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Introduction
Obesity and metabolic disorders have become significant health issues around the world.
In 2016, 13% of the global adult population was affected by obesity according to WHO.
Obesity is linked to metabolic syndrome, which is a group of metabolic irregularities, such as type 2 diabetes, high blood pressure, an increased waist-to-hip ratio, and low HDL (good) cholesterol. Study 1, Study 2
Various diets have been developed to address these issues, including the ketogenic diet, which involves consuming extremely low amounts of carbohydrates. Some studies indicate that this diet could be beneficial for individuals with obesity.
Nonetheless, the health benefits of the keto diet have been met with skepticism by some experts, who argue that more research is needed. Although it may help in weight loss, it could also cause complications. Study 1, Study 2
This article explores the potential benefits of the keto diet for weight loss and managing metabolic diseases, as well as examining possible drawbacks.
What is a ketogenic diet?
A ketogenic diet consists of high-fat, moderate-protein, and low-carbohydrate foods. By reducing carbohydrate intake and increasing fat consumption, the body enters a metabolic state known as ketosis, where it starts converting fats into ketones—molecules that can provide energy for the brain.
After maintaining this diet for a few days or weeks, the body and brain become highly efficient at using fat and ketones as fuel sources instead of carbs.
Additionally, the ketogenic diet reduces insulin levels, which can help enhance insulin sensitivity and regulate blood sugar. Study 1, Study 2
Common ketogenic diet foods include:
- meat
- fish
- butter
- eggs
- cheese
- heavy cream
- oils
- nuts
- avocados
- seeds
- low-carb vegetables
On the other hand, most carbohydrate sources are excluded, such as:
- grains
- rice
- beans
- potatoes
- sweets
- milk
- cereals
- fruits
- some high-carb vegetables
Ketogenic diets and weight loss
There is evidence indicating that ketogenic diets can help with weight loss.
They may help reduce body fat, maintain muscle mass, and improve several health markers according to these studies. Study 1, Study 2, Study 3, Study 4
Some research suggests that a ketogenic diet could be more effective for weight loss than a low-fat diet, even when the total calorie intake is matched.
In an older study, individuals following a ketogenic diet lost 2.2 times more weight than those on a low-calorie, low-fat diet. Additionally, triglyceride and HDL (good) cholesterol levels showed improvement. However, both groups had similar reductions in calorie consumption, which could have contributed to the weight loss.
A graph from the study illustrating typical weight loss results can be seen here:
A 2007 study compared a low-carb diet to Diabetes UK’s dietary guidelines, finding that the low-carb group lost 15.2 pounds (6.9 kg), while the low-fat group lost only 4.6 pounds (2.1 kg). Over three months, the low-carb diet resulted in three times more weight loss (14Trusted Source).
However, there was no difference in HbA1c, ketone, or lipid levels between the groups. The low-carb group also reduced their calorie intake, but there was no difference in fat or protein intake between the two groups. This is noteworthy, especially when individuals increase their fat intake while following a keto diet.
Various theories have been proposed for these findings. Some researchers attribute the results to higher protein intake, while others believe that ketogenic diets offer a clear “metabolic advantage”. Study 1, Study 2
Other studies on ketogenic diets have shown that these diets may lead to reductions in appetite and food intake, which is crucial when applying the research to real-life situations. Study 1, Study 2
If counting calories isn’t appealing, a ketogenic diet might be a suitable option. By eliminating certain foods, you don’t have to monitor calorie intake.
However, following a keto diet requires checking labels and tracking daily carb intake, which necessitates mindful food choices.
It’s important to note that many of the aforementioned studies had small sample sizes and focused on short-term diet effects.
Further research is needed to determine the long-term impact of the diet on weight loss and whether weight is regained once a regular diet is resumed.
How do ketogenic diets promote weight loss?
Ketogenic diets promote weight loss in the following ways:
- Increased protein intake: Some ketogenic diets result in higher protein consumption, which has numerous weight loss advantages. Study 1
- Gluconeogenesis: The body transforms fat and protein into carbs for fuel, potentially burning additional calories each day. Study 1, Study 2
- Appetite suppression: Ketogenic diets can help you feel full, supported by positive changes in hunger hormones like leptin and ghrelin. Study 1
- Enhanced insulin sensitivity: Ketogenic diets may significantly improve insulin sensitivity, improve fuel utilization and metabolism. Study 1
- Reduced fat storage: Research suggests that ketogenic diets might lower lipogenesis, the conversion of sugar into fat, due to the fact that excess carbs are stored as fat. With minimal carb intake, fat is used for energy.
- Increased fat burning: Some studies have shown that ketogenic diets may slightly boost the amount of fat burned during rest, daily activities, and exercise, though more research is needed. Study 1, Study 2
Through these mechanisms, a ketogenic diet can effectively help with weight loss.
However, it’s essential to ensure you’re meeting your calorie needs while on the ketogenic diet. Reducing calories too much can slow your metabolism, making it more difficult to lose weight in the long run. Study 1
Some experts also point out that while the keto diet may result in short-term weight loss, it is unlikely to continue, and maintaining the diet for an extended period can be challenging.
A ketogenic diet and metabolic diseases
Metabolic syndrome refers to five common risk factors for obesity, type 2 diabetes, and heart disease (Study 1):
- High blood pressure
- High waist-to-hip ratio (excess belly fat)
- High levels of LDL (bad) cholesterol
- Low levels of HDL (good) cholesterol
- High blood sugar levels
Many of these risk factors can be improved or even eliminated through dietary and lifestyle changes. Study 1
Insulin plays a crucial role in diabetes and metabolic diseases. Ketogenic diets are highly effective in lowering insulin levels, particularly for individuals with type 2 diabetes or prediabetes. Study 1, Study 2
An older study found that after just two weeks on a ketogenic diet, insulin sensitivity improved by 75%, and blood sugar levels dropped from 7.5 mmol/l to 6.2 mmol/l.
A 16-week study also observed a 16% reduction in blood sugar levels. Additionally, 7 of the 21 participants were able to stop all diabetic medications completely.
Moreover, some human and animal studies have found that the ketogenic diet could decrease total cholesterol and triglyceride levels.
However, most current research focuses on the short-term effects of the ketogenic diet.
In fact, some older studies suggest that the ketogenic diet may negatively impact heart health, especially in children. Study 1, Study 2
While research indicates that saturated fat intake is not directly linked to a higher risk of heart disease, it may raise LDL (bad) cholesterol levels, a risk factor for heart disease.
Additionally, several studies show that consuming high amounts of certain types of fat may be associated with a higher risk of specific types of cancer. Study 1, Study 2, Study 3
Thus, more research is necessary to determine the long-term effects of the ketogenic diet on health and disease.
Impact on metabolic disease
Several key factors explain the significant effects of the ketogenic diet on markers of metabolic disease, including:
- Fewer carbs: A high carb diet can consistently raise blood sugar and insulin levels, reducing the body’s ability to use insulin efficiently. Study 1
- Decreased insulin resistance: Insulin resistance can lead to health issues such as inflammation, high triglyceride levels, and fat gain. Study 1
- Ketone bodies: Ketone bodies, which are molecules produced during ketosis, may help protect against diseases like cancer, Alzheimer’s, and epilepsy. Study 1, Study 2, Study 3
- Inflammation: The ketogenic diet can significantly reduce chronic inflammation, which is linked to metabolic syndrome and various diseases. Study 1, Study 2, Study 3
- Fat loss: This diet promotes body fat loss, particularly unhealthy abdominal fat. Excess fat in the abdominal area is one of the criteria for metabolic disease. Study 1
- Restored normal insulin function: Research indicates that healthy insulin function can combat inflammation, while poor insulin function can increase it. Study 1
You can clearly see that, the combination of these factors plays a remarkable and crucial role in health and disease prevention.
How to follow a ketogenic diet
If you want to try a ketogenic diet, follow these basic guidelines:
- Eliminate carbs: Check food labels and aim for 20-50g (grams) of carbs or fewer per day. Study 1
- Stock up on staples: Purchase meat, cheese, whole eggs, nuts, oils, avocados, oily fish, and cream, as these will now be common and mostly used in your diet.
- Eat your veggies: Since fat sources are high in calories, base each meal on low carb veggies to fill your plate and help keep you full. Veggies also provide fiber, which you’ll no longer get from whole grains, beans, or legumes.
- Experiment: A ketogenic diet can still be diverse and tasty. You can make ketogenic pasta, bread, muffins, brownies, puddings, ice cream, and more.
- Build a plan: Finding low carb meals on the go can be challenging. As with any diet, having a plan and go-to snacks or meals is important.
- Find what you love: Experiment until you discover the perfect keto diet for you.
- Track progress: Take photos, measurements, and monitor your weight every 3 to 4 weeks. If progress stalls, re-examine your daily intake, ensuring you’re consuming enough vegetables at every meal and maintaining moderate portion sizes.
- Replace fluids: Ensure you’re drinking enough water and obtaining proper amounts of electrolytes like sodium, potassium, and magnesium.
- Be consistent: Consistency is key in any diet. There are no shortcuts to success.
You may also want to monitor ketone levels in urine or blood, as these indicate whether you’re maintaining sufficiently low carb levels to achieve ketosis.
Before transitioning to this type of diet or using any supplement, consult your doctor or a dietitian for advice.
Should you try a ketogenic diet?
No single diet is ideal for everyone, as individual metabolism, genes, body types, lifestyles, taste preferences, and personal preferences vary.
A ketogenic diet can be beneficial for people with obesity or a higher risk of developing metabolic syndrome, but it’s not suitable for everyone. For instance, it’s not appropriate for people with the following conditions (Study 1):
- Pancreatitis
- Liver failure
- Disorders of fat metabolism
- Carnitine deficiency
- Porphyrias
- Pyruvate kinase deficiency
There may also be some negative effects. When starting the diet, you may experience flu-like symptoms, known as the “keto flu.” This can include poor energy and mental function, increased hunger, sleep issues, nausea, digestive discomfort, and decreased exercise performance.
Long-term research on the potential effects is still lacking, and there may be risks of kidney or liver problems.
Dehydration is another risk, so it’s essential to drink plenty of fluids, especially water, while on this diet. Study 1
Always consult a doctor before starting a ketogenic diet to ensure it’s safe and appropriate for you.
Sticking to a ketogenic diet can be challenging. If you find it difficult but still like the idea of a low-carb diet, carb cycling or a standard low-carb diet might be better options for you.
A ketogenic diet might not be the best choice for elite athletes or those looking to build significant muscle mass.
Furthermore, vegetarians or vegans may struggle with this diet, given the crucial role of meats, eggs, fish, and dairy.
Conclusion
To maximize the benefits of a ketogenic diet, you should consume high-fat foods and restrict your carb intake to less than 30-50g (grams) per day.
Following a medically supervised ketogenic diet can help with weight loss and may improve your overall health.
It has the potential to decrease your risk of type 2 diabetes, obesity, and other aspects of metabolic disease.
Always consult your doctor before starting any new diet to ensure it is an appropriate choice for you.
