Saturday, January 15, 2011

Ketogenic Diets

I would advocate moderation in just about everything. Ketogenic diets have proven helpful to people with uncontrolled epilepsy and may be of benefit to epileptics in general, to victims of stroke and other forms of brain injury and possibly cancer. They come with other effects that may not be worth the discomfort or unintended risks to healthy people. This includes kidney stones and, in women and girls, amenorrhea. Amenorrhea is associated with bone loss, increasing risk of osteoporosis, and indicates problems in hormone balance. Supplementation with calcium may help with this, but then again, it might not. Physiology can be quite complex, and consumption does not necessarily indicate absorption is occurring. It is quite possible that something that causes hormonal imbalance in women may also cause hormonal imbalance in men. Playing with one’s physiology, when we don’t know the unintended outcomes of such play, may be inadvisable, especially long-term.

I have been a vegetarian for 30 years and an athlete all my life. I have excellent bone density, low blood pressure, low resting heart rate, low fasting blood sugar, excellent blood lipid profile and great strength to body weight ratio. I'm happy and healthy, even though I thoroughly understand I represent but a single data point. I do get a lot of advice from well-meaning friends that I need to eat meat and would be much healthier if I followed a ketogenic diet.  Vegetarians, as described in some current diet books, are weak and "skinny-fat". I will leave it at this: The "optimal diet" for one person may not be the "optimal diet" for another, nor the optimal diet for all conditions. Humans are omnivores and physiologically polymorphic and adaptable. This has given us tremendous abilitity to survive in wildly different climes and environments, and has made us such a resilient species. It is also quite possible, that our individual resilience allows our bodies to adjust to dietary and environmental change.

The current state of research indicates no harm though, from short-term ketogenic diets. I have not found much in the way of research on the risks and benefits of long-term ketogenic diets in healthy adults. Anyone who wishes to add a citation, please feel free.

Kossoff, E., Zupec-Kania, B., & Rho, J. (2009). Ketogenic Diets: An Update for Child Neurologists Journal of Child Neurology, 24 (8), 979-988 DOI: 10.1177/0883073809337162

Bergqvist AG, Chee CM, Lutchka L, Rychik J, & Stallings VA (2003). Selenium deficiency associated with cardiomyopathy: a complication of the ketogenic diet. Epilepsia, 44 (4), 618-20 PMID: 12681013

Brinkworth GD, Buckley JD, Noakes M, Clifton PM, & Wilson CJ (2009). Long-term effects of a very low-carbohydrate diet and a low-fat diet on mood and cognitive function. Archives of internal medicine, 169 (20), 1873-80 PMID: 19901139




  3. Start at about here:

    "As for the serious concerns regarding the possible negative effects of KDs on the heart, kidney and liver functions and situations of acidosis, it must be emphasized that low-carbohydrate diets do not produce harmful alterations in kidney 69,156,157,158] or liver functions 79,163,164. This is because high-protein diets are not associated with harmful alterations of kidney functions in patients with normal kidney functions 166,167 and also because ketosis, which is linked to the use of KDs, is not associated with acidosis and does not alter heart function 68."

  4. I believe the deaths from sudden cardiac arrest in children on ketogenic diets were due to selenium deficiency, not acidosis, kidney or liver function.

    Also, I think assuming that all people living today are genetically suited to a high protein/high fat diet is a bit of a stretch. While Inuit people may have thrived on a very low-carbohydrate diet, it is possible that they are adapted to an arctic biome. It is quite possible that other people, adapted to different climes and different availabilities of various food-types, thrived on other diets. Having worked with the Inuit in the past, I can attest to differences in circulatory response in comparison with my colleagues of European ancestry. Changes in Inuit health status may be due to factors other than dietary changes, though I'd agree that "junk food" is bad for all. Inuit, and probably anyone consuming a high fat diet, are exposed to greater amounts of lipophilic chemicals such as chlorinated hydrocarbons, polychlorinated diphenyl ethers, PCBs and the like, and are thus at increased risk of cardiac disease, obesity, and some neoplasias.

    Thank you for supplying the link to the author-described "one sided review". There is some interesting material in it, but, again, I'm not sure that its wise to provide or write "one-sided reviews" and assume that everyone knows the rest of it. I think, as a general principle, one sidedness, is something to avoid.

  5. On the one sidedness issue, as the author clearly states, he has searched the literature to provide an alternative to the high carb consensus medical view, which seems to me to be endlessly regurgitated by those with a strong investment in the orthodoxy (or chasing grant money from the farm lobby/PITA).

    He writes in his summary:

    "In the opinion of most physicians and nutrition experts, carbohydrates should be a major component of daily energy intake for a healthy lifestyle. For that reason, this paper presents a one-sided review of the literature (the other is already well-known), giving scientific arguments in favor of ketogenic diets and proving that these diets are safe and may be very useful for weight loss, glucose intolerance, type II diabetes, neurological disorders or epilepsy and cancer."


  7. Lets pursue truth from all sides, and not waste energy defending or battling over other people's opinions.