Can you rec­om­mend the ke­to­genic diet?

Marlborough Express - The Saturday Express, Marlborough - - BACKYARD BANTER -

Q: I keep hear­ing about a new diet called the ke­to­genic diet that’s good for weight loss. Just won­der­ing if you could ex­plain what it is and whether you sup­port it? Thanks, Michael

The ke­to­genic diet – or ‘keto diet’ – is a high fat, very low car­bo­hy­drate diet. While it cer­tainly has been gain­ing pop­u­lar­ity re­cently, it’s ac­tu­ally not a new diet.

The clas­si­cal ke­to­genic diet has been used since the early 1920s as an ef­fec­tive non­phar­ma­co­logic ther­apy for chil­dren with in­tractable epilepsy.

The clas­si­cal ke­to­genic diet re­quires care­ful plan­ning and mon­i­tor­ing to achieve a spe­cific ra­tio of macronu­tri­ents (pro­tein, fat and car­bo­hy­drates), with about 90 per cent of to­tal en­ergy (calo­ries) com­ing from fat, and the re­main­ing 10 per cent of en­ergy (calo­ries) from pro­tein and car­bo­hy­drates com­bined.

This is vastly dif­fer­ent from a typ­i­cal Western diet, and leads the body to switch its main source of fuel from glu­cose (sugar) to fat.


This meta­bolic state is called ke­to­sis.

It’s quite mirac­u­lous to think that by sim­ply chang­ing their diet, a per­son can ex­pe­ri­ence a sig­nif­i­cant re­duc­tion in seizures (or in some cases, elim­i­nate them), which can have a huge im­pact on their qual­ity of life.

How­ever, the re­stric­tive na­ture of the diet means that sup­ple­men­ta­tion is nec­es­sary to meet nu­tri­tional needs, and there are po­ten­tial side ef­fects, in­clud­ing fluid and elec­trolyte im­bal­ances and di­ges­tive symp­toms such as nau­sea and di­ar­rhoea.

Over the past decade or so, a more re­laxed ke­to­genic diet pro­to­col – re­ferred to as the Mod­i­fied Atkins Diet in sci­en­tific lit­er­a­ture – has been used with sim­i­lar seizure re­duc­tion ef­fects.

It dif­fers from the clas­si­cal fol­low­ing a ke­to­genic diet, and there are some con­cerns about how sus­tain­able it is.

As the ke­to­genic diet tends to be lower in fi­bre, it’s also im­por­tant to con­sider po­ten­tial im­pacts on gut health – and we are dis­cov­er­ing more and more about the im­por­tance of the gut mi­cro­biome to our over­all health and also our weight.

It is not dif­fi­cult for a diet to re­sult in short-term weight loss – this is the case for most di­ets. How­ever, more of­ten than not, peo­ple who go on a weight loss diet for a pe­riod of time go on to re­gain the weight they lost, plus more.

There is no ‘‘one size fits all’’ ap­proach to the way we eat, so if a ke­to­genic diet ap­peals to you, it’s im­por­tant to con­sult a pro­fes­sional to en­sure you are meet­ing your nu­tri­tional needs.

Dr Libby is a nu­tri­tional bio­chemist, best-sell­ing au­thor and speaker. The ad­vice con­tained in this col­umn is not in­tended to be a sub­sti­tute for di­rect, per­son­alised ad­vice from a health pro­fes­sional. See dr­

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