The ketogenic diet: its benefits, risks, and types

The ketogenic diet is one of the most popular and controversial diets in medical and sports circles in recent years. This diet is based primarily on changing the traditional nutritional equation by reducing carbohydrates to a minimum and replacing them with healthy fats, thus pushing the body into a unique metabolic state known as ketosis.

Historical background and medical context

Although the keto diet has recently gained popularity as an effective weight-loss method, its historical roots date back to the 1920s. Developed around 1924, its initial purpose wasn't weight loss, but rather its use as an effective medical treatment for epilepsy, specifically children who hadn't responded to conventional medications. Physicians at the time observed that this dietary pattern significantly reduced seizures, lending the diet medical credibility beyond its status as a mere weight-loss fad.

How does the ketogenic diet work?

The keto diet works by depriving the body of its primary energy source, glucose (sugar), which is derived from carbohydrates. When carbohydrate intake is reduced to less than 50 grams per day, the liver is forced to find an alternative, breaking down fat and converting it into molecules called ketones. These ketones become the primary fuel for the brain, heart, and muscles, effectively turning the body into a fat-burning machine.

Different types of keto diets

There is no single model that suits everyone; rather, there are many keto diets to suit different needs:

• The Standard Diet (SKD): This is the most common diet, based on 70% fat, 20% protein, and only 10% carbohydrates.
• Cyclical Diet (CKD): Often used by athletes, it involves periods of carbohydrate intake (e.g., 5 keto days and 2 high-carbohydrate days) to replenish glycogen stores.
• Targeted Diet (TKD): Allows carbohydrate consumption only around times of intense exercise.
• High-protein diet: Similar to the standard diet but with an increased protein percentage of 35% and a reduced fat percentage of 60%.

Health benefits and their impact on chronic diseases

Recent studies, including reports from the American Diabetes Association, indicate that the ketogenic diet has benefits beyond rapid weight loss. It effectively contributes to:

• Improving insulin sensitivity and controlling type 2 diabetes.
• A decrease in the glycated hemoglobin (HbA1c) level in the short term (3-6 months).
• Reducing triglyceride levels in the blood, which promotes heart health.

Precautions and contraindications

Despite the benefits, doctors and the Ministry of Health warn against following this regimen without medical supervision, especially for the following groups:

• Those suffering from diseases of the pancreas, liver, or gallbladder.
• Patients with chronic kidney disease, due to the burden that protein and fat metabolism may place.
• Pregnant and breastfeeding women.
• People who suffer from eating disorders or thyroid dysfunction.