Introduction and Background
Introduction
The ketogenic diet (KD) is defined as “a high-fat, low carbohydrate diet, with adequate protein content, which makes the body utilize fat, rather than carbohydrate, as a preferred energy substrate” (Kalra et al., 2018, 62). Primary, patients, or individuals adhering to this dietary guideline are required to lower their intake of carbohydrates. In addition, the patient is required to replace carbohydrates with fat. This puts an individual’s body into a metabolic state called ketosis. This means that the body will burn fat for energy. In addition, the liver turns fat into ketones. KD has become quite popular in recent years. Studies have found that KD is effective for “weight loss, diabetes, and epilepsy” (Moreno et al., 2016).
Background
The KD become quite popular in the 1920s and 1930s (Sampaio, 2016). At the time, this diet was used as a therapy for epilepsy. This dietary plan was used as an alternative to fasting. However, this dietary plan was abandoned after new therapies were introduced. One therapy that was introduced to replace KD was anticonvulsant therapies. But still, these therapies did not effectively control epilepsy. Thus, the diet was reintroduced. In ancient times, fasting played a crucial role in managing epilepsy (Sampaio, 2016). Scientific studies that were conducted in the 20 th century showed the role of fasting in the treatment of epilepsy. In one study, 20 patients who have epilepsy followed a low-calorie, vegetarian diet plan that was combined with fasting (Sampaio, 2016). Only two of the patients adhered to the dietary plan. These two patients showed significant improvements.
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During the early 20 th century, Hugh Conklin, an American scientist, introduced fasting as a treatment for this condition (Sampaio, 2016). Conklin believed that epilepsy was caused by a toxin secreted in the intestine. Conklin suggested that if an epileptic patient fasts for 18 to 25 days, the toxin may dissipate (Sampaio, 2016). Conklin conducted a study to prove this. He put patients on a “water diet.” From the study, Conklin found that the diet cured 90 percent of children the condition (Sampaio, 2016). In addition, the diet cured 50 percent of adults (Sampaio, 2016). Further analysis revealed that 20 percent of Conklin’s patients became seizure-free, while 50 percent showed significant improvements (Sampaio, 2016). Following Conklin’s findings, fasting therapy was adopted as a mainstream therapy for epilepsy.
It was in 1921 that an endocrinologist named Rollin Woodyatt noted that the liver secreted “acetone, ? -hydroxybutyrate and acetoacetate” due to starvation or epileptic patients followed a high-fat, low carbohydrate diet (Sampaio, 2016). The diet was later called “ketogenic diet,” and was used to treat the condition. After this discovery, scientists started to devise ketogenic diets that are more enjoyable. This led to the introduction of medium-chain triglycerides (MCTs) diets in place of KD. Many hospitals adopted the MCT diet as it was more effective. However, some hospitals still use the KD diet as a treatment option for epilepsy.
What foods, vitamins, and rituals are typical of this fad diet, and why?
There are several versions of the KD, including standard KD (SKD), cyclical KD (CKD), target KD (TKD) and high-protein KD. SKD contains “75% fat, 20% protein, and only 5% carbs” (Freeman et al., 2007). CKD involves periods of higher-carb refeed. This means that an individual following this dietary guideline takes a KD diet and high-carb diets. However, it is important to note that the individual takes a KD diet more times in a week than high-carb diets. TKD allows an individual to add carbs around workouts. High-protein KD is similar to SKD. However, this diet includes more protein.
Typical foods to enjoy on a KD include the following: seafood, such as fish and shellfish; low-carb vegetables, such as kale, broccoli, and cauliflower; cheese; avocados; fresh meat and poultry; eggs; coconut oil; nuts and seeds, such as almonds, Brazil nuts, cashews, and walnuts; and berries. Seafood like salmon is rich in B vitamins and potassium (k), yet virtually carb-free. Non-starch vegetables are low carbs and calories. However, they are rich in other nutrients like vitamin C. Generally, KD has many health benefits. This diet is effective for “weight loss, diabetes, and epilepsy” (Moreno et al., 2016).
Discuss significant data and statistics from the scholarly article you found about this fad diet.
Typically, KD limits the intake of carbohydrates to 20-50 grams per day. In a “carbohydrate-replete person,” this substrate is converted to glucose. The body organs, such as the brain, then uses this glucose as a fuel. In the case of carbohydrate depletion, ketogenesis is activated (Masood & Uppaluri, 2019). This process takes place in the liver. The process involves breaking down fat into fatty acids and ketone bodies. The brain and other body systems can utilize these ketone bodies as an efficient energy source.
Studies document that KD has a number of health benefits. KD is effective for “weight loss, diabetes, and epilepsy” (Moreno et al., 2016). Studies document that KD is effective in reducing weight. In 2014, Saslow et al. carried out research to investigate the effect of KD on patients with Type I diabetes. The researchers subjected 16 patients and 18 patients on KD and the American Diabetes Association diet, respectively. Hemoglobin A1c decreased by 0.6 percent for KD patients. In addition, 44 percent of the KD patient discontinued their medication due to the effectiveness of KD. With regard to weight, the KD group lost 5.5 kg, while the other group lost 2.6 kg. In another study, Sumirthan et al. (2013) carried out research to investigate the effect of KD on non-diabetic, non-obese diets. The researchers subjected 39 participants to this diet. From their study, the researchers found that the participants lost 13 percent of initial weight. In addition to weight loss, fasting ? -hydroxybutyrate fell.
KD has also been recognized as a treatment option for a number of conditions, such as epilepsy, especially severe childhood epilepsy. However, how this diet works remain largely uncertain. In 2008, Hartman et al. (2008) carried out a study to determine the effect of KD on epilepsy. From the study, the researchers proved the efficacy of a KD in the “6-Hz seizure test in mice” ( Hartman et al., 2008). A recent Cochrane review supports the effectiveness of KD. According to the study, KD effectively reduces 30 to 40 percent of seizures (Kessler et al., 2011). The authors also reported that KD is more effective in children than adults.
What do critics say about this fad diet…. And what is your analysis?
Critics say that the KD diet can be unhealthy. More specifically, the critics of KD say that adhering to this dietary guideline is an unhealthy way to lose weight. They also believe that this diet can be downright dangerous as it can be unhealthy. Lastly, critics say that KD only works in the short-term. Based on my analysis, KD has more health benefits. This diet is effective in treating or managing a number of conditions, including excess weight, diabetes, and epilepsy. Thus, it should be used by individuals who are diabetic, epileptic, or want to lose weight.
Do you recommend this fad diet? Where can the public get more information?
Weight loss is the primary reason patient, and other people use the KD. Several studies have documented the effectiveness of KD in reducing weight (Saslow et al., 2014;
Sumirthan et al., 2013). This diet also is an effective therapy for severe childhood epilepsy (Hartman et al., 2008; Kessler et al., 2011). Therefore, I would recommend this diet to epileptic patients, diabetic patients, and non-diabetic people who want to lose weight. The public can get more information about KD from the U.S. Dietary Guidelines for Americans, which is available at the U.S. Department of Health and Human Services.
References
Freeman, J. M., Kossoff, E. H., & Hartman, A. L. (2007). The ketogenic diet: one decade later. Pediatrics , 119 (3), 535-543.
Hartman, A. L., Lyle, M., Rogawski, M. A., & Gasior, M. (2008). Efficacy of the ketogenic diet in the 6‐Hz seizure test. Epilepsia , 49 (2), 334-339.
Kalra, S., Singla, R., Rosha, R., Dhawan, M., Khandelwal, D., & Kalra, B. (2018). The Ketogenic Diet. US Endocrinology, 14 (2): 62-64.
Kessler, S. K., Neal, E. G., Camfield, C. S., & Kossoff, E. H. (2011). Dietary therapies for epilepsy: future research. Epilepsy & Behavior , 22 (1), 17-22.
Masood, W., & Uppaluri, K. R. (2019). Ketogenic Diet. In StatPearls [Internet] . StatPearls Publishing.
Moreno, B., Crujeiras, A. B., Bellido, D., Sajoux, I., & Casanueva, F. F. (2016). Obesity treatment by very low-calorie-ketogenic diet at two years: reduction in visceral fat and on the burden of disease. Endocrine , 54 (3), 681-690.
Sampaio, L. P. D. B. (2016). Ketogenic diet for epilepsy treatment. Arquivos de Neuro-psiquiatria , 74 (10), 842-848.
Saslow, L. R., Kim, S., Daubenmier, J. J., Moskowitz, J. T., Phinney, S. D., Goldman, V., ... & Hecht, F. M. (2014). A randomized pilot trial of a moderate carbohydrate diet compared to a very low carbohydrate diet in overweight or obese individuals with type 2 diabetes mellitus or prediabetes. PloS one , 9 (4).
Sumithran, P., Prendergast, L. A., Delbridge, E., Purcell, K., Shulkes, A., Kriketos, A., & Proietto, J. (2013). Ketosis and appetite-mediating nutrients and hormones after weight loss. European journal of clinical nutrition , 67 (7), 759-764.
