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Commentary: Questions About the Ketogenic Diet

We've all heard of the keto diet by now, the darling of the diet industry for the past couple of years. Health columnists weigh in.
keto
Keto diets are very popular, focused on fat and protein and nixing the carbs. Photo supplied.

What is a ketogenic diet? How does it differ and is it more effective than other diets?  Apart from the hype surrounding this diet, what are the medical concerns about it?

Recent marketing of the ketogenic diet suggests it’s a new one. But a report from the University of California says it’s been used for years to treat medical problems such as epilepsy in children.

But what is it about the ketogenic diet that causes weight loss? A major factor is that it’s low in carbohydrates and high in fats.

Blood sugar (glucose) is normally the body’s main source of energy. But when blood sugar is diminished by eating less carbohydrates, the body is unable to maintain needed levels. To compensate, the body must start burning fat for energy. It also obtains more energy by converting some amino acids from protein in foods. And if this does not suffice, it gets energy from muscles.

The breakdown of fat, and to a lesser extent, protein, creates a condition called “ketosis” which is also used for energy. Hopefully none of us will ever be in a situation where we’re starving. But if that happens, we develop ketosis. It also occurs in uncontrolled diabetes.

Ketosis starts within a few days after carbohydrates are decreased to between 20 and 50 grams a day. This is not much carbohydrate, as two one-ounce slices of bread contain 28 grams of carbs!

How does a ketogenic diet compare with a normal diet? The average North American gets 50-55% of energy from carbohydrates, 30-35% from fats, and 15-20% from protein. The ketogenic diet obtains 5-10% from carbohydrates, 70-75% from fats, and 20% from protein.

A ketogenic diet contains full-fat dairy, eggs, fish, poultry, meat, nuts, non-starchy vegetables and butter. You are allowed to eat as many of these foods until you are full. It eliminates starchy vegetables, most fruits, grains, and sweets.

The British Journal of Nutrition analyzed 13 diet studies and reported that most, but not all, found that patients on a ketogenic diet lost more weight than those on other diets. They also ended up with lower blood pressure and blood triglycerides. And it helped those with type 2 diabetes. The negative of this diet is that it also increases bad cholesterol because of its high content of saturated fat.

Another negative is that the low carbohydrate content makes it hard for people to stick to it. Also, by eliminating most fruits, many vegetables, whole grains, and fibre, constipation is more likely to be a problem. Moreover, it removes ingredients essential for good health. No one should start a ketogenic diet without the help of your trusted family doctor.

It’s unfortunate that most diets wouldn’t be needed if people would follow a sound lifestyle. The first error is not having a bathroom scale that you step on every day. Scales tell it the way it is. Focus on losing any gained weight the same day the scale reports an increase.

This means saying no to high calorie desserts, eating smaller portions on smaller plates, and declining any offered second portions. Healthy weight loss also means an increase in daily exercise. Loss of excess weight and common-sense healthy living significantly reduces the risks associated with the epidemics of obesity, heart disease, and Type 2 diabetes. A sustained commitment can add years of longevity.

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