The ketogenic diet is currently very popular, but is it healthy?

A ketogenic diet is, by definition, a very high-fat diet, 75% of your calories come from fat. Protein is about 20% of a ketogenic diet, leaving a mere 5% for carbohydrates.

It’s important to keep in mind that critical cycles within your body’s biochemistry require carbohydrates to function. Energy producing cycles such as the Kreb’s Cycle or citric acid cycle is a set of chemical reactions in your body that generate energy. The Kreb’s Cycle relies on carbohydrates to begin its operation.

Does a diet with almost no carbohydrates resonate with how your body actually functions day to day?

All carbs are not created equal

It’s VERY important to understand the difference between sugar, starch, and complex, or good carbohydrates. Everyone agrees that simple added sugar and refined overprocessed grains are terrible for your health.

But what is also clear from a multitude of studies is that complex carbohydrates such as vegetables and legumes, including all beans, plus fresh fruit in moderation, are excellent sources of carbohydrates and should encompass the vast majority of our diet.

What are ketones?

Once you have fasted for 24-30 hours, your body begins to break down fat and produces ketone bodies to create a source of calories and nutrients internally. This is often called the first phase of survival mode in fasting.

The bottom line is that ketone bodies are produced during a fast to burn fat as fuel. Please note the correlation of fasting and ketone body production.

Can you lose weight on a ketogenic diet?

You can engage in a ketogenic diet for a week and lose weight. You can also lose some of that belly bloat at the same time.

But that flatter tummy doesn’t correlate with the type of belly weight most Americans need to lose which is the fat surrounding their organs.

Dr Longo, author of The Longevity Diet, states that a ketogenic diet isn’t going to handle central abdominal adiposity, the dangerous fat that puts you at risk for heart disease, cancer and diabetes.

Everyone loves a quick fix

I lecture regularly and I am frequently asked the question: “What’s the one thing I can do to best improve my health?” We all wish it was so easy – do one thing and optimize your health. There might be one thing that’s more important for you to do than your best friend, but the answer is predicated upon your health vs theirs. Your genetics vs theirs. Your health history vs theirs.

And, it’s rarely a single thing.

Perhaps you know people who have embarked on a variety of new diets only to lose weight but gain it right back, plus more, later.

How do I know what diet is right for me?

When evaluating food and diet choices it’s critical you delve deeper into science, facts, and long-term studies that have been well performed with no bias.

The confusion stems from an individual who gets some media attention from sharing what “they” feel good doing. What “they” did to lose 40 pounds, etc.

Imagine you like a celebrity and he or she puts butter in their coffee. Due to their celebrity status they’re able to tell millions about the new “healthy thing” they’re doing that makes them feel great. Does that make it right for the majority of people? Does the fact that one or a few people feel better doing something make it science? You know the answer.

Similarly, confusion can come from companies just trying to sell their product and impressing you with success stories of how they can quickly have you energized and losing weight.

You need criteria to guide you when making dietary decisions.

Dr. Valter Longo, the author of The Longevity Diet, is the world’s leading expert on longevity and
Juventology (the study of how to stay healthier, longer).

He advises that when evaluating nutritional information that you should confirm it is validated across several layers of science, not just one. It just makes sense. He calls this evaluation process the 5 Pillars of Health.

The idea is to evaluate multiple layers of evidence and when they all support the same conclusion you can feel confident that you’re making the right decision. The pillars include:

1. Basic research e.g. amino acids, aging and disease pathways
2. Epidemiological studies – these are broad population studies
3. Clinical studies – randomized controlled studies
4. Centenarian studies – looking at pockets around the world where people regularly live to over 100.
5. Complex systems – looking at the big picture planet-wide

Using this rationale, if one study supports that a ketogenic diet long-term is safe, you should be suspect until you see support across the rest of the pillars of evidence.

Some scientific studies are flawed

Unfortunately, there is one more variable to check when evaluating studies, and that is how well they are performed. This can be tricky. The “gold standard” is double-blind, randomized, controlled trials. So that’s the first thing to check for.

Next, we want to ensure no bias enters in.

Researchers must, by law, disclose any affiliations they have with any companies.

• You want to know, is the study funded by a company that has a vested interest in the results? In other words, is the drug or product being researched owned by the company funding the research?
• Are the researchers paid by the company that has such a vested interest?
• Are the researchers employed by the company conducting the study?

Sometimes this data is more difficult to discover than it should be. Coca-cola as an example has been known to create front groups, e.g. Society for the Betterment of Children’s Health [fictional name] that fund studies. The front group sounds innocent enough until you learn it’s really Coke funding a study that concluded sugar doesn’t cause childhood obesity.

This is a true account: Such a study did occur and it was funded by a front group of Coca-Cola.

Is there robust research supporting the use of ketogenic diets?

The only body of research supporting ketogenic diets is for those suffering from refractory seizures. These are seizures for which medication does not help. In fact, before such seizure medications existed, the very high-fat ketogenic diet was the only option for such individuals – and it did work.

There are dozens of studies supporting its use for such seizure patients and they go back nearly a century.

What if you aren’t a seizure sufferer? Does a ketogenic diet make sense?

Evaluating across the 5 pillars of evidence, ketogenic diets don’t hold up. Dr. Longo has been quoted as saying: “It’s about ½ a pillar.” In other words, there is no substantial evidence to support its use.

This isn’t an opinion; it’s simply the absence of scientific research, population studies, etc.

Does a Ketogenic diet reverse type 2 diabetes?

You may hear of a single study just published last year that has been getting a lot of press. The study claims that type 2 diabetes can be reversed with a ketogenic diet. Let’s delve into the quality of the study and see how you think it holds up to the basic scrutiny all studies should receive.

The study was funded by Virta Health and all of the authors disclosed a financial relationship with the company. [Note: this is definitely a red flag as it has been proven that the author paid by the company funding the research tend to come to results or conclusions favoring the funder at an alarmingly high rate.]

The same authors further disclosed receiving funding from Atkins Nutritionals, the National Dairy Council and the Palm Oil Board. Grouping all those companies together you would see how coming out in favor of a ketogenic diet supported each and every one one of the companies the authors receive money from. Again, a red flag.

Specifics of the study: Adults with type 2 diabetes, 262 in all, were coached to follow a diet for 10 weeks that was low in carbohydrates, high in protein, and high in fat. In fact, they could eat as much fat as they desired in order to stay satisfied.

They received non-starchy vegetables and minerals, plus fluid to ensure a ketogenic state.

The study had no control group

With no control group, the research did not meet the standards of a well-performed study.

The drop-out rate was 10% despite the short duration of the study. The blood marker for diabetes, hemoglobin A1C (HgA1C) dropped on average from 7.6% to 6.6% in those who completed the study. Participants also lost weight, averaging about 7%.

The study was published in the Journal of Medical Internet Research Diabetes, an e-site recently launched, which according to Dr. Joel Kahn will publish your research if you pay them to.

What do you think of that data? I know, weak at best.

What’s more concerning however is the mantle that has been taken up by the ketogenic and paleo communities citing this study as “proof” that a ketogenic diet reverses type 2 diabetes. It’s a single study, poorly done with no control group, of short duration and funded and performed by those with a vested interest.

Are there well-performed studies that show type 2 diabetes reversal?

Let’s compare that study to this one: in this research, they used a low-fat plant-based diet in patients with type 2 diabetes.  The study lasted 74 weeks (almost 1 1 /2 years), was published in a respected journal, American Journal of Clinical Nutrition, had a control group, and its authors had no corporate conflicts other than previously published books.

HgA1C decreased 3-4x that of the control group, which was following a conventional American Diabetes Association diet. Over and above diabetes markers improving, so to did the participants’ cholesterol and LDL (bad cholesterol), far above the control group.

You typically will not see such cholesterol markers improve on a ketogenic diet that has been followed long-term, often the opposite occurs.

There are many, many such studies showing a predominantly plant-based diet with high complex carbohydrates, moderate to low fat and low protein can reverse type 2 diabetes. Please see the references section at the end of this blog.

Are there any long-term dangers of a ketogenic diet?

Based on the nutrient constituents, i.e. low carbohydrate, high fat, and high protein, there are definite concerns relating to the long term use of a ketogenic diet. There are multiple peer-reviewed studies indicating a higher risk of all-cause mortality, premature death when low carbohydrate diets are followed.

You can see in the references section below seven different studies and their consensus on the dangers associated with a diet low in carbohydrates.

From the Annals of Internal Medicine in 2010, researchers concluded:

A low-carbohydrate diet based on animal sources was associated with higher all-cause mortality in both men and women, whereas a vegetable-based low-carbohydrate diet was associated with lower all-cause and cardiovascular disease mortality rates.

Epidemiological data support that a high animal-based diet leads to high mortality or a shorter lifespan.

A research paper from USC’s Longevity Center found high protein diets associated with a several fold increased risk of  cancer, along with a 75% increase mortality from all causes.

Animal studies concur that if you feed mice a high fat, high protein diet, they die earlier.

No centenarian populations in the world have high fat, high protein diet

The Inuit, part of the Eskimo population eat very high fat, high protein diet and suffer a 10 yr shorter lifespan than their neighboring Canadians.

When it comes to a ketogenic diet, you can find data supporting 1 pillar, but not 5. The 5 pillars are layers of evidence that add up to an agreed-upon conclusion vs cherry-picking from one pillar, which frequently happens in the media.

Does a ketogenic diet have to be high protein?

Could you create a ketogenic diet that was plant-based and low protein? Yes. There are some people doing that. It would be safer than the typical high animal protein ketogenic diet, and with a rich percentage of fruits, vegetables, nuts, and legumes, it would be more sensible, the only problem is that it is still very high in fat, typically 75%.

Can I take separate ketone bodies?

There are some new products on the market in the form of ketone bodies that you can add to your daily diet.

Ketones are produced naturally during starvation. If you introduce them into your diet when you’re eating, you’re giving your body mixed signals. You’re telling your body to “act” like it’s fasting when food is coming in.

Taking ketone bodies might “seem” okay for a while, but eventually, the body will break down because it’s not designed to work that way.

Per the author of The Longevity Diet and his research, the body will break down under the confusing message; confusing the brain and eventually increasing your likelihood of developing a neurological problem.

What do the experts say?

Dr. Kahn, a cardiologist, and professor, and Dr. Longo, an expert in anti-aging whose three decades of research garnered him the Jubilee award for coming in second for the Novel Prize for Medicine last year, agree that a ketogenic diet is a very bad idea. Neither of these doctors has a vested interest in a particular diet other than what works for humans long-term.

Dr. Kahn states that a high protein animal ketogenic diet “ages you faster than any other diet”.

Dr. Longo agrees that it’s not a long term healthy diet. Short term you’ll lose weight and notice increased energy. Long term you won’t live as long.

Are you playing a long game of health?

I define the long game as following diet and lifestyle protocols that result in living longer, healthier.

What then would be the short game? The short game is following fads that may give you quick results, but the long term causes more disease risk and a shorter lifespan.

I don’t advise the short game, but you get to make that choice. I truly believe that a ketogenic diet done for any length of time is a bad idea and I’ve tried to prove the point with science and research.

Personally, I have no vested interest in any particular eating pattern beyond what makes humans live longer, healthier. That is my only goal. Honestly, I miss some of the animal protein I used to enjoy, but the science is clear and animal products are not moving any of us toward the health and longevity we desire, therefore I no longer include them in my diet.

Does a long and healthy life sound good?

There are many populations around the world including those from Okinawa and Loma Linda here in California, who eat predominantly plant-based and truly thrive, enjoying the 100 years plus mark in longevity. There are several centenarian zones in Italy and Greece as well.

These centenarian populations are one for one eating high complex carbohydrates, moderate healthy fats and low protein diets.

How’s your health?

Do you suffer from any degenerative disease such as high blood pressure, type 2 diabetes, high cholesterol, overweight or autoimmune disease? 

Too many Americans are suffering from these preventable, treatable, and, as research supports, reversible diseases.

Are you ready to enjoy optimal health?

Our team of doctors is here to help. The good news is we have excellent success in treating chronic degenerative diseases. Discovering your optimal diet is a mainstay of our program, as is the evaluation of nutrient levels, food sensitivities, infections, toxins, genetic predispositions, and hormonal imbalance.

Each program is tailored to you; it addresses the exact imbalances creating your symptoms.

We can help.