One argument against the consumption of a high fat diet is that it causes obesity. The major concern in this regard is whether a high percentage of dietary fat promotes weight gain more than a low percentage of fat intake. Because fat has a higher caloric density than carbohydrate, it is thought that the consumption of a high fat diet will be accompanied by a higher energy intake (31). On the contrary, recent studies from our laboratory (12) and many other laboratories (24,32–34) have observed that a ketogenic diet can be used as a therapy for weight reduction in obese patients.
I’m in ketogenesis now – 3 weeks in. Lost over 10kg. Protein shakes. Great. But what I wanted to add was that i’m Diabetic (2) and quite badly so. I was Injecting insulin twice a day – Novomix (part immediate, part slow acting). But since I went into keto, my blood sugar has been steady between 5-9, normal range. No injections needed. And no hypo attacks either – that occurs below a reading of 4, for me. This is NOT a cure of course – it’s directly related to low carb intake. But I do wonder if discontinuing insulin is partly responsible for my improvement in alertness, activity level and so on. Magnesium tabs, 1000 units twice a day, have also been helpful – I suffer leg and foot cramps due to spinal arthritis – but they had worsened until I upped the dose.
Low carb, high fat diets have been used for centuries by doctors when working with obese patients. William Banting published the widely popular booklet titled ‘Letter on Corpulence Addressed to the Public’ in 1863. In this booklet he explained how he had slimmed down by eating a diet high in fat void of carbs. The Banting diet was used for decades by individuals looking to lose weight.
Another benefit of the ketogenic diet I’d like to mention has been reported in patients with Alzheimer’s disease. In my recent interview with Dr. Dale Bredesen , author of the landmark book, The End of Alzheimer’s, he describes the use of a ketogenic diet along with other modalities to improve brain function in individuals suffering from Alzheimer’s disease.
Longer-term studies conducted on animals have shown the KD may be associated with some adverse events. For example, in rodent studies, some will develop nonalcoholic fatty liver disease (defined as liver damage that is not due to excess consumption of alcohol, viral or autoimmune causes, and iron overload ) and insulin resistance when put on the keto diet long-term. Other studies suggest that some individuals may be predisposed to heart-related problems if they eat a very high-fat diet for an extended period of time.
Until recently, ketosis was viewed with apprehension in the medical world; however, current advances in nutritional research have discounted this apprehension and increased public awareness about its favourable effects. In humans, ketone bodies are the only additional source of brain energy after glucose (23,24). Thus, the use of ketone bodies by the brain could be a significant evolutionary development that occurred in parallel with brain development in humans. Hepatic generation of ketone bodies during fasting is essential to provide an alternate fuel to glucose. This is necessary to spare the destruction of muscle from glucose synthesis.
The most important thing that diabetics have to learn is that there is no reason to avoid fat, not even saturated fat. It is not saturated fat that causes arteriosclerosis and heart disease, but an excess of refined carbohydrates like sugar and flour. Seed oils are implicated in the disease although by other mechanisms that involve damaged lipids and mitochondrial toxins.
We have solid evidence showing that a ketogenic diet reduces seizures in children, sometimes as effectively as medication. Because of these neuroprotective effects, questions have been raised about the possible benefits for other brain disorders such as Parkinson’s, Alzheimer’s, multiple sclerosis, sleep disorders, autism, and even brain cancer. However, there are no human studies to support recommending ketosis to treat these conditions.
The primary outcome was the change from baseline to week 16 in hemoglobin A1c. Changes in all variables were analyzed by the paired t-test or Wilcoxon signed-ranks test, as appropriate. Linear regression analysis was used to examine predictors of change in hemoglobin A1c. A p value of 0.05 or less was considered statistically significant. Statistical analysis was performed using SAS version 8.02 (SAS Institute, Cary, NC).
The catch, of course, is that if it sounds too good to be true, it probably is. And that’s exactly what hopeful dieters need to keep in mind when approaching the ketogenic diet (if we're calling it by its formal name). It’s not that this high-fat, moderate-protein, low-carbohydrate approach to eating can’t deliver weight loss in a delicious package, but it’s a restrictive, sometimes complicated affair that isn’t sustainable for most people.
Luiza Petre, MD, a board-certified cardiologist and weight management specialist in New York City, suggests focusing on eating more low-carb, fiber-rich foods that can help beat this bowel issue. “Try fibrous vegetables, such as broccoli, asparagus, and cabbage, consume more fat like MCT oil, coconut oil, or ghee, and, as always, drink plenty of water,” she says.
We all have different meanings for “quality of life” for me it means feeling good, with energy, no bloating, no heartburn, on my weight, normal glucose levels… for you it means having “white stuff” to eat, enjoy it while you eat it and then feeling bad about it, ’cause if you’re a diabetes educator you know (or at least you should) the harm it does to your body! I’m glad no one believed this biased article! It means everyone out there know what is real and what is not…
Thank you for your wonderful comments Marcia. To share more about me personally with you all…I am not a completely non-diabetic Certified Diabetes Educator. I found out I had Prediabetes 15 years ago when I became a Diabetes Educator. I tested my own A1c and found it was 5.8%. The incredible news? There have been years when my A1c dropped to a normal level of 5.4%…out of the prediabetes range. My last A1c in May was 5.8%, so I still have Prediabetes 15 years later, but not diabetes, and without any medication, just the sensible diet I’ve discussed and exercise, so I really am living with this. I feel it everyday, I wonder what my A1c is going to be just like you every 6 months when I go to have it drawn.
“Rapid, significant weight loss is a common side effect of the keto diet because of the water losses that occur as carbohydrate stores are depleted,” says Clark. In a study in the American Journal of Clinical Nutrition, obese men following a modified version of the ketogenic diet, with high protein and low carbs, lost about 14 pounds in one month, compared with the control group, which lost about 10 pounds on a high-protein, medium-carb diet.
Heart disease. The connection between the ketogenic diet and cardiovascular disease risk factors is complicated. Many studies have found that the keto diet can lead to significant reductions in total cholesterol, increases in HDL cholesterol levels, decreases in triglycerides levels, and reductions in LDL cholesterol levels, as well as potential improvements in blood pressure levels.
Some of us experience a rise in BG that’s hard to manage when trying Keto. This is one of the reasons why keto did not work out for me (plus weight gain and feeling lousy). That being said, there could be a lot of other reasons why he’s running high, so I’d highly recommend you work with a medical professional and dietitian if you decide to continue down this path. And if your doctor isn’t supporting you, find one that will.
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.
Josh Axe, a doctor of natural medicine and clinical nutritionist, estimates that about 25% of people who try a ketogenic diet experience these symptoms, with fatigue being the most common. “That happens because your body runs out of sugar to burn for energy, and it has to start using fat,” he says. “That transition alone is enough to make your body feel tired for a few days.”
Research shows there is a weak relationship between levels of dietary cholesterol and blood cholesterol.6 The effect isn’t the same for everyone either. There are “responders” and “non-responders” to dietary cholesterol; some people experience higher fluctuations in blood cholesterol levels according to the amount of cholesterol they eat, while others are more stable regardless of diet.
Turoff doesn't think the keto diet should be a go-to solution for weight loss, and she's not alone in this opinion. Many of the dietitians Shape spoke to for this story had similar thoughts on the keto diet, which is why many of them strongly encourage anyone who is thinking about trying a ketogenic diet to chat with a registered dietitian first. (Related: Why This Dietitian Is Completely Against the Keto Diet)
Despite its explosive popularity, there’s a lot of confusion about what the ketogenic (keto) diet really is. “Many people think they’re following a keto diet when they’re really just consuming a low-carbohydrate diet,” says Patti Urbanski, MEd, RD, CDE, a certified diabetes educator with St. Luke’s Hospital in Duluth, Minnesota. “So one person’s ‘keto diet’ may look very different than another’s.”
The ketogenic diet is usually something that’s prescribed by a registered dietitian. For example, Jessica Lowe, a Keck School of Medicine of USC ketogenic dietitian, said she might prescribe it to a patient who has epilepsy, since there’s research that shows it can help control seizures. There’s also growing interest in whether high-fat diets could help with brain injuries or neurodegenerative diseases, Lowe said. For the everyday dieter, Lowe said, it’s important to consult a registered dietitian.
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Difficulty. Many experts question how long a person can realistically give up carbs. “This is a very restrictive diet that requires a drastic change in eating behaviors and even taste,” says Sandra Arevalo, MPH, RDN, CDE, a certified diabetes educator and spokesperson for the Academy of Nutrition and Dietetics. “It isn’t very practical or easy to maintain, for people both with and without diabetes.” That’s not saying you can’t stick with it, but before you commit, make a plan and set measurable goals to help you stay on track. Being prepared with the right foods can also help. Urbanski recommends making a shopping list that focuses on a few basic keto-friendly meals and snacks, so you’ll always have the right foods on hand to ensure success.