Health Risks of the Ketogenic Diet

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They are many potential benefits to the ketogenic diet, but there are also a number of potentially serious health risks. It appears that most of these health risks can be mitigated with care.

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1 Perspective

All diets have risk;

2 Context

My of the data on KD risks come from KD epilepsy, obesity, starvation.

3 Health Risks

3.1 Death

There have been two reported cases of sudden death of children on the Ketogenic Diet, probably due to selenium deficiency causing heart failure[1]. Selenium deficiency can occur rapidly; one child was diagnosed with selenium deficiency and related heart problems before their scheduled 3 month selenium test[2]. In addition, a study of 20 children on the Ketogenic Diet found heart rhythm abnormalities and heart enlargement in 3 (15%, diet duration 13 ± 8.4 months), and one had severe dilated cardiomyopathy[3]. The effected children has normal selenium levels, but there was a significant correlation was found between the heart rhythm abnormality (QTc) and both bicarbonate and blood ketones, suggesting the level of acidosis or ketosis may be important factors.

3.2 Sodium Loss and Hypotension

Low carbohydrate diets cause of the kidneys to excrete more sodium. This is known as "natriuresis of starvation", and may be due to low insulin[4], increased dopamine excretion[5], or elevated Glucagon[6]. If carbohydrate and sodium intakes are both limited, then the body will secrete the hormone aldosterone[7] which will cause the kidneys to excrete potassium and conserve sodiumCite error: Closing </ref> missing for <ref> tag [8] [5] [6] [4] [9] [10] [11] [12] [13] [1] [3] [2] [14] [15] [16] [17] [18] [19] [20] [21] [22] [23] [24] [25] [26]

</references>
  1. ↑ 1.0 1.1 Ilana M. Bank, Sam D. Shemie, Bernard Rosenblatt, Chantal Bernard, Andrew S. Mackie, Sudden Cardiac Death in Association With the Ketogenic Diet, Pediatric Neurology, volume 39, issue 6, 2008, pages 429–431, ISSN 08878994, doi 10.1016/j.pediatrneurol.2008.08.013
  2. ↑ 2.0 2.1 NS. Sirikonda, WD. Patten, JR. Phillips, CJ. Mullett, Ketogenic diet: rapid onset of selenium deficiency-induced cardiac decompensation., Pediatr Cardiol, volume 33, issue 5, pages 834-8, Jun 2012, doi 10.1007/s00246-012-0219-6, PMID 22367552
  3. ↑ 3.0 3.1 TH. Best, DN. Franz, DL. Gilbert, DP. Nelson, MR. Epstein, Cardiac complications in pediatric patients on the ketogenic diet., Neurology, volume 54, issue 12, pages 2328-30, Jun 2000, PMID 10881264
  4. ↑ 4.0 4.1 P. Stenvinkel, A. Ottosson-Seeberger, A. Alvestrand, J. Bolinder, Effect of insulin on renal sodium handling and renal haemodynamics in insulin-dependent (type 1) diabetes mellitus patients., Acta Diabetol, volume 32, issue 4, pages 230-4, Dec 1995, PMID 8750761
  5. ↑ 5.0 5.1 R. Swaminathan, G. Cope, M. Sheltawy, MR. Lee, JK. Wales, Dopamine excretion during natriuresis of starvation., Int J Obes, volume 7, issue 1, pages 31-5, 1983, PMID 6840964
  6. ↑ 6.0 6.1 C. D. Saudek, P. R. Boulter, R. A. Arky, The Natriuretic Effect of Glucagon and Its Role in Starvation, Journal of Clinical Endocrinology & Metabolism, volume 36, issue 4, 1973, pages 761–765, ISSN 0021-972X, doi 10.1210/jcem-36-4-761
  7. ↑ Cite error: Invalid <ref> tag; no text was provided for refs named Phinney-2011-p312
  8. ↑ RL. Veech, The therapeutic implications of ketone bodies: the effects of ketone bodies in pathological conditions: ketosis, ketogenic diet, redox states, insulin resistance, and mitochondrial metabolism., Prostaglandins Leukot Essent Fatty Acids, volume 70, issue 3, pages 309-19, Mar 2004, doi 10.1016/j.plefa.2003.09.007, PMID 14769489
  9. ↑ Christopher J. Lote http://www.amazon.com/Principles-Renal-Physiology-Christopher-Lote/dp/0792360745 Principles of Renal Physiology], 22 June 2012, Springer, ISBN 978-1-4614-3785-7
  10. ↑ NS. Willmott, RA. Bryan, Case report: scurvy in an epileptic child on a ketogenic diet with oral complications., Eur Arch Paediatr Dent, volume 9, issue 3, pages 148-52, Sep 2008, PMID 18793598
  11. ↑ A. Sampath, EH. Kossoff, SL. Furth, PL. Pyzik, EP. Vining, Kidney stones and the ketogenic diet: risk factors and prevention., J Child Neurol, volume 22, issue 4, pages 375-8, Apr 2007, doi 10.1177/0883073807301926, PMID 17621514
  12. ↑ MA. McNally, PL. Pyzik, JE. Rubenstein, RF. Hamdy, EH. Kossoff, Empiric use of potassium citrate reduces kidney-stone incidence with the ketogenic diet., Pediatrics, volume 124, issue 2, pages e300-4, Aug 2009, doi 10.1542/peds.2009-0217, PMID 19596731
  13. ↑ EH. Kossoff, PL. Pyzik, SL. Furth, HD. Hladky, JM. Freeman, EP. Vining, Kidney stones, carbonic anhydrase inhibitors, and the ketogenic diet., Epilepsia, volume 43, issue 10, pages 1168-71, Oct 2002, PMID 12366731
  14. ↑ A. C. Bergqvist, J. I Schall, V. A Stallings, B. S Zemel, Progressive bone mineral content loss in children with intractable epilepsy treated with the ketogenic diet, American Journal of Clinical Nutrition, volume 88, issue 6, 2008, pages 1678–1684, ISSN 0002-9165, doi 10.3945/ajcn.2008.26099
  15. ↑ Eric. Kossoff, Ketogenic diets : treatments for epilepsy and other disorders, date 2011, publisher Demos Health, location New York, isbn 1-936303-10-8, Kindle Offset 1864
  16. ↑ Eric. Kossoff, Ketogenic diets : treatments for epilepsy and other disorders, date 2011, publisher Demos Health, location New York, isbn 1-936303-10-8, Kindle Offset 2218
  17. ↑ Eric. Kossoff, Ketogenic diets : treatments for epilepsy and other disorders, date 2011, publisher Demos Health, location New York, isbn 1-936303-10-8, Kindle Offset 2533
  18. ↑ Eric. Kossoff, Ketogenic diets : treatments for epilepsy and other disorders, date 2011, publisher Demos Health, location New York, isbn 1-936303-10-8, Page 174
  19. ↑ Eric. Kossoff, Ketogenic diets : treatments for epilepsy and other disorders, date 2011, publisher Demos Health, location New York, isbn 1-936303-10-8, Page 271
  20. ↑ Eric. Kossoff, Ketogenic diets : treatments for epilepsy and other disorders, date 2011, publisher Demos Health, location New York, isbn 1-936303-10-8, Kindle Offset 2522
  21. ↑ Eric. Kossoff, Ketogenic diets : treatments for epilepsy and other disorders, date 2011, publisher Demos Health, location New York, isbn 1-936303-10-8, Kindle Offset 2512
  22. ↑ Eric. Kossoff, Ketogenic diets : treatments for epilepsy and other disorders, date 2011, publisher Demos Health, location New York, isbn 1-936303-10-8, Page 318
  23. ↑ Eric. Kossoff, Ketogenic diets : treatments for epilepsy and other disorders, date 2011, publisher Demos Health, location New York, isbn 1-936303-10-8, Page 109
  24. ↑ Eric. Kossoff, Ketogenic diets : treatments for epilepsy and other disorders, date 2011, publisher Demos Health, location New York, isbn 1-936303-10-8, Page 137
  25. ↑ Phd Stephen D. Phinney MD, Rd Jeff S. Volek Phd, The Art and Science of Low Carbohydrate Living: An Expert Guide to Making the Life-saving Benefits of Carbohydrate Restriction Sustainable and Enjoyable, 2011, publisher Beyond Obesity LLC, isbn 978-0-9834907-0-8, Page 343
  26. ↑ Phd Stephen D. Phinney MD, Rd Jeff S. Volek Phd, The Art and Science of Low Carbohydrate Living: An Expert Guide to Making the Life-saving Benefits of Carbohydrate Restriction Sustainable and Enjoyable, 2011, publisher Beyond Obesity LLC, isbn 978-0-9834907-0-8, Page 312
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