Ketogenic diet makes the Journal of American Medical Association

According to the Journal of American Medical Association (JAMA) January 2018 the ketogenic diet is finally making its way to research studies for obesity management (previous studies are heavily directed toward epilepsy management).

Let’s hit the highlights of the article.

David S. Ludwig, ME, PhD a professor of pediatrics and nutrition at Harvard Medical School and Harvard T.H. Chan School of Public Health states “it’s hard to lose weight, but it’s much harder to maintain that weight loss because of well-described psychological adaptations” furthermore, it’s stated that “after most diet-induced weight loss hunger goes up and metabolic rate goes down, and a tendency to restore fat increases”. I have to admit, I concur!

Amy Miskimon Gross a registered dietician (RD) and an assistant professor of Nutrition Obesity Research at University of Birmingham at Alabama (UAB) thirteen randomized controlled trials of people on Ketogenic diets suggests this is NOT the case with the Ketogenic diet, citing that people on Ketogenic diets lose more weight and keep it off longer than those people who follow low-fat diets. Surprise! They also state that patients following Ketogenic diets often report a decrease in hunger. It is thought that the appetite suppression may be related to the fats and proteins ability to satiate as well as the changes in the appetite regulating hormones that occur during low-carbohydrate diets. Moreover, get this …. “a direct hunger-reducing role of ketone bodies-the bodies MAIN fuel source in the diet.” Again, I concur!

One of the most interesting points of the article was the statement that the keto diet may not affect the metabolism in the same manner that other diets do (ie, slowing down metabolism and thus weight loss occurring at a much slow rate). Ludwig reports “metabolism slowed more than 400 kcalories/d on a low-fat diet” this is not found to be true with no significant decline noted with very low carbohydrate diets. Most importantly he states that an important factor may be the quality of food consumed in low carb diets affecting the number of calories being burned and if this is the case it may be beneficial in improving the long term weight loss maintenance success.

Wahooo, we’re getting somewhere folks ❤️

1. Deprived of dietary sugars and starches in the very-low carb diet, the body reduces insulin secretions and switches to primarily burning fat within 1 week (whaaaat, 1 week, our bodies are amazing!)

2. Metabolic state known as Nutritional Ketosis (notice that does NOT say ketoacidosis, because that is something completely separate from ketosis)

a. The liver converts fatty acids into compounds called ketone bodies that can penetrate the blood-brain barrier (this is NOT an easy feat, for example it can take antidepressant medications 4 to 6 weeks to do this) and provide fuel to the brain and other body tissues.

b. Keto vs Atkins: orig Atkins diet emphasized protein and limited fat. But amino acids in protein can be converted to glucose, kicking the body out of ketosis (mmmhmmm that’s why we try to tell you that keto is not all you can eat protein)

*** therefore, a well-formulated ketogenic diet limits protein to adequate amounts to maintain lean body mass but doesn’t restrict fat or overall calories

c. Despite eating fat to fullness people on keto often experience rapid weight loss of up to 10 lbs in 2 weeks. Some coming from water weight loss (the diet had a diuretic effect)

d. Body switches from carb burning mode to fat burning more, sucks out stores fat deposits, increasing weight loss.

3. Diabetes management

a. Helps reduce need for diabetic medications with improvement in Hgb A1c (the key number tracked with diabetic management)

4. Heart health

a. Controlling blood glucose levels decreasing triglycerides, increasing HDL (the hero cholesterol) decreased abdominal circumference and decreased blood pressure levels all point toward possible heart health.

b. More studies are needed on the outcome of LDL cholesterol (the bad loser cholesterol” as an initial increase has been noted with keto onset; however, it is though that unsaturated fats vs saturated fats may aid in managing this increase AND it may actually be an increase related to large ldl particles and NOT small ldl particles which are more harmful

“A diet that lets a person eat fat to satiety-even saturated fat- without relying on calorie counting and still lose substantial weight, treat diabetes into remission, raise HDL, and lower triglycerides and blood pressure? It could be game changing for the field of chronic disease” ❤️

5. The worst found side effects of keto

Wait for it …… keto flu! The light headedness, dizziness, fatigue, difficulty exercising, poor sleep, and constipation all of which tend to pass in a few weeks – making sure you get good quality protein helps ensure you’re getting adequate potassium magnesium and sodium which will help with these pesky side effects

And here is the final words the words that made me smile (a big cheeky grin)

“It should be our highest scientific priorities to invest in top-quality, long-teen, rigorous nutrition research, so we can answer questions that have befuddled us for a century or more regarding low-fat versus low-carb diets” you Mr Ludwig are correct and I CONCUR!

Journal of American Medical Association: volume 319. Number 3. Pages 215-217. January 16, 2018.

Quotes, data, and information directly paraphrased and or quoted from the article. I do not own this information and do not take credit for any of it.