A ketogenic diet is successful at reducing diabetes medication, helping patients lose weight and reducing HbA1c, a 12-month study has shown.
The study, conducted at the University of California in San Francisco, compared a low-carb, high fat ketogenic diet against a low fat, low calorie diet in 34 adults. All participants either had diabetes or prediabetes at the start of the study.
Those on the ketogenic diet were instructed to eat less than 50g of carbohydrates per day, and achieve a blood ketone level of 0.5-3 mmol/l. The other participants were instructed to have 45-50% of their calories come from carbohydrates, lower their fat intake and consume 500 kcal less than their weight maintenance needs.
All participants were encouraged to practice mindful eating, stay active and get enough sleep.
The keto group lost more weight (7.9 kg) than the low fat group (1.7 kg). Those on the keto diet also saw a greater HbA1c reduction. Six out ten people in the keto group who were on medication at the start of the study were able to come off of the medication.
Within the first six months of the study, the keto group lost a significant amount more weight than those in the low fat group, despite the low fat group recording lower calorie intake.
Those in the low fat group also found it harder to restrict calorie intake by the 12-month mark, while those in the keto group were eating fewer calories by the end of the study.
The results of the study show that lower calorie intake does not necessarily mean better weight loss. Restricting carbohydrate intake, however, makes it easier to stick to a lower energy intake over the long-term.
The study has been published in the Nutrition & Diabetes journal.
According to the The Complete Ketogenic Diet Guide for Beginners, the keto diet is “a low carbohydrate, high fat diet.” Studies have shown that the keto diet helps reduce risk factors of heart disease, diabetes, Alzheimer’s, stroke, epilepsy and more.
Those following the diet avoid sugar, low-fat foods, processed foods, high-carb fruit, grains, gluten and vegetable oils. Instead, meals consist of lean meats, fish, nuts, full-fat dairy, seeds and non-starchy vegetables.
Foods consumed by keto diet followers include:
- Sour cream
- Olive oil
- Avocado oil
- Strawberries, blueberries and raspberries in small amounts
Fruits are only eaten in moderation, as they contain high amounts of sugar.
While on a ketogenic diet, the body enters a state of ketosis. When the body is in this state, it uses ketone bodies for energy instead of using glucose. Ketone bodies, which are derived from fat, are more of a stable energy source than glucose, which is derived from carbohydrates.
It can take anywhere from three days to one week for the body to enter ketosis. Once the body enters this state, it uses fat for fuel, including the fat stored in the body.
Those following the diet can use special test strips to determine whether the body is in a ketosis state.
Fat is largely regarded as the most efficient form of energy, with each gram containing 9 calories compared to four calories per gram of carbohydrates and protein.
The ketogenic diet may help diabetic patients, but many are still apprehensive to adopt a high fat diet. Fat has been vilified for decades, and has long been linked with an increased risk of heart disease. Many still believe that fat also leads to more weight gain.
Dozens of studies, including meta studies with more than 900,000 subjects, have found that saturated and monounsaturated fats have no effect on heart disease risk.
Even with evidence to the contrary, experts recently voted the keto diet as the worst diet for 2018. The concern appears to be with the drastic cut in carbohydrates and not necessarily the high fat intake.
“The keto diet is just not sustainable over the long term,” one nutritionist said. “It doesn’t teach how to acquire healthy eating habits. It’s good for a quick fix, but most people I know can hardly give up pasta and bread, let alone beans and fruit.”
Many may agree with the sentiment, but it can be argued that refusal to give up certain foods is part of the problem.
It is true, however, that those who are just starting the diet may experience some uncomfortable symptoms. These symptoms might include bad breath, insomnia, headaches and constipation.
Studies have shown people following a low carb, high fat diet have better good cholesterol levels, lose more weight, are less likely to overeat, have reduced insulin resistance, have lower triglyceride levels and have lower blood pressure.
Another study, published in Diabetes & Metabolic Syndrome: Clinical Research & Reviews, found that a low carb, high fat diet may help burn ten times more fat than other diets. In this study, scientists took 30 adults with metabolic syndrome. Participants were divided into three groups: one followed the standard American diet and exercised 30 minutes for up to five days a week, one ate a standard American diet with no exercise, and the last followed a ketogenic diet with no exercise.
In 10 weeks, the group following the ketogenic diet had seen “significant” changes in their weight, BMI, ketones and hemoglobin. Their resting metabolic rate, or the rate at which the body burns fat at rest, was ten times higher than those who followed the standard American diet.
While this study is small, it serves as yet more proof that the keto diet can be beneficial for those who have been diagnosed with prediabetes and type 2 diabetes.
The keto diet has made waves in the media and has caught the attention of many doctors. Dr. Patrick Hwu, a leading cancer specialist in the U.S., told Today that a low carb, high fat diet may help prevent diseases, like cancer.
Hwu says cancer loves sugar in any form, and metabolizes it in a way that makes helps the cell thrive. Cancer cells live on insulin, glucose and IGF-1, a hormone associated with metabolism.
Studies are still needed to determine whether the diet can inhibit cancer cells, but the keto diet has been shown to reduce IGF-1 levels. In one study from 2017, participants who fasted (omitting carbohydrates in the process) reduced their IGF-1, blood glucose, blood pressure and inflammation.
Yet another study from Johns Hopkins found that the keto diet was both safe and effective for adults with severe forms of epilepsy. The findings support previous research.
Without serious changes, diabetes will continue to be a growing problem. A 2014 report from the CDC (Centers for Diseases Control and Prevention) found that 1 in 3 adults in the United States (about 86 million people) have prediabetes, which occurs when blood sugar levels are always high. Prediabetes typically leads to type 2 diabetes and other medical problems.
Nearly 1 in 10 people in America have type 2 diabetes compared to 1 in 40 adults in 1980.
While there’s still a stigma against fat, influencers in today’s society may help turn the tide. A host of celebrities, including Megan Fox, Vanessa Hudgens and Halle Berry, all claim to follow the keto lifestyle.