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Keto Diet: Yay or Nay?

The ketogenic diet (aka the keto diet) found its beginnings almost 100 years ago in treating drug-resistant epilepsy in children, but it’s emerged as a favorite among women looking to shed pounds quickly. But is it really a good idea?

Here’s how a keto diet works: High in fat but extremely low in carbohydrates (think: a 4-to-1 ratio of fat to combined protein and carbohydrates), the keto diet forces the liver to convert fat into fatty acids and ketone bodies. The ketone bodies are what are important here: Their elevated presence in the blood causes a metabolic state known as ketosis, which induces a body to break down fat for energy rather than use blood sugar from carbs as an energy source. The result: The body burns fat more efficiently while blood sugar and insulin levels fall.

All in Favor

Those who champion the keto diet believe it shows promise not only for weight loss but also an improvement in health issues such as diabetes, certain cancers, heart disease, Alzheimer’s, Parkinson’s, and polycystic ovary syndrome. But of the four types of ketogenic diets, only two have undergone focused research: the standard ketogenic diet (SKD), which consists of 75 percent fat, 20 percent protein, and 5 percent carbs; and the high-protein ketogenic diet, which allows 60 percent fat, 35 percent protein, and 5 percent carbs.

Studies find that the SKD diet keeps you satiated without the tedious work of counting calories (sounds like a blessing!), can produce weight-loss results that are more than two times more than a calorie-restricted diet (while also lowering HDL cholesterol levels — another blessing!) and might improve insulin sensitivity by up to 75 percent, which helps people with Type 2 diabetes and prediabetes.

But this should all be taken with a grain of salt: No long-term research on humans supports keto’s effects on the body for metabolic, insulin-related, or neurological (aside from epilepsy) improvements over time.

Those Opposed

The keto diet is highly restrictive: no alcohol, root vegetables, beans, grains, or fruit. For this reason, many doctors believe it’s unsustainable. The other issue is that people on a keto diet often rely heavily on processed foods.

And then there are the side effects: lethargy (at least in the beginning), sleep issues, constipation, vomiting, nausea, and bad breath. More seriously, if you suffer from kidney disease, a keto diet is not for you: It can exacerbate the condition.

The Verdict

Though a ketogenic diet definitely appears to have some immediate benefits, like accelerated weight loss and a possible decrease in blood sugar levels, the chance you’ll be able to sustain it over the long term is unlikely. According to Harvard Medical School’s Harvard Health Blog, most people stick it out only for a few weeks to a few months.

Yo-yo dieting has been linked to higher mortality rates — and nobody we know wants to sign up for that. Until further research establishes hardline conclusions about keto’s health benefits, we suggest a balanced, whole-foods diet filled with lean meat and fish and lots of colorful fruits and veggies.

Photo: Thitaree Sarmkasat

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