A breakdown of the ketogenic diet both via video and text

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The ketogenic diet is gaining popularity in the media. As a nutrition educator the most common question that I’m asked among medical students, residents and the media is, “should I follow the ketogentic diet?” Checkout my video below, and the recap is outlined with 5 main takeaways (and references too). 

1. Evidence:

                We don’t have enough information to establish this diet as a widely applied evidence based method. The Academy of Nutrition and Dietetics doesn't yet recommend or advise this diet to be used for the masses, or general populations. With this diet folks are consuming up to 40% percent of calories from fats. Some research does show this diet can be an effective method in the short term, but we need more research to show long term effects.

2. Background:

                The diet isn't new, but some evidence does show that this approach is used to control pediatric epilepsy. More research is needed for adults and disease stages such as diabetes.

3. Science of the diet:

                the ketogentic diet forces the body to metabolize fat, it puts the body in a starvation stage by using fat as the primary fuel (~40% of macro-nutrient profile) instead of the preferred method which is carbohydrates. Keto dieters throw their body into ketosis with the macro-nutrient ratio and favorability to fat. If a ketogentic dieter “slips up” they can easily throw their bodies out of ketosis which negates the "diet" entirely. Research shows that we might need blood studies or an EKG to monitor our heart when following this strict diet plan.

4. Different types and ranges within the “ketogenic diet” plan:

  • MCT oil
  • Classic
  • Low glycemic diet
  • Modified atkins

5. Final takeaways-- and, would I try this dietary pattern?

                With close medical supervision some folks have shown to benefit from this dietary pattern in the short term. Following this diet is difficult. I would not “try” the ketogenic diet because a. I'm skeptical of the safety and b. I subscript to the plant based approach which favors a higher percentage of carbohydrate intakes. The Academy of Nutrition and Dietetics and 2015-2020 American Dietary Guidelines back up three dietary patterns: Mediterranean, plant based and modified DASH. More on that coming up.

 

References (from me):

https://www.charliefoundation.org/explore-ketogenic-diet/explore-1/introducing-the-diet

andy the rd blog and his take:

http://andytherd.com/2017/04/11/thoughts-keto-diet-craze-crazy/

sources from universities and hosptials:

http://hospitals.jefferson.edu/tests-and-treatments/ketogenic-diet-therapy/getting-started.html

specific peds resourceS:

http://www.uchicagokidshospital.org/specialties/epilepsy/treatment/ketogenic-diets/

more peds:

https://neuro.wustl.edu/patient-care/pediatric-neurology/pediatric-epilepsy-center/patient-family-and-physician-information/ketogenic-diet/

keto diet planner:

http://web.stanford.edu/group/ketodiet/

great summary with side effects:

http://coc.unm.edu/common/pdf/Ketodiet_eng_10Dec09.pdf

checkout the summary from this study:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3945587/

read conclusion here too:

http://www.nature.com/ejcn/journal/v67/n8/full/ejcn2013116a.html

From @theglobalrd

ISSN: https://www.facebook.com/groups/TheISSN/

Podcast on fat and the athlete: https://chrismasterjohnphd.com/2017/07/08/can-fat-fuel-athlete/

Collection of keto studies by Adam Tzur: http://sci-fit.net/2017/keto-study-collection/

Ketones and human performance: https://www.ncbi.nlm.nih.gov/pubmed/28599043/

Affects of keto diet on performance: https://jissn.biomedcentral.com/articles/10.1186/s12970-017-0180-0

Neuroprotectice and disease modifying affects of keto diet: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2367001/

Other Websites & Books:

¨The Charlie Foundation, www.charliefoundation.org

¨KetoCalculator, www.ketocalculator.com

¨Matthew’s Friends, http://www.matthewsfriends.org/

¨Epilepsy Foundation, http://www.epilepsy.com/learn/treating-seizures-and-epilepsy/dietary-therapies

¨Glut1 Deficiency Foundation, www.g1dfoundation.org

¨Ketogenic Diet Support Group, groups.yahoo.com/neo/groups/ketogenic/info  

¨Books:

¤Keto Kid, Deborah Ann Snyder

¤Ketogenic Diets, John Freeman MD, et al.

¤Dietary Treatment of Epilepsy, Elizabeth Neal

Studies:

1.Cobo, et al. The ketogenic diet as broad spectrum treatment for super-refractory pediatric epilepticus: Challenges in implementation in the pediatric and neonatal intensive care units. J Child Neurol. 2014 Jan 23.

2.Dhamija, et al. Ketogenic Diet. Can J Neurol Sci. 2013 Mar;40(2):158-67.

3.Ebus, et al. Can an early 24-hour EEG predict the response to the ketogenic diet? A prospective study in 34 children and adults with refractory epilepsy treated with theketogenic diet. Seizure. 2014 Apr 2. pii: S1059-1311(14)00090-9.

4.Kossof, et al. Ketogenic Diets: treatments for epilepsy and other disorders. 5th edition. Demos Health, June 2011.

5.Lutas, et al. The ketogenic diet: metabolic influences on brain excitability and epilepsy.Trends Neurosci. 2013 Jan;36(1):32-40.

6.O’connor, et al. The ketogenic diet for the treatment of pediatric status epilepticus.Pediatr Neurol. 2014 Jan;50(1):101-3

7.Runyon, et al. The use of ketogenic diet in pediatric patients with epilepsy. ISRNPediatr. 2012;2012:263139.

8.Schoeler, et al. Can we predict a favourable response to ketogenic diet therapies for drug-resistant epilepsy? Epilepsy Res. 2013 Sep;106(1-2):1-16

From @vivenutrition

An Online Intervention Comparing a Very Low-Carbohydrate Ketogenic Diet and Lifestyle Recommendations Versus a Plate Method Diet in Overweight Individuals With Type 2 Diabetes: A Randomized Controlled Trial

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5329646/