Should You Go Keto? (Ketogenic Diet)

The ketogenic diet gets a lot of coverage in the health media. And that coverage is well-deserved. There have been very few dietary interventions that have the impact on blood sugar, insulin, cholesterol, high blood pressure, and weight that the ketogenic diet does. Yet, the “medical establishment” still frowns upon its use largely because it requires that you consume fat. And for at least a generation, we have been misled by the unsubstantiated claims that low-fat diets are the healthy way to eat. First, let’s take a look at exactly what the ketogenic diet is. Then we’ll cover the pros and cons of the ketogenic diet with regard to heart health, diabetes, weight loss, and cancer.

What exactly is the ketogenic diet?

Most of you can probably answer “low-carb” right away.  But the real health benefits come from being on what has been called a “well-formulated ketogenic diet” and not just low-carb. The well-formulated ketogenic diet includes whole foods, significant carbohydrate restriction, healthy fats, moderate protein, no calorie restriction, and eating to satiety and will result in a state of nutritional ketosis. Nutritional ketosis occurs when the consumption of carbohydrates is so low that they are no longer used as a primary energy source to power your body’s daily needs.  Your body will switch to burning fat which produces ketones. Carbohydrate consumption usually needs to be less than 50 grams per day to accomplish this.

What’s the downside to the ketogenic diet?

The short answer to that question would be staying on it. The degree of carbohydrate restriction required to stay in nutritional ketosis can be hard to maintain. It requires encouragement, support, and guidance. This change should be thought of as a lifestyle choice and not a temporary “diet.” And, if you have any chronic medical conditions, especially heart disease, high blood pressure, or diabetes, you will need medical guidance throughout this process since your medication needs will likely change dramatically.

In the beginning, you will lose some water and electrolytes because you are not storing as much glycogen (which holds water) and your insulin levels will be much lower. So, you may need to add salt and magnesium to your diet.  Consult with your doctor first. Because of these changes that happen in the first week or two, you can feel sluggish and have headaches. Some people refer to this as the “Atkins flu” after the famous Atkins diet which was one of the first popular low-carb diets.

Now for the upside to the ketogenic diet

You will lose weight. Hurray! I’ll address some of the weight loss issues specifically in the next post. What may be more or at least just as important as the weight loss are some of the metabolic changes that come with being on a ketogenic diet (in a state of nutritional ketosis). The benefits are most dramatic with regards to reducing the risk of heart disease and treating diabetes or pre-diabetes. Here’s why:

• Cholesterol profile: nutritional ketosis raises your good cholesterol (HDL) and lowers your triglycerides. This improves your triglyceride to HDL ratio which is a strong predictor of heart disease. Some critics will argue that this diet can raise your LDL cholesterol but just as there is good and bad cholesterol, there is good and bad LDL cholesterol. This diet raises the good light fluffy LDL and lowers the small atherogenic (heart attack causing) LDL.
• Diabetes and pre-diabetes (insulin resistance): nutritional ketosis dramatically lowers blood sugar and insulin levels. It also reduces inflammation and improves insulin sensitivity (both good things). Many diabetics will be able to reduce their medications very soon after starting the diet.
• Metabolic syndrome is a collection of conditions that increases your risk of heart disease, stroke, and diabetes. These conditions are high blood pressure, high blood sugar, excess fat around the waist, and abnormal cholesterol or triglycerides. In addition to improving your blood sugar and cholesterol profile, the ketogenic diet reduces your blood pressure and results in more fat loss around waist than other diets.

The ketogenic diet is a low-carb, moderate protein, high healthy fat diet that results in weight loss and lowers your risk of heart disease and stroke.  It also is a very effective treatment for diabetes, insulin resistance, and metabolic syndrome. Next, we’ll talk about using the ketogenic diet specifically for weight loss, the benefits there might be for cancer patients on a ketogenic diet, and who could or should try a ketogenic diet.

References:

Allen BG, Bhatia SK, Anderson CM, et al. Ketogenic diets as an adjuvant cancer therapy: History and potential mechanism. Redox Biol. 2014;2:963-70. 

da Luz PL, Favarato D, Faria-Neto JR, Lemos P, Chagas AC. High ratio of triglycerides to HDL-cholesterol predicts extensive coronary disease. Clinics (Sao Paulo). 2008;63(4):427-32.