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Ketogenic diet: What you need to know

Kristi King

The ketogenic diet was recently called the “latest buzzy” weight loss plan by the mainstream media. However, this particular weight loss plan actually dates, according to some estimates, to as early as 500 BC.

Fast forward to the 1920s, when the diet was linked to treating epilepsy. Even more recently, the ketogenic diet has “exploded in use and scientific interest” in this century, according to one researcher.

“New kinds of ketogenic diets using meals that mimic carbohydrate-rich foods could improve the compliance to the diet, Antonio Paoli, MD, BSc, of the department of biomedical sciences at the University of Padova in Italy, wrote in an article that appeared in the International Journal of Environmental Research and Public Health.

“The duration of ketogenic diet may range from a minimum (to induce the physiological ketosis) of 2 to 3 weeks to a maximum (following a general precautionary principle) of many months (6 to 12 months), Paoli continued. Correctly understood, the ketogenic diet can be a useful tool to treat obesity in the hands of the physician.”

So what exactly is the ketogenic diet, and as the obesity prevalence continues to grow among adults in the United States and around the world, is it the right diet to help patients reach their weight loss goals?

Healio Family Medicine asked Kristi King, MPH, RDN, CNSC, LD, a senior clinical dietitian at Texas Children’s Hospital, to provide some additional insight to help primary care physicians and other medical professionals. – by Janel Miller

Question: What is the ketogenic diet?

Answer: The ketogenic diet includes foods that are high in fat, low in carbohydrate and contain appropriate amounts of protein. The idea of the diet is to force the body into ketosis, which is a fat burning state. However, it is unknown if weight loss that might be associated with a ketogenic diet is truly from the ketosis state or from overall consumption of fewer calories.

Q: What medical benefits does it provide?

A: Besides the possibility of controlling seizures in patients with epilepsy, the ketogenic diet has been researched in patients with brain cancer. Emerging research is showing the diet could potentially help some patients with type 2 diabetes control their blood glucose levels. However, it is not intended to be followed for a long period of time.

Q: Are there any population groups that should avoid the ketogenic diet?

A: Since the ketogenic diet is high in fat, which the gallbladder helps to break down, it is not intended for those who have gallbladder disease or have had their gallbladder removed. In addition, a person who has kidney, liver, or pancreatic disease (including type 1 diabetes), a history of bariatric surgery and/or or a history of delayed gastric emptying also should not go on the ketogenic diet.

Q: What are the risks of going on the ketogenic diet?

A: The research is still yet to be 100% conclusive for the ketogenic diet, but some adverse events include fatigue, headaches, kidney stones, vitamin and mineral deficiencies and potential weight gain once carbohydrates are added back into the diet.

Q: What is the best advice you can give a primary care physician and other medical professional who has a patient on the ketogenic diet?

A: Watching the patient’s overall health assessment is important. Blood pressure, weight, liver function and kidney function should be monitored. Vitamin and mineral levels may also need to be checked while following the diet. Physicians who have patients following the ketogenic diet should seek the guidance of a registered dietitian nutritionist to ensure all energy, protein and vitamin and mineral needs are being met.

References:

Newsweek. “Keto diet or intermittent fasting: What’s best for weight loss?”

http://www.newsweek.com/keto-diet-vs-intermittent-fasting-whats-best-weight-loss-864900. Accessed March 29, 2018.

Paolo, A. Int J Environ Res Public Health. 2014;doi:10.3390/jerph.110202092.

Wheless, JW. Epilepsia. 2008;doi:10.1111/j.1528-1167.2008.01821.x

Disclosures : Neither King nor Paoli report any relevant financial disclosures.