In many developing countries, the ketogenic diet is expensive because dairy fats and meat are more expensive than grain, fruit and vegetables. The modified Atkins diet has been proposed as a lower-cost alternative for those countries; the slightly more expensive food bill can be offset by a reduction in pharmaceutical costs if the diet is successful. The modified Atkins diet is less complex to explain and prepare and requires less support from a dietitian.[55]
In the first week, many people report headaches, mental fogginess, dizziness, and aggravation. Most of the time, this is the result of your electrolytes being flushed out, as ketosis has a diuretic effect. Make sure you drink plenty of water and keep your sodium intake up.6One of the fathers of keto, Dr. Phinney, shows that electrolyte levels (especially sodium) can become unbalanced with low carb intake.
There’s also some evidence that it might help with type 2 diabetes. “An emerging body of research is finding that a keto plan may have some real benefits thanks to its ability to improve the body’s ability to use insulin and also help control appetite, which can result in easier weight loss,” says Karen Ansel, R.D.N., co-author of Healthy in a Hurry.
During the 1920s and 1930s, when the only anticonvulsant drugs were the sedative bromides (discovered 1857) and phenobarbital (1912), the ketogenic diet was widely used and studied. This changed in 1938 when H. Houston Merritt, Jr. and Tracy Putnam discovered phenytoin (Dilantin), and the focus of research shifted to discovering new drugs. With the introduction of sodium valproate in the 1970s, drugs were available to neurologists that were effective across a broad range of epileptic syndromes and seizure types. The use of the ketogenic diet, by this time restricted to difficult cases such as Lennox–Gastaut syndrome, declined further.[10]
There are so many tricks, shortcuts, and gimmicks out there on achieving optimal ketosis – I’d suggest you don’t bother with any of that. Optimal ketosis can be accomplished through dietary nutrition alone (aka just eating food). You shouldn’t need a magic pill to do it. Just stay strict, remain vigilant, and be focused on recording what you eat (to make sure your carb and protein intake are correct).
When you eat foods high in carbohydrates and fat, your body naturally produces glucose. Carbohydrates are the easiest thing for the body to process, and therefore it will use them first – resulting in the excess fats to be stored immediately. In turn, this causes weight gain and health problems that are associated with high fat, high carbohydrate diets (NOT keto).
The keto diet isn’t new, and it’s been around for nearly a century. It was originally developed to treat people with epilepsy. In the 1920s, researchers found that raised levels of ketones in the blood led to fewer epileptic seizures in patients. The keto diet is still used today to treat children with epilepsy who don’t respond well to anti-epileptic drugs.[2]
The thing is, for keto to work, it can’t just be treated like any other diet, which is really confusing considering all the pundits touting the “keto diet.” Eating a balanced diet in daylight hours and night capping with a “keto bar” from Whole Foods is not going to put you in a state of ketosis, nor is eating keto religiously and bingeing the family sized bag of Doritos twice a week. Putting the word “diet” beside “keto” is a bit misleading because it downplays the outrageous restrictions required to put your body in an unnatural fat-burning state. In order to accomplish the “ketosis” most diet plans talk about, you need to radically change your lifestyle -- and, unlike switching to a balanced diet of whole foods, you must be fairly religious about carb restriction in order to reap the benefits.
Swanson, a professor of neurology who has researched the impacts of ketogenic diets on inflammation in the brain, got curious about the ketogenic diet when trying to treat the inflammation that persists for days after a person suffers a stroke. When he tried inducing a ketogenic state in mice with stroke injuries, he said, “I was overwhelmed by the effect.” Blocking glucose metabolism worked to suppress inflammatory genes, which in turn helped stroke healing.
There are many ways in which epilepsy occurs. Examples of pathological physiology include: unusual excitatory connections within the neuronal network of the brain; abnormal neuron structure leading to altered current flow; decreased inhibitory neurotransmitter synthesis; ineffective receptors for inhibitory neurotransmitters; insufficient breakdown of excitatory neurotransmitters leading to excess; immature synapse development; and impaired function of ionic channels.[7]
Two years after my first oatmeal binge, I found myself in an All Ages and Genders eating disorder support group, sandwiched between a bulimic father/bodybuilder and a teenage girl who had to drop out of high school for inpatient treatment. We would sit around and discuss incentives to eat normally, such as “I don’t want to die of osteoporosis” and “I’d like to have a friend or two sometime in the future” and “I want to enjoy a croissant again.” Together we relearned how to eat, because we had a new and sustainable goal -- we wanted to live a life without shame and obsession.
Hi Maya. I LOVE your site!! Interesting, informative with fab recipes and ideas. Hubby and I have just started eating low carb and I have to say, we are not finding it too difficult and I already feel sooo much better!! I find the hardest part is choosing low carb veg, I feel as if we are not eating enough. Any suggestions on how to get more veggies into our diet?
The ketogenic diet is a mainstream dietary therapy that was developed to reproduce the success and remove the limitations of the non-mainstream use of fasting to treat epilepsy.[Note 2] Although popular in the 1920s and '30s, it was largely abandoned in favour of new anticonvulsant drugs.[1] Most individuals with epilepsy can successfully control their seizures with medication. However, 20–30% fail to achieve such control despite trying a number of different drugs.[9] For this group, and for children in particular, the diet has once again found a role in epilepsy management.[1][10]
The keto diet was originally designed not for weight loss, but for epilepsy. In the 1920s, doctors realized that keeping their patients on low-carb diets forced their bodies to use fat as the first-line source of fuel, instead of the usual glucose. When only fat is available for the body to burn, the body converts the fats into fatty acids, and then into compounds called ketones, which can be taken up and used to fuel the body's cells.
First, that study, which was reported upon widely, was on mice. Mice are not like humans in the way they fatten or contract metabolic diseases. Journalists/media should stop reporting on mice stories as if they were applicable to humans, especially when there is such a large body of clinical trial data on humans. Let’s be clear: rigorous clinical trial data on humans trumps any data on mice. Every time. And what does the rigorous data on humans say?
Hi Cyn, The numbers are general guidelines but will vary depending on many factors, such as activity level, insulin resistance, weight and more. There is no single magic number, just conventional recommendations that are a good starting point. I will have a macro calculator coming soon that will help determine what is best for each person, but even then it’s an approximation. The only way to know for sure is to test. If keto is your goal, it’s usually best to start lower and then see if you can stay in ketosis when increasing.
During my private and group therapy sessions I learned a lot of information that would be beneficial to the average dieter. My first therapy assignment was to go out and buy a food I used to enjoy, so I purchased M&Ms and relearned how to allow myself a little bit each day. I learned that binges are triggered not by enjoyment of a food but by the feeling that you should stop eating and can’t. I was taught about intuitive eating, which helped me break down my regimented eating schedule and lean into my natural inclination to seek variety of foods in order to reduce cravings. You can find all of these materials online.
The Johns Hopkins Hospital protocol for initiating the ketogenic diet has been widely adopted.[43] It involves a consultation with the patient and their caregivers and, later, a short hospital admission.[19] Because of the risk of complications during ketogenic diet initiation, most centres begin the diet under close medical supervision in the hospital.[9]
The ketogenic diet is calculated by a dietitian for each child. Age, weight, activity levels, culture, and food preferences all affect the meal plan. First, the energy requirements are set at 80–90% of the recommended daily amounts (RDA) for the child's age (the high-fat diet requires less energy to process than a typical high-carbohydrate diet). Highly active children or those with muscle spasticity require more food energy than this; immobile children require less. The ketogenic ratio of the diet compares the weight of fat to the combined weight of carbohydrate and protein. This is typically 4:1, but children who are younger than 18 months, older than 12 years, or who are obese may be started on a 3:1 ratio. Fat is energy-rich, with 9 kcal/g (38 kJ/g) compared to 4 kcal/g (17 kJ/g) for carbohydrate or protein, so portions on the ketogenic diet are smaller than normal. The quantity of fat in the diet can be calculated from the overall energy requirements and the chosen ketogenic ratio. Next, the protein levels are set to allow for growth and body maintenance, and are around 1 g protein for each kg of body weight. Lastly, the amount of carbohydrate is set according to what allowance is left while maintaining the chosen ratio. Any carbohydrate in medications or supplements must be subtracted from this allowance. The total daily amount of fat, protein, and carbohydrate is then evenly divided across the meals.[37]
Because people with type 2 diabetes are at an increased risk for cardiovascular disease, there’s a specific concern that the saturated fat in the diet may drive up LDL, or “bad,” cholesterol levels, and further increase the odds of heart problems. If you have type 2 diabetes, talk to your doctor before attempting a ketogenic diet. They may recommend a different weight-loss diet for you, like a reduced-calorie diet, to manage diabetes. Those with epilepsy should also consult their doctor before using this as part of their treatment plan.
