The Keto Question

"I like the night. Without the dark, we'd never see the stars."

– Stephenie Meyer ("Twilight")

"The night is dark and full of terrors"

– George R R Martin ("Game of Thrones")

Note the two opposite descriptions of the night by two well-known writers. In a similar fashion, experts too hold different views about the hugely popular Ketogenic diet, also known as 'Keto' diet. Some experts praise its dietary benefits, while others try to rubbish it and point at its ill-effects.

Carbohydrates are an important dietary source of energy and the body generates glucose from the same. The Keto diet consists of high fat and normal protein intake, but with a complete or drastic restriction of carbohydrates. This diet is increasingly being considered for improving Diabetes and obesity. The Keto diet has several benefits, including weight loss and dramatic reductions in blood glucose levels. But the Keto diet has problems too, like 'Keto flu' and side effects such as headache and vomiting.

Clearly, Keto is not for everyone. Dramatic lowering of blood glucose may cause hypoglycaemia or very low blood glucose levels, leading to coma. Also, when fat intake is increased and carbohydrate intake is lowered, the body starts using fat for energy. This leads to weight loss, but also generates chemicals called ketones (hence the name 'keto-genic').

However, in excess quantities, ketones can be harmful. Fasting, starvation, insulin-dependent Diabetes, very low carbohydrate intake and certain coexisting anti-diabetes medications called gliflozins, when associated with Keto diet, can increase the risk of a life-threatening accumulation of excess ketones, called ketoacidosis. Another point is that Keto diet should be avoided in pregnancy. Finally, the lipid and heart-related safety of Keto diet remain unanswered. Individuals should start Keto diets only with the advice of their doctors and dieticians.

The American Diabetes Association treatment guidelines state that low carbohydrate diets have the potential for reducing Diabetes medication. A low carbohydrate diet, without going extremely low enough to generate ketone bodies, may be a safe option and is also recommended nowadays by doctors and dieticians.

Coming back to the example of the dark, starry night. The terror of the night is often accompanied by the glittering of the stars. In the same way, every special diet, including the Keto diet, has its pros and cons.

Final word: to find out if you're fit for the diet, work on your nutrition with a qualified specialist.

Dr Unnikrishnan AG

Editor