Those of you reading this may have most likely heard of the very popular ketogenic diet.
The ketogenic diet in a nutshell is essentially a low-carbohydrate, high-fat diet which includes energy consumption in the form of minimal carbohydrates at less than 20%, high fat energy intake of 50% or more, and varying energy requirements from protein.
Many people have sworn by this diet in helping them to shed tons of pounds, but the question is how truly safe and effective is the ketogenic diet? I decided to research through medical literature to answer this question for not just myself but for others who may also wonder about the ketogenic diet.
A 2019 retrospective study conducted by Selby et al. studied 100 obese adult patients over a 6-month period who followed a ketogenic based diet. The patients ranged from the age 13 to 65 years old with a BMI of 30 or greater. All patients had to engage in the following dietary restrictions:
- Drink one-half of body weight (in pounds) in ounces of water daily
- Keep total carbohydrates less than 50 g per day
It is recommended to eat fresh or frozen vegetables, such as asparagus, cabbage, green beans, lettuce, artichokes, cauliflower, spinach, bell peppers, cucumber, squash, broccoli, celery, mushroom, kale, brussels sprouts, eggplant, onions and zucchini
- Eat plenty of healthy fats (ex. Avocado, butter, nuts and seeds, animal fats)
Avoid canola or vegetable oil, margarine and shortening as sources of fat
- Consume a moderate amount of protein (ex. Turkey, lamb, beef, pork)
- Avoid white foods (ex. potatoes, breads, cereals, tortillas, and grain products).
- Avoid processed foods, fast food, and sugar-containing drinks and sodas.
- Eliminate artificial sweeteners, including sugar-free drinks and diet soda
Consider the use of stevia as a sweetener, do not use maple syrup and honey
Conclusion from this study was that the mean BMI of the study population decreased by 3.36 kg/m2 and their triglycerides decreased by a mean of 24.5 mg/dL despite the high-fat portion of the diet, which were very positive results. However no safety results were reported in this study.
Another study by Vargas et al. which only focused on the efficacy of the ketogenic diet, studied the effects of the ketogenic diet on the body fat mass of 24 healthy men who underwent an 8-week resistance training program. This study revealed a significant reduction in fat mass and visceral adipose tissue without affecting the lean body mass of the men.
Conducting my literature search I realized it was hard to find randomized clinical trials that would show just how safe the ketogenic diet is until I came across a study published in the European Review for Medical and Pharmacological Sciences.
In this study, the ketogenic diet once again proved to significantly reduce body mass index and intermuscular adipose tissue, however from a safety perspective it was found to significantly increase uric acid levels in the blood, increase serum creatinine and aspartate aminotransferase (AST) levels.
So in other words, you could be at increased risk of gout with the ketogenic diet, increased risk of poor kidney function and increased risk of liver damage.
Overall the ketogenic diet without a doubt has scientifically shown to help individuals lose weight, in fact it is also being studied in the setting of multiple sclerosis and other disease states. However there are some risks as shown above and possibly more that we may not know about now, so ensure to keep following up with your primary care physician while on this diet, if you plan to or are currently pursuing the ketogenic diet, to ensure it is healthy for your body.
References
Selby LM, Tobin BS, Conner BT, Gomez M, Busch G, Hauser J. A quantitative, retrospective inquiry of the impact of a provider-guided low-carbohydrate, high-fat diet on adults in a wellness clinic setting. Diabetes & Metabolic Syndrome: Clinical Research & Reviews. 2019;13(3):2314-2319.
Vargas S, Romance R, Petro JL, et al. Efficacy of ketogenic diet on body composition during resistance training in trained men: a randomized controlled trial. Journal of the International Society of Sports Nutrition. 2018;15(1)
C. Colica, G. Merra, A. Gasbarrini et al. Efficacy and safety of very-low-calorie ketogenic diet: a double blind randomized crossover study. Eur Rev Med Pharmacol Sci 2017; 21 (9): 2274-2289