What are the health benefits and risks of ketogenic diets?

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Health Benefits and Risks of Ketogenic Diets

Introduction to Ketogenic Diets

Ketogenic diets (KDs) are very-low-carbohydrate, high-fat diets that have gained popularity for their potential health benefits, particularly in weight loss and chronic disease management. Originally used to reduce seizure frequency in epilepsy, KDs are now promoted for conditions such as obesity, diabetes, and cardiovascular diseases .

Health Benefits of Ketogenic Diets

Weight Loss and Glycemic Control

One of the most well-documented benefits of ketogenic diets is their effectiveness in weight loss and glycemic control. Studies have shown that KDs can significantly reduce body weight, waist circumference, and glycated hemoglobin (HbA1c) levels in overweight patients with type 2 diabetes mellitus (T2DM) . These diets also improve lipid profiles by lowering triglycerides and increasing high-density lipoprotein (HDL) cholesterol .

Cardiovascular Health

KDs have been found to have a beneficial impact on cardiovascular health. They improve lipid profiles by lowering low-density lipoprotein (LDL) cholesterol and triglycerides while increasing HDL cholesterol . Additionally, KDs exhibit anti-inflammatory and cardioprotective properties, which may contribute to the prevention and treatment of cardiovascular diseases.

Other Health Benefits

KDs may also offer benefits beyond weight loss and cardiovascular health. They have been shown to improve cognitive function, sleep quality, and thyroid function in healthy adults. Moreover, KDs can positively affect the microbiome and epigenome, potentially increasing genetic diversity and producing beneficial signaling molecules like β-hydroxybutyrate (BHB).

Risks and Concerns of Ketogenic Diets

Diet Quality and Nutrient Deficiency

One of the primary concerns with KDs is their impact on diet quality. These diets often increase the intake of foods linked to chronic disease risk, such as saturated fats, while decreasing the intake of protective foods like fruits, vegetables, and whole grains. This imbalance can lead to nutrient deficiencies and other health issues .

Long-term Safety and Adherence

The long-term safety of KDs remains inadequately studied. While short-term benefits are evident, the sustainability and long-term health impacts are less clear. Studies have shown low adherence levels to KDs over 12 months or longer, raising questions about their practicality as a long-term dietary solution .

Specific Health Risks

KDs can pose specific health risks, particularly for individuals with preexisting conditions. For example, in patients with chronic kidney disease, KDs may increase the risk of heart disease due to higher saturated fat intake and can exacerbate metabolic acidosis and kidney stone formation. Other documented adverse effects include constipation, muscle cramps, headaches, and potential cardiac arrhythmias due to nutrient deficiencies.

Conclusion

While ketogenic diets offer several health benefits, particularly in weight loss, glycemic control, and cardiovascular health, they also come with significant risks and concerns. The impact on diet quality, potential nutrient deficiencies, and the lack of long-term safety data suggest that the risks may outweigh the benefits for many individuals. Careful consideration and further research are needed to fully understand the long-term implications of ketogenic diets.