Ketogenic diet. How the low carbohydrate diet came to be.

By: Charlie Dannelly Personal Trainer
Recently, some of my clients have been asking about a ketogenic diet.  Should they do it? Would I do It?  Leave it to Hollywood to push a “medical diet” to popularity. The ketogenic diet has been used to treat drug-resistant epilepsy for nearly 100 years, mainly in children. In 1972, Dr. Atkins Branded this type of diet calling it the “Atkins diet”. Over the years, other fad diets incorporated a similar approach for weight loss.

How does the ketogenic diet work for weight loss?

The ketogenic diet causes the body to release ketones into the blood for energy. This happens when there is an absence of blood sugar from carbohydrates, your main source of cellular energy.  When blood sugar is missing, your body starts breaking down stored fat into molecules called ketone bodies. The process is called ketosis. Once you reach ketosis, most cells will use ketone bodies to generate energy until we start eating carbohydrates again. The shift, from using circulating glucose to breaking down stored fat as a source of energy, usually happens over two to four days of eating fewer than 20 to 50 grams of carbohydrates per day. Keep in mind that this is a highly individualized process, and some people need a more restricted diet to start producing enough ketones. Which requires blood samples to determine.

What is in a ketogenic diet?

Because it lacks carbohydrates, a ketogenic diet is rich in proteins and fats. It typically includes plenty of meats, eggs, processed meats, sausages, cheeses, fish, nuts, butter, oils, seeds, and fibrous vegetables. Because it is so restrictive, it is hard to follow over the long run. Carbohydrates normally account for at least 50% of the typical American diet.

The cause and effects of a ketogenic diet:

One of the main criticisms of this diet is that many people tend to eat too much protein and poor-quality fats from processed foods, with very few fruits and vegetables. People with kidney disease need to be cautious because this diet could worsen their condition. Additionally, some people may feel a little tired in the beginning, while some may have bad breath, nausea, vomiting, constipation, and sleep problems.

The ketogenic diet was initially designed and intended for children to reduce seizures.  Weight loss is the primary reason adults use the ketogenic diet. Some research shows evidence of faster weight loss when adults go on a ketogenic or very low carbohydrate diet compared to adults on a more traditional low-fat diet, or even a Mediterranean diet. But it has been documented that the difference in weight loss disappears over time. A ketogenic diet also has been shown to improve blood sugar control for people with type 2 diabetes, at least in the short term. But that could be from losing weight.  There is even more controversy when we consider the effect on cholesterol levels. A few studies show some people have increase in cholesterol levels in the beginning, only to see cholesterol fall a few months later. However, there is no long-term research analyzing its effects over time on diabetes and high cholesterol. Bear in mind that this type of eating was intended for children which generally don’t have these medical issues.

What would I do or recommend?

Personally, I like carbs so I’m out.  To much fun on the plate to go cold turkey. Pardon the pun.  A ketogenic diet could be an interesting alternative to accelerate weight loss. If you are gluten sensitive this may be a good route for weight loss. But I would check your vitals with a doctor before doing it, cholesterol count, blood pressure, etc. But based on my experience with clients a diet like this can be hard to follow and it can be heavy on red meat and other fatty, processed, and salty foods that are notoriously unhealthy. We also do not know much about its long-term effects, probably because it’s so hard to stick with that people can’t eat this way for a long time. It is also important to remember that “yo-yo diets” that lead to rapid weight loss fluctuation are associated with increased mortality. Instead of engaging in the next popular diet that would last only a few weeks to months (for most people that includes a ketogenic diet), try to embrace change that is sustainable over the long term. A balanced, unprocessed diet, rich in very colorful fruits and vegetables, lean meats, fish, whole grains, nuts, seeds, olive oil, and lots of water seems to have the best evidence for a long, healthier, vibrant life. That way you can have your cake and eat it too!

Information interpreted from the Harvard medical journal.