Ketogenic Diet (KD)
Once again, I am looking at a specific diet, the Ketogenic diet, which has been around for a long time. Recently I have heard a few people talking about it for weight loss, so I thought it would be a good one to have a bit of a look at. If you have read any of my previous blogs, I have indicated that most diets have some positive and some negative aspects to them, and this one is no exception.
The KD is an interesting diet to examine. I have tried this one myself many years ago. It did result in short term weight loss, but I found myself longing for the foods I was restricting, which is not a nice place to be in!
So, what is the Ketogenic Diet?
The basis for the KD is quite simple but requires a fair amount of restriction on behalf of the dieter.
Firstly, the KD involves a reduction of carbohydrate rich foods to 20-50g per day (approximately 6%). This is equivalent to about 1 to 2 apples or 2 slices of bread, or 1-2 medium potatoes, or ½ cup of rice, or 2 cups of milk. Next, the KD includes a moderate protein intake (approximately 21%), and a high fat intake (approximately 73%). By following this eating pattern, the body goes into a state of “ketosis” which essentially means that instead of the body using glucose for energy, it uses fat.
For a healthy diet and to reduce your risk of chronic diseases, extensive research shows that the average person should have between 20-35% of their intake from fats, 45-65% from carbohydrates and 15 to 25% from proteins . As you can see, it is a very different picture.
Some of the concerns currently being voiced over this diet include the short term side effects, one being bad breath. Other side effects can include fatigue, constipation, nausea and headaches.
What are the benefits of this diet?
One of the most beneficial aspects of this diet is that it is a therapeutic diet for those suffering from epileptic disorders. It is not a diet that all people with epilepsy can use, but primarily for those whose seizures are not controlled well by their medication. Using the KD reduces the frequency and severity of seizures in many people suffering from epileptic seizures .
It is important to note that this diet is not suitable for all those who suffer epileptic seizures. In fact, for some it may lead to further harm. So please consult your doctor and dietitian before starting down this road.
There may be other benefits of a low carbohydrate diet. There are some suggestions that ketosis reduces cancer cells from growing, and in-particular, brain cancer cells . The evidence around this is limited and so is not an evidence based method of treatment. There also is limited evidence that the KD may treat autism spectrum disorder .
The KD can be used for weight loss , but as it is quite restrictive, it is important to be guided by your dietitian to ensure you are eating a balanced diet. In addition, most people who go on restrictive diets, end the diet and thus put the weight back on [3,4]. So for weight loss, it may be good for the short term, but difficult to maintain. As mentioned before, it does have a benefit for very specific medical conditions, and should be used with advice from your dietitian or doctor.
In general, lifestyle changes are a much better option for health than choosing a restrictive diet, unless you are on a specific diet for a medical condition. I will do a blog around this in the future, so stay tuned!
It is very difficult for most people to follow and stay on this diet. Unless you have medical reasons to be on the KD, I would not recommend it. It is too restrictive and many people who follow restrictive diets go off them and put back on the lost weight and more [3,4].
So the answer to the question of "is it a Fad diet", is Yes and No. If it is for the purpose of long term health, then YES it is a fad as it is very difficult to maintain for the long term. If it is for a specific medical condition such as epilepsy, then NO as it is important for quality of life and reduction of symptoms.
In general, most people should be eating 4 to 6 serves of grainy foods (ie bread, pasta, rice), around 5 serves of vegetables, 2 ½ to 4 serves of dairy (or alternatives) and 2 serves of fruit . So, by reducing all these foods which are rich in carbohydrate to 20-50g per day, you will be missing out on many other essential nutrients. In addition, fibre which is found in many carbohydrate rich foods, such as vegetables, fruit, and grainy foods, are important for bowel health and provide a rich environment for good bacteria to survive .
I would recommend seeing a dietitian if you struggle with weight loss for simple, achievable, sustainable, lifestyle changes.
It seems as though every time I turn around there is another diet that is being flagged as the best for weight management and health. It can become very challenging to know what is the best choice for “me”. What I can say to this is, it is important to do your research, and if that is why you have been reading this blog, then well done! If you have a diet you would like me to analyse for you, please feel free to contact me on firstname.lastname@example.org or click on the CONTACT button at the top of the page. Thanks for reading!
Michelle Fenner APD
For a summary of the recommended serves and serve sizes related to gender and age, go to Healthy Eating for Adults or Healthy Eating for Children.
Henderson CB, Filloux FM, Alder SC, Lyon JL, Caplin DA. Efficacy of the ketogenic diet as a treatment option for epilepsy: meta-analysis. J. Child Neurol. 2006 Mar [cited 2018 Jan 8];21(3):193-8. Abstract available from: https://www.ncbi.nlm.nih.gov/pubmed/16901419
Gibson, A. A., Seimon, R. V., Lee, C. M. Y., Ayre, J., Franklin, J., Markovic, T. P., Caterson, I. D. and Sainsbury, A. Do ketogenic diets really suppress appetite? A systematic review and meta-analysis. Obes Rev, 2015 [cited 2018 Jan 8];16: 64–76. doi:10.1111/obr.12230
Mann T, Tomiyama AJ, Westling E, Lew AM, Samuels B, Chatman J: Medicare’s Search for Effective Obesity Treatments: Diets Are Not the Answer. Am Psychol 2007, 62:220-233.
Miller WC: How effective are traditional dietary and exercise interventions for weight loss? Med Sci Sports Exerc 1999, 31:1129-1134.
Eric C. Woolf and Adrienne C. Scheck The ketogenic diet for the treatment of malignant glioma J. Lipid Res. 2015 [cited 2018 Jan 8]; 56:(1) 5-10. doi:10.1194/jlr.R046797
Gilby KL. A new rat model for vulnerability to epilepsy and auism spectrum disorder. Epilepsia. 2008 Nov [cited 2018 Jan 8];49 Suppl 8:108-10. Abstract available from: https://www.ncbi.nlm.nih.gov/pubmed/19049604
NHMRC. Eat for Health – Australian Dietary Guidelines. 2013 [cited 2018 Jan 8]; Retrieved from https://www.eatforhealth.gov.au/sites/default/files/files/the_guidelines/n55_australian_dietary_guidelines.pdf