- On June 3, 2018
Family, friends, co-workers – it seems like we all know someone trying the ketogenic diet and reporting stories of instant weight loss, increased energy, and better moods. With reports like that, who wouldn’t want to try it? Far too little people, however, know the details of the diet and the risks associated with it. Read on for everything you need to know about the keto diet from a dietetic professional…
The popular “Modified ‘Keto’ Diet” is different than the “Classic Ketogenic Diet.”
The “Classic Ketogenic Diet” was released by Russell Wiliams at Mayo Clinic in the early 1920s.1 It was used as a novel therapy for epileptic patients before anti-seizure drugs had been developed, and is still used today. It is also currently being investigated for use in neurologic disorders such as Alzheimer’s, brain cancer, and Parkinson’s disease.2 The “Modified Ketogenic Diet” has gained recent popularity for its weight loss claims.
The “Classic Ketogenic Diet” is not the most appetizing.
Classic KD consists of 4 grams of fat for every 1 gram of protein and carbohydrate combined. To put that in perspective, a classic keto breakfast is 1 egg + 1 Tablespoon of mayo + 1 Tablespoon of butter. The diet is strict and requires specific monitoring of nutritional supplementation, electrolytes, hydration, and activity levels. Thus, using the diet for epilepsy treatment is only recommended under the guidance of a dietitian and other healthcare professionals.
The Ketogenic Diet works by changing the body’s main source of fuel from carbohydrates to fat.
Carbohydrates are the body’s main source of energy. When we eat carbohydrate-containing foods like breads, grains, and starchy vegetables, our body breaks these down into a usable form of energy (glucose). Limiting carbohydrate intake mimics starvation and forces our body to break down fat as the main form of energy. The byproduct of this reaction are ketones, and when we reach this state, we are said to be in “ketosis”.
Both the Classic and Modified KD are high in fat, adequate in protein, and low in carb.
Classic: 4 grams of fat for every 1 gram of protein and carbohydrate combined.
Modified: 3 grams of fat for every 1 gram of protein and carbohydrate combined.
Consuming a Ketogenic Diet has potential health risks.
Current research suggests that a KD can result in rapid weight loss, specifically when used short-term in pre-bariatric surgery patients.3 However, following the KD does not come without risks. In patients with diabetes, use of the KD resulted in weight loss and improved blood glucose control, but put patients at high risk for episodes of low blood sugar, which can be fatal. Following a KD was also shown to increase total cholesterol and triglycerides, which can lead to heart disease and fatty liver disease. Aerobic exercise may reverse these levels, but more research is needed to understand the full effect of KD on health.
Following the keto diet does not always address behavioral patterns for weight management.
Achieving and maintaining a healthy weight requires understanding portion control, consuming high-quality foods, staying active, and being mindful to hunger and fullness cues. Using a restrictive diet to achieve weight loss does not address these issues, and weight regain is a prominent occurrence in people who stop adhering to the Keto Diet.
Bottom line: The short term benefits of the keto diet do not outweigh its risks and potential long-term complications.
Because the diet nearly eliminates an entire food group, it is low in fiber and puts individuals at risk of nutrient deficiencies and other complications. Thus, it is NOT recommended by dietetic professionals for weight loss.
So if you’re wanting to lose weight, what should you do?
Maintain a diet of 55-65% of calories from carbohydrates, 20% from protein, and 10% from fat. Focus on whole grain carbohydrates and limit processed chips, snacks, and desserts. Add healthy fats like avocado, olive oil, and fish, but remember that these are high in calories, as well, so be mindful of your portion sizes. Talk to your dietitian for the specific recommendations that are right for you.
Written by: Renae Brown, MS
Case Western Reserve University, MS in Nutrition, BS in Biology & Anthropology
- The Ketogenic Diet. Charlie Foundation. https://charliefoundation.org/. Accessed May 30, 2018.
- Ismayilova N, Leung M-A, Kumar R, Smith M, Williams RE. Ketogenic diet therapy in infants less than two years of age for medically refractory epilepsy. Seizure. 2018;57:5-7. doi:10.1016/j.seizure.2018.02.014.
- Pilone V, Tramontano S, Renzulli M, et al. Metabolic effects, safety, and acceptability of very low-calorie ketogenic dietetic scheme on candidates for bariatric surgery. Surgery for Obesity and Related Diseases. 2018. doi:10.1016/j.soard.2018.03.018.
- Leow ZZX, Guelfi KJ, Davis EA, Jones TW, Fournier PA. The glycaemic benefits of a very-low-carbohydrate ketogenic diet in adults with Type 1 diabetes mellitus may be opposed by increased hypoglycaemia risk and dyslipidaemia. Diabetic Medicine. 2018. doi:10.1111/dme.13663.
- Masood WM., Uppaluri, KR. Ketogenic Diet. StatPearls. May 2018. https://www.ncbi.nlm.nih.gov/books/NBK499830/#article-23879.s1. Accessed May 30, 2018.