Ketogenic diet
Alternate names: Classical Ketogenic Diet, Classic Long-Chain Triglyceride Ketogenic Diet, Keto Diet, LCD, LCHPD, Low-Carb Diet, Low-Carbohydrate Diet, Low-Carbohydrate High-Protein Diet, Low Carb Diet, Low Carbohydrate Diet, Low Glycemic Index Treatment, Medium Chain Triglyceride Diet, Modified Atkin's Diet, Very Low Carbohydrate Diet, Very-Low-Carbohydrate Ketogenic Diet
Actions: General, Anticancer, Anticachectic, Antiseizure, Motor function, Neuroprotective, Weight loss
Background
The ketogenic diet is a high-fat, very low-carb diet. It usually limits carbs to 20-50 grams daily. This forces the body to break down fat for energy.
The body breaks down fat into molecules called ketone bodies. These ketone bodies can be used for energy. The classical ketogenic diet, which is used to reduce seizures in children, requires up to 4 times as many calories from fat as from carbohydrate and protein.
A very strict form of the ketogenic diet is used for seizure disorders in people with hard-to-treat epilepsy. Less strict forms of the ketogenic diet are used for obesity, diabetes, Parkinson disease, and many other conditions, but there is no good scientific evidence to support many of these uses.
Don't confuse the Modified Atkins Diet, a type of ketogenic diet, with the Atkins diet. Also don't confuse the ketogenic diet with "Keto diet pills." These are not the same and don't have the same effects.
The body breaks down fat into molecules called ketone bodies. These ketone bodies can be used for energy. The classical ketogenic diet, which is used to reduce seizures in children, requires up to 4 times as many calories from fat as from carbohydrate and protein.
A very strict form of the ketogenic diet is used for seizure disorders in people with hard-to-treat epilepsy. Less strict forms of the ketogenic diet are used for obesity, diabetes, Parkinson disease, and many other conditions, but there is no good scientific evidence to support many of these uses.
Don't confuse the Modified Atkins Diet, a type of ketogenic diet, with the Atkins diet. Also don't confuse the ketogenic diet with "Keto diet pills." These are not the same and don't have the same effects.
Safety Safety definitions
When taken by mouth: The ketogenic diet is likely safe for most adults when used for up to 1 year. The most common side effects include constipation, fatigue, dizziness, weakness, nausea, diarrhea, and stomach pain. The long-term safety of the ketogenic diet in adults is unknown. It is important to ensure any diet remains balanced and contains nutrient-rich foods.
Breast-feeding: The ketogenic diet is possibly unsafe when breast-feeding. Following a very-low carbohydrate ketogenic diet when breast-feeding might increase the risk for a serious health issue called ketoacidosis. Don't follow this diet unless under the care of a healthcare professional.
Children: The ketogenic diet is possibly safe when used by children under the care of a doctor, short-term. There is some concern about the ketogenic diet when used long-term. When used for more than 2 years, the ketogenic diet has been linked with slowed growth, fractures, and kidney stones in children.
Heart conditions: Use with caution. The ketogenic diet might worsen certain heart conditions.
Diabetes: Following a very-low carbohydrate ketogenic diet might increase the risk for diabetic ketoacidosis (DKA), a serious complication of diabetes. If you have diabetes, speak with a healthcare professional before starting the ketogenic diet.
Acid reflux: Some ketogenic diets are high in fat. High-fat diets can worsen symptoms of acid reflux.
High levels of fat in the blood: Some ketogenic diets are high in fat. Diets high in fat can increase levels of cholesterol and other fats called triglycerides. This might be a problem for people who already have high levels of these fats in the blood. Talk to your doctor before starting the ketogenic diet.
Liver disease: The ketogenic diet might cause liver injury and may worsen symptoms of liver disease.
Problems breaking down fats in the diet: The ketogenic diet forces the body to break down fat for energy. For people unable to break down fat, the ketogenic diet might lead to serious adverse effects, including coma or death.
Kidney disease: The ketogenic diet may worsen kidney disease and has been linked with kidney stone development.
Weak and brittle bones (osteoporosis): Long-term use of the ketogenic diet may weaken the bones. Use caution if you are at risk for or have a history of osteoporosis.
Swelling (inflammation) of the pancreas (pancreatitis): The ketogenic diet may increase the risk of developing pancreatitis. Use caution if you have a history of pancreatitis or have very high triglyceride levels.
Surgery: Certain medications used during surgery contain carbohydrates. Talk to your healthcare provider before any surgery if you are using the ketogenic diet to reduce seizures. Changes to some medications used during surgery might be needed.
Special Precautions & Warnings:
Pregnancy: There isn't enough reliable information to know if the ketogenic diet is safe when pregnant. Ketone bodies are chemicals made in the body when people follow a ketogenic diet. There is some concern that these chemicals might pass to the baby and slow down growth during pregnancy and after birth. Don't follow this diet unless under the care of a healthcare professional.Breast-feeding: The ketogenic diet is possibly unsafe when breast-feeding. Following a very-low carbohydrate ketogenic diet when breast-feeding might increase the risk for a serious health issue called ketoacidosis. Don't follow this diet unless under the care of a healthcare professional.
Children: The ketogenic diet is possibly safe when used by children under the care of a doctor, short-term. There is some concern about the ketogenic diet when used long-term. When used for more than 2 years, the ketogenic diet has been linked with slowed growth, fractures, and kidney stones in children.
Heart conditions: Use with caution. The ketogenic diet might worsen certain heart conditions.
Diabetes: Following a very-low carbohydrate ketogenic diet might increase the risk for diabetic ketoacidosis (DKA), a serious complication of diabetes. If you have diabetes, speak with a healthcare professional before starting the ketogenic diet.
Acid reflux: Some ketogenic diets are high in fat. High-fat diets can worsen symptoms of acid reflux.
High levels of fat in the blood: Some ketogenic diets are high in fat. Diets high in fat can increase levels of cholesterol and other fats called triglycerides. This might be a problem for people who already have high levels of these fats in the blood. Talk to your doctor before starting the ketogenic diet.
Liver disease: The ketogenic diet might cause liver injury and may worsen symptoms of liver disease.
Problems breaking down fats in the diet: The ketogenic diet forces the body to break down fat for energy. For people unable to break down fat, the ketogenic diet might lead to serious adverse effects, including coma or death.
Kidney disease: The ketogenic diet may worsen kidney disease and has been linked with kidney stone development.
Weak and brittle bones (osteoporosis): Long-term use of the ketogenic diet may weaken the bones. Use caution if you are at risk for or have a history of osteoporosis.
Swelling (inflammation) of the pancreas (pancreatitis): The ketogenic diet may increase the risk of developing pancreatitis. Use caution if you have a history of pancreatitis or have very high triglyceride levels.
Surgery: Certain medications used during surgery contain carbohydrates. Talk to your healthcare provider before any surgery if you are using the ketogenic diet to reduce seizures. Changes to some medications used during surgery might be needed.
Effectiveness
NatMed Pro rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, Ineffective, and Insufficient Evidence to Rate.
Possibly effective Effectiveness definitions
- Diabetes. Following a ketogenic diet seems to improve blood sugar control in people with type 2 diabetes.
- Seizure disorder (epilepsy). A strict ketogenic diet that is high in fat and very low in carbohydrates can reduce seizures in some people with hard-to-treat epilepsy. Following less restrictive forms of the diet seems to be less effective.
- Obesity. Following a ketogenic diet that limits carbohydrate intake to less than 50 grams daily can reduce body weight by 10% to 30% in 1 year. But it's not clear if it works any better than other diets that limit calorie intake.
Dosing & administration
The classical ketogenic diet requires 90% of daily calories to come from fat. But there are many other, less restrictive versions of the ketogenic diet that typically allow 20-50 grams of carbs daily. Variations include the medium chain triglyceride diet, modified Atkins diet, modified Mediterranean diet, and low glycemic index treatment. Speak with a healthcare provider to find out which variation of the ketogenic diet might be best for a specific condition. The ketogenic diet isn't suitable for everyone.
Interactions with pharmaceuticals
Medications for diabetes (Antidiabetes drugs)
Interaction Rating=Moderate Be cautious with this combination.
The ketogenic diet might lower blood sugar levels. Following the ketogenic diet while also taking diabetes medications might cause blood sugar to drop too low. Monitor your blood sugar closely.
Medications that slow blood clotting (Anticoagulant / Antiplatelet drugs)
Interaction Rating=Minor Be watchful with this combination.
The ketogenic diet might slow blood clotting. Following the ketogenic diet while taking medications that also slow blood clotting might increase the risk of bruising and bleeding.
Medications used for seizures and glaucoma (Carbonic anhydrase inhibitors)
Interaction Rating=Moderate Be cautious with this combination.
Some medications used for seizures and glaucoma can increase the risk of kidney stones. The ketogenic diet might also increase the risk of kidney stones. Following the ketogenic diet along with these medications might increase the risk of kidney stones.
Medications used to prevent seizures (Anticonvulsants)
Interaction Rating=Moderate Be cautious with this combination.
The ketogenic diet might reduce blood levels of some medications used to prevent seizures. This might lower the effects of these medications and increase the risk of seizures. Levels of medications used to prevent seizures should be monitored in people starting the ketogenic diet.
Valproate
Interaction Rating=Minor Be watchful with this combination.
Taking valproate might increase the risk of side effects in some people following the ketogenic diet. But this is rare.
Interactions with herbs & supplements
Herbs and supplements that might lower blood sugar: The ketogenic diet might lower blood sugar. Following the ketogenic diet while taking supplements with similar effects might lower blood sugar too much. Examples of supplements with this effect include aloe, bitter melon, cassia cinnamon, chromium, and prickly pear cactus.
Interactions with foods
There are no known interactions with foods.
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This monograph was last reviewed on 17/12/2024 11:00:00 and last updated on 03/04/2023 04:41:05. Monographs are reviewed and/or updated multiple times per month and at least once per year.
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Natural Medicines rates safety based on scientific evidence according to the following scale: Likely Safe, Possibly Safe, Possibly Unsafe, Likely Unsafe, Unsafe, and Insufficient Evidence to Rate. For more information about Natural Medicines’ Safety Rating System, click here.
The Natural Medicines Effectiveness Ratings are assigned for specific indications. A product might be rated "Possibly Effective" for one condition, but be rated "Likely Ineffective" for another condition, depending on the evidence. For more info click here.
