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.