The Ketogenic Diet Reviewed by a Dietitian

If you have at all been following diet trends this past year, chances are you have heard of the ketogenic diet. According to Men’s Health magazine, the ketogenic diet falls within the top 10 most Googled diets of 2017. Aside from its popularity in the fitness industry, everyday recipes now come with “Keto-friendly” labels to boost their appeal.

But what is the ketogenic diet all about, and would we ever recommend it to our clients?

The premise of the ketogenic diet is to stimulate the metabolic effects seen in starvation, forcing the body to burn fat (rather than carbohydrates) as its primary fuel source. When the body is fasting and there is insufficient glucose (the simplest form of carbohydrate and body’s preferred fuel source), it begins to release fatty acids from storage in the body. These fats are converted to ketones and can be used as an alternate fuel by your brain, organs, etc. Ultimately, if this state is maintained you will enter ketosis where ketones are the only fuel being used in the body. The ketogenic diet is a “very low carbohydrate, moderate protein and high fat” diet.

As a frame of reference…
Balanced Diet: 45-65% carbohydrate, 10-30% protein, 20-35% fat
Ketogenic Diet: <5% carbohydrate, 15-20%, 60-90% fat

The key to the ketogenic diet is to keep protein moderate to ensure that you do not begin to enter “regular” metabolism. In order to stay in ketosis, it is essential that CHO is kept very low but also to limit protein.


Looking at the research

Established in 1920’s, the ketogenic diet emerged as a treatment for epilepsy. Research in this area has been promising; however, due to the restrictive nature of the diet and development of medications to treat this condition, the popularity of the diet to treat epilepsy diminished. The ketogenic diet has also seen potential success in other diseases such as cancer and after serious trauma to the body. Additional research is required in these areas to make definitive statements warranting changes to current recommendations.

For the general population looking for weight loss, the keto diet as been a go-to. While there is research to show weight loss (along with improvements in blood sugar control) in the short term, no real data exists beyond 1-2 years. This is concerning, as we cannot definitively say that other heath concerns would not arise with the macronutrient composition of the keto diet. Additionally, we know that weight loss isn’t as simple as a number on the scale, but rather is a matter of body composition, which often is not done or reported in research, so we cannot be sure where the weight is being lost in the body.

Aside from being very difficult to follow for extensive periods of time, the long-term research for the health effects of the ketogenic diet are not there. Additionally, as with any “diet” I would encourage you to ask yourself: “Is this something I could realistically and joyfully do for the rest of my life?” If the answer is no, it’s likely not the best fit for your health goals.



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