In recent years, the ketogenic diet has quickly become popular and has almost become the mainstay of the weight loss industry. Whenever it comes to losing weight, someone will definitely “strongly” recommend the ketogenic diet to you. And the ultimate weight loss method of “watching your mouth and taking more steps” seems to have faded out of the arena.
What exactly is the ketogenic diet? Maybe some people don’t know much about it.
The ketogenic diet (Ketogenic Diet, KETO) is a dietary strategy that involves consuming extremely low carbohydrates and a large amount of fat. To put it simply, it is to eat less or even no carbohydrates, a moderate amount of protein, and a large amount of fat. As a therapy used in the 1920s to treat intractable epilepsy in children, the ketogenic diet has a history of 200 years.
The biggest difference between this dietary method and other weight loss methods is that it also restricts protein intake and increases fat intake. The ketogenic diet aims to induce ketosis to replace glucose to supply energy to the body.
Indeed, many people have lost weight after following the ketogenic diet; indeed, many people have experienced various side effects after the ketogenic diet, including hair loss, constipation, irregular menstruation in women, fatigue, headaches, nausea, difficulty concentrating, and rough skin.
Recently, in a review article published in “Frontiers in Nutrition”, researchers from the Physicians Committee for Responsible Medicine (PCRM) in the United States, New York University, University of Pennsylvania, George Washington University, and Bellevue Hospital in New York conducted the most comprehensive assessment of the ketogenic diet to date, weighing the pros and cons of this dietary strategy with chronic diseases. And draw the conclusion that the ketogenic diet may cause long-term damage to health. The researchers said that the difference between a high-fat diet and other weight loss strategies is that it also increases the risk of multiple diseases. These diseases include heart disease, cancer, diabetes, and Alzheimer’s disease.
Dr. Lee Crosby, the head of the nutrition education program at the Physicians Committee for Responsible Medicine and the person in charge of the study, said: “A typical ketogenic diet is a disaster that causes diseases. A large intake of red meat, processed meat, and saturated fats, while restricting vegetables, fruits, beans, and whole grains that are rich in carbohydrates, is an unhealthy recipe.”
The researchers said that the ketogenic diet is really popular because this mixed food fuel attempts to induce ketosis. This process activates the production of ketones, which are the body’s alternative source of energy. The reason why this dietary strategy is so appealing is that neurons and other cells can metabolize this energy better than fatty acids. However, this new study found that the foods used in the ketogenic diet to achieve this goal may cause long-term damage to health.
First, the utilization of protein changes in the process of ketosis induced by the ketogenic diet, causing the body to allocate as much protein as possible to gluconeogenesis, using only the minimum necessary amount for tissue repair.
Secondly, extreme carbohydrate restriction affects the quality of the diet, usually reducing the intake of fruits, vegetables, whole grains, and beans, resulting in a lack of vitamins, minerals, fibers, and phytochemicals in these foods. The content of thiamine, folic acid, vitamin A, vitamin E, vitamin B6, calcium, magnesium, iron, and potassium in low-carbohydrate diets is also usually low. Without a variety of vitamin supplements, nutritional deficiencies may occur. It has been reported that a 4:1 ketogenic diet (4 parts fat and 1 part carbohydrate) also has various micronutrient deficiencies, usually lacking vitamin K, linolenic acid, and water-soluble vitamins except vitamin B12.
Since the fiber content of the ketogenic diet is also low, it is not conducive to the healthy function of the intestine. You should know that the intestine affects all aspects of physical health.
In terms of short-term weight loss effects, the ketogenic diet is indeed successful. A study last year involving 6,499 participants for 6 to 12 months showed that the low-carbohydrate diet group had a greater weight loss.
However, researchers believe that adhering to the ketogenic diet in the long term is a challenge because of the limited choice of foods, but adverse reactions are common. Therefore, there are potential health risks in following this diet in the long term. Some believe that the weight loss caused by the ketogenic diet may be due to decreased appetite, but one study shows that a low-fat vegetarian diet can better suppress appetite than the ketogenic diet.
In the management of type 2 diabetes, the ketogenic diet promotes weight loss, reduces blood sugar, and glycosylated hemoglobin (HbA1c) by suppressing appetite in the short term. Some studies also show that it improves insulin sensitivity.
However, a recent meta-analysis shows that the HbA1c reduction achieved through a carbohydrate-restricted diet usually weakens after a few months, and this diet is no more effective than other dietary strategies.
Also, studies have found that a low-carbohydrate diet with high levels of animal protein and fat increases the risk of type 2 diabetes in men by 37% more than other diets; those who emphasize plant protein and fat in a low-carbohydrate diet do not increase the risk. Foods associated with reduced risk of diabetes always include fruits, vegetables, beans, and whole grains.
In epidemiological studies, a diet high in saturated fat, trans fat, simple sugars, and animal protein (especially from red meat and processed meat), and low in dietary fiber significantly increases the risk of non-alcoholic fatty liver disease. Excessive fat stored in liver cells can lead to steatosis and develop into non-alcoholic steatohepatitis, increasing the risk of hepatocellular carcinoma. These factors also apply to increasing the risk of cancer and Alzheimer’s disease.
Researchers say that the ketogenic diet is also particularly dangerous for pregnant women and those who want to have children. Because studies have found that a low-carbohydrate diet is associated with a high risk of neural tube defects in infants. Even if the mother takes folic acid during pregnancy, this risk still increases.
One of the greatest potential risks of the ketogenic diet is the formation of kidney stones, which is frequently mentioned in the literature on pediatric epilepsy. Moreover, a high-protein ketogenic diet can also accelerate renal failure in patients with kidney disease.
In addition, researchers pointed out that the ketogenic diet is often seen as a potential way to treat heart disease and even cancer. However, although some studies have found that it may starve cancer cells, new research has found that restricting carbohydrates actually leads people’s diets to be more prone to carcinogenic foods.
Crosby explained, “In addition to the significant risks to patients with kidney disease and pregnant women, the ketogenic diet also poses risks to others because these diets increase levels of low-density lipoprotein cholesterol (LDL), or ‘bad cholesterol,’ thereby increasing the risk of overall chronic diseases. Although the ketogenic diet can lead to weight loss in the short term, this method is no more effective than other weight-loss diets.”
However, researchers have indeed found the benefits of the ketogenic diet, as it may reduce the frequency of seizures in some drug-resistant epilepsy patients.
Researchers say that there is currently a lack of long-term and large-scale research on the ketogenic diet. Therefore, based on the existing evidence, for most people, the risks of the ketogenic diet are clearly greater than the benefits.
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