Take It In: Pro’s and con’s of the ketogenic diet

Jun 14, 2019 by Carol Bareuther

Take It In: by Carol Bareuther

The ketogenic diet was first a hot topic when it was introduced in the 1920s. Physicians at the time found that the high-fat low-carbohydrate diet put patients into the state of what’s called ketosis. Ketosis is the state that happens when the body is carb-starved and body fat is burned for energy, thus putting ketone bodies in the blood.

Turn of the 20th century research showed the greater the ketone bodies in the blood, the better the control of epileptic seizures. By the 1950s, the diet fell out of use in favor of more effective anti-epileptic drugs.

What’s old becomes new and in the 1990s the ketogenic diet emerged again to help patients, usually children, whose seizures couldn’t be controlled by medication. Fast forward and in the past few years, the ketogenic diet is making headlines as a great way to lose weight.

Is it or isn’t it? There are pros and cons to consider.

First, let’s look more closely at the ketogenic diet. Specifically, it calls for 75 percent of daily calories to come from fat. This includes oils, butter, nuts and fruits such as avocados. Twenty percent of daily calories should come from protein-containing foods such as meat, poultry, eggs and cheese. The remaining 5 percent of calories is allotted to non-starchy vegetables and leafy greens.

Carbohydrate-rich foods such as beans, grains, pastas, bread, cereal, fruits and starchy vegetables either aren’t allowed or strictly limited. It takes two to three weeks of eating this way to enter into the state of fat-burning ketosis. In comparison, the typical American diet has a carb-fat-protein ratio of 50-35-15 and the Atkins diet a ratio of 4-64-32, compared to the ketogenic diet at 75-20-5.

A sample ketogenic menu for children from the late 1990s featured: Breakfast: ¼ cup cooked oatmeal and 2 ounces of milk. Lunch: 1 hard-cooked egg, ¼ cup carrots and ¼ cup grapes. Dinner: 1-ounce hamburger and ¼ cup broccoli. Added to this was ½ cup heavy cream, 2 tablespoons mayonnaise and 1 tablespoon oil, throughout the day.

A more contemporary meal plan from the non-medical site, www.ketowave.com, calls for a breakfast of baked eggs in avocado, beef curry for lunch and rosemary roasted chicken and veggies for dinner. Each of these come with specific recipes to assure these dishes are keto-friendly.

On the pro side, ketogenetic diets do work in terms of producing weight loss and other health benefits. For example, a study of 77 healthy overweight adults in their late 30s or early 40s were randomly assigned to three types of low-carb diets: 5 percent carbs (akin to a ketogenic diet), 15 percent and 25 percent carbs. After 12 weeks, the New Zealand researchers, writing in the February issue of the Journal of Life and Environmental Sciences, learned that those eating only 5 percent carbs lost the most weight. What’s more, side benefits include increases in HLD (good) cholesterol, and decreases in total cholesterol and triglycerides, all three measures of cardiovascular health.

The cons? In the study cited above, 77 participants started and only 39 completed the 12-week diet study. A ketogenic diet is darn hard to stick to in terms of planning, preparation and palatability. Also, because it restricts so many foods, anecdotal reports suggest some people feel tired and foggy headed. This feeling is often termed the “keto flu”. Also, limited fresh fruits, vegetables and whole grains can create gastrointestinal symptoms such as constipation.

The bottom line is that the ketogenic diet can produce weight loss. However, keeping the weight off requires a less extreme and more liberal diet that can be lived with for life.

Carol Bareuther is a registered dietitian and freelance health and nutrition writer. Comments are welcome below.