What you need to know about the ketogenic diet

by Kaiser Permanente |
Pork chops with a side of mango salsa

If you’ve been considering options to improve your health, you may have heard about the popular ketogenic diet — also known as the keto diet. But did you know that today’s latest diet trend isn’t all that new? In fact, one of the reasons the ketogenic diet was originally developed in the 1920s was to treat epilepsy.1

The ketogenic diet is currently drawing mass appeal. Studies have shown this diet can aid with overall metabolic health, including weight loss, lipid profiles, glucose levels, and insulin sensitivity — and could stave off feelings of hunger.2-6

So, is the ketogenic diet the right option for you?

The ketogenic diet explained

This low-carbohydrate diet, typically containing 0 to 50 grams of carbs a day, shares some similarities with other low-carb diets, like Paleo or Atkins. However, it’s not a high-protein diet, and instead focuses on eating higher-fat foods. The aim of the ketogenic diet is to reduce your carbohydrate intake so that your body uses fat as a primary fuel — rather than using carbohydrates. How does the ketogenic diet do this? By replacing processed foods containing refined carbohydrates such as bread, pasta, potatoes, and rice, which can cause an unhealthy rise in blood sugar in some people.

Instead of eating foods containing carbs, the ketogenic diet calls for eating higher fat, nutrient dense foods. This includes meats, cheeses, eggs, and oil-rich plants such as avocados, olives, and nuts — and non-industrial fruit oils such as olive oil or coconut oil. Vegetables include non-starchy ones, such as leafy greens, broccoli, cauliflower, and cabbage.

When the diet is followed, your body will begin to use fat as a source of energy, which can result in weight loss. But the greater impact for many people can be improved metabolic health.3 Better metabolic health can mean lower blood pressure, better lipid profiles, lower blood sugar levels, and a decrease in body fat.

The challenges of a ketogenic diet

While the ketogenic diet has its benefits, it can be difficult to cut carbs, including starches and some types of fruit — even while substituting for more filling options. And it can be easy to focus on the wrong kinds of higher-fat foods, like those that are ultra-processed. Some experts recommend foods containing more monounsaturated and polyunsaturated fat, often found in plant-based foods or certain fish, such as salmon.

Is the ketogenic diet right for you?

There is no one-size-fits-all approach to managing your health. What works for one person may not work for you, and what works in the short term may not work in the long term. Some diets could even be dangerous depending on your health history, genetic makeup, or if you have a chronic condition like diabetes, cancer, or heart disease (because you may need to change the dosage or slowly taper off current medications).

As an advocate for your personal health and well-being, your doctor can help you develop healthy eating patterns. They can also encourage a plan that contains a variety of nutritious, high-quality unprocessed foods tailored to helping your health. Your doctor will also take your personal and cultural preferences, dietary restrictions and allergies, and budget into consideration.

Bottom line: When it comes to any diet or major lifestyle change, it’s best to talk to your doctor first. They may recommend something like the ketogenic diet or a low-carb diet — or they may not. It all depends on you, your body type, and your medical history. So, if you’re considering a weight-loss program or looking to improve your metabolic health, work with your doctor to create a plan that will help you thrive.

EH Kossoff and HS Wang, "Dietary therapies for epilepsy," Biomedical Journal, January–February 2013, http://www.ncbi.nlm.nih.gov/pubmed/23515147

Laura R. Saslow et al., "Twelve-month outcomes of a randomized trial of a moderate-carbohydrate versus very low-carbohydrate diet in overweight adults with type 2 diabetes mellitus or prediabetes," Nutrition & Diabetes, December 21, 2017, http://www.nature.com/articles/s41387-017-0006-9

RD Feinman et al., "Dietary carbohydrate restriction as the first approach in diabetes management: critical review and evidence base," Nutrition, January 31, 2015, http://www.ncbi.nlm.nih.gov/pubmed/25287761

Amy L. McKenzie et al., "A Novel Intervention Including Individualized Nutritional Recommendations Reduces Hemoglobin A1c Level, Medication Use, and Weight in Type 2 Diabetes," JMIR Diabetes, March 7, 2017, http://diabetes.jmir.org/2017/1/e5/

A.A. Gibson et al., "Do ketogenic diets really suppress appetite? A systematic review and meta analysis," Obesity Reviews, November 17, 2014, http://doi.wiley.com/10.1111/obr.12230

SJ Hallberg et al., "Effectiveness and Safety of a Novel Care Model for the Management of Type 2 Diabetes at 1 Year: An Open-Label, Non-Randomized, Controlled Study," Diabetes Therapy, April 9, 2018, http://www.ncbi.nlm.nih.gov/pubmed/29417495