What Is the Ketogenic Diet? Its Benefits and Health Risks

Since the 1920s, the ketogenic diet has been recommended for epilepsy and cancer patients, while also chosen for rapid weight loss, characterized by very low carbohydrate intake. Disease-related diets generally aim at healthier eating, weight loss and disease prevention or delay. Recently, however, keto has changed this pattern with different promises. We will try to answer what it is and its role in cancer.

Advocates say it is nearly as effective as medication for certain illnesses. It has long been used to control specific disorders such as epilepsy. With obesity, diabetes and other chronic conditions growing as health problems, the question arose whether keto might also help other conditions.

How is the ketogenic diet followed?

The diet consists primarily of fat (70-80%), with protein (8-15%) and small amounts of carbohydrates (2% - 5%). The aim is to keep the dieting body in ideal condition without weight gain. Restricting carbohydrate and protein means energy comes instead from body fat and dietary fat: the body burns fat for energy. As glucose falls, fat-derived ketone groups become the main energy source, a metabolic state called ketosis. Three forms exist: the medium-chain triglyceride diet, modified Atkins diet and low-glycemic-index treatment.

Even with these choices, health concerns remain. If incorrectly followed, it risks nutrient deficiency, hypovolemia, hypokalemia, kidney stones and gout. It must therefore be formulated appropriately.

Foods recommended by the ketogenic diet include:

• Red meat
• Poultry
• Fish
• Eggs 
• Cheese
• Avocado
• Olive oil
• Coconut oil, among other options.

It also includes some starchy vegetables such as greens, green beans and broccoli. Although restrictive, its high fat content is said to make these foods more appealing and satisfying.

Foods not recommended (to be restricted or avoided) include: 

• Grains and similar products (rice, wheat, rye, oats, barley, quinoa, pasta, cereal, pizza)
• Legumes and beans
• Some vegetables and roots (peas, corn, potatoes, potatoes)
• High-carbohydrate fruits; dried fruit (bananas, apples, oranges) 
• Low-fat dairy products
• Refined solid and liquid fats; vegetable oils
• Sugar
• Alcohol.

Does the ketogenic diet have a role in cancer?

Cancer is the collective name for a large heterogeneous group of diseases, but many types share the Warburg effect;

Low oxygen alters cancer cells' energy-production mechanisms. They can therefore produce energy, grow and proliferate without oxygen. Even with extra oxygen, they continue producing energy without using it through anaerobic glycolysis. This is called the "Warburg effect."

Lactic acid consequently accumulates. An acidic environment is therefore a result of cancer, not its cause. For this reason, alkaline treatments are ineffective in cancer.

Keto advocates interpret the Warburg effect — summarized as cancer cells producing energy without oxygen — as meaning cells die if deprived of sugar, a misinterpretation. Although fat molecules do not directly become sugar (glucose), the liver obtains energy from fats to produce glucose.

- What are starch and fructose, and how does excess sugar become fat?

Perhaps for this reason, clinical studies testing keto in cancer and other chronic conditions have produced inconsistent results.

Conclusion

Very high fat, low protein and almost no carbohydrate make long-term use nearly impossible. Radically changing food habits is a lifelong approach with considerable potential side effects. Many studies proving efficacy in epilepsy are accompanied by studies and evidence for treating obesity and type 2 diabetes. However, most applications in cancer and other neurological disorders offer early, uncertain evidence.

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