Keto Diet: Effective Against Which Diseases?

The ketogenic (keto) diet is a low-carb, high-fat diet that has been linked to several health benefits, including weight loss and improved management of certain diseases. The diet induces a metabolic state called ketosis, where the body burns fat instead of glucose for energy, resulting in the production of ketones. While the keto diet is popular for weight loss, it has also been explored as a potential treatment for various health conditions, such as epilepsy, type 2 diabetes, metabolic syndrome, polycystic ovary syndrome, and even certain cancers. However, it's important to note that the keto diet may not be suitable for everyone, and it's always recommended to consult a healthcare professional before starting any new diet, especially for the management of specific diseases.

Epilepsy

The ketogenic diet is a high-fat, low-carbohydrate, controlled-protein diet that has been used to treat epilepsy since the 1920s. The diet is usually considered for children with epilepsy when at least two suitable medications have been tried and proven unsuccessful. The diet is also an established treatment option for children with hard-to-control epilepsy. However, adults may also benefit from the diet.

The ketogenic diet is a medical treatment that must be followed with the support of an experienced epilepsy specialist and dietitian. The diet is carefully measured and monitored, with foods being weighed and measured. The diet is stricter than the modified Atkins diet, requiring careful measurements of calories, fluids, and proteins. The diet is typically started in the hospital, with the child fasting under close medical supervision for 18-24 hours before the diet is started.

The ketogenic diet is proven to reduce seizures in children with epilepsy. Over half of the children who go on the diet have at least a 50% reduction in the number of their seizures. Some children, usually 10-15%, even become seizure-free. The diet has been shown to be particularly helpful for some epilepsy conditions, including infantile spasms, Rett syndrome, tuberous sclerosis complex, Dravet syndrome, Doose syndrome, and GLUT-1 deficiency.

The diet works by altering the metabolic pathway of how the body burns fuel for energy. Typically, the body uses glucose, which is the preferred method of energy for cells, from carbohydrates such as grains, legumes, vegetables, and fruits. However, the ketogenic diet restricts carbohydrates and increases fat intake, sending the body into a state of ketosis, where it burns fat instead of carbohydrates for energy. The body can work very well on ketones and fats, and ketones are not dangerous.

The exact mechanism of how the diet helps reduce seizures is not entirely clear. However, research has shown that a particular fatty acid called decanoic acid may be involved in the way the diet works. The diet can be adapted to suit different cultures and individuals with allergies or those on modified texture diets. The dietitian will calculate the diet and try to include foods that the individual likes.

The ketogenic diet is not recommended as a primary anti-seizure option because patients are often averse to drastic changes in their food intake or have trouble staying on the diet due to its strict requirements and potential side effects like nausea, constipation, and fatigue. The diet can be challenging to follow due to its restrictive nature, and it is important to work with a dietitian to maximize nutrient intake and avoid potential deficiencies.

Type 2 diabetes

The ketogenic (keto) diet is a high-fat, low-carb, and moderate-protein diet. It involves drastically reducing carbohydrate intake and eating a high-fat diet to send the body into a state of ketosis, where it burns fat instead of carbohydrates for energy.

The keto diet can be beneficial for people with Type 2 diabetes, as it can help with weight loss and lower blood sugar levels. This is because the keto diet lowers carb intake to the point that blood glucose levels drop, which in turn reduces insulin production and improves insulin sensitivity.

However, there are some drawbacks and risks associated with the keto diet for people with Type 2 diabetes. Firstly, low blood sugar, or hypoglycemia, can be dangerous for people with diabetes, especially if they are also taking diabetes medication or insulin. Therefore, it is important to monitor blood sugar levels regularly and work with a doctor to adjust medication dosages as needed.

Secondly, the keto diet can be difficult to stick to in the long term due to its restrictive nature. This can lead to yo-yo dieting, which is dangerous for people with diabetes. Additionally, the keto diet may not provide adequate nutrients and can be low in fiber, leading to constipation.

Furthermore, people with diabetes are already at risk for high cholesterol and heart disease. The keto diet may not distinguish between "good" and "bad" fats, so it is important for people with diabetes to choose heart-healthy fats and lean protein sources when following the keto diet.

Overall, while the keto diet can be effective for managing Type 2 diabetes, it is not suitable for everyone and should be undertaken with caution and under medical supervision. It is important to work with a doctor or registered dietitian to determine the best diet for managing Type 2 diabetes, as there may be other dietary approaches, such as the Mediterranean diet, that may be more suitable and sustainable.

Alzheimer's disease

The condition is difficult to prevent and cure, but there is some hope in using a ketogenic diet (KD) to reduce the cognitive and quality-of-life decline experienced by patients. A KD is a high-fat, low-carbohydrate diet that shifts the body towards fat metabolism. The liver converts fats into ketones, which can be used as a major energy source for neurons.

Several studies have shown that a KD can improve the cognitive abilities and quality of life of patients with mild to severe AD. For example, a 2021 randomised crossover trial found that patients with clinically confirmed diagnoses of AD who followed a modified ketogenic diet for 12 weeks improved in daily function and quality of life compared to those on a usual diet. Additionally, a small 2012 study found that older adults with mild cognitive impairment who followed a very low-carb ketogenic diet for six weeks experienced improved memory function.

However, there are also studies that showed no cognitive improvements in patients with mild to moderate AD who followed a KD. More research is needed to determine the true effect of the diet and the mechanisms behind any improvements. It is also important to note that the ketogenic diet can be difficult to follow and may produce side effects such as "keto flu", constipation, and high cholesterol.

Heart disease

The ketogenic (keto) diet is a high-fat, low-carb, and moderate-protein eating plan that has been linked to several health benefits, including the potential to lower the risk of heart disease. Heart disease, or cardiovascular disease, is a condition that affects the heart's function and typically involves a buildup of cholesterol in the coronary arteries.

The keto diet works by altering the body's fuel source. Instead of relying on glucose from carbohydrates, the body is trained to use ketone bodies, which are produced by the liver when it breaks down fat for energy. This metabolic state, known as ketosis, can be achieved by consuming very low amounts of carbohydrates (less than 20-50 grams per day) and high amounts of healthy fats, such as olive oil, nuts, and avocados.

Benefits of Keto for Heart Disease

The keto diet may offer the following benefits for individuals with or at risk of heart disease:

• Lower blood pressure
• Improved HDL ("good") cholesterol levels
• Lowered triglycerides
• Reduced abdominal obesity
• Lower blood sugar

Risks and Considerations

While the keto diet has shown potential benefits for heart health, it is not without risks. The diet is high in saturated fat, which has been linked to an increased risk of heart disease. Additionally, the restriction of whole grains, legumes, and fruits in the keto diet can result in a loss of dietary fiber, which is important for heart health. Furthermore, most people on the keto diet will experience a rise in cholesterol levels, which can be dangerous for those with a history of heart disease or high cholesterol.

Recommendations

The keto diet should be approached with caution and is best undertaken with the guidance of a healthcare professional. It is recommended as a short-term dietary change to jumpstart weight reduction rather than a long-term solution. For sustainable weight loss and heart health, a balanced diet of healthy, whole foods is generally recommended.

Polycystic ovary syndrome

The ketogenic diet has been proposed as a possible treatment for PCOS due to its potential benefits in managing insulin resistance and weight loss. The diet typically consists of fewer than 20 grams of carbohydrates per day, with unlimited consumption of animal foods, eggs, salad and low-carb vegetables, and some cheeses.

A pilot study by Mavropoulos et al. (2005) investigated the effects of a low-carbohydrate, ketogenic diet on overweight and obese women with PCOS over six months. The study found significant reductions in body weight, percent free testosterone, LH/FSH ratio, and fasting insulin. Two women in the study became pregnant despite previous infertility problems.

Another study by Paoli et al. (2020) examined the effects of a ketogenic diet on 14 overweight women with PCOS over 12 weeks. They observed significant decreases in blood glucose, insulin levels, and the HOMA-IR index, as well as improvements in the LH/FSH ratio and testosterone levels.

While these studies suggest potential benefits of the keto diet in managing PCOS, more long-term, randomized controlled trials are needed to establish its safety and effectiveness for all women with PCOS. Additionally, the keto diet should be approached with caution due to its restrictive nature and potential side effects, and it is always recommended to consult a healthcare professional before starting any new diet.

Frequently asked questions