Ketogenic diet

History:

The ketogenic diet dates back to as early as 500 BC when various forms of starvation and fasting were used to treat epilepsy, however, the term ketogenic diet was not coined until 1921 (1). Research began to emerge in the early 1920s, finding that through the absence of food or shortage of carbohydrates the body burns fat for fuel instead of glucose, having a significant effect on controlling seizures. Observations lead to the belief that the benefits of fasting could be obtained if ketonemia was produced by other means, a diet containing to low a proportion of carbohydrates and to high proportion of fat, known as the ketogenic diet. Since this diet is as effective as fasting and more adherable in the long-term, it was widely used for the treatment of epilepsy for two decades. However, while antiepileptic drugs became more popular the ketogenic diet faded. The ketogenic diet is a valuable therapeutic option for patients with epilepsy and while it is still used today, it is now commonly being used for weight loss. This diet ranked 34 out of 35 in US News Best Diet Overall for 2020.

Purpose:

This diet is used in medicine primarily to treat epilepsy. Currently, this diet has gained popularity for its weight loss effects (2). The goal is to lose weight quickly while feeling the benefits of satiety, fewer cravings, enhanced mood, increased mental focus, and boosted energy. The diet forces the body into burning fats for energy rather than carbohydrates. Instead of the normal pathway of using glucose, the ketogenic diet relies on turning fat into ketones in the liver, which can supply energy for the brain and rest of the body.

General dietary practices:

This high-fat, adequate-protein, low-carbohydrate diet has many restrictions. In terms of carbohydrates, less than 8% or 20 grams of carbohydrates can be consumed a day (2-4). Bread, potatoes, rice, pasta, and most fruits are not suitable for a ketogenic diet. High-fat foods such as avocados, nuts, seeds, olives, and full-fat dairy products are consumed regularly. The diet also contains moderate amounts of protein-rich foods, such as pure grass-fed meat, poultry, fish, eggs, and cheese.

Key concerns:

There have been long-term adverse effects reported on the ketogenic diet such as gastrointestinal symptoms, carnitine deficiency, kidney stones, and elevated lipids (5). Other unknown dangers include nutrient deficiencies, liver problems, kidney problems, constipation, and mood swings. People on the ketogenic diet may miss out on essential nutrients like B vitamins, zinc, potassium, calcium, magnesium, and fiber which are commonly found in whole grains, certain vegetables, and fruits, which are limited on the ketogenic diet. People may turn to processed foods, particularly processed meats, that are still considered ketogenic under the guidelines but are not necessarily healthy. This diet is not recommended for people at risk for heart disease, who have problems with their kidneys or liver, or who have had their gallbladder removed. It is advised to talk to your doctor and dietitian if you have type 1 diabetes, are pregnant, or breastfeeding. It is not easy to get the body to reach a state of ketosis and typically takes a few days. This diet is not environmentally friendly. A daily multivitamin with minerals including potassium and magnesium is recommended while following this diet.

Further Resources:

Websites:

• Wikipedia

• Keto Connect

• US News Best Diet 2020

• Mayo Clinic

• Harvard Health Publishing

Apps: Keto.app, Carb Manager, Keto diet & ketogenic recipes

Books: 

• Keto Diet: Your 30-Day Plan to Lose Weight, Balance Hormones, Boost Brain Health, and Reverse Disease, by Josh Axe;

• Keto Diet Cookbook: 125+ Delicious Recipes to Lose Weight, Balance Hormones, Boost Brain Health, and Reverse Disease, by Josh Axe;

**The information presented provides an overview of the diet along with credible resources to refer to in order to learn more. This is not intended to make any dietary recommendations, rather an education tool for our clients.**

Reference: 

1. Wheless, J.W. (2008), History of the ketogenic diet. Epilepsia, 49: 3-5. doi:10.1111/j.1528-1167.2008.01821.x

2. Is the keto diet for you? A Mayo expert weighs in. Mayo Clinic. https://www.mayoclinic.org/is-the-keto-diet-for-you-a-mayo-expert-weighs-in/art-20457595. Published 2020. Accessed July 26, 2020.

3. What is the Ketogenic Diet. Eatright.org. https://www.eatright.org/health/weight-loss/fad-diets/what-is-the-ketogenic-diet. Published 2019. Accessed July 26, 2020.

4. Ketogenic diet. En.wikipedia.org. https://en.wikipedia.org/wiki/Ketogenic_diet. Published 2020. Accessed July 26, 2020.

5. Publishing H. Should you try the keto diet? - Harvard Health. Harvard Health. https://www.health.harvard.edu/staying-healthy/should-you-try-the-keto-diet. Published 2019. Accessed July 26, 2020