Does Ketogenic Diet Work for Everyone; What Does Science Say?

What is a Ketogenic Diet?

The ketogenic diet is very popular amongst those trying to lose weight as it is considered a weight-loss wonder. Generally, any low-carb, high-protein diet usually gains a lot of popularity and becomes the latest health trend. Similarly, keto has also become the ultimate weight loss diet however it is important to know that is not what keto is for.

Keto Diet

The ketogenic or keto diet is a medical diet that has been used for years to treat young, epileptic patients and it has some side effects, like most medical diets. The ketogenic diet is defined as a low-carbohydrate, adequate-protein, and high-fat diet that causes the body to break down the body fat into smaller molecules called ketones, hence the name. These ketones then enter the bloodstream and become the main source of energy for the body.

According to the American Epilepsy Society, ‘The ketogenic diet calls for 90 percent of daily calories to come from fat, with the amount of protein or carbs varying as long as it’s 4 grams of fat for every combined 1 gram of carb and protein.’

According to the Harvard School of Public Health, ‘A “typical” ketogenic diet consists of at least 70 percent of calories derived from fat, less than 10 percent from carbs, and less than 20 percent from protein.’

According to the National Cancer Institute, the ketogenic diet is being studied in the treatment of certain cancers.

What are the benefits of the ketogenic diet?

The ketogenic diet has many benefits apart from weight loss, which is the main reason for its recent popularity.

1. Weight loss

Since the ketogenic diet works by affecting the sugar reserves and using them for body energy, hence reducing body fat levels, it helps promote weight loss. It also supports weight loss by reducing the appetite of an individual and boosting metabolism.

The fat-filled foods usually eaten in the ketogenic diet are really good for filling up a person and reducing the hunger-stimulating hormones, hence reducing appetite and eventually, resulting in weight loss.

A meta-analysis study of 11 randomized control trials published in the British Journal of Nutrition by Bueno and his colleagues found that very low-carbohydrate ketogenic diets resulted in greater weight loss long term when compared to the conventional low-fat diets.

Overall, the Keto diet is really beneficial in helping individuals lose weight however it is important to remember that this diet cannot be done for long periods of time.

2. Decreased risk of cancer

As mentioned above, the keto diet has been considered for the treatment of certain cancers. In fact, a 2014 study conducted by Allen and colleagues, published in Redox Biology Journal found that the ketogenic diet could, ‘represent a potential dietary manipulation that could be rapidly implemented for the purpose of exploiting inherent oxidative metabolic differences between cancer cells and normal cells to improve standard therapeutic outcomes by selectively enhancing metabolic oxidative stress in cancer cells.

They recommend the use of the ketogenic diet as a complementary or adjuvant cancer therapy along with chemo or radiation therapy.

3. Cardioprotecctive efects

The Ketogenic diet recommends that most of the calories be consumed from fatty foods. However, the fat-filled foods recommended are full of healthy fats like nuts and avocados. The consumption of these healthy fats results in an increase in good cholesterol or HDL and a decrease in bad cholesterol or LDL, and VLDL, therefore leading to an improvement in cardiac health.

However, it is important to note that the cardioprotective effects associated with an increased HDL level are only seen if the ketogenic diet consists of healthy fats rather than unhealthy fats.

4. Decreased PCOS symptoms

PCOS or polycystic ovarian syndrome is a metabolic, gynecologic, and hormonal disorder that affects approximately 4-12% of the female population in the United States alone. PCOS, in general, has skin and weight-related symptoms that can negatively impact the patients’ confidence and self-esteem.

A high carbohydrate diet further worsens the skin condition, resulting in acne and results in overt weight gain. Hence the use of a ketogenic diet or low carbohydrate diet may alleviate these symptoms, helping the patient greatly.

5. Reduce Acne

A highly processed carbohydrate-rich diet can be the cause of acne in many individuals. Acne not only affects the physical features of a person but also their psyche resulting in decreased confidence and other issues with self-image.

A decreased carbohydrate diet or the keto diet has been found to significantly improve the acne in affected individuals

What are the risks of the Ketogenic Diet?

A ketogenic diet presents certain risks and side effects that need to be considered before starting the diet. The Keto diet recommends a fat-filled diet and more often than not, individuals mistake this ‘fat-filled diet’ to mean saturated fats and trans fats which can significantly worsen cardiac health by increasing LDL or the bad cholesterol. It is recommended that we keep saturated fats to no more than 7% of daily calories to prevent negative cardiac effects. This side effect of keto can easily be resolved or prevented if keto is initiated by talking to a specialist or a dietician, to know which are healthy fats and what can be eaten during keto to prevent the cardiotoxic effects. Another side effect associated with initiating keto by yourself without referring to a specialist is nutrient deficiency.

According to a registered dietician and Director of Nutrition at the Harvard-affiliated Brigham and Women’s Hospital, Kathy McManus, “If you’re not eating a wide variety of vegetables, fruits, and grains, you may be at risk for deficiencies in micronutrients, including selenium, magnesium, phosphorus, and vitamins B and C,”

Furthermore, a person with liver disease or kidney disease should not initiate a ketogenic diet as it can overload the organs due to high fat and high protein contents respectively. This would not be a problem if a specialist was consulted before starting the diet.

In general, it is safe to say that the initiation of the ketogenic diet should only be considered after a detailed consultation with a nutritionist. This can reduce several risks.

A ketogenic diet can also cause constipation since it is very low in fibrous foods. Along with that, a low-carb and sugar diet can also affect brain physiology resulting in fuzzy brain and mood swings. According to McManus, ‘The brain needs sugar from healthy carbohydrates to function. Low-carb diets may cause confusion and irritability.’ In the beginning phases of the keto diet, some might develop keto flu since the body is still trying to adapt to the new energy source. The features of keto flu include:

Constipation
Fatigue
Low blood sugar
Nausea
Vomiting
Headaches
Low tolerance for exercise

Who should avoid a ketogenic diet?

Overall, the ketogenic diet is not for everyone. People with the following conditions should avoid it:

People with diabetes who are insulin-dependent
People with diabetes taking SGLT-2 inhibitors
People who have eating disorders
Those with kidney disease or pancreatitis
Women during pregnancy and breastfeeding

The ketogenic diet has many benefits but also many risks and side effects, most of which can be reduced by talking to a specialist before starting the diet and eating healthier fats and a balanced diet.

When starting or considering a ketogenic diet, it is very important to keep in mind that its long-term effects are unknown. Moreover, the continuation of this diet for long periods may or may not have detrimental effects on our health and there is no scientific evidence to point either way.

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