Is the Ketogenic Diet Healthy? Not All Fats Are Created Equal, Experts Warn
- The ketogenic diet is a high fat, low-carbohydrate diet that has shown promise in treating diabetes and several other chronic diseases.
- Studies also indicate that weight loss results are significantly better than what can be achieved through traditional low-fat diets.
- The ketogenic diet is generally considered safe, even for cardiac health, as long as you choose the right types of fat.
With an increasing number of celebrities and athletes endorsing it, the ketogenic diet — or “keto” diet for the initiated — has been generating a substantial amount of buzz in recent months, and with good reason.
Firstly, it’s quite different from the common dietary recommendations we’ve become accustomed to. For years we’ve been told to avoid fat because it leads to clogged arteries and heart disease. Yet the ketogenic diet includes an abundance of fat, making up at least 70 percent of the diet’s composition.
Claims that it may be beneficial in the treatment of diabetes, Alzheimer’s and even cancer have also spurred interest among patients and researchers.
This raises questions about the ketogenic diet’s safety, and its effectiveness at treating chronic illnesses.
To set the record straight from the get-go, Miami-based cardiologist Dr. Adam Splaver assures that there is little evidence suggesting it can be damaging to your health. However, there is a right way to follow the ketogenic diet, and a wrong way that could put you at greater risk of heart disease.
Here’s what you need to know before jumping on the “fat adaptive” bandwagon.
What is the ketogenic diet?
“The high fat, low-carbohydrate ketogenic diet was originally designed as a dietary alternative for seizure control in epileptic patients,” says Suzanne Fisher, a Registered Dietician from South Florida.
In fact, its effectiveness as a treatment option for children with hard to control epilepsy has long been established, with its first uses for that purpose dating back to almost 100 years ago.
It more recent times, keto has frequently been in the media and social spotlight, although not for its merits as an epilepsy treatment. Instead, it’s the lure of rapid fat loss that has turned it into the latest diet trend.
“The theory behind a ketogenic diet is that the body changes how it processes energy,” says Fisher. “Switching preferred fuel to fat as opposed to carbohydrates enables the body to tap into stored fat, accelerating the weight loss process.”
The diet generally follows a fat to protein/carbohydrate ratio of 3:1 for infants, and 4:1 for children, adolescents and adults. For adults, this equates to approximately 70 percent fat, 15 percent protein, and 15 percent carbohydrates.
The highlight of ketogenic diets is to restrict daily carbs to somewhere between 20 and 50 grams, though it’s often on the lower side. The predominant source of carbohydrate selected should be an array of non-starchy vegetables. Since protein can kick the body back to using carbs as fuel, moderate protein is recommended, while fat intake and calories are often unrestricted.
How effective is the ketogenic diet for weight loss?
Following a ketogenic diet can cause rapid weight loss — in some cases as much as 10 pounds in two weeks. These initial results are often the consequence of losing water, as the diet has a diuretic effect.
With maintenance of the diet plan, insulin levels decrease and the body begins to tap into its fat deposits, leading to even more weight loss. Unlike a low fat, calorie-restricted diet, the keto diet doesn’t slow down the metabolism.
Compared to a low fat diet, you really can expect to lose weight more easily and in higher percentages.
In fact, over a period of eight weeks, ketogenic diets has been shown to produce an average weight loss of 9.7 percent, while low fat diets produce just 2.1 percent. An added benefit is that it helps rid the body of visceral (belly) fat, which is notoriously hard to target.
Still, Dr. Splaver expresses some doubts: “While ketogenic diets are good at accomplishing weight loss, their sustainability is a major challenge. Many people have difficulty avoiding simple carbs like pasta, rice, potatoes, and alcohol for long periods of time.”
For those who are able to maintain the dietary changes, research shows that over longer periods (12 months or more), the ketogenic diet stands out as the clear winner over traditional low fat diets for weight loss.
Can the ketogenic diet help treat other health conditions?
The ketogenic diet has shown promise in the treatment of several chronic illnesses:
- People with type 2 diabetes experience a reduction in blood sugar, hemoglobin A1c, and insulin resistance.
- Results from animal studies show that it may be effective as an adjunct therapy in treating cancer.
- Keto is being studied as a potential treatment against neurological conditions such as Parkinson’s and Alzheimer’s, as well as neuromuscular conditions like amyotrophic lateral sclerosis.
- Researchers are also beginning to explore how the ketogenic diet may impact sleep quality and duration, thyroid health, and cognition.
Is it really safe to eat all that fat?
Given that a ketogenic diet is comprised of at least 70 percent fat, you may be wondering how safe it actually is.
In fact, the popular belief that high fat diets are bad for you may no longer hold true.
“It all stems from an erroneous study called the Seven Countries Study, performed by Ancel Keys, a Minnesota physiologist,” says Dr. Splaver. “He correlated a high fat diet with a higher risk of cardiovascular disease. However, the study itself included more than 30 countries, and Dr. Keys cherry-picked the data to fit his premise.”
According to Dr. Splaver, it’s actually the opposite: a high carb diet, not a high fat diet, is more likely to increase your risk of cardiovasular disease.
“That being said, not all fats are created equal,” warns Dr. Splaver.
Some keto diet enthusiasts will eat pork rinds for snacks, bacon for breakfast, and use lard as their preferred cooking fat — all of which are saturated fats. While a ketogenic diet does include all types of fat, both saturated and unsaturated, it’s recommended that you choose a higher proportion of unsaturated fat.
“Saturated fats such as ghee, coconut oil, palm oil, butter and animal fat are encouraged primarily for cooking, due to their higher smoke point,” Fisher explains. These fats are more stable at a higher heat, making them less likely to oxidize and cause free radical damage or other health problems.
However, it’s still important to be aware of how much saturated fat you consume. “All saturated fats or hydrogenated oils like margarine or Crisco are problematic for your cardiovascular health,” says Dr. Splaver.
Fisher concurs: “Recent research shows an increased risk of coronary heart disease with higher intake of saturated fats. It was noted that replacing just one percent of these saturated fats with heart-healthy fats and plant proteins resulted in a 6 to 8 percent reduction in heart disease risk. For this reason, when following a ketogenic diet, the majority of the fat should come from monounsaturated fat sources.”
The exception to the rule are Medium Chain Triglycerides (MCT) such as coconut oil, as these different types of saturated fats are utilized as immediate energy.
What are there side effects of going keto?
If you choose to follow a ketogenic diet, you’ll see that it’s not without its side effects, at least for a short period of time.
When the body switches from using carbohydrates to fat as fuel, this decreases the amount of sodium in the blood, which can cause very uncomfortable leg cramps.
“Reduced fiber intake from fruit and vegetables can also increase the risk of constipation,” says Fisher. “Bowel changes may occur as the body adjusts to your new diet.” Additionally, you should expect to experience headaches and decreased energy.
The keto flu is also a very real side effect as the body transitions to a ketogenic diet. Common symptoms include:
- Brain fog
“Symptoms usually subside within a few weeks. Easing into the ketogenic diet and maintaining adequate fluid and sodium intake can help lessen these symptoms,” adds Fisher.
Is the ketogenic diet safe?
In short, the answer is yes — if you keep your consumption of saturated fats at an acceptable level, and favor monounsaturated fat sources.
Monounsaturated-rich foods include:
- Avocado oil
- Olive oil
- Macadamia nut oil
- High oleic sunflower oil
- Nuts and seeds
“There is little evidence this diet is damaging to your health, as long as the fats you choose are the heart-healthy ones,” concludes Dr. Splaver.
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