality of life and the ability to perform daily activities compared to when they followed a low-fat diet. The study also found high rates of retention, adherence, and safety. Another study, conducted in 2017, showed that 10 out of 11 participants with mild Alzheimer's experienced significant improvements on cognitive tests after following a ketogenic diet supplemented with MCT oil for three months. However, a month after stopping the diet, those improvements were lost.

In addition to improving cognitive function, the ketogenic diet may also have other benefits for people with Alzheimer's disease. A 2018 study found that ketogenic diets may improve brain energy metabolism in people with Alzheimer's. The study suggested that ketogenic diets could compensate for deteriorating brain glucose uptake during aging and potentially improve cognitive function.

While the ketogenic diet has shown promise in treating Alzheimer's disease, it is important to note that it is a very strict and challenging diet to maintain. It requires a significant increase in fat intake, which can be difficult to adjust to. Additionally, the diet restricts carbohydrates, which can lead to side effects such as keto flu, including symptoms such as headache, fatigue, and constipation. It is also important to drink a lot of water on the ketogenic diet to avoid kidney stones and other kidney problems.

Overall, the ketogenic diet may be a promising treatment option for Alzheimer's disease, but more research is needed to fully understand its effectiveness and long-term impacts.

Ketogenic diet and epilepsy

The ketogenic diet has been used to treat epilepsy since the 1920s. It is a non-pharmacological therapy that involves a very high-fat and low-carbohydrate diet, reducing carbohydrates to as little as 10% of energy intake. This restriction triggers a shift from glucose metabolism to the metabolism of fatty acids, yielding ketone bodies as an alternative energy source for the brain. The diet is usually only considered when at least two suitable medications have been tried and proven ineffective.

The ketogenic diet is an established treatment option for children with hard-to-control epilepsy, but adults may also benefit from it. The diet is a medical treatment that must be followed with the support of an experienced epilepsy specialist and dietitian.

The ketogenic diet has been shown to be effective in reducing seizures in both children and adults with epilepsy. A clinical trial at Great Ormond Street Hospital in 2008 showed that around 4 in 10 children (38%) who started a ketogenic diet had reduced seizures and were able to reduce their anti-seizure medication. There are now other high-quality trials that show the diet to be effective in infants and adults with epilepsy.

The exact mechanism by which the ketogenic diet helps reduce seizures is not yet clear. However, research has shown that a particular fatty acid called decanoic acid may be involved. It is believed that ketone bodies and polyunsaturated fatty acids play a major role in the anticonvulsant effect of the diet. The diet is thought to increase the level of agmatine in the brain, which has neuroprotective properties. It also increases energy production in the brain, making brain tissue more resistant to metabolic stress and thereby increasing the seizure threshold.

The ketogenic diet has several side effects, the most common of which is constipation. Other side effects include hunger, vomiting, lack of energy, severe dehydration or acidosis, lethargy, somnolence, severe infections, mood swings, and abdominal pain.

Ketogenic diet and nutrient deficiencies

The ketogenic diet is a low-carbohydrate, fat-rich eating plan that has been used to treat specific medical conditions. In recent years, it has gained popularity as a weight-loss strategy. However, the keto diet comes with certain risks, including the possibility of nutrient deficiencies.

The keto diet restricts carbohydrates and protein, which can lead to a lack of essential vitamins and minerals. The most common deficiencies associated with the keto diet include folate (B9), biotin (B7), selenium, choline, vitamins A, E, D, chromium, iodine, magnesium, and molybdenum. These nutrients are typically found in foods like whole grains, fruits, and vegetables, which are limited or eliminated on the keto diet.

To prevent nutrient deficiencies, it is important to include a variety of nutrient-dense foods in your diet. Leafy green vegetables, such as kale, spinach, and Swiss chard, are good sources of folate and magnesium. Brazil nuts, mushrooms, oysters, and tuna are rich in selenium. For vitamin D, spending time in the sun or taking supplements can help. Including grass-fed meat, wild-caught fish, liver, and egg yolks in your diet can provide biotin and choline.

In addition to a varied diet, supplementation can also help prevent deficiencies. Taking a methylated form of folate, such as methylfolate, is recommended, especially for those with the MTHFR mutation. A high-quality multivitamin that includes active forms of B vitamins and antioxidants can also help ensure adequate nutrient intake.

It is important to consult with a healthcare professional before starting the keto diet, as it can be restrictive and may not be suitable for everyone. By working with a doctor and a registered dietitian, you can create a meal plan that meets your individual needs and helps prevent nutrient deficiencies.

Frequently asked questions