Is keto healthy?

As medical doctors who specialise in lifestyle medicine, we have extensive knowledge and experience in helping people restore their health using both a low carb lifestyle and /or a ketogenic diet.

The majority of health issues facing our society are related to metabolic health. There is a tsunami of chronic disease threatening to engulf the world related to poor metabolic health. 

The driving force behind this is hyperinsulinemia (high circulating insulin) leading to obesity, hypertension, dyslipidemia, type 2 diabetes, heart disease, fatty liver, and chronic kidney disease.

A low carbohydrate, high fat (LCHF) lifestyle which may include a ketogenic diet is a very powerful tool for reversing hyperinsulinemia and the corresponding diseases that accompany this. When my patients adopt a ketogenic diet, they rapidly lose weight, improve their insulin levels, reverse their metabolic syndrome and able to reduce most if not all their medications. 

There are numerous studies documenting this, including this one from Virta Health.

A ketogenic diet is a diet in which the body changes its preferred fuel source from carbohydrates to fats. The by-product of fat breakdown is ketone bodies. These can be produced endogenously from breaking down own fat stores or exogenously through the ingestion of fat, in particular, medium chain triglycerides (MCT's) Ketone bodies can be used as fuel by all cells in the body including those in our brain. 

The link between food and mood is becoming more and more established. 

Depression and anxiety are multifactorial and a number of lifestyle measures contribute to the cause and therefore the treatment of these conditions. 

It is well established that sleep, stress management, social connection and exercise are important factors. 

Nutrition is an emerging area of interest 

In summary, the issues with regards to nutrition can be broken down into 2 main areas 

1/The effect of ultra processed food diet. 

There is a positive link between processed food and depression. Reference here.

An explanation for this include 

  • Highly processed food negatively affects the gut.
  • Highly processed food is a significant contributor to inflammation which affects all systems in our body including our brain.
  • Highly processed food is devoid of the nutrients required to support brain health and functioning.

2/The type of fuel our brain uses. 

There is more and more evidence that a ketogenic diet is helpful in many conditions that affect the brain. This includes mental illnesses such as depression, anxiety, schizophrenia and bipolar disorder. Other brain conditions include Parkinson disease, epilepsy, and dementia.

The brain can use ketone bodies for fuel.

The original ketogenic diet was devised in the 1920s and was very high in fat with approximately  85% of all intake being fat. The use of ketones as fuel by the brain decreased the reactivity in the brain and reduced the rate of seizures. It is still used in children and adults who are resistant to standard epileptic medications. Reference here.

There are no specific trials analysing the effect of a ketogenic diet on mood but there is anecdotal evidence with people reporting improved mood following a LCHF or ketogenic diet. A proposed model of action looks at the role of the neurotransmitter GABA. In major depressive disorder, GABA is reduced. A ketogenic diet can increase GABA levels.  Many of the medications used in Epilepsy are also used as mood stabilisers and are thought to work through this model. Reference here.

In summary, the health benefits of an LCHF and or ketogenic diet are enormous. It is an extremely safe and effective method for lowering insulin and reversing metabolic disease. The majority of patients reduce their insulin and as such lose considerable weight, reverse fatty liver, reduce their blood pressure and the list goes on.

The effect on mental health is becoming more and more apparent. A low carbohydrate, real food diet with minimalised processed food is of benefit in mood disorders including depression. 

Dr Lucy Burns

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