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Despite continuous advances in the medical world, obesity continues to remain a major worldwide health hazard with adult mortality as high as 2.8 million per year. The majority of chronic diseases like diabetes, hypertension, and heart disease are largely related to obesity which is usually a product of an unhealthy lifestyle and poor dietary habits. Appropriately tailored diet regimens for weight reduction can help manage the obesity epidemic to some extent. One diet regimen that has proven to be very effective for rapid weight loss is a very-low-carbohydrate and high-fat ketogenic diet. This activity reviews the evaluation and considerations for the ketogenic diet and discusses the role of the interprofessional team in educating patients on the risks and benefits of this diet.
Despite continuous advances in the medical world, obesity continues to remain a major worldwide health hazard with adult mortality as high as 2.8 million per year. The majority of chronic diseases like diabetes, hypertension, and heart disease are largely related to obesity which is usually a product of an unhealthy lifestyle and poor dietary habits. Appropriately tailored diet regimens for weight reduction can help manage the obesity epidemic to some extent. One diet regimen that has proven to be very effective for rapid weight loss is a very-low-carbohydrate and high-fat ketogenic diet.[1][2][3]
Russel Wilder first used the ketogenic diet to treat epilepsy in 1921. He also coined the term "ketogenic diet." For almost a decade, the ketogenic diet enjoyed a place in the medical world as a therapeutic diet for pediatric epilepsy and was widely used until its popularity ceased with the introduction of antiepileptic agents. The resurgence of the ketogenic diet as a rapid weight loss formula is a relatively new concept the has shown to be quite effective, at least in the short run.
The popular belief that high-fat diets cause obesity and several other diseases such as coronary heart disease, diabetes, and cancer has not been observed in recent epidemiological studies. Studies carried out in animals that were fed high-fat diets did not show a specific causal relationship between dietary fat and obesity. On the contrary, very-low-carbohydrate and high-fat diets such as the ketogenic diet have shown to beneficial to weight loss.
A well-formulated ketogenic diet, besides limiting carbohydrates, also limits protein intake moderately to less than 1g/lb body weight, unless individuals are performing heavy exercise involving weight training when the protein intake can be increased to 1.5g/lb body weight. This is to prevent the endogenous production of glucose in the body via gluconeogenesis. However, it does not restrict fat or overall daily calories. People on a ketogenic diet initially experience rapid weight loss up to 10 lbs in 2 weeks or less. This diet has a diuretic effect, and some early weight loss is due to water weight loss followed by a fat loss. Interestingly with this diet plan, lean body muscle is largely spared. As a nutritional ketosis state sustains, hunger pangs subside, and an overall reduction in caloric intake helps to further weight loss.
Long-term compliance is low and can be a big issue with a ketogenic diet, but this is the case with any lifestyle change. Even though the ketogenic diet is significantly superior in the induction of weight loss in otherwise healthy patients with obesity and the induced weight loss is rapid, intense, and sustained until at least 2 years, the understanding of the clinical impacts, safety, tolerability, efficacy, duration of treatment, and prognosis after discontinuation of the diet is challenging and requires further studies to understand the disease-specific mechanisms.
Due to the complexity of the mechanism and lack of long-term studies, a general recommendation of the ketogenic diet for prevention of type 2 diabetes mellitus or cardiovascular disease may seem premature but is, however, not farfetched for primary weight loss.
Abstract:Nowadays, obesity is a pandemic, and some people seek slimming diets to guarantee their health and quality of life. However, the cult of the healthy body has been an ongoing concern since the beginning of time. Irrespective of the century to which they belong, these cults reflect no empirical knowledge about physiology, nutrients or kilocalories, with some of them being quantitative diets in contrast to qualitative diets, or even simple food recommendations. On the other hand, some of these treatments might have led to the death of a patient, meaning that it is important for people seeking to lose weight to be followed by a nutrition professional until the individual reaches a desirable body weight. In this article, we highlight that each century and each decade have devised different treatments with the aim of improving health, but it will be science and history that will judge whether the results of these treatments have been adequate.Keywords: diet; weight loss; obesity; history
Cardiovascular exercise for conditioning and weight loss can be achieved without as much impact, such as with brisk hill or stair walking, swimming, or stationary cycling. Even doing bodyweight strengthening exercises such as squats, lunges, wall sits, wall push ups, tricep dips, and bridges in a high intensity interval format raises the heart rate and promotes improved metabolism through increasing muscle mass and cardiovascular challenge.
Studies have shown the direct connection between stress, cortisol and weight gain. Chronic stress leads to cortisol production in large amounts, which leads to obesity and weight gain.6 Dr. Amy Myers recommends infrared sauna for weight loss to help break the connection between cortisol and weight gain by naturally relieving stress. Stress relief lowers cortisol, which can help create a healthy metabolism, thus contributing to weight loss.
Lifestyle interventions that result in weight loss, such as the National Diabetes Prevention Program, may improve glucose tolerance. Even a loss as small as 10 pounds or 5% of your body weight can help, as excess body weight and belly fat are linked to insulin resistance.
While highly restrictive diets may produce immediate results, the weight loss is not often maintained. Focusing on healthy habits, rather than weight loss, may be more beneficial for improving insulin resistance and your overall health.
Diabetes Prevention Program Research Group, Knowler WC, Fowler SE, Hamman RF, Christophi CA, Hoffman HJ, Brenneman AT, Brown-Friday JO, Goldberg R, Venditti E, Nathan DM. 10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study. Lancet. 2009 Nov 14;374(9702):1677-86. doi: 10.1016/S0140-6736(09)61457-4. Epub 2009 Oct 29. Erratum in: Lancet. 2009 Dec 19;374(9707):2054. PMID: 19878986; PMCID: PMC3135022.
Whether for weight loss or anti-aging benefits, what you eat when intermittent fasting makes a difference! This science-backed guide contains everything you need to know about intermittent fasting and eating.
3Kong LC, Wuillemin PH, Bastard JP, Sokolovska N, Gougis S, Fellahi S, Darakhshan F, Bonnefont-Rousselot D, Bittar R, Doré J, Zucker JD, Clément K, Rizkalla S. Insulin resistance and inflammation predict kinetic body weight changes in response to dietary weight loss and maintenance in overweight and obese subjects by using a Bayesian network approach. Am J Clin Nutr. 2013 Dec;98(6):1385-94. doi: 10.3945/ajcn.113.058099. Epub 2013 Oct 30. PubMed PMID: 24172304.
11Cameron JD, Cyr MJ, Doucet E. Increased meal frequency does not promote greater weight loss in subjects who were prescribed an 8-week equi-energetic energy-restricted diet. Br J Nutr. 2010 Apr;103(8):1098-101. doi: 10.1017/S0007114509992984. Epub 2009 Nov 30. PubMed PMID: 19943985.
37Neale EP, Tapsell LC, Martin A, Batterham MJ, Wibisono C, Probst YC. Impact of providing walnut samples in a lifestyle intervention for weight loss: a secondary analysis of the HealthTrack trial. Food Nutr Res. 2017;61(1):1344522. doi: 10.1080/16546628.2017.1344522. eCollection 2017. PubMed PMID: 28747865; PubMed Central PMCID: PMC5510231. 2b1af7f3a8
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