According to the Pew Research Center, American’s diets have changed vastly in the 2010’s, specifically with the increase in consumption of unhealthy grains and fat. In an attempt to reverse this, the keto diet is now being used as a method to limit the consumption of carbohydrates and increase the intake of healthy fats.
Specifically, the keto diet involves the extreme reduction of carbohydrate intake and replacing it with fats. Typically, our body undergoes the metabolic process of cellular respiration, during which glucose is broken down into intermediary molecules to produce ATP that the body can use for energy. A sudden reduction in carbohydrate intake through the keto diet is meant to put the body into a state called ketosis, a metabolic state where the body burns fat for fuel instead of carbohydrates. Ketosis occurs with a significant reduction of the consumption of carbohydrates, limiting the body’s supply of glucose.
Dr. Jennifer Batch, an internal medicine resident physician at the Orange Park Medical Center in Orange Park, CA, found that some benefits of a keto diet include significant reductions in blood sugar and insulin levels as well as improved insulin sensitivity. In addition, studies by the National Library of Medicine have found that this diet has led to reductions in triglyceride levels and diastolic blood pressure, the pressure in the arteries when the heart rests between beats.
The keto diet has also gained mass popularity due to its effectiveness in weight loss. One review of 13 studies found that following a very low carb diet was slightly more effective for long-term weight loss than a low-fat diet. People who followed the keto diet lost an average of two pounds more than the group that followed a low-fat diet.
Maryam Alamoutinia, a nurse practitioner of the Family Practice of Dr. Alan Nili, and Aida Sadeghi, a nutritionist at the same practice, though they advocate a “whole foods-based diet,” do not explicitly advocate following a specific diet.
“I usually encourage my patients with high LDL and high cholesterol, or other warning signs in their blood test results, to have [a] low-fat low cholesterol diet,” Alamoutinia said. “Though the keto diet helps reduce triglyceride levels, I have seen it extremely hard for my patients to be able to maintain.”
Sadeghi emphasizes that the keto diet, in her experience, has resulted in an almost reverse result in her clients, where her patients binge out after a few weeks of restrictive eating.
“When you restrain a part of your diet that used to be so plentiful, your body goes into withdrawal, making you crave it more until you obtain it. The most important aspect of healthy eating is sustainability,” Sadeghi said.
As Sadeghi explained, the keto diet has also been found to have negative effects, such as causing changes in gut bacteria, nutrient deficiencies, damage to bone health, and an increase in risk of binge-eating.
Several animal studies link the keto diet to decreased bone strength, likely due to loss in bone mineral density, which may occur as the body adapts to ketosis. In addition, a six month study of 29 children with epilepsy on the keto diet discovered that 68% had a lower bone mineral density score after going on the diet.
Dr. David Katz, founding director of the Yale University Prevention Research Center, explains that in terms of sustainability, the keto diet might not be the best for long-term health as the eating habits it promotes might lead to heart rhythm problems and its components of high fat and low carbs could make exercises more difficult.
New research presented by the American College of Cardiology has linked low-carb diets to an increased risk of developing atrial fibrillation (AFib). People getting a low proportion of their daily calories from carbohydrates such as grains, fruits and starchy vegetables are significantly more likely to develop such symptoms. Healthy grains are essential to promoting heart health. While the keto diet can help reduce the number of refined grains, it can also remove these heart health-promoting grains.
Although it may be hard to directly pinpoint the best diet, considering nutritional and medical advice before committing to a diet will prove the most effective and safe.
For optimal health, Alice Lichtenstein, director and senior scientist at Tufts University’s Cardiovascular Nutrition Laboratory, said, “We should be focusing on dietary patterns — making changes in current practices that can be sustained lifelong.”