Science, Controversy, and How Keto Diets Work
Wouldn’t it be convenient if there were a way to evaluate all the new diets that come along? I’ve always been baffled by how many fad, “celebrity,” medical, and other diets continually pop up in the media without any detail as to their viability.
One of the diets currently making the talk-show rounds and grabbing tons of public attention is the so-called “keto” diet, also known more properly as the Ketogenic diet. In short, it’s a super-low carb, high fat regimen that includes an average amount of protein but with an overall low calorie count in the first few days.
As someone who has always been interested in nutrition and fitness, I wanted to learn more about all the variations of keto diets out there, so was surprised to find that one of the most popular versions dated way back to the 1970s, and went under the name “Scarsdale medical diet.”
Now all but forgotten, the Scarsdale diet was the first of the keto diets that was supported by a best-selling book as well as a rafter of celebrity endorsements. Today’s keto diets are a little less harsh than the Scarsdale diet but are essentially the same in their basic framework: low carbs, high fat, average protein, few calories during the first week or two, and quick weight loss.
I started digging for details about the new generation of keto diets and was curious to learn whether any new science backed the claims of quick weight loss with relatively healthy outcomes, no medical dangers, and few adverse side-effects.
Figure 1: The main advantages of keto diets
Unlike lots of other celebrity and fad diets, Ketogenic eating plans are simple in their design: they deliver most of their calories in the form of fat and very, very few in the form of carbohydrates. Protein levels are normal, but the general effect is to force the metabolism to use stored fats for its energy supply (hence the quick weight loss).
In non-dieting bodies, human beings use carbohydrates rather than fats for energy, but when there are few carbs to use, the body switches onto a “backup” system in which stored fat is gobbled up as fuel.
This “backup” system is what scientists call the state of ketosis. Here’s how the two different systems look from the outside:
In a normal, non-dieting body: Carbohydrates are used for fueling the physical and brain systems. The body breaks carbs down into glucose, the basic fuel for physical and brain activities. This is called a “normal glucose metabolism” and is what most of us live with 99 percent of our lives, unless we face starvation or go on an intense fasting program.
In a body that is in “ketosis”: When there are no carbs to make the basic fuel, glucose, the body switches over and starts using stored fat for fuel. Your metabolism breaks these stored fats down in the liver by splitting them into two different substances. The two substances the liver creates from stored fat are fatty acids and “ketone bodies.”
These ketone bodies are sent from the liver to the brain, which now uses them instead of glucose to do its work. When you have lots of ketone bodies floating around in your bloodstream, doctors say you are in a “state of ketosis,” which is neither good nor bad but which is a completely different situation than your normal physical state.
The goal of all keto diets is to put your body into ketosis so that it will be burning stored fat as fuel. The upside to this, especially on low calorie keto plans, is quick weight loss. The downside can include constipation, foggy thinking, headaches and several other annoying but not critically dangerous side-effects.
Well, after learning what ketosis was, and realizing that keto diets have been around for a long time, I was a little more accepting of their effectiveness. But I wanted more evidence, from reliable sources, about the safety of keto diets. Here’s what I found out:
In This Corner: Breaking Keto Diet Myths
Authoritative sources proclaim the keto diet to be both safe and effective for short-term weight loss and the control of seizures (for those who suffer from epilepsy). There are about a half-dozen common areas of misunderstanding about keto diets, but each one has a simple explanation. When I started uncovering what the top medical and science websites had to say about these diets, I was generally satisfied that they’re a smart way to lose weight and probably a healthy long-term way to eat as well.
Some of the myths and misconceptions about keto diets are listed below, with a short explanation after each one:
Myth: Keto diets aren’t nutritious enough for basic human needs.
Fact: The general keto plan is actually quite healthy, minimizes junk food, and provided everything the body needs for proper muscle and brain function. Once weight loss goals have been achieved, many people continue on keto eating regimens but up the caloric amounts so that they don’t continue to lose weight. There are lots of “lifers” who stay on the Atkins eating plan forever with no ill effects.
Myth: Keto diets result in dangerous dehydration and a seriously low level of electrolytes.
Fact: This one’s easy to remedy because all you need to do is drink a lot of water while on a keto diet and there will be no risk of dehydration. As for electrolytes like potassium, sodium, and magnesium, you can either eat foods rich in these substances or use a liquid supplement to insure that you get enough of them to prevent any ill effects.
Myth: Keto diets lead to inevitable constipation.
Fact: When done incorrectly, keto diets can lead to constipation, but that is not how they’re designed. The answer to any constipation on a keto diet is the “three Fs,” namely, fluids, fiber and fat.
Some newbies to keto eating do have fewer bowel movements as a result of less waste in the body, but that’s not the same as “blockage,” or standard constipation. In either case, proper keto diets emphasize eating fats, taking in large amounts of fluids and consuming high-fiber foods. If you do those three things, not only will you not suffer constipation, but you’ll feel better, lose weight faster, and look better doing it.
Myths: Keto diets lead to muscle destruction, kidney stones and gallstones.
Facts: None of those three assertions is true. In fact, keto diets are a good way to promote muscle building. The brain uses ketones as its primary fuel source, thus has no need to “break down” muscle protein for fuel. Most of the misunderstanding in this area is based on an incorrect view of what ketosis is.
As for gallstones, it is a fact that the more fat a person consumes, the lower their chance of developing gallstones. However, if you’ve been on super low-fat diet on and off for several years and then suddenly start a keto diet, your body might “flush out” whatever gallstones have already been present in your gallbladder. This effect is not the fault of the keto diet, but the direct result of a past low-fat dieting lifestyle.
Kidney stones as a result of keto dieting: This common misconception is based on the wrong assumption that keto dieting is a “high protein” plan. In reality, keto diets contain normal amounts of protein and high amounts of fat. How or where this myth began no one seems to know, but you’ll certainly encounter it if you begin to talk with people about keto diets.
Figure 2: Three common components of keto diets
Arguments Against Keto Diets
There are criticisms of keto diets. Some experts say that sensible weight loss should be based on permanent lifestyle tweaks and eating habits rather than one-shot, short-term diets of any kind. This criticism is aimed at all diets that aren’t “permanent” eating plans, rather than just at the keto diet.
Criticisms of the keto diet specifically are few in number, but important enough to look at. It’s possible, some say, for keto diets to worsen cholesterol problems by including too many whole dairy items and other high-fat choices like fatty cuts of meat. High cholesterol can lead to heart disease. Countering this claim, many people who were on the Atkins Diet for more than 2 years turned up with healthier cholesterol levels than when they started. So maybe keto diets aren’t such a risk for heart disease after all.
For dieters who already have kidney problems, a keto diet might put too much strain on the kidneys, which is what high protein levels tend to do. But if you do suffer from kidney ailments, it is unlikely that your doctor will clear you to try a keto diet in the first place.
High-protein dieters often excrete a lot of calcium through their urine, which might put them at risk for osteoporosis and related kidney stone problems. The science on this claim is not very solid because some of the studies contradict each other.
The bottom line is that keto diets seem to have few valid negatives but lots of positives. As time goes on, and keto diets continue to gain in popularity, we’ll likely see much more research done on the pros and cons of using “ketosis” as a way of burning excess fat via a keto diet plan.
Figure 3: A keto favorite; baked salmon
Learn More Here!
Books, Websites and Videos about Keto Diets
The following resources include videos, books and websites that offer additional information. Simply click on the hyperlinked resource title and you’ll be able to go directly to a live link for that particular item. Most book listings are from major online retailers like Amazon, Barnes & Noble, and others. All video links are sources from YouTube. Website links for the most part are informational, like WebMD, Wikipedia, and other authoritative business, health and medical resources.
Keto Clarity: Your Definitive Guide to the Benefits of a Low-Carb, High-Fat Diet
The authors explain the keto diet’s huge medical benefits which include quick weight loss, reduction in diabetes symptoms, avoidance of cancer, possible diversion of Alzheimer’s disease, and dozens of other scientific pluses that come with eating a low-carb, high-fat diet.
The book is full of research-backed discussion of the Ketogenic diet program, and is considered one of the primary texts on the subject for those who want the whole story about how keto works, why it is a smart way to eat, and where it came from.
Easy Ketogenic Diet Slow Cooking: Low-Carb, High-Fat Keto Recipes That Cook Themselves
This book “keeps keto interesting” and shows cooks of all experience levels how to prepare a full range of keto-friendly foods the slow-cooking way. Clear and to the point, this is one of the better keto cookbooks on the market and is a bestseller for good reason: it delivers the goods, in the form of simple recipes that taste great and meet the sometimes exacting rules of keto eating. Even for people who aren’t on keto diets, this book makes a nice addition to the kitchen library. Slow-cooking enthusiasts will be in keto heaven.
Dr. Eric Berg’s “7 Benefits of Keto Diets” Video
Dr. Berg’s video is intriguing in the way it breaks down the benefits of keto diets, offering 7 short outlines of how keto eating is the way to go. Berg believes that Ketogenic diets create a “superior fuel” for the body when it utilizes ketones rather than glucose for the brain.
When it comes to fast weight loss, improved mood, and a more powerful memory, Berg says that the keto diet is a winner in all three categories. Not only that, but keto diets have the ability to eliminate hunger and craving, major problems with almost all other diets.
Finally, Dr. Berg points to an overall improved metabolism for keto dieters, while at the same time their bodies are able to avoid insulin dysfunction. For people who have even a mild form of insulin dysfunction, a keto diet can be a fast and effective way of dealing with the problem. This is a huge advantage for those who do not want to, or can’t, take medications for insulin problems.
Re-establishing the body’s metabolic point a notch or two lower is a good way to reduce the “set point” of a keto dieter’s metabolism, which is generally a good thing medically speaking.
Dr. Axe: Video
Dr. Axe is a popular media personality who renders his opinion on all things concerning nutrition, lifestyle and related subjects. Here he dissects the Ketogenic diet and concludes that not only is it a smart way to lose weight, but can possibly help fight cancer, Alzheimer’s disease and other serious maladies.
Dr. Axe explains in lay terms how the diet works to burn fats, rather than carbohydrates, as fuel for the brain. However, the good doctor parts from many other keto enthusiasts when he suggests that no one should be on a keto regimen for more than about 6 months. He claims that the 80-10-10 ratio of fat-carbs-protein is an ideal situation for weight loss and other goals, within certain limits.
He also notes that keto diets are the fastest-working of all the “safe” diets out there, and are able to do double-duty for cancer patients. Cancer cells, according to Dr. Axe, need sugar for their survival, which is why keto diets are able to “starve” cancer cells and prevent their further growth. This is only a theory and Dr. Axe, to his credit, labels it as such. In any case, it is interesting to view the ideas behind the cancer-fighting abilities of keto diets.
For Alzheimer’s patients, Axe feels that healthy, natural fats are the best thing for the brain. Ketones, rather than glucose, are apparently a better fuel for the brain of an Alzheimer’s sufferer.
Axe also suggests that keto dieters make sure they get three kinds of fats: omega-6, omega-3, and saturated fats. By following the rules of Ketogenic diets, it is possible to improve general physical health and safeguard the brain from possible effects of degenerative disease, according to Dr. Axe.
One of the more authoritative medical websites, WebMD has a fantastic rundown of the keto diet via a slideshow. Here is the direct link for those who wish to see the whole thing, and to learn more about the ins and outs of keto diets.
Here’s an interesting look one of the main advantages of the Ketogenic diet: the fact that is can almost completely stop epileptic seizures in children who don’t respond to traditional medications. The team at the Mayo Clinic talks up the advantages of keto diets for this purpose, but has little to say about using keto for weight loss. It’s quite possible that Mayo doesn’t want to highlight the competition to its own commercial eating regimen: the Mayo Clinic Diet.
Note that there are two “Mayo” diets, a real one and a fake one. The real one was developed by the famous clinic. It is a sensible, long-term way to lose weight and keep it off via a reduced junk-food plan coupled with exercise. The fake Mayo diet has been around for about 25 years, passed around on the Internet and through flyers in office buildings. No one knows who started it, but it is not medically sounds and is based on grapefruit juice and fasting for 12 days at a time. If you want to try the Mayo Clinic Diet, be sure to visit the Mayo website and find the real thing.
Figure 4: Olive oil, a keto staple
A Short Ketogenic Glossary
The following glossary contains some of the most common terms and facts that apply to this topic. It’s impossible to include everything, so we’ve chosen a few dozen usages that typically appear in news and media reports, government studies and academic research papers.
Alcohol: On any keto diet, it’s generally okay to drink low-carb alcohol in moderation. Just stay away from beer and other fatty forms of alcohol.
App: There are, of course, hundreds of apps you can download to your preferred device in order to track and follow your keto diet plan. Many of the fancier apps include recipes for each meal, snack options and simple recording of daily calorie, fat, protein and carb data.
Atkins: The Atkins Diet is one of the most popular keto diets currently being used by large numbers of people. Like the Scarsdale Diet before it, the Atkins plan is a full-blown “lifestyle” eating plan that can be followed for more than just a few weeks. Because keto has been around so long, no one “owns” the copyright on the term, so just about anyone who wants to can write a book entitled, “My Keto Diet.”
Cancer: Some cancer patients need to put their bodies into ketosis for a certain period of time during treatment regimens. In the old days, this usually meant fasting, but now there are keto diet plans to follow which accomplish the same goal without harsh fasts. Cancer patients have come to love their “non-fast fast” keto diets whenever they need to induce a state of ketosis for treatment purposes. It sure beats not eating anything at all!
Low-carb vegetables: A staple of keto diets, LCVs are one of the guilt-free and versatile foods for any keto enthusiast. As an adjunct to a meat-centered meal or as a snack, LCVs are one of the main components of most keto diets.
Buddy system: Most keto diet advocates recommend using a buddy system for the duration of the early portion of the plan. This helps a lot with food preparation, mutual encouragement and in maintaining enthusiasm levels on what is essentially a very new way of eating and living. Going it alone is much more difficult.
Cheat day: Many diets allow people to have so-called cheat days, where they are allowed to eat anything they wish. For keto diets, this practice is strongly discouraged because the full Ketogenic effect is hard to maintain or achieve if there are breaks in the process.
Dessert: Unlike most diets, keto diets allow for a full range of desserts as long as they’re low-carb. Cheesecake and similar delicacies are a-okay on Ketogenic diets. The high-fat component of keto diets is what draws some people to them in the first place, after years of low-fat, low-fun dieting.
Exercise: Exercise is allowed on keto diets but is not a mainstay of the plans. Rapid weight loss will take place in ketosis if the dietary regimen is followed correctly. Even so, most keto dieters do exercise as a way of maintaining tone, burning a few extra calories, and keeping themselves in generally good physical shape. A sensible mixture of flexibility/stretching, walking/jogging, and light weight training is a common system for keto dieters.
Fast food: Because most fast food contains “empty” calories, it is advised that keto dieters avoid it. Instead, the goal is to prepare as many of your own meals as possible, to include good fats, protein and a few grams of carbs. One huge disadvantage of fast food is the low nutrient value of the meals.
For dogs: Some studies have shown that cancer in dogs can be avoided with keto diets. There are now commercial dog food products that tout these claims but most researchers believe more work needs to be done before we can say that keto eating is the best way for dogs to avoid getting cancer.
Gallstones: Some keto dieters suffer from gallstones, but that’s not the fault of the diet. Instead, it is believed that many keto dieters previously followed low-fat regimens to lose weight. Low-fat diets are notorious for creating gallstones, which are then “flushed out” when that person begins a high-fat keto diet. Fats stimulate the gallbladder into activity, so when you start a keto regimen, any gallstones already inside you might come out.
Ketosis: The body’s state when it is using broken-down fat as fuel, rather than making glucose from carbohydrates. When the body splits fats apart in the liver, it ends up with fatty acids and ketones. The ketones are then used by the brain for fuel.
Test strips: These inexpensive pieces of paper are ideal for testing your urine and seeing whether your body is in ketosis. It usually takes a few days for most people to reach this point, but the strips will allow you to know, from day to day, whether you’re still “on the plan” or not. If you cheat and eat a high-carb meal, you might notice that it takes a few days to get back into full ketosis.
Olive oil: One of the “good fats” on most keto diet programs.
Restaurants: Eating out can be difficult on a keto diet but there are more restaurants these days that cater to keto enthusiasts. Just be sure to read menu details online before heading to your favorite restaurant and being sure to plan restaurant trips carefully. After a while you’ll figure out what you can and can’t eat while dining out.
Scarsdale: The Complete Scarsdale Medical Diet was one of the first mass-marketed keto diets. It was created by Dr. Herman Tarnower in the 1970s and is named for the city in which he worked. The book sold millions of copies and is generally considered one of the seminal “diet” books in American history.
Protein bread: A high-protein, low-carb bread that you can buy in bakeries or make yourself at home. For people who enjoy having toast with their breakfast, protein bread is a savior for keto dieters because it tastes great and fits into the keto program well.
The “Verdict” on Keto Diets is…
Keto diets appear relatively safe and effective, unlike about 80 percent of all other popular diet plans. For people who want to drop 5 or 10 pounds pretty quickly, a keto plan is probably a good way of doing so, provided you get a doctor’s approval first.
The restrictions and “rules” on keto diets aren’t that bad. In fact, as long as you stick to the “just enough protein” rule, minimize carbs and take in enough fats, you’ll start burning stored fat within a few days of starting the diet. That typically means no pasta, ice cream, cookies, grains, bread, or fruit while on a keto diet, but increasing your intake of butter, extremely lean meat and butter.
Because there haven’t been as many scientific research studies done on keto diets, doctors don’t know as much about them as they do about other diet plans. But it is pretty well accepted by the medical community that keto diets are good for safe, rapid weight loss and for treating epileptic seizures in children!
Compared to traditional diets based on overall decreased caloric intake and the “food pyramid,” keto diets have much more fat and much less carbohydrate sources. The Atkins Diet and the Scarsdale Medical Diet are two examples of formalized plans that are considered effective Ketogenic diets. There’s no consensus opinion on how long a person can or should stay on a keto diet, but most agree that it appears to be a safe way of eating because of the limited amount of junk food and sweets.
We do not offer medical advice, so if you have a concern about your state of health, be sure to speak with a physician or other medical professional. This article is for general informational purposes only and is not intended to be any kind of official medical guidance.
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