Sections; Top Stories; Watch; U.S. International; Politics; Lifestyle; Entertainment; Virtual Reality; Health; Tech; Investigative; Sports; Weather; Shows. The Gluten-Free, Low-Carb Paleo Diet (GFLCP), same as the high-fat, moderate protein, low-carb diet Dr. Mercola promotes, is now hitting the mainstream. Irritable bowel syndrome (IBS) is common in the general population and has a significant medical and socioeconomic impact. Its pathophysiology is still not entirely. How Does an Elemental Diet Treat SIBO? Remember that bacteria are living things. Like all living things, bacteria have to eat something. The bacteria in our small. Caution Advised ~ The Paleo Mom. As the ketogenic diet gains popularity, it’s important to have a balanced discussion regarding the merits of this diet. Let me emphasize right out of the gate that this is not a diet without merits (excuse the double negative); in fact, it has significant therapeutic potential for some clinical pathologies. However, it is also a diet with inherent risk, as evidenced by the extensive list of adverse reactions reported in the scientific literature—and this has not yet been a thorough enough part of the public discussion on ketogenic diets. Typical ketogenic diet macronutrient ratios. This is the first of a series of articles discussing various facets of a ketogenic diet with an inclination toward balancing the discussion of the pros and cons of this high- fat, low- carb, low/moderate- protein diet. My interest in this topic stems from concerns I have over its general applicability and safety, simultaneous with its growing popularity. I feel a moral and social obligation to share what I understand of these diets, from my perspective as a medical researcher. The dangers of a ketogenic diet was, in fact, the topic of my keynote presentation at Paleo F(x) this year (links to video will be provided once available). This series of articles will share the extensive research that I did in preparation for this presentation, including all of the topics covered during my talk as well as several topics that I didn’t have time to discuss (also see the free PDF Literature Review at the bottom of this post). For every anecdotal story of someone who has regained their health with a ketogenic diet, there’s a counterpoint story of someone who derailed their health with an identical diet. I’m not here to trade anecdotes. I’m here to cite a collection of scientific papers, including results from clinical trials, case studies, and mechanistic studies that show a potential dark side to the ketogenic diet. However, it wasn’t until 1. Two French doctors, Guelpa and Marie, observed that a 4- day fast decreased seizure frequency in 2. La cure du Dr. Guelpa”, a prescribed treatment for epilepsy that consisted of fasting followed by a very limited vegetarian diet. Hugh Conklin popularized fasting (three days to three weeks) as a way to cure numerous illnesses, including epilepsy. The banner was taken up in 1. Dr. Rawle Geyelin, who was the first to document cognitive improvement resulting from fasting in a scientific study performed on 2. Dr. Conklin’s work hit the news! As the ketogenic diet gains popularity, it’s important to have a balanced discussion regarding the merits of this diet. Let me emphasize right out of the gate that. Fasting has one very important barrier to rampant clinical use: it’s not sustainable. You can’t starve for the rest of your life and expect it to last very long. In 1. 92. 1, Drs. Stanley Cobb and W. How and When to Be Your Own Doctor. Moser with Steve Solomon. Chapter Three. From The Hygienic Dictionary. Hydrogen Therapy. The Emergence of A New Field of Medicine and How You Can Benefit From It Right Now (with a little help from your friends. Banish your bloat with the low FODMAP diet. The low FODMAP diet is a dietary approach used to minimize symptoms of irritable bowel syndrome (IBS). G. Lennox became the first to observe that control of seizures by fasting occurs via a change in body metabolism that can be induced either by absence of food or by a very low carbohydrate intake. And this observation led to the birth of a form of nutritional starvation, the ketogenic diet, a term coined by Dr. Russell Wilder who developed the diet as an alternative to fasting and demonstrated its comparable effectiveness in epilepsy. Wilder observed that the diet produced high levels of ketone bodies in the blood and hypothesized that a high fat, low carbohydrate diet would mimic the anticonvulsant effects of fasting because limited glucose supply would force fat to be metabolized into ketones, which could then be used as an alternative fuel by the brain (this hypothesis took decades to prove, and the more detailed mechanisms remain largely a mystery). In 1. 92. 5, Dr. Mynie Peterman, calculated the exact formula for nutritional ketosis, a daily diet comprised of: 1. In the earliest epilepsy studies, calories were restricted to 7. Research into ketogenic diets went through many ups and downs over the decades that followed. Every time a new anticonvulsant drug for epilepsy was developed, interest in ketogenic diets waned under the presumption that it’s easier, and more tolerable, to take a pill every day compared to a severely restrictive diet. However, interest was rekindled in the wake of professional and public recognition subsequent to: the popularity of the Atkins’ Diet Revolution; a Dateline report featuring a 2- year- old Charlie Abrahams whose intractable seizures are successfully stopped after he adopted a ketogenic diet; the creation of The Charlie Foundation which disseminates informational ketogenic diet videos to doctors and dieticians; and the movie Do No Harm. Since the late- 1. Alzheimer’s. Adverse Reactions to Ketogenic Diets. As the list of health conditions that may be at least partially alleviated by ketogenic diets increase (and which currently includes epilepsy, Alzheimer’s, Parkinson’s, Autism, traumatic brain injury, bipolar disease, PCOS, cancer, obesity, and diabetes), so too does a body of literature pointing to common side effects and potential adverse reactions. Adverse reactions to a ketogenic diet have been reported in the scientific literature. Yes, even including well- designed clinical trials performed and published very recently. Side effects are typically what are reported in shorter- term studies, where as both side effects and adverse reactions are reported in the long- term ketogenic dietstudies (typically 6 months to 2 years, but any study that allows for keto- adaptation, which takes up to a month, can be considered long- term). A long list of not- good things. And did you can’t that last one? Five scientific papers have reported deaths as an adverse effect from long- term ketogenic diets (here’s the citations: Stewart, et al., 2. Kang, et al., 2. 00. Kang, et al., 2. 00. Bank, et al., 2. 00. Suo, et al., 2. 01. PDF download of my Literature Review at the bottom of this post which contains details on all of the papers reporting adverse reactions). Two of these papers are case studies, and the other three are papers derived from two separate clinical trials, all studies in epileptic children. Some of the deaths can be attributed to extra complications from secondary conditions or accidents that befell the child during the course of the clinical trial; however, other deaths—most typically from severe infection or heart disease—are attributed directly to long- term ketosis. The Relevance of Adverse Reactions. I believe the potential for adverse reactions is important information for people to know when they are weighing a ketogenic diet versus other diets or therapeutic options. But, that doesn’t mean that everyone need avoid ketogenic diets. It’s a question of weighing the pros and cons for each individual. Because the overwhelming majority of the long- term ketogenic diet studies have thus far been performed in the context of epilepsy, this is the field of research that has most thoroughly reported adverse reactions. Certainly, these kids belong to a more sensitive population (why documented deaths as a result of adverse reactions to a ketogenic diet have occurred almost exclusively in epileptic children), but that doesn’t mean that these reports don’t provide extremely useful information, or a warning worth heeding (another double negative!). After all, it’s not typically the robust healthy person who experiments with ketogenic diets to improve their health—and while death is probably very unlikely, the potential harm to other body systems (cardiovascular, immune, endocrine, digestive) remains. The Need For More Science. The body of scientific literature on ketogenic diets is surprisingly sparse when you consider the therapeutic applications of this diet have been in effect for nearly a century. A mere 1. 59. 2 scientific papers are returned by Pub. Med (the US National Library of Medicine and National Institutes of Health online medical research database) with the search term “ketogenic diet”. It’s not that other diets are more thoroughly researched per se, but certainly other therapeutic strategies to mitigate disease, the most relevant example being anticonvulsant drugs for epilepsy (c. Pub. Med returns 1. Frankly, research is just beginning to scratch the surface in terms of understanding how ketogenic diets work to reduce seizures in epilepsy or to provide the other documented benefits. Why is that important? Because the extensive list of documented side effects and adverse reactions indicate that the positive health effects of a ketogenic diet comes at a cost, one that may not be acceptable to many. Understanding how a ketogenic diet works to provide a benefit, also gives clues as to why it causes adverse reactions. And because the documented adverse reactions include serious illness and death, understanding why these might come about is a prerequisite for adopting this therapeutic strategy in a more widespread way. What insight we can glean from mechanistic studies will be the topic of several future articles. Does the need for more science give ketogenic diets a green light or a red light? And while certainly other diets (Paleo, or the autoimmune protocol being good examples) stake therapeutic claims, the mechanisms of action are purely through micronutrient saturation and avoidance of foods known to be inflammatory. The ketogenic diet is different in that it was designed to emulate starvation, taking advantage of the biochemical benefits of starvation for certain body systems (mainly neurological, but this is also why weight loss is a common result of a ketogenic diet) while tolerating the detriments to other body systems (such as endocrine and immune systems). And this is why a thorough understanding of both the pros and cons of a ketogenic diet are necessary in order for every individual to make the best decision for themselves. Citations and Additional Reading. This PDF contains a review of the literature on ketogenic diets. Normally, my science- based posts contain a dozen or so references at the bottom.
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