Contraindications of a Ketogenic Diet
Successfully maintaining any diet requires patience, determination, and discipline, which is one of the reasons 95 percent of diets fail. Changing the way we eat is not as easy as altering our weekly grocery shopping lists, but rather requires profound shifts in lifestyles. This lack of commitment to healthier nutrition and overall wellness is one of the reasons why almost all people tend to regain lost weight within 1 to 5 years after having originally begun a certain dietary program. In the specific case of the Keto Diet, replacing the carbohydrates that are often at the center of most household meals for healthy fats and limited amounts of protein represents a profound shift in how we eat. For many Keto Diet advocates, however, the health benefits associated with this dramatic change in eating patterns is well worth the struggle.
For any diet to be successful, developing an in-depth understanding of how the nutritional change will affect your body and your metabolism is essential. The Dietary Guidelines for Americans published by the Mayo Clinic recommends that carbohydrates make up 45 to 65 percent of total daily calorie intake. For an average of 2,000 calories a day, the average American is most likely eating between 225 and 325 grams of carbohydrates a day, though unhealthy eating patterns most likely mean that many people consume much more carbs than that. The Keto Diet, however, sets an upper carbohydrate limit of just 35 grams (25 grams of net carbs) per day and often encourages people to limit that number even further in order to get into ketosis more quickly.
While low carb diets do offer a number of important health benefits that we will explore below, this dramatic decrease in carbohydrate consumption (and a subsequent increase in healthy fats) can certainly affect how our bodies function. Below, we offer a complete guide to the indications and contraindications of a Ketogenic Diet, to help people develop a more complete understanding of how the Keto Diet works and whether it is a safe alternative for you.
The Indications of the Keto Diet
The ketogenic diet was originally developed as an alternative therapy for children with drug-resistant epilepsy. Keto has been used for several decades as a successful, therapeutic diet for people with this neurological condition. In a clinical context, the dietary trend focusing on strictly limiting carbohydrates and protein in favor of healthy fats in order to put the metabolism into a state of ketosis was also shown to offer tangible benefits in the management of some other health conditions. Besides childhood epilepsy, the Keto Diet is often prescribed even before prescription pharmacotherapy for the following health conditions:
• Dravet syndrome
• Infantile spasms
• Myoclonic-astatic epilepsy
• Tuberous sclerosis complex
Furthermore, the Keto Diet has also been shown to be an effective first-line of treatment for several metabolic diseases, including Pyruvate dehydrogenase (E1) deficiency and Glucose transporter 1 deficiency syndrome. Both of these metabolic syndromes stop the body from being able to use carbohydrates as an effective energy source. By putting the body into ketosis through strictly limiting carbohydrate intake, people with these conditions can live healthier lives by depending on ketone bodies as their primary energy source.
As a medically-prescribed nutritional program, the Keto Diet might also offer benefits in the treatment of autism, depression, chronic migraines, Alzheimer´s Disease, Parkinson´s Disease, and Amyotrophic lateral sclerosis, though further research is required.
In more recent years, however, the Keto Diet has quickly grown beyond the walls of medical facilities and is today practices by thousands of people who do not suffer from epilepsy or rare, congenital metabolic conditions. In fact, the Keto Diet was the most “Googled” dietary trend in 2018. The low-carb, high-fat consumption that defines Keto has been shown by over 30 studies to be an effective way to lose weight and improve overall health. So who exactly stands to benefit from adopting the rigorous standards and recommendations of the Keto Diet?
People Wanting to Lose Weight: The obesity rate in the United States recently passed 40 percent for the first time ever. Obesity is one of the leading risk factors for a number of chronic diseases including heart disease and diabetes. The Keto Diet is not only a proven weight loss strategy but has been shown by several studies to be more effective than the low-fat diets often recommended by doctors and nutritionists. In fact, one recent study found that people on the Keto Diet were able to lose more than double the amount of weight than people following a calorie-restricted and low-fat diet. As an added benefit, this study found that people on the Keto Diet also improved their healthy triglyceride and HDL cholesterol levels. For people wanting to lose weight but who struggle with cravings and hunger, the Keto Diet is often a better option because of the ability to “indulge” in healthy fats that are good at reducing feelings of hunger and cravings. See: The clinical evidence of the Ketogenic Diet and weight loss.
People Suffering from Diabetes or Pre-diabetes: Excess fat in the body is closely linked to type 2 diabetes which was mentioned as a cause of death in a total of 270,702 certificates in 2017. When entering into a metabolic state of ketosis, the body burns fat for fuel, instead of glucose in the form of carbs. This can, in turn, help people lose excess fat and reduce the risks associated with diabetes and pre-diabetes. One recent study found that strict adherence to the Keto Diet could improve insulin sensitivity by up to 75 percent. Furthermore, another study of 21 people living with type 2 diabetes found that a third of the patients were able to stop using all their diabetes medications after having successfully switched to a Keto Diet. For the millions of people across the world suffering from diabetes and pre-diabetes, the Keto Diet might offer tangible benefits through boosting insulin sensitivity and causing fat loss.
People wanting Increased Energy and Cognitive Function: People who are dedicated to staying in ketosis report increased energy levels, mental clarity, and improved brain function. Lowering carbs from the diet can quickly regulate and stabilize blood sugar levels, which is important for cognitive functioning. The Keto Diet, then, might also be recommended for people who are suffering from the physical and mental sloth that comes with high carb diets.
Potential Opportunities for Other Diseases: Though further research is required the Keto Diet might also be able to slow tumor growth in people suffering from certain types of cancer. It might also slow the progression of Alzheimer’s disease, and even aid in recovery after traumatic brain injuries.
The Contraindications of the Keto Diet
Though some diehard advocates of the Keto Diet will wholeheartedly profess that entering into ketosis is the only pathway towards healthy nutrition and lifestyle, the Keto Diet is not for everyone. While reducing unhealthy carbohydrates from refined grains and sugar is simple dietary advice that everyone should follow, there are both important medical reasons and certain lifestyle issues that might make the Keto Diet not an ideal nutritional program for everyone. With that having been said, the Keto Diet should not be followed by the following groups of people:
People Unable to Metabolize Fatty Acids: There are some people who have congenital health conditions that do not allow their body to properly metabolize fatty acids. Some of these conditions or disorders include pyruvate carboxylase deficiency, porphyria, and other fat metabolism disorders. Obviously, if your body cannot use fatty acids to produce ketones that can be burned as a source of energy for your body, then the Keto Diet is not for you. If you try to follow the Keto Diet with one of these disorders, your body may consume protein for energy and this could lead to the dangerous condition of ketoacidosis. Fortunately, fat metabolism disorders are relatively rare, with only about 200,000 people in the USA suffering from any form of porphyria. While carbohydrates will need to be the primary fuel for people with these conditions, focusing on healthy sources of carbs such as whole grains and fruits and vegetables can improve your nutrition.
People with other Rare Metabolic Conditions: Other rare metabolic conditions that are contraindicated for the Keto Diet include:
• Carnitine deficiency (primary)
• Carnitine palmitoyltransferase (CPT) I or II deficiency
• Carnitine translocase deficiency
• Beta-oxidation defects
• Mitochondrial 3-hydroxy-3-methylglutaryl-CoA synthase (mHMGS) deficiency
• Medium-chain acyl dehydrogenase deficiency (MCAD)
• Long-chain acyl dehydrogenase deficiency (LCAD)
• Short-chain acyl dehydrogenase deficiency (SCAD)
• Long-chain 3-hydroxyacyl-CoA deficiency
• Medium-chain 3-hydroxyacyl-CoA deficiency
People with other Health Conditions: There are other serious health conditions that might be exacerbated by following the Keto Diet. These conditions include:
• Active gall bladder disease
• Impaired liver function
• Overall poor nutritional status
• People who have undergone gastric bypass surgery
• A history of abdominal tumors
• A history of kidney failure
Women who are Pregnant or Breast Feeding: Lastly, following a strict Keto Diet while pregnant is generally not recommended for women. Many fruits and vegetables are high in carbs and sugars which are avoided on the Keto Diet. These fruits and vegetables, however, offer a number of important vitamins and minerals such as iron and folate that can help nourish the growing fetus. While prenatal vitamins do offer these vitamin and mineral supplements, it is also important to get as much nutrition as possible to your growing baby through a diverse, whole food diet including plenty of fruits and vegetables.