To mimic fasting metabolism, modern physicians introduced the ketogenic diet (KD) as a treatment for epilepsy in the 1920s. For two decades this therapy was widely used, but with the modern era of anti-epileptic drug treatment its use declined dramatically. The ketogenic diet is a diet rich in fats, adequate protein and low in carbohydrates that in medicine is mainly used to treat difficult-to-control (refractory) epilepsy in children. The diet forces the body to burn fat instead of carbohydrates.
Normally, carbohydrates from food are converted into glucose, which is transported throughout the body and is important for fueling brain function. But if there are few carbohydrates left in the diet, the liver converts the fat into fatty acids and ketone bodies, the latter of which pass into the brain and replace glucose as a source of energy. A high level of ketone bodies in the blood (a state called ketosis) ultimately reduces the frequency of epileptic seizures. About half of the children and young people with epilepsy who have tried some form of this diet have seen the number of seizures reduced by at least half, and the effect persists after stopping the diet.
Some evidence shows that adults with epilepsy can benefit from the diet and that a less strict regimen, such as the modified Atkins diet, is equally effective. Side effects can include constipation, high cholesterol, growth retardation, acidosis and kidney stones. In the 33 years I have been working with nutritional therapies, none come close to the remarkable results I have seen achieved with ketogenic diets. I have had the honour of working with hundreds of people on the diet, which has taken me all over the world where together with the Charlie Foundation we have trained over 200 hospitals in ten countries.
The ketogenic diet is a very low-carb, high-fat diet that shares many similarities with the Atkins and low-carb diets. For a bunch of recipes, check out these 101 healthy low-carb recipes and this ketogenic shopping list. Our product selections are editor-tested and expert-approved. We may earn a commission through links on our site.
Meet the bodybuilders, biohackers, scientists, doctors and hucksters behind the nutrition craze. Recent research by Phinney showed that those who followed a ketogenic diet and received dietary counselling for a year significantly reduced their use of diabetes medication and lost an average of 9 kilos. Among the best snacks for a ketogenic diet are pieces of meat, cheese, olives, boiled eggs, nuts, raw vegetables and dark chocolate. A modified version, with 80 e fat, 15 e protein and 5 e carbohydrates, has emerged as the most popular, and keto cycles (doing one keto week a month) became a thing.
Two large trials of the Modified Atkins Diet compared to a non-diet control had similar results, with more than 50 per cent of children having half or fewer seizures on the diet compared to about 10 per cent in the control group. Yet the no-sugar principle of the Banting diet was the same as that of the current keto technique, which is used therapeutically to treat epileptic seizures and shows promise for controlling type 2 diabetes. It seems strange that a diet that requires more fat can raise "good cholesterol" and lower "bad cholesterol", but ketogenic diets are related to just that. And in fact, the ketogenic diet is associated with an increase in bad LDL cholesterol, which is also linked to heart disease.
It is important to note that the ketogenic diet is a short-term diet that focuses on weight loss rather than the pursuit of health benefits. The ketogenic diet is usually started in combination with the patient's existing anticonvulsant regimen, although patients may be able to stop taking anticonvulsants if the diet is successful. The idea that a low-carbohydrate, high-fat diet might benefit certain people was largely dismissed by the medical community until ketogenic diets began to be used clinically in the 1920s. A review of 13 studies found that following a very low-carbohydrate ketogenic diet was slightly more effective for long-term weight loss than a low-fat diet.
With ongoing research into the impact of ketogenic diets on many different conditions, it is my greatest hope that these special diets will evolve to the level of disease prevention. And starting a ketogenic diet - or returning to a normal diet afterwards - can be complicated if you are obese because of other health problems you are likely to have, such as diabetes, a heart condition or high blood pressure. No significant difference was found in the amount of weight loss after one year between people on a low-fat diet and those on a low-carbohydrate diet.