IS THE KETOGENIC DIET A FAD OR COULD IT HELP CONTROL DIABETES?

 Discovering a diet that feeds our body's needs and keeps us healthy without sacrificing taste is a daunting task for anyone. Add diabetes to the equation and this task can suddenly seem like an insurmountable hurdle that can only be overcome by the most health-conscious fitness guru. Some diets are clearly fads that appear seemingly overnight, selling books and recipes and often food, only to disappear at twilight and be overtaken the next day by another set of guidelines by which we must convert, from optimistically, in the best person we can be.

There are seemingly endless options for curing a diet that satisfies every notion or need. However, people with diabetes may find that these diets do not always work to balance glycemic control and blood sugar. So what about the ketogenic diet? Is it a fad that will one day be supplanted by the next new way of eating, or will the science behind it make sure it keeps a faithful and permanent following? And if it is the latter, what role can it play in the lives of people living with diabetes?

ORIGINS

Ketogenic diets were first proposed as a way to control epileptic seizures in children. Before ketogenic diets, commonly called keto, epileptics frequently fasted to reduce seizures, so the keto diet offered a less restrictive alternative. Although effective, the diet was mostly supplanted by drugs, except in a segment of the population suffering from epilepsy who cannot control it with drugs, and for them, the ketogenic diet has been very successful. Along with the benefits it offers to epileptics, especially children, the keto diet is also being studied as a potential balm for many neurological conditions and diabetes.

WHAT DOES "KETOGENIC" MEAN?

All of our cells need fuel to function. This fuel comes from three sources: fat, carbohydrates, and protein, called macronutrients. Too much fat-free protein puts us at risk for a handful of complications, so protein can never serve as a primary source of fuel. So we are left with fat and carbohydrates as the main energy providers, the energy that allows us to do everything from breathe and blink as we hit the couch and swim in the English Channel. The preferred fuel for our cells comes from carbohydrates, which are easily converted into glucose, which, in turn, is easily converted into energy. This is why athletes "load up on carbs" before competing. Peak performance occurs when the body has sufficient glucose and glycogen stores available. When glycogen runs out, that's when the body turns to fat. When there is no more sugar in the blood for our cells to consume, they look for an alternative form of energy. This energy comes from ketones, which are compounds that our body produces from stored fat. Therefore, a ketogenic diet is high in fat and very low in carbohydrates, which results in the production of ketones for fuel instead of glucose. This energy comes from ketones, which are compounds that our body produces from stored fat. Therefore, a ketogenic diet is high in fat and very low in carbohydrates, resulting in the production of ketones for fuel instead of glucose. This energy comes from ketones, which are compounds that our body produces from stored fat. Therefore, a ketogenic diet is high in fat and very low in carbohydrates, which results in the production of ketones for fuel instead of glucose.

The word "keto" often has negative associations for people living with diabetes, especially Type 1 diabetes. DKA, diabetic ketoacidosis, is a life-threatening condition that arises when the body produces too many ketones. So how does deliberately entering ketosis through a conscientious diet differ from accidentally entering? The answer has to do with the level of ketones, the first causes "regulated and controlled production" and the second causes an overabundance.

WHAT DOES THE KETOGENIC DIET HAVE TO OFFER?

The benefits of a ketosis diet have been well organized for those living with Type 2 diabetes. The diet not only helps control blood sugar but also promotes weight loss. The results for those living with Type 1 diabetes are less conclusive. Many studies tend to address low-carb diets like paleo and Atkins, which focus more on the types of low-carb foods to eat, as opposed to a keto diet, which pays a lot of attention to macronutrients and ketosis. There seem to be fewer studies exploring the keto diet, but there is observational information that seems to indicate that the diet offers a way to control A1c levels and glycemic control. Many people with diabetes who follow the keto diet have found that they significantly reduce their use of insulin.

MEAT, MEAT AND MORE MEAT

So what makes the keto diet different from other diets? Meat, meat, and more meat. There is no meat or fish that is off-limits to the keto diet, including bacon which is generally prohibited. Non-starchy vegetables like Brussels sprouts and cauliflower are recommended, as are oils, butter, and lard. Greek cheese and yogurt can also be staples of a keto diet.

However, this diet is not for everyone. If you live for traditional bread, pasta, rice, potatoes, and fruits, then you might be miserable on the keto diet. However, if you are open to exploring different flavors, the good news is that there are many substitutes for many of these foods. The pizza crust of cauliflower, rice, and even gnocchi; the noodles made from zucchini; almond flour bread, and almond milk are available in most stores now. A small amount of berries is okay, but for the most part, you have to say goodbye to apples, melons, plums, and peaches. Alcohol and sugar are out too, but if you live with diabetes, you probably already know how to handle these cravings.

LISTEN TO YOUR BODY ... AND YOUR DOCTOR

If you take insulin, you may need to immediately decrease your injecting from 30 to 50% as soon as you enter ketosis. For those living with Type 1 diabetes, this can significantly help control high blood sugar levels and hypoglycemia.

As with any diet, precautions must be taken. Pregnant women and people with kidney disease are not good candidates for this diet, and some people with diabetes may find that the diet increases their insulin resistance. Dairy products can often spike blood sugar, so avoiding dairy on a keto diet and taking a vitamin D supplement might be a better option for some people. It is important to pay attention to the way your body responds and to keep in mind that no one diet is a one size fits all model.

The trick to reaping the benefits of the keto diet is staying in ketosis, which means keeping your carbs at 5% or less of your calories. 5% can drop between 20 to 50 grams a day. However, if you miss an insulin shot while in deep ketosis, chances are you're pretty sick, so it's probably best to avoid risk and keep carbs on the higher end of this spectrum.

This diet can be unsustainable as a long-term way of life for many people, but if you have iron willpower and a desire to try a restrictive diet that still allows you to enjoy fatty meats and oils, a keto diet could very well. be the way you can help manage your diabetes while controlling your weight. 

See More About the Ketogenic Diet click here

References

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2129159/ (2004)

https://www.virtahealth.com/research (2018)

https://www.dietdoctor.com/low-carb/with-diabetes-medications (2018)

https://ketologic.com/keto-faqs/how-many-carbs-a-day-for-ketosis/ (2017)

https://www.nytimes.com/2018/05/07/well/live/low-carb-diet-type-1-diabetes.html (2018)

https://diabetesstrong.com/ketogenic-diet-and-diabetes (2018)

[1] https://en.wikipedia.org/wiki/Ketogenic_diet