{"id":7133,"date":"2020-09-25T22:42:36","date_gmt":"2020-09-25T17:42:36","guid":{"rendered":"https:\/\/drmohans.com\/?p=7133"},"modified":"2024-11-27T08:18:16","modified_gmt":"2024-11-27T08:18:16","slug":"should-you-take-the-ketogenic-diet-seriously","status":"publish","type":"post","link":"https:\/\/drmohans.com\/backend\/should-you-take-the-ketogenic-diet-seriously\/","title":{"rendered":"Should you take the Ketogenic Diet seriously?"},"content":{"rendered":"

As the world gets fatter, the ultimate low-carb, high-fat eating regimen emerges as the fashionable diet trend of the moment. But is it right for you? Here\u2019s the lowdown from experts<\/strong><\/p><\/blockquote>\n

With new fad diets popping up every now and then, you are bound to wonder what they are all about. The \u201cit\u201d diet of the moment is the ketogenic diet. Celebrities can’t get enough of it, stars swear by it. Food and beverages manufacturers are launching new keto snacks every day. The global ketogenic diet industry estimated at USD 10.3 billion is rising at a fast clip of 8 per cent a year.<\/span><\/p>\n

This diet was created way back in the 1920s as a treatment for epilepsy. It was widely used until anti-epileptic drugs came on the market in 1938. It started gaining attention once again from the 1990s. Not so much for epilepsy, as for providing metabolic protection against the ailments of modern times: obesity, diabetes, heart disease and so on.<\/p>\n

DIGGING INTO RESEARCH<\/strong><\/h3>\n

Here, we dig into a recent article by Shilpa Joshi and Dr Viswanathan Mohan\u00b9<\/span><\/strong>. Joshi is a dietician with the Mumbai Diet and Health Centre. Dr Mohan is the Chairman of Dr Mohan\u2019s Diabetes Specialities Centre & President of Madras Diabetes Research Foundation in Chennai.<\/p>\n

Published in the Indian Journal of Medical Research, September 2018, their research\u2014\u201cKetogenic diets: Boon or bane?\u201d\u2014analyses threadbare the pros, cons and controversies around the diet. Although meant for the academic community, here we present the easy-to-understand facts, to make it accessible to all.<\/p>\n

WHAT\u2019S THE K DIET?<\/strong><\/h3>\n

The ketogenic diet is, typically, an eating pattern marked by very low carbohydrates and very high protein and fat. In fact, extremely high percentage of fat is often used in this diet plan. The classic keto diet requires about 90 per cent calories from fat, 6 per cent from proteins and 4 per cent from carbohydrates. And there are no restrictions on the type of fat to be consumed.<\/p>\n

The purpose of this diet is to drastically reduce carbohydrate consumption (below 50 g\/day) and shift the body\u2019s primary fuel source from carbs to fat. As carbs are cut out, the glucose reserves of the body become insufficient. And the body starts to mimic the effects of fasting. An alternative source of energy emerges: the ketone bodies, produced in the liver by the breakdown of fats.<\/p>\n

\u00a0<\/strong>WHAT\u2019S ON OFFER<\/strong><\/p>\n

One of the unique aspects of the keto diet is its flexibility. Although the basic principles are universal, there are several ways to do this diet. Explore the different types of keto diets:<\/p>\n

\u2014 The Standard Ketogenic Diet (SKD) is very low-carbohydrate (about 10 per cent), with moderate-protein (20 per cent) and high-fat diet (about 70 per cent).<\/p>\n

\u2014 Cyclical Ketogenic Diet (CKD) involves periods of higher-carbohydrates in between the Keto diet cycles. For instance, five Ketogenic days, followed by two high-carbohydrate days.<\/p>\n

\u2014 Targeted Ketogenic Diet (TKD) permits the addition of more carbohydrates, to coincide with intensive physical workout regimes.<\/p>\n

\u2014 High-protein Ketogenic Diet (HPKD) allows 35 per cent protein, 60 per cent fat and five per cent carbohydrates.<\/p>\n

The SKD is the most researched and recommended. HPKD has also been tried out extensively. CKD and TKD are recent additions, used mostly by bodybuilders or athletes. The SKD is the most researched and recommended, and the rest of this article will deal with SKD.<\/p>\n

FAT OF THE MATTER<\/strong><\/p>\n

To Joshi and Mohan, the context of the keto diet is the rising wave of obesity in the last few decades, globally and in India. Obesity puts people at risk of type 2 diabetes, high blood pressure, heart disease, bone and sleep disorders, some forms of cancer and even depression. Yet, it is hard to manage obesity medically. \u201cThis leads to frustration among individuals with obesity,\u201d write Joshi and Mohan, leading many to resort to extreme dietary interventions. Latest research shows that people who follow the diet lose more weight than those who follow balanced diets.<\/p>\n

The keto diets seem to benefit in blood sugar control, reduce total cholesterol, serum triglycerides and increase high-density lipoprotein cholesterol. There are reported benefits on cancer and neurological disorders\u2014Alzheimer\u2019s disease to epilepsy. There are adverse effects, too: muscle cramps to bad breath, changes in bowel habits, keto-flu and loss of energy. \u201cMonitoring individuals on keto-diet closely, once or twice a month, for blood glucose<\/a>, ketones, cardiac and other parameters is essential,\u201d point out Joshi and Mohan.<\/p>\n

THE CARB QUESTION<\/strong><\/p>\n

Indian health and diet have complicated relationship with carbohydrates. Study after study has shown in the last few years, that Indians consume very high percentage of calories in their diets from carbohydrates.<\/p>\n

\u2014 In 2009, The Chennai Urban Rural Epidemiology Study (CURES)\u00b2 conducted by Dr Mohan and others on people with newly-detected type 2 diabetes had revealed how carbs constituted the major source of calories in South India.<\/p>\n

\u2014 It was followed by the STARCH study\u00b3 of 2014. Conducted by endocrinologist Dr S.R. Joshi, this dietary survey on people with type 2 diabetes showed how Indians got 65 per cent of their dietary calories from carbs\u00b3.<\/p>\n

\u2014 In 2017, came the PURE Study4<\/sup>, conducted across 18 countries from five continents. Dr Mohan, a collaborator of the study that probed the linkages between fat-carbohydrate intake and heart disease-death. It was found that high carb intake (more than about 60% of calories) was associated with high death toll. In contrast, higher fat intake was found to have lower risks.<\/p>\n

\u2014 A 2018 study5<\/sup> now shows a long-term adverse effect on life-expectancy with both low-carb and high-carb diets. Led by Dr S.B. Seidelmann of Brigham and Women’s Hospital, Boston, US, the study suggests extremely high-carb diet (60% and above) as well as very low-carb (<30% carbs) diets increases the risk of dying. In fact, the risk was lowest when the carb intake was between 50 and 55 per cent; plant-based proteins and fats were also found to be more protective than animal-based proteins and fats.<\/p>\n

\u2014 And finally the latest study in 20206<\/sup> from the PURE study with Bhavadharini Balaji as the lead author and Dr.V. Mohan as the Second author has conclusively shows an association between excess white rice intake and new-onset type 2 diabetes.\u00a0 <\/sup><\/a><\/p>\n

TOWARDS SOLUTION<\/strong><\/h3>\n

Should you go for the keto diet? Joshi and Mohan suggest \u201cmoderation.\u201d The diet shows a dramatic improvement in the short-term. But is it sustainable? The researchers explain that initially people are thrilled with the weight-loss and the excellent diabetes control they get from keto diets. Gradually, however, they get bored, many feel weak and slowly increase carbohydrate intake. \u201cSoon they are back to their original weight and diabetes control,\u201d they add.<\/p>\n

What is the long-term impact of not having all food groups on the plate? Low-carb diets lead to lower intake of vegetables, fruits, grains and greater intake of fat\u2014a detrimental slope in the long term because it is likely to stimulate inflammatory pathways, oxidative stress and biological ageing. There are issues of serious complications like sensitivity of the liver to insulin, micronutrient deficiency. As \u201cthe pendulum of nutrients swing on either side, one must be vigilant of the balance and interplay of nutrients,\u201d they warn.<\/p>\n

Here are some recommendations from them, if you plan to follow the keto diet:<\/p>\n