- Nutrition
- 4474 views
We know that the world of‘weight-loss diets’ has for decades been characterised by fads, unrestrained marketing and the over-hyping of all sorts of things.
It is precisely this attitude that has led to the ketogenic diet and some of its best-known variants (the paleo diet, the Atkins diet, etc.) to gain popularity: seen as a quick and easy way to speed up weight loss and reduce body fat, they have attracted increasing attention in recent years.
I’ve received hundreds of questions on this subject:
- What is the ketogenic diet?
- Is it worth trying?
- One of my friends lost 10 kg in a month by taking a ketone supplement!
We’ve already explained above how the weight-loss process, however complex it may be, is always driven by a calorie deficit, but let’s try to understand why the ketogenic diet is so popular, how effective it really is, and what the potential side effects are of following it ‘à la carte’.
What is the ketogenic (KETO) diet?
The ketogenic diet is a nutritional approach in which carbohydrate intake is drastically reduced to 20–30g per day.
Our bodies are programmed for survival: in the event of prolonged fasting or a carbohydrate deficit, it is ‘forced’ to draw the necessary energy from fatty acids present in adipose tissue (AGA) and to use certain amino acids to produce glucose (neoglucogenesis).
Let’s explore this topic further...
However, the energy provided by free fatty acids (FFAs) cannot be utilised by the brain. This is where the liver’s production of ketone bodies comes into play – organic acids produced by lipid metabolism that are able to cross the blood-brain barrier and provide the energy required for the brain to function properly.
The build-up of ketone bodies in the blood is known as ketosis.
Our bodies have therefore, over the course of evolution, developed the mechanism of ketosis for a temporary emergency situation, not for a prolonged physiological state!
The ketogenic diet and neurology
It is important to note that the first studies on the ketogenic diet were conducted in the field of neurology, as it proved effective in stabilising patients with epilepsy.
The question of how the ketogenic diet can help control seizures and manage other conditions such as Parkinson’s disease, amyotrophic lateral sclerosis (ALS), multiple sclerosis and schizophrenia is not yet fully understood in the scientific literature.
There are various hypotheses regarding the action of ketone bodies, as well as to the reduction in blood glucose levels, decreased insulin secretion by the pancreas, reduced markers of inflammation, improved mitochondrial function, or a combination of all these factors.
Generally speaking, most of these studies agree that, in specific clinical cases, the brain functions more efficiently when part of the energy required comes from ketones, thereby optimising mitochondrial function.
The ketogenic diet and weight loss
Over the years, the impact of the ketogenic diet on the regulation of glucose and lipid metabolism has attracted the interest of the scientific community with regard to the treatment of obesity and most of its associated comorbidities (diabetes in particular).
When used for weight loss, the ketogenic diet is no different from other diets which, to be effective, must create a negative energy balance.
However, unlike other diets, it is accompanied by a number of symptoms that can sometimes make the state of ketosis rather unpleasant:
- Dry mouth
- Increased urine output leading to dehydration
- Bad breath
- Reduced energy and stamina during intense workouts
- Headaches
Adherents of the ketogenic diet claim that these symptoms are temporary, but in my day-to-day clinical practice, we have honestly found quite the opposite to be true.
It should also be noted that if a ketogenic diet is prescribed by a doctor with the support of a dietitian, there are methods for monitoring ketone body levels (in urine and blood) which can be used to intervene and prevent or alleviate certain symptoms.
On the other hand, a ‘do-it-yourself’ ketogenic diet can lead to a state of excessive acidosis, kidney strain and metabolic imbalances that are difficult to reverse.
Unless there are specific clinical needs, I therefore consider the ketogenic diet to be unsustainable, particularly for those who exercise and require all macronutrients (carbohydrates, proteins, fats) in the correct proportions.
Let us move away from unhealthy ‘anything goes’ approaches and the exploitation of emergency metabolic mechanisms, and commit ourselves, with the support of professionals, to finding a nutritional balance that is sustainable over the long term.
Copyright: All rights to the texts and trademarks mentioned in this article are reserved by their respective owners.
Disclaimer: This article does not propose any therapies or diets; you should consult a doctor or dietitian before making any changes to your treatment or diet.
Note: The article may refer to findings from medical, psychological, scientific or sports research which reflect the state of knowledge at the time of publication.