In this series of three posts we will introduce you to the history of Ketogenic Diet, its physiological relevance and numerous health benefits.

PART1

A short History and Introduction,

The ketogenic diet, or keto diet, for short, is a high-fat, low carb diet with adequate protein supply.

Despite the new hype around it, the keto diet was used for more than 100 years in medicine. The original application of the keto diet was to control epilepsy in times when no consistently effective medication was available.

 In medicine, we have been using it for almost 100 years to treat drug-resistant epilepsy, especially in children. 

Marcelo Campos, MD, Harvard Health Publishing, Harvard Medical School

In 1921 Dr. Russel Wilder, a neurologist suffering from epilepsy, determined that a keto diet helped him to reduce seizures and control his epilepsy. Interestingly, fasting, a more generalized form of the keto diet, is the only therapy recorded in the Hippocratic collection from 500 B.C. In the King James Version of the Bible, a story is found in which Jesus curing an epileptic boy through fasting.

What initially started as fasting therapy was later modified by Dr. Wilder at Mayo Clinic into the ketogenic diet. He argued that ketonemia, the accumulation of “abnormally” high levels of ketone bodies in the blood, can be achieved through the ketogenic diet, and he treated numerous patients with this form of nutrition. In contrast to starvation, the ketogenic diet can be maintained for a much longer period of time and therefore has a more significant therapeutic effect.

Following Dr. Wilder’s treatment program, Dr. Peterman established a “ketogenic recipe” in 1925 a that is still used today. His recipe limited daily carbohydrate intake to a total of 10-15 grams and daily protein consumption to 1 gram per kilogram of body weight. The rest of the food intake had to come from fat. In later years, precise calculations for meal plans were introduced for epileptic therapy(1).

After the development of effective medication to treat epilepsy, as stringent a diet as the ketogenic diet was no longer justified and was thus discontinued.

Current use of the Ketogenic Diet

The appreciation of the Keto Diet as a potent health management tool developed slowly. In the years before 2000, the Keto Diet was rarely applied and almost forgotten.

NBC-TV’s Dateline show aired a story about a boy named Charlie, a two-year-old child suffering from uncontrollable epilepsy. The boy was successfully treated with a modified version of the Keto Diet at Johns Hopkins University, and as a result of his story, the public interest in Keto Diet spiked. In 1997, Charlie’s father, Jim Abrahams, directed the movie “First Do No Harm,” starring Meryl Streep. It tells the story of Charlie and further amplified the public interest in the Keto Diet.

In its current form, the Keto Diet is an established form of medical therapy still used in over 45 countries to treat pediatric epilepsy.

Many neurologists agree about the effectiveness of the Keto Diet in treating epilepsy. However, many physicians’ perceptions of the Keto Diet as an essential tool for health management are, in general, not favorable.

Health issues in modern-day lives, such as the lack of proper nutrition, overconsumption of carbohydrates, obesity(2) and associated diseases such as Type 2 Diabetes(3), cardiovascular diseases, and the search for a healthy lifestyle brought the Keto Diet back into public focus (2, 4).

The modern mainstream application of the Keto Diet focuses on health reasons. Today, healthy individuals use the Keto Diet to reduce their risk of developing diseases, to lose weight, and to reduce other health risks(5).

The Keto Diet is a part of a healthy lifestyle and defines the nutritional choices of those who follow it.

Murat Digicaylioglu, MD., Ph.D., Scripps Research Institute

Keto Diet is more than just a diet. Properly applied, the Keto Diet is a part of a healthy lifestyle and defines the nutritional choices of those who follow it. Nutritional supplements, proper hydration, balanced electrolytes, and regular exercise complement the Keto Diet and result in a healthy lifestyle overall.

 Keep in mind that this is a highly individualized process, and some people need a more restricted diet to start producing enough ketones.

Marcelo Campos, MD, Harvard Health Publishing, Harvard Medical School

In general, healthy individuals are good candidates for the Keto Diet. However, we urge you to consult with your licensed physician, as well as your dietician, about your eligibility and course of action for adopting a ketogenic diet plan.

The benefits of the Keto Diet in healthy individuals are numerous, including but not limited to optimized performance, weight control, blood sugar control, reduction of inflammation, and oxidative stress.

I’ve been on the keto diet for 15 months. My triglycerides went from 293 to 71 after four months. I’m 45 years old. I no longer need statins. I haven’t felt this good in 20 years. I think I eat less meat then the average American. There’s my scientific proof.

Mike Harris, a Keto Diet follower

In the second part we will discuss the physiological background and changes of the Keto Diet.

References:

1.         J. M. Freeman et al., The efficacy of the ketogenic diet-1998: a prospective evaluation of intervention in 150 children. Pediatrics 102, 1358-1363 (1998).

2.         G. Muscogiuri et al., The management of very low-calorie ketogenic diet in obesity outpatient clinic: a practical guide. J Transl Med 17, 356 (2019).

3.         N. Cox, S. Gibas, M. Salisbury, J. Gomer, K. Gibas, Ketogenic diets potentially reverse Type II diabetes and ameliorate clinical depression: A case study. Diabetes Metab Syndr 13, 1475-1479 (2019).

4.         D. S. Ludwig, W. C. Willett, J. S. Volek, M. L. Neuhouser, Dietary fat: From foe to friend? Science 362, 764-770 (2018).

5.         S. Bruce, A. Devlin, L. Air, L. Cook, Changes in quality of life as a result of ketogenic diet therapy: A new approach to assessment with the potential for positive therapeutic effects. Epilepsy Behav 66, 100-104 (2017).