Keto Diet: A Solution For Severe Overweight?

The keto diet is a low-carb, high-fat diet that has been adopted by many looking to lose weight and improve health. The diet involves drastically reducing carbohydrate intake and replacing it with fat. This reduction in carbs puts the body into a metabolic state called ketosis, where it becomes very efficient at burning fat for energy instead of glucose. While the keto diet has been shown to be effective for weight loss, it is not suitable for everyone and should be implemented correctly. It is also not a long-term solution, and once a normal diet is resumed, the weight will likely return.

Weight loss

The keto diet is a low-carb, high-fat diet that has been shown to be effective for weight loss. In fact, research indicates that the keto diet may be as effective for weight loss as a low-fat diet. The diet is so filling that people can lose weight without counting calories or tracking their food intake.

The keto diet aims to force the body into using a different type of fuel. Instead of relying on glucose (sugar) from carbohydrates, the keto diet relies on ketone bodies, a type of fuel that the liver produces from stored fat.

• Achieving and maintaining ketosis is crucial for weight loss on the keto diet. To reach ketosis, reduce your carbohydrate intake to 20-50 grams per day and ensure that fat makes up about 55-60% of your calorie intake.
• Eat nutritious, whole foods such as full-fat dairy products, eggs, fish, meat, poultry, and healthy fats like avocado and olive oil.
• Create a calorie deficit by reducing your calorie intake or increasing physical activity. Even on the keto diet, it is possible to consume too many calories, especially from high-calorie foods like avocados, olive oil, nuts, and full-fat dairy.
• Manage stress and get adequate sleep. Research shows that chronic stress and lack of sleep can negatively impact weight loss.
• Exercise regularly to stimulate fat loss and boost your metabolism.
• Rule out any underlying medical issues that may hinder weight loss, such as hypothyroidism, polycystic ovarian syndrome, Cushing's syndrome, depression, or hyperinsulinemia.

Precautions and potential risks

While the keto diet can be effective for weight loss, it is important to note that it may not be suitable for everyone and should only be followed in the short term. The keto diet carries some health risks, including nutrient deficiencies, liver problems, kidney problems, constipation, and fuzzy thinking or mood swings due to low carbohydrate intake. Therefore, it is essential to consult a doctor and a registered dietitian before starting the keto diet.

Improved heart health

The keto diet may have some benefits for heart health, but it is also associated with an increased risk of heart disease. The long-term effects of the keto diet on heart health are still unclear.

Positive effects on heart health

The keto diet has been shown to have some positive effects on heart health. These include:

• Lowering of triglycerides: The keto diet lowers triglycerides, a type of fat in the blood that increases the risk of heart disease, stroke, and pancreatitis.
• Increase in HDL cholesterol: The keto diet is associated with higher levels of HDL, or "good" cholesterol, which is linked to a decreased risk of heart disease.
• Lowering of blood sugar: The keto diet has been shown to decrease blood sugar levels and reduce the need for diabetes medication. High blood sugar levels are a risk factor for heart disease.

Negative effects on heart health

Despite these positive effects, the keto diet also has some negative effects on heart health. These include:

• Increase in LDL cholesterol: The keto diet is associated with higher levels of LDL, or "bad" cholesterol, which increases the risk of heart disease.
• High saturated fat intake: The keto diet is high in saturated fat, which is linked to an increased risk of heart disease.
• Substitution of animal-based fats for carbohydrates: Studies have shown that substituting animal-based fats for carbohydrates can increase the risk of mortality, particularly from heart disease.
• Incompatibility with certain medications: The keto diet may be incompatible with certain medications, such as SGLT-2 inhibitors, which are used to treat diabetes and heart failure.
• Nutritional deficiencies: The strict carbohydrate restrictions of the keto diet may lead to deficiencies in vitamins and minerals that are important for heart health, such as potassium, magnesium, and vitamin C.

Overall impact on heart health

The overall impact of the keto diet on heart health is still uncertain. While it has some positive effects, such as lowering triglycerides and increasing HDL cholesterol, these benefits may be offset by the negative effects, such as raising LDL cholesterol and increasing saturated fat intake. More long-term studies are needed to fully understand the effects of the keto diet on heart health.

Reduced risk of certain cancers

The ketogenic diet has been linked to a reduced risk of certain cancers. While the exact mechanism is not yet fully understood, the diet's high-fat and low-carbohydrate composition is thought to play a key role.

The Warburg Effect

Cancer cells thrive on glycolysis, a process where glucose is broken down to produce energy. This phenomenon, known as the Warburg effect, suggests that cancer cells have a higher demand for glucose compared to normal cells. By restricting carbohydrate intake, the ketogenic diet limits the glucose available to cancer cells, potentially slowing their growth and proliferation.

Ketosis and Ketones

When the body is deprived of carbohydrates, it enters a state called ketosis, where it breaks down fat for energy instead. This process produces ketones, which are molecules that can be used as an alternative fuel source for normal cells but are not efficiently utilized by cancer cells. By switching the body's primary fuel source to fat, the ketogenic diet may help starve cancer cells of the glucose they need to grow and spread.

Impact on Insulin and IGF-1

The ketogenic diet can also influence cancer growth by regulating insulin and insulin-like growth factor 1 (IGF-1) levels. High carbohydrate intake stimulates the pancreas to release insulin, which can promote cell growth and proliferation. Additionally, IGF-1 plays a crucial role in cell development and reduces programmed cell death. By reducing carbohydrate intake, the ketogenic diet lowers insulin and IGF-1 levels, which may help slow tumor growth and decrease cancer risk.

Calorie Restriction and Weight Loss

The ketogenic diet can also aid in cancer prevention by restricting calorie intake and promoting weight loss. Obesity is a known risk factor for cancer, and the ketogenic diet is effective in reducing body weight and body mass index. By addressing obesity, the ketogenic diet may indirectly lower the risk of certain cancers associated with high body fat percentages.

Anti-Inflammatory Effects

Inflammation is a key driver of cancer growth and progression. The ketogenic diet has been shown to reduce inflammation, which may help create an environment that is less conducive to cancer development. Additionally, the diet's ability to lower insulin levels may also contribute to its anti-inflammatory effects, as insulin can promote the production of inflammatory markers.

Gene Expression and Epigenetic Modifications

The ketogenic diet may also influence cancer risk by modifying gene expression and epigenetic factors. Studies have shown that the diet can alter the expression of genes involved in cell behaviour, potentially impacting the growth and proliferation of cancer cells. Additionally, the diet's effect on chromatin modification, specifically through the inhibition of histone deacetylase, may also play a role in cancer prevention.

Clinical Evidence and Ongoing Research

While the majority of research on the ketogenic diet and cancer has been conducted in animal models, there is a growing body of evidence from human studies and case reports. Some of the strongest evidence comes from studies on glioblastoma, an aggressive form of brain cancer. These studies suggest that the ketogenic diet can slow tumor growth and enhance the effects of traditional cancer treatments. However, the diet's effectiveness appears to vary depending on the type of cancer, and more research is needed to fully understand its impact on different cancer subtypes.

Improved brain health

The ketogenic (keto) diet has been shown to have a positive impact on brain health. The diet is known to improve muscle function in older animals by preventing muscle mass loss due to age (sarcopenia). It has also been used to treat epilepsy and other neurocognitive diseases.

How it works

The keto diet increases the number of mitochondria in muscles. The more mitochondria we have, the more energy our muscles can make from fat, and the better we are at breaking down potential neurotoxins – chemicals that destroy nerve tissues and harm the nervous system.

The keto diet also increases the production of the neurotransmitter gamma-aminobutyric acid (GABA) in the brain. GABA is the primary inhibitor of neurotransmission, making a neuron more refractory to abnormal firing due to hyperpolarization. This helps to decrease seizures by increasing the synthesis of GABA or decreasing its metabolism and breakdown.

Benefits

The keto diet has been shown to improve memory in older adults at risk of Alzheimer's disease. It has also been shown to improve brain function in older and obese rats.

Precautions

The keto diet is not recommended for everyone. It is important to consult a doctor before starting the keto diet, especially if you have any health conditions. There can be issues with bone health when switching to a low-carbohydrate keto diet. It can also cause constipation, which is common and usually easy to treat with stool softeners or dietary changes.

Reduced seizures in epileptic children

The ketogenic diet has been used to reduce seizures in epileptic children since the 1920s. The diet is high in fat, low in carbohydrates, and adequate in protein. Typically, it consists of 70% to 80% fats, 20% proteins, and 5% to 10% carbohydrates. The diet works by changing how the brain gets energy to function. Instead of relying on glucose from carbohydrates, the body uses ketones, which are formed when the body uses fat for energy.

The ketogenic diet is usually recommended for children whose seizures have not responded to medication. It is not typically recommended for adults due to the limited food choices that make the diet hard to maintain in the long run. The diet should be carried out under the care, supervision, and guidance of trained medical specialists, including a neurologist and a registered dietitian.

Several studies have shown that the ketogenic diet can reduce or prevent seizures in many children whose seizures could not be controlled by medications. Over half of the children who go on the diet experience at least a 50% reduction in the number of seizures, and some children, typically 10-15%, become seizure-free. The diet has also been shown to have other benefits, such as increased alertness, awareness, and responsiveness.

While the ketogenic diet has proven effective in reducing seizures, it is not without its risks and side effects. Side effects occurring with long-term diet use include low bone density and bone fractures, slower growth than typical, and sluggishness or tiredness. Additionally, the diet does not provide all the vitamins and minerals found in a balanced diet, so vitamin and mineral supplements are recommended.

In summary, the ketogenic diet has been successfully used to reduce seizures in epileptic children for many decades. While it can be an effective treatment option, it should be closely monitored by healthcare providers and is typically recommended for children whose seizures have not responded to medication.

Frequently asked questions