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.

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1 Hypoglycemia

Hypoglycemia (low blood sugar) seams to predominantly a risk if the ketogenic diet is started with a fast.

2 Acidosis

Talk about mild and serious acidosis, monitoring urine pH routinely.

3 Hyperketosis

The underlying cause is probably acidosis.

4 Sodium Loss and Hypotension

Natriuresis of starvation, probably due to low insulin, associated loss of Potassium and reduced blood volume.

5 Vitamin or mineral deficiency

The ketogenic diet is frequently deficient in some vitamins and minerals, so supplementation is required.

6 Kidney Stones

Occurrence is 5%, talk about need for urine monitoring.

7 Elevated cholesterol and blood lipid changes

About 30% of children on the ketogenic diet experience elevated cholesterol levels, but this is normally transient, and the levels return to baseline after 6-12 months[1]. Broader anecdotal evidence suggests that some people's cholesterol improves, while others cholesterol levels degrade. The health implications of cholesterol while on a Ketogenic Diet are unclear. If cholesterol levels are a concern, then the Ketogenic Ratio could be reduced, the percentage of unsaturated fats increased, MCT can be added, or carnitine can be supplemented[2].

8 Bone fractures

Issue in children – another impact of acidosis or reduced dairy intake?

9 Growth reduction

Children treated with the ketogenic diet can have growth reduction[3]. Personally, I wonder if this is due to the earlier epilepsy diets restricting calories.

10 Constipation

Constipation is an issue, even with extra Fiber, probably due to changes in intestinal flora.

11 Fat Intake Imbalance

It's easy to get too much Omega-6.

12 Insulin Resistance

While the Ketogenic Diet can be beneficial for those suffering from insulin resistance or diabetes[4], there are also concerns that the Ketogenic Diet may also result in some insulin resistance[5]. This would not be expected to be an issue while on a Ketogenic Diet, but it may mean that care should be taken when exiting the Ketogenic Diet.

13 Thirst and Hydration

Ketones may reduce thirst[6].

14 Contraindications

There are a number of contraindications for the ketogenic diet, including genetic deficiencies in fat metabolism[7]. A discussion of these contraindications is outside of the scope of this article.

15 References

  1. Eric. Kossoff, Ketogenic diets : treatments for epilepsy and other disorders, date 2011, publisher Demos Health, location New York, isbn 1-936303-10-8, Kindle Location 2512
  2. Eric. Kossoff, Ketogenic diets : treatments for epilepsy and other disorders, date 2011, publisher Demos Health, location New York, isbn 1-936303-10-8, Kindle Location 2522
  3. Eric. Kossoff, Ketogenic diets : treatments for epilepsy and other disorders, date 2011, publisher Demos Health, location New York, isbn 1-936303-10-8, Kindle Location 2533
  4. 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
  5. F. R. Jornayvaz, Fibroblast growth factor 21, ketogenic diets, and insulin resistance, American Journal of Clinical Nutrition, volume 94, issue 3, 2011, pages 955–955, ISSN 0002-9165, doi 10.3945/ajcn.111.019646
  6. Eric. Kossoff, Ketogenic diets : treatments for epilepsy and other disorders, date 2011, publisher Demos Health, location New York, isbn 1-936303-10-8, Kindle Location 2218
  7. Eric. Kossoff, Ketogenic diets : treatments for epilepsy and other disorders, date 2011, publisher Demos Health, location New York, isbn 1-936303-10-8, Kindle Location 1864