A Cochrane systematic review in 2018 found and analysed eleven randomized controlled trials of ketogenic diet in people with epilepsy for whom drugs failed to control their seizures. Six of the trials compared a group assigned to a ketogenic diet with a group not assigned to one. The other trials compared types of diets or ways of introducing them to make them more tolerable. In the largest trial of the ketogenic diet with a non-diet control, nearly 38% of the children and young people had half or fewer seizures with the diet compared 6% with the group not assigned to the diet. Two large trials of the Modified Atkins Diet compared to a non-diet control had similar results, with over 50% of children having half or fewer seizures with the diet compared to around 10% in the control group.
Dr. Walter Willett, chairman of the nutrition department at the Harvard T. H. Chan School of Public Health, said the study did not support a “precision medicine” approach to nutrition, but that future studies would be likely to look at many other genetic factors that could be significant. He said the most important message of the study was that a “high quality diet” produced substantial weight loss and that the percentage of calories from fat or carbs did not matter, which is consistent with other studies, including many that show that eating healthy fats and carbs can help prevent heart disease, diabetes and other diseases.
But a new study, published Tuesday in JAMA, may turn that advice on its head. It found that people who cut back on added sugar, refined grains and highly processed foods while concentrating on eating plenty of vegetables and whole foods — without worrying about counting calories or limiting portion sizes — lost significant amounts of weight over the course of a year.
But beyond that, experts aren't convinced that the keto diet has any other scientifically-proven health benefits. In fact, it may have some distinct downsides. If you follow the keto diet incorrectly, for example (like by eating lots of saturated fats, versus healthy unsaturated fats), you're at risk of raising your cholesterol levels. “The best strategy to keep your heart healthy is to get as much fat as possible from unsaturated sources such as olive, avocado and canola oils, nuts, seeds, avocados, and olives," says Ansel.
Even if you've been eating right on track, it may be tough to stay on track if your partner, coworkers, or friends don't share your healthy-eating habits. What to do? If your partner loves pizza, try ordering a pie that's heavy on the veggies and light on the cheese—then supplement it with a side salad. Or, if your friends are having a girls' night out, suggest a restaurant that's got healthy appetizer options, instead of the typical fare of onion rings and cheese dip. And at work, instead of Friday baked-goods day, suggest a Friday "make it healthy" day, and swap in baked pears with cinnamon or mini fruit-and-nut muffins for brownies and blondies.
Those issues can be part of what's known as the “keto flu,” Warren says. Other side effects of the keto diet, all of which are tied to carb withdrawal, can include lightheadedness, nausea, mental fog, cramps, and headaches, in addition to tiredness. Luckily, the keto flu doesn't usually last more than a week—which is coincidentally about when people start to see the number on the scale go down, says Warren.
Advocates for the diet recommend that it be seriously considered after two medications have failed, as the chance of other drugs succeeding is only 10%. The diet can be considered earlier for some epilepsy and genetic syndromes where it has shown particular usefulness. These include Dravet syndrome, infantile spasms, myoclonic-astatic epilepsy, and tuberous sclerosis complex.
It's easy to get in a diet rut, even if you're loading up on flavorful fruits and veggies. The solution? Have plenty of spices, fresh herbs, and lemons at your cooking beck and call. "It's amazing what a little dash of spice, sprinkle of herbs, pinch of lemon zest, or squirt of lime juice can do to liven up a dish—and your diet," says Newgent. The best part: They contain almost no calories. Experiment with your dinner, tonight!
Take action: Aim to do aerobic (cardio) exercise, such as running or biking, for at least 150 minutes a week. The intensity should vary from moderate to vigorous so that you increase your cardiac capacity without overtaxing your body. Two times a week, also do a 20-minute session of resistance training, such as weight lifting. (These sessions can be done on the same days as the aerobic workouts or on alternate days.) Both types of exercise make your heart pump more blood, which strengthens it. Hate to exercise? Walking counts as cardio. Just be sure to wear a pedometer or an activity-tracking device (Gulati likes those from Fitbit), and shoot for 10,000 steps a day, or about five miles. “This amount ensures that you’re getting the minimal daily cardio-exercise recommendations,” says Gulati. To add resistance benefits, carry five-pound arm weights on your walks and include steep hills in your route.
Start with 40 grams of Net Carbs of carbohydrates a day. Net Carbs represent the total carbohydrate content of the food minus the fiber content and sugar alcohols (if in the product). The Net Carbs number reflects the grams of carbohydrate that significantly impact your blood sugar level and therefore are the only carbs you need to count when you do Atkins.
A ketogenic diet helps control blood sugar levels. It is excellent for managing type 2 diabetes, sometimes even leading to complete reversal of the disease. This has been proven in studies. It makes perfect sense since keto lowers blood-sugar levels, reduces the need of medications and reduces the potentially negative impact of high insulin levels.
The ketogenic, or "keto," diet — which first became popular in the 1920s as a treatment for epilepsy and diabetes— limits carbohydrates to no more than 50 grams a day, which is the rough equivalent of a plain bagel or a cup of white rice. By comparison, dietary guidelines laid out by the US Department of Agriculture recommend consuming between 225 and 325 grams of carbs a day.
A simple pen and paper can dramatically boost your weight loss. Studies show the act of writing down what you eat and drink tends to make you more aware of what, when, and how much you're consuming -- leading you to ultimately take in fewer calories. One study found that people who kept a food diary six days a week lost about twice as much as those who only kept a diary one day a week or less.