The ketogenic diet has been described as the biggest diet sensation – ever – in the nutrition industry. So it's worth looking into for that reason alone.
A ketogenic diet is very high in fat (about 75%), moderate in protein (about 20%), and very low in carbohydrates (about 5%). It's intended to put the body into a state of ketosis. In ketosis, the body breaks down fat to create ketones for energy, rather than burning glucose.
Benefits of Keto?
Ketosis benefits we typically hear about are weight loss, increased HDL (“good”) cholesterol, and improvement in type 2 diabetes, as well as decreased epileptic seizure activity and inhibition of cancerous tumor growth.
Small studies have shown promise for women with PCOS (polycystic ovary syndrome), an insulin-related condition. This may be due to its possible (not conclusive) ability to reset insulin sensitivity.
Everything Old Is New Again?
The current Keto diet is not the first time we've targeted carbs as a dietary villain. Medical trials with low-carb eating and/or fasting go back to the 1850s and even earlier.
In 1967, Stillman introduced The Doctor's Quick Weight Loss Diet, featuring essentially nothing but low-fat protein and water.
Next came the Atkins diet in 1972, high in fat and protein, low in carbs. It helped with weight loss and also with diabetes, hypertension and other metabolic conditions. It's still popular today.
In 1996, Eades and Eades introduced Protein Power, a very low-carb diet that seemed to help patients with obesity, hypertension, high cholesterol, and/or diabetes.
So reducing carbs, as the Keto diet does, has a history of helping people lose weight and/or improve metabolic factors. Anecdotal evidence supports that.
Does Keto Have Any Other Benefits?
Probable benefits may be seen with neurodegenerative conditions, such as multiple sclerosis, Alzheimer's or Parkinson's, likely because these brain disorders are related to metabolic disorders. In fact, Alzheimer's is now called Type 3 diabetes.
Care for these conditions is best done under medical supervision.
Ketones also appear to improve traumatic brain injury, based on research done on rats.
In the Interest of Full Disclosure…
Initial weight loss with the Keto diet is rapid. The body has used its stored glycogen (carb stored in muscle) and dumped the water that's stored with it. After that, weight loss may continue, but at a slower rate.
Metabolism shows an initial increase that seems to disappear within 4 weeks.
Keto doesn't appear to offer long-term advantages in either fat loss or lean mass gains.
In some people, Keto seems to increase LDL (“bad”) cholesterol.
What About Negative Effects?
The usually mentioned “cons” of a ketogenic diet are nutrient deficiencies due to missing food groups and an unpleasant transitional state called “Keto flu,” which may last for days. It comprises hunger, dehydration, headaches, nausea, fatigue, irritability, constipation, brain fog, sluggishness, poor focus, and lack of motivation. Because these symptoms are so similar to those of people quitting caffeine, Keto has been posited as a “detox” plan.
Other negatives include problems with gut health on such a low-fiber diet and difficulties with adherence.
Regarding workouts, the Keto diet probably offers no advantage for most people. In fact, the glycogen depletion it induces may lead to hitting the wall (bonking). Athletic performance involving speed and power may be lower without glucose and carbohydrates as fuel.
The International Olympic Committee has urged athletes to avoid low-carb diets. They may lead to poor training adaptations and decreases in both power output and endurance. A colleague of mine induced cardiac arrhythmias in rats exercising on a low-carb diet.
Due to the low-carb nature of the Keto plan, my concern is how women may fare with respect to serotonin synthesis and function. Carbs play a significant role in transporting tryptophan (the serotonin precursor) to the brain, so serotonin levels might drop without those carbs. How does that affect women in terms of mood, appetite, impulsivity, and more?
What's the Bottom Line?
Keto seems to be viable for short-term weight-loss and the other health issues described above. Whether the approach is suitable long-term is still in debate. Its benefits are still in debate, as well. Critics cite possible kidney damage and the lack of long-term studies and scientific evidence.
Overall, Keto seems to be neither a long-term cure nor the ideal solution for those who just want to “be healthier.” Not least, the diet is difficult for many people to follow consistently.
A preferable long-term food plan might be a more balanced one that's low in sugar and “junky” carbs and emphasizes healthful, high-fiber foods, including vegetables.
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