Ketogenic Diet: Positives and Negatives
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This literature review examines the positive and negative impacts of the ketogenic diet. It discusses the benefits of weight loss, blood sugar regulation, and improved heart health, as well as the potential side effects such as constipation, vitamin deficiency, and muscle loss. The review also highlights the impact of the diet on conditions like cancer, cardiovascular health, type 1 diabetes, obesity, and fatty liver. Overall, it provides a comprehensive overview of the ketogenic diet and its effects on the body.
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Ketogenic diet: literature review
on positives and negatives of the
dietary approach
1
on positives and negatives of the
dietary approach
1
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Table of Contents
LITERATURE REVIEW................................................................................................................3
Positive impacts of Ketogenic diet..............................................................................................3
Negative impacts of ketogenic diet.............................................................................................7
REFERENCES................................................................................................................................9
2
LITERATURE REVIEW................................................................................................................3
Positive impacts of Ketogenic diet..............................................................................................3
Negative impacts of ketogenic diet.............................................................................................7
REFERENCES................................................................................................................................9
2
LITERATURE REVIEW
Aim: '' The Impact of Ketogenic dietary approach''
Ketogenic diet is basically a diet that makes a human body to deliver ketones into the
bloodstream. Cells in the body tends to use blood sugar which arise from carbohydrates and is
consider as main source of energy in the body. During the absence of circulating blood sugar
from food, body starts breaking down fats which is stored in the form of energy into molecules
known as ketone bodies. As per the perspective of Vargas and et.al., (2018), This particular
process of breaking down of fats into ketone bodies is consider as ketosis. The process of ketosis
will make the cells to use ketone bodies as a prior source of energy until an individual consume
carbohydrates again. This is a highly specific process and needs a particular diet in order to
initialise production of ketones. As it contains less amount of carbohydrate, a ketogenic diet is
majorly rich in proteins and fats. It particularly includes eggs, meat, sausages, fish, butter, nuts
oils, seeds and fibrous vegetables. It is not easy to follow a keto diet for a long run because it is
so restricted and consist of some particular items only. However, it there are both positive and
negative impacts of ketogenic diet on human body. As one of the major drawback of this diet is
that many individuals indulge in having too much of protein and low quality of fats from
processed food items, and include very less amount of vegetables and fruits in their diet. It has
been examined in the study that ketogenic diet could be very harmful for the patients who are
experiencing kidney diseases. In addition to this, some of the individuals tends to feel little tired
in the initial phase of the diet and some of them may experience nausea, bad breath, constipation,
vomiting and sleeping issues.
Positive impacts of Ketogenic diet
A low-carb diet or ketogenic diet has proved to be controversial since many years. A low
carbohydrate diet is evidenced to be healthy and beneficial for most of the individuals and has a
number of health benefits. For instance, a diet that contains low amount of carbohydrate
eventually leads to reduction in appetite of an individual. It has been analysed that when
individuals avoid to intake carbohydrate in their diet and consume more amount of fats and
3
Aim: '' The Impact of Ketogenic dietary approach''
Ketogenic diet is basically a diet that makes a human body to deliver ketones into the
bloodstream. Cells in the body tends to use blood sugar which arise from carbohydrates and is
consider as main source of energy in the body. During the absence of circulating blood sugar
from food, body starts breaking down fats which is stored in the form of energy into molecules
known as ketone bodies. As per the perspective of Vargas and et.al., (2018), This particular
process of breaking down of fats into ketone bodies is consider as ketosis. The process of ketosis
will make the cells to use ketone bodies as a prior source of energy until an individual consume
carbohydrates again. This is a highly specific process and needs a particular diet in order to
initialise production of ketones. As it contains less amount of carbohydrate, a ketogenic diet is
majorly rich in proteins and fats. It particularly includes eggs, meat, sausages, fish, butter, nuts
oils, seeds and fibrous vegetables. It is not easy to follow a keto diet for a long run because it is
so restricted and consist of some particular items only. However, it there are both positive and
negative impacts of ketogenic diet on human body. As one of the major drawback of this diet is
that many individuals indulge in having too much of protein and low quality of fats from
processed food items, and include very less amount of vegetables and fruits in their diet. It has
been examined in the study that ketogenic diet could be very harmful for the patients who are
experiencing kidney diseases. In addition to this, some of the individuals tends to feel little tired
in the initial phase of the diet and some of them may experience nausea, bad breath, constipation,
vomiting and sleeping issues.
Positive impacts of Ketogenic diet
A low-carb diet or ketogenic diet has proved to be controversial since many years. A low
carbohydrate diet is evidenced to be healthy and beneficial for most of the individuals and has a
number of health benefits. For instance, a diet that contains low amount of carbohydrate
eventually leads to reduction in appetite of an individual. It has been analysed that when
individuals avoid to intake carbohydrate in their diet and consume more amount of fats and
3
proteins mostly ends up eating a lesser amount of calories. As mentioned by Joshi and et.al.,
(2019), Ketogenic diet eliminate the risk of seizures in children and sometimes presented as an
effective medication. The main objective for introducing ketogenic diet is to reduce weight.
Some of the previous research studies has determined that ketogenic diet is the most effective
way for loosing weight at a faster pace. It also seems to intensify blood sugar regulation for the
individuals who are suffering from type 2 diabetes, at least for a shorter period of time. The
ketogenic diet basically cuts daily intake of carbohydrate to less than 20 grams. Thus, it would be
an effective remedy for diabetic patients an help them to regulate their blood sugar level. As per
the views of Klement (2017), Introducing ketogenic diet into treatment of diabetes is beneficial
to improve their blood sugar control. A low-carb diet is very helpful in to reduce anxiety and
depression. It might be due to benefits of taking a healthier and low level of blood sugar level
diet. Accumulation of fats in the liver is linked with occurrence of number of diseases such as
diabetes. In many serious circumstances, fatty liver disorders can result in damage of liver.
Healthcare professionals test for this condition by analysing the levels of liver enzymes by using
number of blood tests. It has been suggested by care professionals that if any of the individuals is
at risk of developing fatty liver is need to introduce respective diet in their daily life as it would
help them to eliminate the risk factors which may arise. Other than this, there are more benefits
of taking selected diet such as many individuals who follow this particular diet plan tends to
sleep much deeper rather than the individuals who take high calorie diet. However, at initial
phase, individuals tends to feel insomniac and would feel some difficulty in sleeping but it will
finish as body will adapt ketosis process and breakdown of stored fat. Eventually, there will be
improvement in sleeping pattern and individuals automatically tends to sleep deeper, longer and
more rested and relaxed. In addition to all such benefits, the most important positive aspect of
ketogenic dietary approach is that it might slow down occurrence and growth of cancer tumers in
the body. As cells of cancer have a high ratio of insulin receptors on them and makes them to
move on environment which is high in blood sugar level and contains insulin. A poor lifestyle
would lead to provide cancer cells a source of fuel to grow and feed. Thus, a ketogentic diet
would help the body to gain energy without even feeding to tumour cells. Ketogenic diet may
result in to boost health conditions of heart. It would reduce the chances of occurring various
heart related disorders and will eliminate the chances of heart strokes.
4
(2019), Ketogenic diet eliminate the risk of seizures in children and sometimes presented as an
effective medication. The main objective for introducing ketogenic diet is to reduce weight.
Some of the previous research studies has determined that ketogenic diet is the most effective
way for loosing weight at a faster pace. It also seems to intensify blood sugar regulation for the
individuals who are suffering from type 2 diabetes, at least for a shorter period of time. The
ketogenic diet basically cuts daily intake of carbohydrate to less than 20 grams. Thus, it would be
an effective remedy for diabetic patients an help them to regulate their blood sugar level. As per
the views of Klement (2017), Introducing ketogenic diet into treatment of diabetes is beneficial
to improve their blood sugar control. A low-carb diet is very helpful in to reduce anxiety and
depression. It might be due to benefits of taking a healthier and low level of blood sugar level
diet. Accumulation of fats in the liver is linked with occurrence of number of diseases such as
diabetes. In many serious circumstances, fatty liver disorders can result in damage of liver.
Healthcare professionals test for this condition by analysing the levels of liver enzymes by using
number of blood tests. It has been suggested by care professionals that if any of the individuals is
at risk of developing fatty liver is need to introduce respective diet in their daily life as it would
help them to eliminate the risk factors which may arise. Other than this, there are more benefits
of taking selected diet such as many individuals who follow this particular diet plan tends to
sleep much deeper rather than the individuals who take high calorie diet. However, at initial
phase, individuals tends to feel insomniac and would feel some difficulty in sleeping but it will
finish as body will adapt ketosis process and breakdown of stored fat. Eventually, there will be
improvement in sleeping pattern and individuals automatically tends to sleep deeper, longer and
more rested and relaxed. In addition to all such benefits, the most important positive aspect of
ketogenic dietary approach is that it might slow down occurrence and growth of cancer tumers in
the body. As cells of cancer have a high ratio of insulin receptors on them and makes them to
move on environment which is high in blood sugar level and contains insulin. A poor lifestyle
would lead to provide cancer cells a source of fuel to grow and feed. Thus, a ketogentic diet
would help the body to gain energy without even feeding to tumour cells. Ketogenic diet may
result in to boost health conditions of heart. It would reduce the chances of occurring various
heart related disorders and will eliminate the chances of heart strokes.
4
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Regulation of blood sugar levels would help an individual to control cravings. Most of
the individuals seems to make better food choices who are not on a high sugar diet. As per the
perspective of Paoli and et.al., (2019), intermittent fasting is very common practice among
ketogenic dieters who have been on the diet for a while. Sugar is a form of energy, and would
not keep the mind of an individual at its best. It has been identified that brain functions better on
ketogenic diet rather than on a high sugar diet. Ketones are generally develop to fuel the body in
the absence of glucose and functions of brain modifies in a drastic manner on a ketogenic diet.
Source: 10 Graphs That Show the Power of a Ketogenic Diet, 2020
In could be interpreted from the above graph that individuals who are on a ketogenic diet
tends to lose weight faster, besides the fact that their calorie or protein intake is equal to
individual who are not on ketogenic diet. Thus, it suggests that low carb diet proved to offer a
metabolic advantage over a high sugar or high carbohydrate containing diet.
5
Illustration 1: Change in level of blood glucose
the individuals seems to make better food choices who are not on a high sugar diet. As per the
perspective of Paoli and et.al., (2019), intermittent fasting is very common practice among
ketogenic dieters who have been on the diet for a while. Sugar is a form of energy, and would
not keep the mind of an individual at its best. It has been identified that brain functions better on
ketogenic diet rather than on a high sugar diet. Ketones are generally develop to fuel the body in
the absence of glucose and functions of brain modifies in a drastic manner on a ketogenic diet.
Source: 10 Graphs That Show the Power of a Ketogenic Diet, 2020
In could be interpreted from the above graph that individuals who are on a ketogenic diet
tends to lose weight faster, besides the fact that their calorie or protein intake is equal to
individual who are not on ketogenic diet. Thus, it suggests that low carb diet proved to offer a
metabolic advantage over a high sugar or high carbohydrate containing diet.
5
Illustration 1: Change in level of blood glucose
Source: What is a keto or low carb diet, 2019
From the above graph, it can be illustrated that specific diet contains low amount of
carbohydrate and low level of fats which could make human body to breakdown fats as a fuel
rather than using glucose or carbs as it prior source of energy.
Some of the conditions under a study with a low carbohydrate or ketogenic diet is
described in the table below:
Conditions Impact of low-carbohydrate diet
Cancer It has a positive impact on patients of cancer
which leads to immune modulation and
eliminate side effects of radiations and
chemotherapy.
Cardiovascular Ketogenic diet is helpful for weight loss and
help to reduce the risk of heart strokes and
heart diseases. Ketogenic diet may result in to
boost health conditions of heart.
Type 1 diabetes It reduce postprandial glycemic excursions and
help to minimize the effects of type 1 diabetes
by regulating blood sugar levels in body. (The
Ketogenic Diet: Evidence for Optimism but
6
Illustration 2: keto and low carb content
From the above graph, it can be illustrated that specific diet contains low amount of
carbohydrate and low level of fats which could make human body to breakdown fats as a fuel
rather than using glucose or carbs as it prior source of energy.
Some of the conditions under a study with a low carbohydrate or ketogenic diet is
described in the table below:
Conditions Impact of low-carbohydrate diet
Cancer It has a positive impact on patients of cancer
which leads to immune modulation and
eliminate side effects of radiations and
chemotherapy.
Cardiovascular Ketogenic diet is helpful for weight loss and
help to reduce the risk of heart strokes and
heart diseases. Ketogenic diet may result in to
boost health conditions of heart.
Type 1 diabetes It reduce postprandial glycemic excursions and
help to minimize the effects of type 1 diabetes
by regulating blood sugar levels in body. (The
Ketogenic Diet: Evidence for Optimism but
6
Illustration 2: keto and low carb content
High-Quality Research Needed, 2020).
Obesity It helps in to minimize anabolic stimulation of
adipose tissues and helps in partitioning of
metabolic fuels which eventually results in low
occurrence of obesity.
Fatty liver It help in to eliminate the risk factors which
may arise due to damaged liver because of
intake poor diet.
Negative impacts of ketogenic diet
In addition to number of positive impacts of ketogenic diet there are few of its side effcts
also. Some of the side effects of ketogenic diet is bound to develop while others may be
developed if the diet is implemented in a poor manner. Any individual who is following a
ketogenic diet for a long term should be careful as it could result in negative consequences that
could even be severe when they are overlooked by the person. Keto diet is often termed as a fad
diet which means makes no mistake. As mentioned by Oliveira and et.al., (2018), unlike other
normal diet, a low-carbohydrate diet is unique as it pushes the body to a natural and alternate
metabolic state known as ketosis. People who gets failed in managing the keto diet in an
effective manner could experience occurrence of some side effects crucially by consuming a
balanced diet, nutrient rich foods as a part of ketogenic diet. Constipation is one such side effect
that may developed due to intake of low-carbohydrate diet. As this particular diet usually cuts
out most common sources of fats. Some of the richest sources of fibres include beans, fibres,
fruits and whole grains which are totally restricted from the diet. As a consequence dieters of
ketogenic diet usually miss out intake of fibre rich food items and its benefits such as micro-
biome support and regular laxation. Micro-biome is involved in everything from mental health to
immune function. Vitamin deficiency is the another negative consequence or a result of intake of
low carbohydrate diet. As it is a diet which restricts an individual to eat many types of
vegetables, fruits and other food items which made him vulnerable to deficiency of minerals and
vitamins. This is the reason why healthcare professionals advice to follow keto diet for a short
period of time only. In addition to this, Diarrhoea is another negative factor that can develop
during the period of low carbohydrate diet. It could be due to lack of fibre in the diet. Klement
7
Obesity It helps in to minimize anabolic stimulation of
adipose tissues and helps in partitioning of
metabolic fuels which eventually results in low
occurrence of obesity.
Fatty liver It help in to eliminate the risk factors which
may arise due to damaged liver because of
intake poor diet.
Negative impacts of ketogenic diet
In addition to number of positive impacts of ketogenic diet there are few of its side effcts
also. Some of the side effects of ketogenic diet is bound to develop while others may be
developed if the diet is implemented in a poor manner. Any individual who is following a
ketogenic diet for a long term should be careful as it could result in negative consequences that
could even be severe when they are overlooked by the person. Keto diet is often termed as a fad
diet which means makes no mistake. As mentioned by Oliveira and et.al., (2018), unlike other
normal diet, a low-carbohydrate diet is unique as it pushes the body to a natural and alternate
metabolic state known as ketosis. People who gets failed in managing the keto diet in an
effective manner could experience occurrence of some side effects crucially by consuming a
balanced diet, nutrient rich foods as a part of ketogenic diet. Constipation is one such side effect
that may developed due to intake of low-carbohydrate diet. As this particular diet usually cuts
out most common sources of fats. Some of the richest sources of fibres include beans, fibres,
fruits and whole grains which are totally restricted from the diet. As a consequence dieters of
ketogenic diet usually miss out intake of fibre rich food items and its benefits such as micro-
biome support and regular laxation. Micro-biome is involved in everything from mental health to
immune function. Vitamin deficiency is the another negative consequence or a result of intake of
low carbohydrate diet. As it is a diet which restricts an individual to eat many types of
vegetables, fruits and other food items which made him vulnerable to deficiency of minerals and
vitamins. This is the reason why healthcare professionals advice to follow keto diet for a short
period of time only. In addition to this, Diarrhoea is another negative factor that can develop
during the period of low carbohydrate diet. It could be due to lack of fibre in the diet. Klement
7
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and et.al., (2017) states that it is more often happen with the individuals who cut carbs such as
whole grain bread and other vegetables along with fibre rich foods. Another major negative
consequence of keto related changes in weight is loss of muscle mass. Individual who is on this
particular diet would loose weight but it might actually be a lot of muscle mass. This is because
muscle burns more calories in comparison to fat that would effect metabolism process. When a
person leaves ketogenic diet and try to regain weight again then there are chances that there are
less possibilities of regaining muscle mass again. It could even have a long lasting effect on
resting metabolic rate and on individual weight for a long duration.
As per the views of Włodarek (2019), the diet that contains low amount of carbohydrate
and higher amount of fats may result in dehydration and a loss of electrolytes. The most
important source of body is glucose which is created from carbohydrate. In a diet that has lesser
amount of carbohydrate, body needs to adjust by using ketones which occurs through breakdown
of fats for energy. In addition to this situation, kidney starts to release more electrolytes. This
results in decrease of total water from body as carbohydrates become low in a keto diet. Keto flu
which consist of several symptoms like headache, nausea, constipation, fatigue, cramps,
irritability and many others are most likely to appear for the individual who is on low
carbohydrate diet since a long period of item. Thus, it is important to drink plenty of water in
order to help a body to deal with they occurrence of such symptoms and individual should
consult with a healthcare professional if such symptoms become severe. As per the idea of
Sarnyai and et.al., (2019), females who are indulge in intake of ketogenic dietary may result in
irregular periods or may completely stops during keto diet. It is more often due to rapid weight
loss rather than the quality of diet itself. It is more likely to appear due to drop of gonadotropin
releasing hormone, follicle stimulating hormone and progesterone. A long term disturbance in
mensuration cycle of female may results in lots of negative consequences including low bone
density. It is majorly because such hormones are important for maintaining bone health. It has
been identified that mensuration irregularity may result in occurrence of depression, sexual
dysfunction, anxiety and cardiovascular diseases.
8
whole grain bread and other vegetables along with fibre rich foods. Another major negative
consequence of keto related changes in weight is loss of muscle mass. Individual who is on this
particular diet would loose weight but it might actually be a lot of muscle mass. This is because
muscle burns more calories in comparison to fat that would effect metabolism process. When a
person leaves ketogenic diet and try to regain weight again then there are chances that there are
less possibilities of regaining muscle mass again. It could even have a long lasting effect on
resting metabolic rate and on individual weight for a long duration.
As per the views of Włodarek (2019), the diet that contains low amount of carbohydrate
and higher amount of fats may result in dehydration and a loss of electrolytes. The most
important source of body is glucose which is created from carbohydrate. In a diet that has lesser
amount of carbohydrate, body needs to adjust by using ketones which occurs through breakdown
of fats for energy. In addition to this situation, kidney starts to release more electrolytes. This
results in decrease of total water from body as carbohydrates become low in a keto diet. Keto flu
which consist of several symptoms like headache, nausea, constipation, fatigue, cramps,
irritability and many others are most likely to appear for the individual who is on low
carbohydrate diet since a long period of item. Thus, it is important to drink plenty of water in
order to help a body to deal with they occurrence of such symptoms and individual should
consult with a healthcare professional if such symptoms become severe. As per the idea of
Sarnyai and et.al., (2019), females who are indulge in intake of ketogenic dietary may result in
irregular periods or may completely stops during keto diet. It is more often due to rapid weight
loss rather than the quality of diet itself. It is more likely to appear due to drop of gonadotropin
releasing hormone, follicle stimulating hormone and progesterone. A long term disturbance in
mensuration cycle of female may results in lots of negative consequences including low bone
density. It is majorly because such hormones are important for maintaining bone health. It has
been identified that mensuration irregularity may result in occurrence of depression, sexual
dysfunction, anxiety and cardiovascular diseases.
8
REFERENCES
Books and Journals
Vargas, S., and et.al., 2018. Efficacy of ketogenic diet on body composition during resistance
training in trained men: a randomized controlled trial. Journal of the International
Society of Sports Nutrition. 15(1). p.31.
Joshi, S., and et.al., 2019. The ketogenic diet for obesity and diabetes—enthusiasm outpaces
evidence. JAMA internal medicine. 179(9). pp.1163-1164.
Klement, R.J., 2017. Beneficial effects of ketogenic diets for cancer patients: a realist review
with focus on evidence and confirmation. Medical Oncology. 34(8). p.132.
Paoli, A., and et.al., 2019. Ketogenic diet and microbiota: friends or enemies?. Genes. 10(7).
p.534.
Oliveira, C.L., and et.al., 2018. A nutritional perspective of ketogenic diet in cancer: a narrative
review. Journal of the Academy of Nutrition and Dietetics. 118(4). pp.668-688.
Klement, R.J., and et.al., 2017. Need for new review of article on ketogenic dietary regimes for
cancer patients. Medical Oncology. 34(6). p.108.
Włodarek, D., 2019. Role of ketogenic diets in neurodegenerative diseases (Alzheimer’s disease
and Parkinson’s disease). Nutrients. 11(1). p.169.
Sarnyai, Z., and et.al., 2019. Ketogenic diet for schizophrenia: clinical implication. Current
opinion in psychiatry. 32(5). pp.394-401.
Online:
10 Graphs That Show the Power of a Ketogenic Diet. 2020. [Online]. Available
through:<https://www.healthline.com/nutrition/10-graphs-power-of-ketogenic-diet#section4>.
What is a keto or low carb diet. 2019.[Online]. Available through:<https://holisticyum.com/keto-
and-low-carb-beginners-diet-guide/>.
The Ketogenic Diet: Evidence for Optimism but High-Quality Research Needed. 2020.[Online].
Available through:<https://academic.oup.com/jn/advance-article/doi/10.1093/jn/
nxz308/5673196>
9
Books and Journals
Vargas, S., and et.al., 2018. Efficacy of ketogenic diet on body composition during resistance
training in trained men: a randomized controlled trial. Journal of the International
Society of Sports Nutrition. 15(1). p.31.
Joshi, S., and et.al., 2019. The ketogenic diet for obesity and diabetes—enthusiasm outpaces
evidence. JAMA internal medicine. 179(9). pp.1163-1164.
Klement, R.J., 2017. Beneficial effects of ketogenic diets for cancer patients: a realist review
with focus on evidence and confirmation. Medical Oncology. 34(8). p.132.
Paoli, A., and et.al., 2019. Ketogenic diet and microbiota: friends or enemies?. Genes. 10(7).
p.534.
Oliveira, C.L., and et.al., 2018. A nutritional perspective of ketogenic diet in cancer: a narrative
review. Journal of the Academy of Nutrition and Dietetics. 118(4). pp.668-688.
Klement, R.J., and et.al., 2017. Need for new review of article on ketogenic dietary regimes for
cancer patients. Medical Oncology. 34(6). p.108.
Włodarek, D., 2019. Role of ketogenic diets in neurodegenerative diseases (Alzheimer’s disease
and Parkinson’s disease). Nutrients. 11(1). p.169.
Sarnyai, Z., and et.al., 2019. Ketogenic diet for schizophrenia: clinical implication. Current
opinion in psychiatry. 32(5). pp.394-401.
Online:
10 Graphs That Show the Power of a Ketogenic Diet. 2020. [Online]. Available
through:<https://www.healthline.com/nutrition/10-graphs-power-of-ketogenic-diet#section4>.
What is a keto or low carb diet. 2019.[Online]. Available through:<https://holisticyum.com/keto-
and-low-carb-beginners-diet-guide/>.
The Ketogenic Diet: Evidence for Optimism but High-Quality Research Needed. 2020.[Online].
Available through:<https://academic.oup.com/jn/advance-article/doi/10.1093/jn/
nxz308/5673196>
9
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