What you need to know about the keto diet

For the past year or so, the “keto diet” has been the latest fad diet to be popularized by health and fitness magazines and touted on social media. But what is the keto diet? Is it safe and, perhaps, even effective for your patients?

The keto—or ketogenic—diet is very low in carbohydrates, moderate in protein, and very high in fats. The “classic keto” diet consists of only 4% carbs, 6% protein, and as much as 90% fat. By starving the body of carbohydrates (ie, glucose, our typical energy source), the diet forces the body to burn fats as its main fuel. To get to this point, the body must not only use up its glucose, but also deplete its stored glycogen.

After a few days of strict dieting, the metabolism switches into a state of ketosis, in which it burns up fats at a high rate. The fats are then converted into fatty acids and ketone bodies, which are used as energy in place of the missing glucose. This is what gives the keto diet its reputation for fat-burning weight loss.

Origin of the ketogenic diet

But the diet didn’t start off this way. About a century ago, researchers confirmed that fasting reduced epileptic attacks in children. Because constant fasting is not exactly a great diet plan for anyone, endocrinologist and researcher Russell M. Wilder, MD, at the Mayo Clinic, Rochester, MN, proposed in 1921 that a ketogenic diet (a term he coined) could have the same effect as fasting in reducing epileptic attacks. The diet could be maintained for a longer period than fasting, too. This made it a popular treatment option for the management of epileptic episodes until newer, more conventional antiepileptic drugs came along, starting in the 1930s.

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