Visitor Question: What is a ketogenic diet and do they work?

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Ketogenic diets: The basics and some research 

Ketogenic low carbs diet.

Ketogenic low carbs diet.

woman with tape measure worried about weight

Woman with measuring tape

A keto or ketogenic diet is not a new diet.  This type of diet has been well known for being a low carb diet that is centered around the production of ketones.  It has been used When your body does not have a supply of glucose for energy; the body produces ketones in the liver to be used as energy in place of glucose.  Glucose is often the preferred source of energy by your body, but in starvation mode, we can use many compounds for energy.  You probably already know the ketogenic diet by another name, and that is low carb diet, low carb high fat.  It is very similar to the Adkins diet, but it is a subtle difference.  

To understand the basis of this diet, you must understand insulin.  Insulin is a hormone that signals our cells to take up glucose from the blood.  The purpose is to regulate glucose levels so that we have a stable level in the bloodstream after meals.  Without it, glucose would reach toxic levels when we eat a meal high in glucose.  So, when you eat something high in carbohydrates, your body will break down the carbohydrates into single sugar moieties such as glucose and glucose is the easiest molecule for your body to convert and use as energy.  As levels of glucose rise, your pancreas will release insulin into your bloodstream.   Insulin also signals the body to store excess energy.  Since the glucose is being used as primary energy, your fats are not needed and are therefore stored.  Any excess protein and carbohydrates can also be converted to fat to be stored.  

On a typical higher carbohydrate diet found in the United States, the body will use glucose as the main form of energy.  Keto or ketogenic diets are higher in fat and lower in carbohydrates, so there are fewer carbohydrates to serve as the primary energy source.  Ketogenic diets differ from Adkins by being high in fat consumption.  Macronutrient distribution is at least 70% fat, 10-30 protein, and less

Ketogenic Diet - Macronutrient Distribution

Ketogenic Diet – Macronutrient Distribution

than 5% carbohydrates.  In low carbohydrate situations, our bodies have to make glucose in the liver from amino acids and glycerol.  We cannot make enough to power the entire body.  By lowering the intake of carbs, the body is induced into a state known as ketosis.  The type of diet forces the body to burn fats rather than carbohydrates which is less efficient and leads to ketone bodies being left over.  We can use them for energy by the process is slow.  The ketone bodies pass into the brain and are used as an energy source.  An elevated level of ketone bodies in the blood, a state known as ketosis which creates an energetic and euphoric feeling.  Ketosis is a part of our natural processes that are initiated to help us survive when food intake is low.  


Is a ketogenic diet healthy?  Yes and no.  Doctors commonly prescribe ketogenic type diets for epilepsy.  It has been prescribed since 1991 when a physician first wrote about his success treating his own son with one of these diets.  There is plenty of evidence that backs the use of them with little to no side-effects.  There have been some reports of kidney stones, and gout and this type of diet do increase your risk of low potassium, dehydration, and heat injury.   These risk of side-effects can be easily controlled with a proper diet, and many of the modern ketogenic diets are set up to avoid complications.  

Do ketogenic diets work for weight loss?  Yes.  The shift toward promoting low-fat diets certainly has not reduced obesity in the United States, and there is growing evidence to back higher fat diets for weight loss.  In recent years, researchers have begun investigating this very question.  In 2013, a very promising study shined doubt on the belief that low-fat diets were more successful[1].   Subjects in this study were given either a low-fat or high fat diet and were followed for 12 months.  The researchers found that assigned to a ketogenic diet achieve a greater weight loss than those assigned to the low-fat group at 12 months.   The results of this study have been confirmed in many studies to include on from 2018[2].  There is also growing research that shows ketogenic diets increase insulin sensitivity and reduce blood glucose which might help highlight a potential mechanism[3].   Another potential mechanism is the ketones appear to reduce appetite.  A meta-analysis of prior research appears to show that ketogenic diets reduce appetite and cause satiety[4].   The results have been promising and appear to show two potential mechanisms, but further studies are needed.  

The bottom line: Ketogenic diets might work for some people.  Ketones appear to have a mechanism to reduce your appetite and insulin sensitivity.  If you can tolerate the fat and lower carbohydrate levels, give it a try.  Overall, eating a higher level of fat, moderate protein, and low amount of carbohydrates can have an impact on your health if you choose the right fats.  Avocado, nut, olive, and coconut oils are good choices.  A ketogenic diet can be hard to follow at first, but it gets easier to follow over time.


N. Bueno, M. de, O. de, and R. da, “Very-low-carbohydrate ketogenic diet v. low-fat diet for long-term weight loss: a meta-analysis of randomised controlled trials.,” Br J Nutr, vol. 110, no. 7, pp. 1178–87, Oct. 2013. [PubMed]
S. Iacovides and R. Meiring, “The effect of a ketogenic diet versus a high-carbohydrate, low-fat diet on sleep, cognition, thyroid function, and cardiovascular health independent of weight loss: study protocol for a randomized controlled trial.,” Trials, vol. 19, no. 1, p. 62, Jan. 2018. [PubMed]
S. Hallberg et al., “Effectiveness and Safety of a Novel Care Model for the Management of Type 2 Diabetes at 1 Year: An Open-Label, Non-Randomized, Controlled Study.,” Diabetes Ther, Feb. 2018. [PubMed]
A. Gibson et al., “Do ketogenic diets really suppress appetite? A systematic review and meta-analysis.,” Obes Rev, vol. 16, no. 1, pp. 64–76, Jan. 2015. [PubMed]
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About the Author

I am a family physician who has served in the US Army. In 2016, I found myself overweight, out of shape, and unhealthy, so I made a change to improve my health. This blog is the chronology of my path to better health and what I have learned along the way.

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