THE KETOGENIC DIET FOR OBESITY AND DIABETES
ConscienHealth’s
Ted Kyle reports on a meta-analysis of ketogenic diets for obesity in
JAMA Internal Medicine that suggests that currently enthusiasm is
outpacing the evidence. Shivam Joshi, Robert Ostfeld, and Michelle
McMacken tell us: “Although the ketogenic diet has garnered much
attention for the dietary treatment of chronic diseases such as obesity
and type 2 diabetes, the evidence supporting its use is currently
limited and the diet’s potential risks are real. Physicians and patients
should continue to judiciously appraise the benefits and risks of the
ketogenic diet in accordance with the evidence, not the hype.”
In the short term, a ketogenic diet can be quite impressive for
weight loss. People have less hunger, eat less, and lose more weight.
However, the long-term results are not nearly so impressive.
Meta-analysis of data from studies that lasted more than a year shows a
difference of less than a kilo versus lower fat diets. This is a case
where statistical significance is clinically insignificant.
Likewise,
we’ve seen sensational results in short-term studies of ketogenic diets
in type 2 diabetes. But if you look at longer-term studies, the results
are bland. Once again, a meta-analysis shows no difference in glycemic
control.
Joshi et al point out that long-term risks
merit your consideration. People report fatigue with keto diets that may
be more annoying than anything. But other issues, including nutritional
deficiencies, are possible. However, the most significant issue, they
say, may come from limiting whole grains, fruits, and legumes in a
person’s diet over the long term. Whole grains offer benefits for
reducing the risk of cardiovascular disease, cancer, and mortality.
Fruits and legumes are also quite beneficial.
It might
be a good thing that keto diets are tough to maintain for the long term.
Banishing beneficial foods from your diet is not something to do
lightly, based solely on short-term benefits.
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