The letogenic diet has seen a recent increase in popularity, and many people are beginning to ask questions.
Is it an effective weight loss strategy? Does it help control diabetes? Is it safe?
The research is still fairly limited, but here are some important details.
What’s a ketogenic diet?
The ketogenic diet is a high-fat, low-carbohydrate diet. Carbohydrate containing foods, including bread products, cereals, rice, pasta, fruit, milk, yogurt, and sweets, are almost completely eliminated from this diet.
Typically, the amount of carbohydrate per day is not more than 50 grams, or 5 to 10% of total energy (compared to a typical diet which contains about 200 to 300 grams or 45 to 65% of total energy). The idea is that when the body can no longer use carbohydrates as its main energy source, it will switch to using fat. This produces ketones, which gives the diet its name.
It should be noted that this is not a “high protein” diet, contrary to popular belief. Only 20 to 25% of calories come from protein, which is comparable to a “typical diet.” If too much protein is eaten, the body will not truly go into ketosis as proteins will be turned into carbohydrates instead.
Studies comparing the ketogenic diet to low-fat diets found a similar or better initial effect. That is to say, people did in fact lose weight on this diet. However, after six months, it was common to regain weight, meaning the ketogenic diet was not significantly better than any other diet.
Diabetes
Research has shown that a ketogenic diet can be helpful in the short-term for managing diabetes. In these studies, people with type 2 diabetes following a ketogenic diet were able to decrease blood sugar levels as well as medications. The long-term effects of this diet are currently unknown however, and it is recommended to first discuss it with your health care or diabetes education team.
This diet is not appropriate for those with type 1 diabetes due to the high risk of ketoacidosis, a complication in which the blood becomes too acidic.
There are currently no studies on the long-term effects of the ketogenic diet. It is hard to stick with because it is so restrictive.
Furthermore, it takes about three days for ketosis to begin, plus three more days for the brain to adapt. This can be uncomfortable causing many people to quit before the diet really begins. Side effects include gastrointestinal discomfort and an increased risk of ketoacidosis. As this diet excludes nearly an entire food group, vitamin, mineral and fibre supplementation may be needed. It is crucial to work closely with your health care team including a registered dietitian to ensure this diet is safe for you.
There are parts of the ketogenic diet that make it successful, besides limiting carbohydrates. As with any diet, calorie restriction is still necessary for weight loss. Because fats are satisfying and increase the feeling of being full, appetite is reduced. Furthermore, food options are limited, and the lack of variety increases boredom with food, thus reducing mindless eating and snacking.
This diet eliminates added sugars and processed foods such as muffins, chips, cereals and juice.
It is possible that many of the benefits associated with the ketogenic diet come from eliminating these foods. These are elements that can be incorporated into a healthy, balanced diet without the burden of following a strict ketogenic diet.
Tiffany Rusch is a dietetic intern with North Wellington Health Care. For more information about any of the free services offered by your local Family Health Team ask your doctor or nurse practitioner during your next visit, visit the website www.afhto.ca or google ‘family health team locations’.
