Keto Clarity: Your Definitive Guide to the Benefits of a Low-Carb, High-Fat Diet (46 page)

I tell my patients that we can learn some important things from evolutionary biology and empirical science. What did our evolutionary ancestors eat? We can’t be sure, but we do know it wasn’t Twinkies, soda, and pizza! If people eat in a certain way—say the Standard American Diet—and they keep getting sick and fat, that should tell us something about the dangers of consuming processed food. We can argue to the ends of the earth about exactly
why
this type of diet is harmful, but the argument about whether or not it is dangerous is clearly over.

– Dr. Bill Wilson

The modern research on low-carb, high-fat diets for the treatment of type 2 diabetes (also known as
adult-onset diabetes
) includes several randomized, controlled trials that allowed for carbohydrate intake from 20 to 100 grams per day. Overall, the studies found that reducing carbohydrate in the diet results in a greater reduction of blood glucose and less need for diabetes medications. In many instances, the need for diabetes medication was eliminated and blood sugar control was even better than before! A randomized, controlled trial comparing the low-carb, high-fat, ketogenic diet to the low-glycemic, low-calorie diet over a six-month period found that those on the ketogenic diet needed less diabetes medication.

Many patients with type 2 diabetes have noticed a total reversal of their disease off of all medications.

– Dr. Ron Rosedale

The low-carb, high-fat diet as a treatment for diabetes really combines two different approaches: 1) eliminating foods that raise blood sugar levels, and 2) losing weight. Sometimes the food and beverage effect is so great that when carbohydrates are eliminated, there is no longer any need for medication. In these cases, the diabetes was caused by diet. (Of course, in the case of type 1 diabetes, in which the body doesn’t produce insulin at all, some medication will still be needed, but even then, a ketogenic diet can reduce how much is required.) If the diabetes is exacerbated by or a result of excessive weight, then it makes sense to treat the obesity as well. Thankfully, research strongly supports the use of a ketogenic diet for diabetes as well as weight loss, which leads us to the next area for which there is strong evidence supporting the ketogenic approach.

Weight Loss

A ketogenic diet may provide weight loss benefits over and above those achieved with carbohydrate restriction alone. It provides all the benefits of a low-carb diet but to a somewhat greater degree, since ketosis increases satiety and provides mental clarity, focus, prolonged concentration, and increased energy.

– Dr. William Davis

The low-carb, high-fat diet is perhaps best known for helping overweight people lose weight. In fact, since the late 1800s, doctors having been using this approach to help people shed pounds, and up until the 1970s it was common knowledge that if you wanted to make the numbers on the scale go down, you just cut back on bread, pasta, and rice. The great benefit of following a ketogenic diet for weight loss is that it greatly reduces and many times eliminates the hunger that accompanies most other diets, which is a big reason why so many people fail on most diets.

The low-carb approach to weight loss was used in the 1990s by a small group of doctors, as outlined in bestselling diet books such as
Dr. Atkins’ Diet Revolution
by Dr. Robert Atkins and
Protein Power
by Dr. Michael Eades and Dr. Mary Dan Eades. Many of these books sold millions of copies, but researchers didn’t really examine this approach seriously until about 2004. That’s when several randomized, controlled clinical trials were published showing the diet’s beneficial effects on weight and metabolism in general, and over the past decade, multiple randomized, controlled trials have shown similar results.

Jacqueline Eberstein, a registered nurse who worked with the late, great Dr. Robert C. Atkins for three decades, said Dr. Atkins never measured blood ketones because it was too expensive. Eberstein noted that the best tool Dr. Atkins and his medical team had for determining if a patient was in ketosis was urine ketone testing strips, which she said were “used for every patient on every visit.” The initial baseline reading almost always came back negative, so they were able to track when ketone production began. The Atkins Center later added a large, cumbersome machine that could analyze the breath for ketones. Routine calibration was needed to keep it operating. These days, the technology is a lot more sophisticated and user-friendly than it was in the 1970s and 1980s, and better ketone monitoring can help you determine if you are burning sugar or fat.

Getting into ketosis may not immediately kick-start weight loss. But the presence of ketones is a clear indication that your body is primed to burn fat for fuel, and that means you’ll lose weight.

Cardiovascular Disease, Metabolic Syndrome, and Contributing Factors

For over two decades I have been using a low-carb, high-fat diet to treat very sick diabetic and cardiovascular patients. I have noticed a vast improvement in diabetes, cardiovascular disease, and obesity in nearly all of my patients on the diet.

– Dr. Ron Rosedale

Most of us have been taught that a low-fat diet is the healthiest, most nutritious diet, especially for cardiovascular health. At the same time, we’ve been told that a high-fat diet is completely unhealthy because it raises cholesterol, which in turn “clogs your arteries” and leads to heart disease (an erroneous idea that we debunked in
Cholesterol Clarity
). In the 1950s and 60s, virtually every major health organization came out against high-fat diets even though there was no direct evidence that they were harmful to anyone’s health. They simply believed the hypothesis, promoted by Ancel Keys, that saturated fat raises cholesterol, which in turn increases your risk for heart disease. That concept was never actually tested by researchers.

This teaching was based entirely on a prediction of what
might
happen, not on any direct research on the effects of a high-fat diet. Today, all of the studies directly examining the low-carb, high-fat diet have shown these fatalistic predictions to be wrong—dead wrong! The ketogenic diet does not worsen the state of metabolism; instead, it improves it!

The most beneficial aspect of a strongly ketogenic environment and metabolism is that they protect us from nearly all the modern diseases plaguing us today, including heart disease and obesity.

– John Kiefer

The understanding of the causes of heart disease has changed, too, over the last ten years—so it can be confusing to doctors and the public alike. The umbrella term
metabolic syndrome
now encompasses all of the various contributors to heart disease: increased abdominal circumference, high blood pressure, elevated blood sugar, high blood triglycerides, and low HDL cholesterol (the “good” cholesterol). It turns out that the low-carb, high-fat, ketogenic diet improves all of these telltale signs of metabolic syndrome.

In fact, the scientific evidence shows that the ketogenic diet reduces belly fat, lowers blood pressure and blood sugar levels, reduces triglycerides, increases good cholesterol (HDL), and so much more. Researchers Dr. Richard Feinman and Dr. Jeff Volek published a study in the November 16, 2005, issue of the journal
Nutrition & Metabolism
that concluded all of the markers of metabolic syndrome are the same ones that are improved by carbohydrate restriction. This is not a coincidence.

DOCTOR’S NOTE FROM DR. ERIC WESTMAN: Good cholesterol (HDL) rises in most people who are following a low-carb, high-fat diet, which is one of the reasons why the diet doesn’t increase the risk of heart disease. The best way to raise the HDL cholesterol is by eating eggs and saturated fat (seriously!).

Polycystic Ovary Syndrome (PCOS)

PCOS is a common hormonal disorder that affects women of reproductive age and is a major cause of infertility. It is usually associated with an irregular or absent menstrual cycle, excessive body hair, obesity, and type 2 diabetes. PCOS often occurs alongside insulin resistance, and because the two are so closely related, it stands to reason that PCOS is helped immensely by a ketogenic diet.

A clinical study on PCOS and the ketogenic diet was conducted by Dr. Eric Westman and others and published in the medical journal
Nutrition & Metabolism
in 2005. Five women with PCOS were put on a low-carb, high-fat, ketogenic diet for a period of six months, and these women had an average weight loss of 12 percent as well as improvements in their hormonal measurements. In fact, two of the five women became pregnant during the study despite previously experiencing infertility problems.

Irritable Bowel Syndrome (IBS)

IBS is a common disorder in the United States, affecting 10 to 15 percent of the adult population. People with IBS tend to experience stomach discomfort, pain, and bloating. This condition is divided into “diarrhea-predominant” and “constipation-predominant” types depending upon which symptom is experienced more often. It’s a miserable condition, and some people suffering from it feel hopeless about making any progress through diet changes.

In fact, the idea of a low-carb, high-fat diet for someone with IBS may not be very appealing at first glance. After all, eating more fat can lead to even more diarrhea at first. But soon after, the symptoms all start to clear up and you feel normal again. This improvement is not an uncommon experience based on the many anecdotal experiences shared across the Internet. But additionally, several clinical trials have shown that a diet low in sugar can improve IBS.

A study published in the June 2009 issue of
Clinical Gastroenterology and Hepatology
looked at thirteen patients who used a low-carb, high-fat, ketogenic diet for diarrhea-predominant IBS over a four-week period and saw an improvement in stool frequency, stool consistency, abdominal pain, and quality of life. The ketogenic diet is giving people suffering with this uncomfortable condition hope.