Losing heart muscle may not be the only heart-associated risk with the keto diet, Derocha says. “If you have high blood pressure and are taking medication, the prescription mixed with the diet may cause abnormally low blood pressure test results,” Derocha says. Before you start the keto diet, she suggests you talk with your doctor to avoid low blood pressure, which can be dangerous, even deadly.
Dementia and Alzheimer’s Disease A small study published in February 2013 in the journal Neurobiology of Aging found that older higher-risk adults on a keto diet experienced better memory functioning after just six weeks. (11) Some experts, like Richard Isaacson, MD, director of the Alzheimer’s Prevention Clinic at Weill Cornell Medicine and NewYork–Presbyterian in New York City, support low-carb diets for patients as one way to delay brain aging and possibly Alzheimer’s disease, the most common form of dementia.
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The diet calls for consuming high amounts of fat, a moderate amount of protein, and a very limited amount of carbs. It’s usually broken down to 75, 20, and 5 percent of your daily calories, respectively, says Pamela Nisevich Bede, RD, a dietitian with Abbott’s EAS Sports Nutrition in Columbus, Ohio. Compare that with the typical American diet — which is usually 50 to 65 percent carbs — and it’s safe to say this is a completely different way of eating, Nisevich Bede says.
But what does the science say? Results are mixed. In one Spanish study of 20 obese adults, participants were put on a low-calorie keto diet and lost an average of 40 pounds over four months. Another small experiment had a similar outcome. In a six-month Experimental & Clinical Cardiology study of 83 obese adults, those on the keto diet lost an average of 33 pounds, while lowering their bad (LDL) cholesterol levels and increasing their good (HDL) cholesterol.
Check your ratios. Total cholesterol/HDL ratio is a good indicator of how long LDL is hanging around in the blood and remains the best standard assessment of heart disease risk. Another good one is triglyceride/HDL ratio, which is a strong surrogate marker for insulin resistance. In both cases, lower is better. An ideal T/HDL ratio is 1:1. I’d say 2:1 is about as high as you want to go. An ideal TC/HDL ratio is 3.5:1 or lower.
The keto diet has also been studied as a possible cancer therapy. In a study focusing on people with cancer who followed the ketogenic diet as a medical therapy,4 the authors reported: “There is a great need for complementary approaches that have limited patient toxicity while selectively enhancing therapy responses in cancer versus normal tissues.
If you’re wondering why iron is at risk on a meat-based diet, hear me out. Many grain foods provide a considerable amount of iron, because wholegrains naturally contain iron in their inner layer called the ‘germ’. Another reason is that some grain products can have iron added to them during manufacturing. So, once you cut grains out, your iron status could suffer, which can lead to unpleasant symptoms like tiredness and lethargy. It can even compromise your immune system.