The benefits of a ketogenic diet

Ketogenic diets have been getting increasing attention in the media and the scientific literature. The high fat, low carb, moderate protein diets mimic the physiology of fasting and provide a wide variety of benefits. During the winter or in times of food scarcity, our ancestors would have seamlessly drifted into ketosis – a state where fat provides the major fuel for the brain, muscle, and other organs, and the liver manufactures what little glucose the body needs.

With the constant availability of high carbohydrate, processed food, we’ve lost this metabolic flexibility that allows us to use fat as fuel. Yet ketosis, or even just moderate fat-adaptation, has so many benefits. In this article, I’ll discuss the 15 evidence-based benefits of ketogenic diets.

Weight loss

Perhaps the number one reason people adopt a ketogenic diet is for sustained weight loss, without the need to count calories. Ketosis effectively downregulates fat storage genes and upregulates genes and enzymes that mobilize stored body fat and burn it for energy. Meta-analyses consistently find that individuals who are not restricting calories achieve the greatest weight loss on a ketogenic diet compared to other diets.1 This is especially true when a ketogenic diet is part of an integrative approach to weight loss.

Body composition

Contrary to popular opinion, a ketogenic diet doesn’t necessarily cause loss of lean muscle mass, so long as you’re consuming adequate calories. In fact, it can improve body composition by maintaining or increasing lean mass while reducing fat mass, especially when combined with resistance training.2

Blood sugar control

Most people are sugar burners. They eat, their blood sugar and insulin spike, and a few hours later, their blood sugar crashes and they become insatiably hungry again. This doesn’t have to happen though. If you remove the unlimited supply of dietary carbohydrates, your body learns to become efficient at burning fat for energy. Haven’t eaten in a few hours? No problem – your body simply taps into your stored body fat to maintain steady blood sugar levels.

Diabetes

This isn’t just true for those without diabetes. Several controlled studies have found significant improvements in short and long-term blood glucose control in Type 2 diabetics consuming a ketogenic diet.3,4 Many were able to reduce or even discontinue their medications. Meanwhile, people with Type 1 Diabetes have fewer hypoglycemic and hyperglycemic episodes on a low-carbohydrate diet, and can often reduce the amount of insulin and other medications required to manage their blood sugar.5,6 One 19-year-old male with newly diagnosed Type 1 Diabetes described in a case report was even able to discontinue insulin after adopting a paleo-ketogenic diet.7

Mental clarity

Mental clarity is one of the top two reasons people adopt a ketogenic diet (the other being weight loss). The brain runs most efficiently on a combination of ketones and glucose, and ketogenic diets have been shown to enhance cellular energy production in the brain.8 They also reduce the amount of reactive oxygen species produced in the brain. Combine this with steady blood sugar control, and you’re looking at pure, sustained mental energy.

Freedom from food

You don’t really realize what a psychological burden having to eat constantly is until you’re free from it, but it can be incredibly liberating. A 2015 systematic review found that most individuals adhering to a ketogenic diet were less hungry and had a reduced desire to eat.9 This makes sense, since fat is more satiating than carbohydrates, and you’re also mobilizing stored body fat for energy.10

Productivity

The mental clarity and freedom from food translates into enhanced productivity. Many productivity experts recommend starting your work day with your most important task. This is when your brain is the most fresh, creative, and focused. It’s also a great opportunity for intermittent fasting, and ketosis can provide the sustained mental energy and freedom from food to get into deep flow states.

Inflammation and oxidative stress

Ketones themselves are anti-inflammatory. The ketone body β-hydroxybutyrate has been shown to increase the expression of the body’s natural antioxidants.11 A ketogenic diet has been shown to reduce the generation of reactive oxygen species, which can damage cells and tissues.12

Improved lipid profiles

It’s a common concern that the high levels of fat in a ketogenic diet will cause cholesterol levels to go through the roof. On the contrary, studies find that lipid profiles consistently improve on low carbohydrate and ketogenic diets. For instance, one study found that a low-carbohydrate diet increased HDL cholesterol, lowered triglycerides by more than half, and resulted in a more favorable LDL particle distribution.13 Another study found that a ketogenic diet cured people of metabolic syndrome and non-alcoholic fatty liver disease.14

Treatment of epilepsy

The ketogenic diet first emerged as a treatment for patients with epilepsy. The ketogenic diet raises antioxidant levels in the hippocampus15, increases the formation of new mitochondria in the brain16, and reduces formation of reactive oxygen species, which are thought to be a cause of seizures17. It also increases the conversion of glutamate to glutamine, which is the precursor for GABA, increasing inhibitory neurotransmission and reducing the excitability of neurons.18 For many patients, it’s the only thing that provides consistent seizure control.

Mood and anxiety

Studies on mood and anxiety in ketogenic diets are mixed and the experience will greatly depend on the individual. Some people, including myself, experience a mild euphoria and sense of relaxation when in ketosis. One study suggests that a ketogenic diet may stabilize mood in bipolar disease.19 This may again be due to the increased inhibitory neurotransmission. Others report experiencing negative mood symptoms on a ketogenic diet, which may be more common in those that have had less time to adapt to the diet.

Neurodegenerative disease

Ketosis also has benefits in neurodegenerative diseases. In a rat model of multiple sclerosis, a ketogenic diet reduced inflammatory cytokines and enhanced synaptic plasticity, resulting in improved memory, learning, and motor ability.20 Ketone bodies are also neuroprotective in animal models of Alzheimer’s and Parkinson’s disease.21 In people with mild cognitive decline, a ketogenic diet enhances memory.22

Cancer

I recently wrote about the metabolic theory of cancer, and why mitochondrial dysfunction, rather than somatic mutation, is likely the initiating event in tumor growth. Ketosis has the benefit of starving cancer cells, while feeding the healthy ones, and can therefore be an excellent adjuvant to conventional treatments. A ketogenic diet also supports mitochondrial health by increasing the formation of new mitochondria and putting less stress on existing mitochondria. Studies have shown that a ketogenic diet improves quality of life and enhances treatment efficacy in many different cancers.23,24

Athletic performance

Fat is a much more efficient and available energy source than carbohydrates, meaning a steady stream of energy to the muscles and less reliance on muscle glycogen. One study found that ultra-endurance athletes who had been keto for many months burned 59% more fat overall and 2.3 times more fat a peak oxidation than endurance athletes on non-ketogenic diets.13 Body fat is a virtually endless store of energy: even the leanest of people carry about 10,000 calories worth of energy in body fat. As for strength or anaerobic exercise performance, studies are mixed. However, the formation of new mitochondria also isn’t something to scoff at, and developing the metabolic machinery to utilize fat is something any athlete could benefit from, even if they consume carbohydrates before performing in an athletic event.

Longevity and aging

A study in mice published in 2017 in the journal Cell suggests that a ketogenic diet improves longevity and health-span. Mice in the ketogenic group had a 13% longer lifespan than mice in the control group. Memory, muscle mass, and motor function were also better preserved in aged mice on a ketogenic diet compared to a control diet.25 This may be due to increased mitochondrial efficiency and reduced inflammation.

Is ketosis right for everyone?

While there are clearly many benefits to ketosis, it is not right for everyone. The following groups should be particularly cautious:

  • Those with HPA-dysregulation/high cortisol: ketosis may increase cortisol levels
  • Those with hypothyroidism: low carbohydrate diets can decrease thyroid hormone production26,27
  • Those who are underweight: ketosis generally does not support weight gain
  • Children: Some studies have found issues with growth and cardiovascular abnormalities in select cases, mostly due to nutrient deficiencies. However, many children with autism, ADHD, or epilepsy can benefit from a low-carbohydrate ketogenic diet.
  • Pregnant or lactating women: It’s important to avoid ketoacidosis and obtain all the nutrients necessary to support the growing baby. Several people anecdotally report having healthy pregnancies while consuming a ketogenic diet, but controlled studies have not been performed and I would advise caution unless you’ve really done your homework.

My personal experience with the ketogenic diet

Personally, keto makes me feel invincible. I experience extreme mental clarity, about 40% higher productivity, and improved body composition even if I don’t exercise. I don’t tolerate starchy carbohydrates well anyways, so my gut is much happier in ketosis. My emotional eating and carb cravings disappear. I’m more relaxed.

Performance-wise, I consume only grass-fed butter with home-roasted coffee before soccer games and experience a state that is almost magical. As a goalkeeper, the added mental clarity, focus, and mental quickness of ketosis (and a bit of caffeine) is unparalleled. You might think I’d need the explosive energy of carbohydrates, but most of my “performance” intervals aren’t more than ten seconds to a minute in length. Besides, contrary to popular belief, a ketogenic diet does not reduce glycogen stores.13

I’m not keto all the time, existing in “the keto zone” (a term coined by Mark Sisson) where I drift easily in and out. Some weeks I’m squarely in low-moderate carb land, and other weeks I’m in deep ketosis. It almost doesn’t matter now that I’m fat adapted. Which brings me to my next point…

Cycling in and out of ketosis

In most cases, it’s not necessary, and may not even be beneficial, to stay in ketosis indefinitely. Cycling in and out of ketosis or hovering in the “keto zone” can offer the benefits of ketosis without the need for diligent carb-counting or forgoing the occasional indulgence.

Unless you are using a ketogenic diet for the treatment of epilepsy, neurodegenerative disease, or cancer, the ultimate goal is NOT to elevate your ketones to a certain level; rather, it’s to increase your metabolic flexibility. Dipping into periodic ketosis will reset your metabolism and make your body what it evolved to be: a well-oiled, fat-burning machine.

Did you like this article? Be sure to subscribe so you don’t miss my next article in this series: the beginner’s guide to keto.

 

Sources:

  1. Bueno, N. B., de Melo, I. S. V., de Oliveira, S. L. & da Rocha Ataide, T. Very-low-carbohydrate ketogenic diet v. low-fat diet for long-term weight loss: a meta-analysis of randomised controlled trials. Br. J. Nutr. 110, 1178–1187 (2013).
  2. Jabekk, P. T., Moe, I. A., Meen, H. D., Tomten, S. E. & Høstmark, A. T. Resistance training in overweight women on a ketogenic diet conserved lean body mass while reducing body fat. Nutr. Metab. 7, 17 (2010).
  3. Westman, E. C., Yancy, W. S., Mavropoulos, J. C., Marquart, M. & McDuffie, J. R. The effect of a low-carbohydrate, ketogenic diet versus a low-glycemic index diet on glycemic control in type 2 diabetes mellitus. Nutr. Metab. 5, 36 (2008).
  4. Yancy, W. S., Foy, M., Chalecki, A. M., Vernon, M. C. & Westman, E. C. A low-carbohydrate, ketogenic diet to treat type 2 diabetes. Nutr. Metab. 2, 34 (2005).
  5. Dressler, A. et al. Type 1 diabetes and epilepsy: efficacy and safety of the ketogenic diet. Epilepsia 51, 1086–1089 (2010).
  6. Nielsen, J. V., Gando, C., Joensson, E. & Paulsson, C. Low carbohydrate diet in type 1 diabetes, long-term improvement and adherence: A clinical audit. Diabetol. Metab. Syndr. 4, 23 (2012).
  7. Tóth, C. & Clemens, Z. Type 1 diabetes mellitus successfully managed with the paleolithic ketogenic diet. Int. J. Case Rep. Images IJCRI 5, 699–703 (2014).
  8. DeVivo, D. C., Leckie, M. P., Ferrendelli, J. S. & McDougal, D. B. Chronic ketosis and cerebral metabolism. Ann. Neurol. 3, 331–337 (1978).
  9. Gibson, A. A. et al. Do ketogenic diets really suppress appetite? A systematic review and meta-analysis. Obes. Rev. Off. J. Int. Assoc. Study Obes. 16, 64–76 (2015).
  10. Paoli, A. et al. Ketogenic diet does not affect strength performance in elite artistic gymnasts. J. Int. Soc. Sports Nutr. 9, 34 (2012).
  11. Shimazu, T. et al. Suppression of oxidative stress by β-hydroxybutyrate, an endogenous histone deacetylase inhibitor. Science 339, 211–214 (2013).
  12. Sullivan, P. G. et al. The ketogenic diet increases mitochondrial uncoupling protein levels and activity. Ann. Neurol. 55, 576–580 (2004).
  13. Volek, J. S. et al. Carbohydrate restriction has a more favorable impact on the metabolic syndrome than a low fat diet. Lipids 44, 297–309 (2009).
  14. Pérez-Guisado, J. & Muñoz-Serrano, A. The effect of the Spanish Ketogenic Mediterranean Diet on nonalcoholic fatty liver disease: a pilot study. J. Med. Food 14, 677–680 (2011).
  15. Jarrett, S. G., Milder, J. B., Liang, L.-P. & Patel, M. The ketogenic diet increases mitochondrial glutathione levels. J. Neurochem. 106, 1044–1051 (2008).
  16. Bough, K. J. et al. Mitochondrial biogenesis in the anticonvulsant mechanism of the ketogenic diet. Ann. Neurol. 60, 223–235 (2006).
  17. Shin, E.-J. et al. Role of oxidative stress in epileptic seizures. Neurochem. Int. 59, 122–137 (2011).
  18. Yudkoff, M., Daikhin, Y., Horyn, O., Nissim, I. & Nissim, I. Ketosis and brain handling of glutamate, glutamine, and GABA. Epilepsia 49 Suppl 8, 73–75 (2008).
  19. Phelps, J. R., Siemers, S. V. & El-Mallakh, R. S. The ketogenic diet for type II bipolar disorder. Neurocase 19, 423–426 (2013).
  20. Kim, D. Y. et al. Inflammation-mediated memory dysfunction and effects of a ketogenic diet in a murine model of multiple sclerosis. PloS One 7, e35476 (2012).
  21. Kashiwaya, Y. et al. D-beta-hydroxybutyrate protects neurons in models of Alzheimer’s and Parkinson’s disease. Proc. Natl. Acad. Sci. U. S. A. 97, 5440–5444 (2000).
  22. Krikorian, R. et al. Dietary ketosis enhances memory in mild cognitive impairment. Neurobiol. Aging 33, 425.e19-27 (2012).
  23. Abdelwahab, M. G. et al. The Ketogenic Diet Is an Effective Adjuvant to Radiation Therapy for the Treatment of Malignant Glioma. PLOS ONE 7, e36197 (2012).
  24. Schmidt, M., Pfetzer, N., Schwab, M., Strauss, I. & Kämmerer, U. Effects of a ketogenic diet on the quality of life in 16 patients with advanced cancer: A pilot trial. Nutr. Metab. 8, 54 (2011).
  25. Roberts, M. N. et al. A Ketogenic Diet Extends Longevity and Healthspan in Adult Mice. Cell Metab. 26, 539–546.e5 (2017).
  26. Kose, E., Guzel, O., Demir, K. & Arslan, N. Changes of thyroid hormonal status in patients receiving ketogenic diet due to intractable epilepsy. J. Pediatr. Endocrinol. Metab. JPEM 30, 411–416 (2017).
  27. Fery, F., Bourdoux, P., Christophe, J. & Balasse, E. O. Hormonal and metabolic changes induced by an isocaloric isoproteinic ketogenic diet in healthy subjects. Diabete Metab. 8, 299–305 (1982).

The benefits of a ketogenic diet

Ketogenic diets have been getting increasing attention in the media and the scientific literature. The high fat, low carb, moderate protein diets mimic the physiology of fasting and provide a wide variety of benefits. During the winter or in times of food scarcity, our ancestors would have seamlessly drifted into ketosis – a state where fat provides the major fuel for the brain, muscle, and other organs, and the liver manufactures what little glucose the body needs.

With the constant availability of high carbohydrate, processed food, we’ve lost this metabolic flexibility that allows us to use fat as fuel. Yet ketosis, or even just moderate fat-adaptation, has so many benefits. In this article, I’ll discuss the 15 evidence-based benefits of ketogenic diets.

Weight loss

Perhaps the number one reason people adopt a ketogenic diet is for sustained weight loss, without the need to count calories. Ketosis effectively downregulates fat storage genes and upregulates genes and enzymes that mobilize stored body fat and burn it for energy. Meta-analyses consistently find that individuals who are not restricting calories achieve the greatest weight loss on a ketogenic diet compared to other diets.1 This is especially true when a ketogenic diet is part of an integrative approach to weight loss.

Body composition

Contrary to popular opinion, a ketogenic diet doesn’t necessarily cause loss of lean muscle mass, so long as you’re consuming adequate calories. In fact, it can improve body composition by maintaining or increasing lean mass while reducing fat mass, especially when combined with resistance training.2

Blood sugar control

Most people are sugar burners. They eat, their blood sugar and insulin spike, and a few hours later, their blood sugar crashes and they become insatiably hungry again. This doesn’t have to happen though. If you remove the unlimited supply of dietary carbohydrates, your body learns to become efficient at burning fat for energy. Haven’t eaten in a few hours? No problem – your body simply taps into your stored body fat to maintain steady blood sugar levels.

Diabetes

This isn’t just true for those without diabetes. Several controlled studies have found significant improvements in short and long-term blood glucose control in Type 2 diabetics consuming a ketogenic diet.3,4 Many were able to reduce or even discontinue their medications. Meanwhile, people with Type 1 Diabetes have fewer hypoglycemic and hyperglycemic episodes on a low-carbohydrate diet, and can often reduce the amount of insulin and other medications required to manage their blood sugar.5,6 One 19-year-old male with newly diagnosed Type 1 Diabetes described in a case report was even able to discontinue insulin after adopting a paleo-ketogenic diet.7

Mental clarity

Mental clarity is one of the top two reasons people adopt a ketogenic diet (the other being weight loss). The brain runs most efficiently on a combination of ketones and glucose, and ketogenic diets have been shown to enhance cellular energy production in the brain.8 They also reduce the amount of reactive oxygen species produced in the brain. Combine this with steady blood sugar control, and you’re looking at pure, sustained mental energy.

Freedom from food

You don’t really realize what a psychological burden having to eat constantly is until you’re free from it, but it can be incredibly liberating. A 2015 systematic review found that most individuals adhering to a ketogenic diet were less hungry and had a reduced desire to eat.9 This makes sense, since fat is more satiating than carbohydrates, and you’re also mobilizing stored body fat for energy.10

Productivity

The mental clarity and freedom from food translates into enhanced productivity. Many productivity experts recommend starting your work day with your most important task. This is when your brain is the most fresh, creative, and focused. It’s also a great opportunity for intermittent fasting, and ketosis can provide the sustained mental energy and freedom from food to get into deep flow states.

Inflammation and oxidative stress

Ketones themselves are anti-inflammatory. The ketone body β-hydroxybutyrate has been shown to increase the expression of the body’s natural antioxidants.11 A ketogenic diet has been shown to reduce the generation of reactive oxygen species, which can damage cells and tissues.12

Improved lipid profiles

It’s a common concern that the high levels of fat in a ketogenic diet will cause cholesterol levels to go through the roof. On the contrary, studies find that lipid profiles consistently improve on low carbohydrate and ketogenic diets. For instance, one study found that a low-carbohydrate diet increased HDL cholesterol, lowered triglycerides by more than half, and resulted in a more favorable LDL particle distribution.13 Another study found that a ketogenic diet cured people of metabolic syndrome and non-alcoholic fatty liver disease.14

Treatment of epilepsy

The ketogenic diet first emerged as a treatment for patients with epilepsy. The ketogenic diet raises antioxidant levels in the hippocampus15, increases the formation of new mitochondria in the brain16, and reduces formation of reactive oxygen species, which are thought to be a cause of seizures17. It also increases the conversion of glutamate to glutamine, which is the precursor for GABA, increasing inhibitory neurotransmission and reducing the excitability of neurons.18 For many patients, it’s the only thing that provides consistent seizure control.

Mood and anxiety

Studies on mood and anxiety in ketogenic diets are mixed and the experience will greatly depend on the individual. Some people, including myself, experience a mild euphoria and sense of relaxation when in ketosis. One study suggests that a ketogenic diet may stabilize mood in bipolar disease.19 This may again be due to the increased inhibitory neurotransmission. Others report experiencing negative mood symptoms on a ketogenic diet, which may be more common in those that have had less time to adapt to the diet.

Neurodegenerative disease

Ketosis also has benefits in neurodegenerative diseases. In a rat model of multiple sclerosis, a ketogenic diet reduced inflammatory cytokines and enhanced synaptic plasticity, resulting in improved memory, learning, and motor ability.20 Ketone bodies are also neuroprotective in animal models of Alzheimer’s and Parkinson’s disease.21 In people with mild cognitive decline, a ketogenic diet enhances memory.22

Cancer

I recently wrote about the metabolic theory of cancer, and why mitochondrial dysfunction, rather than somatic mutation, is likely the initiating event in tumor growth. Ketosis has the benefit of starving cancer cells, while feeding the healthy ones, and can therefore be an excellent adjuvant to conventional treatments. A ketogenic diet also supports mitochondrial health by increasing the formation of new mitochondria and putting less stress on existing mitochondria. Studies have shown that a ketogenic diet improves quality of life and enhances treatment efficacy in many different cancers.23,24

Athletic performance

Fat is a much more efficient and available energy source than carbohydrates, meaning a steady stream of energy to the muscles and less reliance on muscle glycogen. One study found that ultra-endurance athletes who had been keto for many months burned 59% more fat overall and 2.3 times more fat a peak oxidation than endurance athletes on non-ketogenic diets.13 Body fat is a virtually endless store of energy: even the leanest of people carry about 10,000 calories worth of energy in body fat. As for strength or anaerobic exercise performance, studies are mixed. However, the formation of new mitochondria also isn’t something to scoff at, and developing the metabolic machinery to utilize fat is something any athlete could benefit from, even if they consume carbohydrates before performing in an athletic event.

Longevity and aging

A study in mice published in 2017 in the journal Cell suggests that a ketogenic diet improves longevity and health-span. Mice in the ketogenic group had a 13% longer lifespan than mice in the control group. Memory, muscle mass, and motor function were also better preserved in aged mice on a ketogenic diet compared to a control diet.25 This may be due to increased mitochondrial efficiency and reduced inflammation.

Is ketosis right for everyone?

While there are clearly many benefits to ketosis, it is not right for everyone. The following groups should be particularly cautious:

  • Those with HPA-dysregulation/high cortisol: ketosis may increase cortisol levels
  • Those with hypothyroidism: low carbohydrate diets can decrease thyroid hormone production26,27
  • Those who are underweight: ketosis generally does not support weight gain
  • Children: Some studies have found issues with growth and cardiovascular abnormalities in select cases, mostly due to nutrient deficiencies. However, many children with autism, ADHD, or epilepsy can benefit from a low-carbohydrate ketogenic diet.
  • Pregnant or lactating women: It’s important to avoid ketoacidosis and obtain all the nutrients necessary to support the growing baby. Several people anecdotally report having healthy pregnancies while consuming a ketogenic diet, but controlled studies have not been performed and I would advise caution unless you’ve really done your homework.

My personal experience with the ketogenic diet

Personally, keto makes me feel invincible. I experience extreme mental clarity, about 40% higher productivity, and improved body composition even if I don’t exercise. I don’t tolerate starchy carbohydrates well anyways, so my gut is much happier in ketosis. My emotional eating and carb cravings disappear. I’m more relaxed.

Performance-wise, I consume only grass-fed butter with home-roasted coffee before soccer games and experience a state that is almost magical. As a goalkeeper, the added mental clarity, focus, and mental quickness of ketosis (and a bit of caffeine) is unparalleled. You might think I’d need the explosive energy of carbohydrates, but most of my “performance” intervals aren’t more than ten seconds to a minute in length. Besides, contrary to popular belief, a ketogenic diet does not reduce glycogen stores.13

I’m not keto all the time, existing in “the keto zone” (a term coined by Mark Sisson) where I drift easily in and out. Some weeks I’m squarely in low-moderate carb land, and other weeks I’m in deep ketosis. It almost doesn’t matter now that I’m fat adapted. Which brings me to my next point…

Cycling in and out of ketosis

In most cases, it’s not necessary, and may not even be beneficial, to stay in ketosis indefinitely. Cycling in and out of ketosis or hovering in the “keto zone” can offer the benefits of ketosis without the need for diligent carb-counting or forgoing the occasional indulgence.

Unless you are using a ketogenic diet for the treatment of epilepsy, neurodegenerative disease, or cancer, the ultimate goal is NOT to elevate your ketones to a certain level; rather, it’s to increase your metabolic flexibility. Dipping into periodic ketosis will reset your metabolism and make your body what it evolved to be: a well-oiled, fat-burning machine.

Did you like this article? Be sure to subscribe so you don’t miss my next article in this series: the beginner’s guide to keto.

 

Sources:

  1. Bueno, N. B., de Melo, I. S. V., de Oliveira, S. L. & da Rocha Ataide, T. Very-low-carbohydrate ketogenic diet v. low-fat diet for long-term weight loss: a meta-analysis of randomised controlled trials. Br. J. Nutr. 110, 1178–1187 (2013).
  2. Jabekk, P. T., Moe, I. A., Meen, H. D., Tomten, S. E. & Høstmark, A. T. Resistance training in overweight women on a ketogenic diet conserved lean body mass while reducing body fat. Nutr. Metab. 7, 17 (2010).
  3. Westman, E. C., Yancy, W. S., Mavropoulos, J. C., Marquart, M. & McDuffie, J. R. The effect of a low-carbohydrate, ketogenic diet versus a low-glycemic index diet on glycemic control in type 2 diabetes mellitus. Nutr. Metab. 5, 36 (2008).
  4. Yancy, W. S., Foy, M., Chalecki, A. M., Vernon, M. C. & Westman, E. C. A low-carbohydrate, ketogenic diet to treat type 2 diabetes. Nutr. Metab. 2, 34 (2005).
  5. Dressler, A. et al. Type 1 diabetes and epilepsy: efficacy and safety of the ketogenic diet. Epilepsia 51, 1086–1089 (2010).
  6. Nielsen, J. V., Gando, C., Joensson, E. & Paulsson, C. Low carbohydrate diet in type 1 diabetes, long-term improvement and adherence: A clinical audit. Diabetol. Metab. Syndr. 4, 23 (2012).
  7. Tóth, C. & Clemens, Z. Type 1 diabetes mellitus successfully managed with the paleolithic ketogenic diet. Int. J. Case Rep. Images IJCRI 5, 699–703 (2014).
  8. DeVivo, D. C., Leckie, M. P., Ferrendelli, J. S. & McDougal, D. B. Chronic ketosis and cerebral metabolism. Ann. Neurol. 3, 331–337 (1978).
  9. Gibson, A. A. et al. Do ketogenic diets really suppress appetite? A systematic review and meta-analysis. Obes. Rev. Off. J. Int. Assoc. Study Obes. 16, 64–76 (2015).
  10. Paoli, A. et al. Ketogenic diet does not affect strength performance in elite artistic gymnasts. J. Int. Soc. Sports Nutr. 9, 34 (2012).
  11. Shimazu, T. et al. Suppression of oxidative stress by β-hydroxybutyrate, an endogenous histone deacetylase inhibitor. Science 339, 211–214 (2013).
  12. Sullivan, P. G. et al. The ketogenic diet increases mitochondrial uncoupling protein levels and activity. Ann. Neurol. 55, 576–580 (2004).
  13. Volek, J. S. et al. Carbohydrate restriction has a more favorable impact on the metabolic syndrome than a low fat diet. Lipids 44, 297–309 (2009).
  14. Pérez-Guisado, J. & Muñoz-Serrano, A. The effect of the Spanish Ketogenic Mediterranean Diet on nonalcoholic fatty liver disease: a pilot study. J. Med. Food 14, 677–680 (2011).
  15. Jarrett, S. G., Milder, J. B., Liang, L.-P. & Patel, M. The ketogenic diet increases mitochondrial glutathione levels. J. Neurochem. 106, 1044–1051 (2008).
  16. Bough, K. J. et al. Mitochondrial biogenesis in the anticonvulsant mechanism of the ketogenic diet. Ann. Neurol. 60, 223–235 (2006).
  17. Shin, E.-J. et al. Role of oxidative stress in epileptic seizures. Neurochem. Int. 59, 122–137 (2011).
  18. Yudkoff, M., Daikhin, Y., Horyn, O., Nissim, I. & Nissim, I. Ketosis and brain handling of glutamate, glutamine, and GABA. Epilepsia 49 Suppl 8, 73–75 (2008).
  19. Phelps, J. R., Siemers, S. V. & El-Mallakh, R. S. The ketogenic diet for type II bipolar disorder. Neurocase 19, 423–426 (2013).
  20. Kim, D. Y. et al. Inflammation-mediated memory dysfunction and effects of a ketogenic diet in a murine model of multiple sclerosis. PloS One 7, e35476 (2012).
  21. Kashiwaya, Y. et al. D-beta-hydroxybutyrate protects neurons in models of Alzheimer’s and Parkinson’s disease. Proc. Natl. Acad. Sci. U. S. A. 97, 5440–5444 (2000).
  22. Krikorian, R. et al. Dietary ketosis enhances memory in mild cognitive impairment. Neurobiol. Aging 33, 425.e19-27 (2012).
  23. Abdelwahab, M. G. et al. The Ketogenic Diet Is an Effective Adjuvant to Radiation Therapy for the Treatment of Malignant Glioma. PLOS ONE 7, e36197 (2012).
  24. Schmidt, M., Pfetzer, N., Schwab, M., Strauss, I. & Kämmerer, U. Effects of a ketogenic diet on the quality of life in 16 patients with advanced cancer: A pilot trial. Nutr. Metab. 8, 54 (2011).
  25. Roberts, M. N. et al. A Ketogenic Diet Extends Longevity and Healthspan in Adult Mice. Cell Metab. 26, 539–546.e5 (2017).
  26. Kose, E., Guzel, O., Demir, K. & Arslan, N. Changes of thyroid hormonal status in patients receiving ketogenic diet due to intractable epilepsy. J. Pediatr. Endocrinol. Metab. JPEM 30, 411–416 (2017).
  27. Fery, F., Bourdoux, P., Christophe, J. & Balasse, E. O. Hormonal and metabolic changes induced by an isocaloric isoproteinic ketogenic diet in healthy subjects. Diabete Metab. 8, 299–305 (1982).
By |2018-02-21T16:18:33+00:00February 6th, 2018|