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Created page with "They are many potential benefits to the ketogenic diet, but there are also a number of potentially serious health risks.
{{Skeleton}}
=Hypoglycemia=
Hypoglycemia (low blood ..."
They are many potential benefits to the ketogenic diet, but there are also a number of potentially serious health risks.
{{Skeleton}}
=Hypoglycemia=
Hypoglycemia (low blood sugar) seams to predominantly a risk if the ketogenic diet is started with a fast.
=Acidosis=
Talk about mild and serious acidosis, monitoring urine pH routinely.
=Hyperketosis=
The underlying cause is probably acidosis.
=Sodium Loss and Hypotension=
Natriuresis of starvation, probably due to low insulin, associated loss of Potassium and reduced blood volume.
=Vitamin or mineral deficiency=
The ketogenic diet is frequently deficient in some vitamins and minerals, so supplementation is required.
=Kidney Stones=
Occurrence is 5%, talk about need for urine monitoring.
=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<ref name="Kossoff-2011-2512"/>. 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<ref name="Kossoff-2011-2522"/>.
=Bone fractures=
Issue in children – another impact of acidosis or reduced dairy intake?
=Growth reduction=
Children treated with the ketogenic diet can have growth reduction<ref name="Kossoff-2011-2533"/>. Personally, I wonder if this is due to the earlier epilepsy diets restricting calories.
=Constipation=
Constipation is an issue, even with extra [[Fiber]], probably due to changes in intestinal flora.
=Fat Intake Imbalance=
It's easy to get too much Omega-6.
=Insulin Resistance =
While the Ketogenic Diet can be beneficial for those suffering from insulin resistance or diabetes<ref name="Veech-2004"/>, there are also concerns that the Ketogenic Diet may also result in some insulin resistance<ref name="Jornayvaz2011"/>. 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.
=Thirst and Hydration=
Ketones may reduce thirst<ref name="Kossoff-2011-2218"/>.
=Contraindications=
There are a number of contraindications for the ketogenic diet, including [http://en.wikipedia.org/wiki/Fatty-acid_metabolism_disorder genetic deficiencies in fat metabolism]<ref name="Kossoff-2011-1864"/>. A discussion of these contraindications is outside of the scope of this article.
=References=
<references>
<ref name="Jornayvaz2011">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 [http://www.worldcat.org/issn/0002-9165 0002-9165], doi [http://dx.doi.org/10.3945/ajcn.111.019646 10.3945/ajcn.111.019646]</ref>
<ref name="Veech-2004">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 [http://dx.doi.org/10.1016/j.plefa.2003.09.007 10.1016/j.plefa.2003.09.007], PMID [http://www.ncbi.nlm.nih.gov/pubmed/14769489 14769489]</ref>
<ref name="Kossoff-2011-1864">Eric. Kossoff, [http://www.amazon.com/Ketogenic-Diets-Eric-H-Kossoff/dp/1936303108 Ketogenic diets : treatments for epilepsy and other disorders], date 2011, publisher Demos Health, location New York, isbn 1-936303-10-8, Kindle Location 1864</ref><ref name="Kossoff-2011-2218">Eric. Kossoff, [http://www.amazon.com/Ketogenic-Diets-Eric-H-Kossoff/dp/1936303108 Ketogenic diets : treatments for epilepsy and other disorders], date 2011, publisher Demos Health, location New York, isbn 1-936303-10-8, Kindle Location 2218</ref><ref name="Kossoff-2011-2533">Eric. Kossoff, [http://www.amazon.com/Ketogenic-Diets-Eric-H-Kossoff/dp/1936303108 Ketogenic diets : treatments for epilepsy and other disorders], date 2011, publisher Demos Health, location New York, isbn 1-936303-10-8, Kindle Location 2533</ref><ref name="Kossoff-2011-2522">Eric. Kossoff, [http://www.amazon.com/Ketogenic-Diets-Eric-H-Kossoff/dp/1936303108 Ketogenic diets : treatments for epilepsy and other disorders], date 2011, publisher Demos Health, location New York, isbn 1-936303-10-8, Kindle Location 2522</ref><ref name="Kossoff-2011-2512">Eric. Kossoff, [http://www.amazon.com/Ketogenic-Diets-Eric-H-Kossoff/dp/1936303108 Ketogenic diets : treatments for epilepsy and other disorders], date 2011, publisher Demos Health, location New York, isbn 1-936303-10-8, Kindle Location 2512</ref></references>
{{Skeleton}}
=Hypoglycemia=
Hypoglycemia (low blood sugar) seams to predominantly a risk if the ketogenic diet is started with a fast.
=Acidosis=
Talk about mild and serious acidosis, monitoring urine pH routinely.
=Hyperketosis=
The underlying cause is probably acidosis.
=Sodium Loss and Hypotension=
Natriuresis of starvation, probably due to low insulin, associated loss of Potassium and reduced blood volume.
=Vitamin or mineral deficiency=
The ketogenic diet is frequently deficient in some vitamins and minerals, so supplementation is required.
=Kidney Stones=
Occurrence is 5%, talk about need for urine monitoring.
=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<ref name="Kossoff-2011-2512"/>. 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<ref name="Kossoff-2011-2522"/>.
=Bone fractures=
Issue in children – another impact of acidosis or reduced dairy intake?
=Growth reduction=
Children treated with the ketogenic diet can have growth reduction<ref name="Kossoff-2011-2533"/>. Personally, I wonder if this is due to the earlier epilepsy diets restricting calories.
=Constipation=
Constipation is an issue, even with extra [[Fiber]], probably due to changes in intestinal flora.
=Fat Intake Imbalance=
It's easy to get too much Omega-6.
=Insulin Resistance =
While the Ketogenic Diet can be beneficial for those suffering from insulin resistance or diabetes<ref name="Veech-2004"/>, there are also concerns that the Ketogenic Diet may also result in some insulin resistance<ref name="Jornayvaz2011"/>. 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.
=Thirst and Hydration=
Ketones may reduce thirst<ref name="Kossoff-2011-2218"/>.
=Contraindications=
There are a number of contraindications for the ketogenic diet, including [http://en.wikipedia.org/wiki/Fatty-acid_metabolism_disorder genetic deficiencies in fat metabolism]<ref name="Kossoff-2011-1864"/>. A discussion of these contraindications is outside of the scope of this article.
=References=
<references>
<ref name="Jornayvaz2011">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 [http://www.worldcat.org/issn/0002-9165 0002-9165], doi [http://dx.doi.org/10.3945/ajcn.111.019646 10.3945/ajcn.111.019646]</ref>
<ref name="Veech-2004">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 [http://dx.doi.org/10.1016/j.plefa.2003.09.007 10.1016/j.plefa.2003.09.007], PMID [http://www.ncbi.nlm.nih.gov/pubmed/14769489 14769489]</ref>
<ref name="Kossoff-2011-1864">Eric. Kossoff, [http://www.amazon.com/Ketogenic-Diets-Eric-H-Kossoff/dp/1936303108 Ketogenic diets : treatments for epilepsy and other disorders], date 2011, publisher Demos Health, location New York, isbn 1-936303-10-8, Kindle Location 1864</ref><ref name="Kossoff-2011-2218">Eric. Kossoff, [http://www.amazon.com/Ketogenic-Diets-Eric-H-Kossoff/dp/1936303108 Ketogenic diets : treatments for epilepsy and other disorders], date 2011, publisher Demos Health, location New York, isbn 1-936303-10-8, Kindle Location 2218</ref><ref name="Kossoff-2011-2533">Eric. Kossoff, [http://www.amazon.com/Ketogenic-Diets-Eric-H-Kossoff/dp/1936303108 Ketogenic diets : treatments for epilepsy and other disorders], date 2011, publisher Demos Health, location New York, isbn 1-936303-10-8, Kindle Location 2533</ref><ref name="Kossoff-2011-2522">Eric. Kossoff, [http://www.amazon.com/Ketogenic-Diets-Eric-H-Kossoff/dp/1936303108 Ketogenic diets : treatments for epilepsy and other disorders], date 2011, publisher Demos Health, location New York, isbn 1-936303-10-8, Kindle Location 2522</ref><ref name="Kossoff-2011-2512">Eric. Kossoff, [http://www.amazon.com/Ketogenic-Diets-Eric-H-Kossoff/dp/1936303108 Ketogenic diets : treatments for epilepsy and other disorders], date 2011, publisher Demos Health, location New York, isbn 1-936303-10-8, Kindle Location 2512</ref></references>
