FAM203A - Literature Review on the Ketogenic Diet: Benefits & Risks

This literature review examines the ketogenic diet, exploring its therapeutic benefits and potential risks. It discusses the diet's impact on weight loss, cardiovascular health, and the treatment of epilepsy, referencing multiple studies. The review highlights the diet's composition, emphasizing high fat and low carbohydrate intake, while also addressing associated challenges such as potential short-term adverse effects and long-term health considerations. The analysis underscores the diet's growing popularity, particularly among individuals seeking weight management and those with specific health conditions, while also cautioning about the need for informed implementation and awareness of potential complications. The student's work provides a comprehensive overview of the ketogenic diet's role in health and wellness.

Running head: LITERATURE REVIEW ON KETOGENIC DIET
Literature Review on Ketogenic Diet
Name of the Student
Name of the University
Author Note

1LITERATURE REVIEW ON KETOGENIC DIET
Introduction
All over the world along with the development of the technologies, various treatment
processes are evolved. However, the issue of obesity is still growing around the world and it
causes a major threat to the society as it has become a major hazard along with a primary
contributor to the overall mortality rate of the world. According to the study of Smith and
Ryckman (2015), it is reported that the most of the chronic diseases such as hypertension,
diabetes and heart disease are mostly correlated with the onset of the obesity. In various
studies, the researchers reported that the obesity and various chronic disease conditions are
mostly related with the poor dietary practices and unhealthy lifestyles. According to the study
of Paoli (2014), it is reported that the concept of ketogenic diet is mainly based on the low
level of carbohydrate consumption and high level of fat consumption. As per this dietary
model an individual must drastically reduce the consumption of the carbohydrates and along
with this the consumption of the fat contents and it is reported that the reduction in the carbs
allows the body into such metabolic state that is called ketosis. From the classifications of the
diet, it can be stated that in specific type of diet the principles of the holistic nutrition is not
met as in this diet the mainly based on the low carbohydrate and high fat content foods (Paoli
et al., 2015).
In this essay, the effect of Ketogenic diet on the individuals along with the therapeutic
effects of this diet is discussed in a brief manner.
Therapeutic Benefits of the Model
While discussing about the therapeutic benefits of this Ketogenic diet model, it can be
stated that one of the most important therapeutic intervention is associated with the weight
loss of the individuals. Moreover, the problem of obesity is also associated with the onset
diabetes type 2 mellitus. According to the study of Goday et al. (2016) it is stated that the use

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of very low-calorie-ketogenic (VLCK) is very effective in reducing the weight of the
individuals. In this study 89 men and women were included in the study and they were
involved in 4 months dietary program. The study participants were randomly assigned to the
VLCK diet (VLCK diet group) or to the low-calorie diet (LC diet group). The study result
showed that the use of the VLCK diet among the patients are quite beneficial in losing
weight and along with this this diet program is tolerable to the diabetic type patients
compared to the LC diet. This study finding was also supported by the study result of
Moreno et al. (2016). In this study, the authors found that the effectiveness of long term use
of Ketogenic diet program and they found that the use of this diet for at least 24 months can
reduce the visceral adipose tissue and a reduction in the individual burden of disease.
Moreover, reduction in the body weight, body fat mass and waist circumference was also
reported by the researchers.
In order to improve the conditions of the various cardiovascular disease, the use of
Ketogenic diet can be recommended. In this context, it can be stated that use of this diet is
beneficial for the improvement of the cardiovascular disease. According to the study of
Kanikarla-Marie and Jain (2016), it is stated that the reduction in the carbohydrate levels can
induce the physiological ketosis and as a consequence of this, lowering of the blood lipid
profile takes place. It is assumed the effect of Ketogenic diet is mainly associated with the
reduction of the blood triglyceride levels, total cholesterol levels and along with this overall
increase in the high-density lipoprotein levels were also reported by the researchers.
Moreover in another study by Gjuladin-Hellon et al. (2019), it is reported that the use of
Ketogenic diet can enhance the size and volume of the low-density lipoprotein–cholesterol
particles that is associated with the reduction of risks of cardiovascular disease development.
In another study by Castro et al. (2016), it is reported that the low amount of carbohydrate
consumption will also alter the cholesterol biosynthesis by reducing the amount of insulin in

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the body and it is reported that the insulin can active the HMG-CoA reductase, a key rate
limiting enzyme of cholesterol biosynthesis. This study finding was also supported by the
research result of Kosinski and Jornayvaz (2017) as they also reported that the use of this diet
can reduce the various risk factors of the cardiovascular disease such as HDL cholesterol
levels, obesity. However, the study also warned about the adverse incidents such as formation
of development of nonalcoholic fatty liver disease (NAFLD).
Another important therapeutic use of the Ketogenic diet is associated with the
treatment process of epilepsy patients. According to the study of Zhang et al. (2018), the
effectiveness of Ketogenic diet in the treatment of the epilepsy patients was examined and in
this systematic review study it was reported that the use of Ketogenic diet in case of epilepsy
patients may enhance the therapeutic strategies against the epilepsy. In another study by
Hallböök et al. (2015) the effectiveness of this diet among the children epilepsy patients was
examined and this study was conducted in five centres specialised in KD located in
Scandinavia. The study result reported that the use of this dietary intervention was quite
beneficial. The research showed that, at 6, 12 and 24 months approximately 16 per cent, 13
per cent and 10 per cent of the study population were free from seizure. Moreover, none of
the children reported about the enhanced seizure frequency. However, the study also reported
about the side effects in a few cases as well. The best outcome of Ketogenic diet regarding
the epilepsy was shown in case of atonic seizures. Therefore the study concluded that KD is
very effective among the Scandinavian children. In the study of Li, Zou and Ding (2013)
supported the study finding of Hallböök et al. (2015) as they also reported about the efficacy
of the KD in the treatment of the epilepsy disease. This meta-analysis study reported
that 58.4% of physicians opted for KD as a treatment option at 3 month (n=336) and at 6
months, this number was almost 492 that is approximately 42.8% (95%CI =36.3% – 50.3%).
The weighted success rate was almost 53.9% (95%CI 45.5% – 63.8%) at 3 months (n=474),

4LITERATURE REVIEW ON KETOGENIC DIET
53.2% (95%CI =44.0% – 64.2%) at 6 months and in case of 12 months this rate was almost
55.0% (95%CI =45.9% – 65.9%) at 12 months (n=347) (Li, Zou and Ding ,2013).
Composition of the Nutritional Model
While discussing about the composition of the Ketogenic diet it can be stated that
generally this type of diet consists high am amount of fat, moderate amount of proteins and
very low amount of carbohydrate components. The dietary macronutrients are mainly divided
into 55 to 60 per cent of fat of total food materials, 30 to 35 per cent of protein components
and 5 to 10 per cent of the carbohydrate components. In this context it can be mentioned that
in a 2000 kcal per day diet, 20 to 50 gm of carbohydrate can be consumed by an individual
(Masood & Uppaluri, 2019).
Challenges Associated with the Dietary Model
Ketogenic diet is mainly used for the weight management that is the people who are
suffering from the issue of obesity can follow this diet after taking opinions from the
nutritional experts. Moreover, it can be reported that this diet can be used among the
community people who are suffering from various diseases such as cardiovascular disease,
epilepsy, diabetes type 2 (Masood & Uppaluri, 2019).
While discussing about the adverse consequences of the Ketogenic diet
implementation, it can be stated that the short term effects of the Ketogenic diet is well
established and in case of the long term effect of the condition, it is still not known
completely. Thus the short term adverse effect of this diet include nausea, fatigue, vomiting,
headache, difficulty in exercise tolerance, dizziness, insomnia and constipation and all these
symptoms sometimes are referred to as keto flu (Masood & Uppaluri, 2019). Moreover, in
other studies, it was reported that the people suffering from the problem of diabetes may

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suffer from critical hypoglycaemia if the medications are not managed properly before
initiating the Ketogenic diet (Abbasi, 2018). In another study by Hannigan and Field (2018),
it was reported that the use of Ketogenic diet is not at all safe for the individuals who are
suffering from the problems like liver failure, pancreatitis, disorders related to fat
metabolism, carnitine palmitoyltransferase deficiency, primary carnitine deficiency, carnitine
translocase deficiency, porphyrias, or pyruvate kinase deficiency.
Conclusion
Hence, it can be concluded that the use of Ketogenic diet has become very popular in
recent time and it is widely used by the people around the world. The use of this diet is
mostly popular among the people who are obese. However, in the management of the various
diseases such as cardiovascular diseases, epilepsy, diabetes type 2. However, there are a few
evidences that suggest about multiple complications.

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References
Abbasi, J. (2018). Interest in the ketogenic diet grows for weight loss and type 2
diabetes. Jama, 319(3), 215-217.
Castro, C., Corraze, G., Firmino-Diógenes, A., Larroquet, L., Panserat, S., & Oliva-Teles, A.
(2016). Regulation of glucose and lipid metabolism by dietary carbohydrate levels and
lipid sources in gilthead sea bream juveniles. British Journal of Nutrition, 116(1), 19-34.
Gjuladin-Hellon, T., Davies, I. G., Penson, P., & Amiri Baghbadorani, R. (2019). Effects of
carbohydrate-restricted diets on low-density lipoprotein cholesterol levels in overweight
and obese adults: a systematic review and meta-analysis. Nutrition reviews, 77(3), 161-
180.
Goday, A., Bellido, D., Sajoux, I., Crujeiras, A. B., Burguera, B., García-Luna, P. P., ... &
Casanueva, F. F. (2016). Short-term safety, tolerability and efficacy of a very low-calorie-
ketogenic diet interventional weight loss program versus hypocaloric diet in patients with
type 2 diabetes mellitus. Nutrition & diabetes, 6(9), e230-e230.
Hallböök, T., Sjölander, A., Åmark, P., Miranda, M., Bjurulf, B., & Dahlin, M. (2015).
Effectiveness of the ketogenic diet used to treat resistant childhood epilepsy in
Scandinavia. European Journal of Paediatric Neurology, 19(1), 29-36.
Hannigan, S., & Field, S. (2018). Inherited Metabolic Diseases: Research, Epidemiology and
Statistics, Research, Epidemiology and Statistics. CRC Press.
Kanikarla-Marie, P., & Jain, S. K. (2016). Hyperketonemia and ketosis increase the risk of
complications in type 1 diabetes. Free Radical Biology and Medicine, 95, 268-277.

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Kosinski, C., & Jornayvaz, F. R. (2017). Effects of ketogenic diets on cardiovascular risk
factors: evidence from animal and human studies. Nutrients, 9(5), 517.
Li, H. F., Zou, Y., & Ding, G. (2013). Therapeutic success of the ketogenic diet as a
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