03/08/2018 10:29 BST | Updated 03/08/2018 10:29 BST

Ketogenic Diets - Good, Bad, Ugly

Remember, there is a lot more to managing your health and weight than the food you choose

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There has been a lot of hype about ketogenic diets or low carb, high fat (LCHF). Maybe you have tried them or read about them but not been convinced? Perhaps you have tried the Atkins or Dukan diet (similar but different!) and aren’t sure what all the fuss is about?

Want the low down on the good points and why they can be no better than the other fads? Read on.

The good

Ketogenic or similar low-carb diets are based on a really simple principle – reducing the insulin load. And with it, insulin resistance. What’s that all about?

One in three of us are reportedly pre-diabetic and have some degree of difficulty controlling our blood sugar. Fatty liver disease and type 2 diabetes are on the increase. What ties all of those together? Insulin resistance. Insulin resistance is a condition that is linked to an increased risk of all of these, plus heart disease and more. It is associated with stomach fat or fat around our organs and is more common in those of us who are overweight or obese. Our high carb, heavily processed diets and constant snacking means our insulin levels are constantly up and down – and insulin promotes storage of excess energy as fat. The more we are exposed to insulin, the greater the chance of becoming resistant to it.

Ketogenic diets aim to slash our carb consumption as well as moderating lean protein that can also raise insulin. Instead, they focus on healthy fats and protein-fat combos that lead to a much lower insulin response. This, in theory, reduces fat storage and helps us burn off our excess fat stores, as the fat is broken down to ketone bodies (hence ketogenic) to use for energy instead of sugar. Fats and protein keep you full, you don’t have to religiously calorie count and you automatically cut out the sugar and processed carbs that are lacking in nutrients. 

The bad

That’s all great in theory but there are all sorts of ways to abuse it. So many diets have a nugget of sound science but people tend to latch on to the bits that suit them without applying common-sense. This popular way of losing fat has spawned a huge number of websites, especially within the body-building community. And some of them make me shudder. Focusing on fats and protein has encouraged various people to believe that a diet of bacon is the way to go. But bacon and other processed meats have been deemed carcinogenic (cancer-causing) due to an increased risk of bowel cancer. And whilst we are on the subject, high-fibre diets are another way to protect against bowel cancer and many other diseases. We already eat far less than the 30g of fibre a day and many keto diet plans I see include very little fibre. 

Others soon fall out of love with the keto diet when the weight doesn’t shift as they expect. Could it be that they are getting carried away with the fat intake? It should be a highER-fat diet meaning you eat a greater proportion of your energy requirements as fat rather than carbs, not a HIGH fat diet. It’s not a free license to eat as much fat as you can, in the mistaken belief that you won’t put on an ounce. 

The ugly

Aside from justifying poor food choices by focusing purely on the high-fat low carb mantra with no thought to other considerations, there are some who take things to extremes. They obsess about their level of ketosis. As with anything to do with our body, take it to extremes and it tends to fight back. Either by finding a way around your extreme behaviour, or getting sick.

And then there are others taking supplements to increase ketosis or trying to make up for the nutritional deficits that a poorly-managed ketogenic diet can bring. Vitamin and mineral supplements are not generally needed if you eat well. And other supplements to boost ketosis are likely to be unregulated, meaning you may be taking something that is worthless at best or dangerous at the worst.

Finally, who wants to hang out with a diet zealot – of whatever type? Going out with friends, bringing up a family and life in general can be a constant hassle if you are obsessively trying to micro-manage a LCHF diet. Eating well should help you regain and enjoy your life – not rule it. 

So, if you really want to improve your health with ketogenic diets, don’t replace sugar and processed carbs with carcinogenic, cheap meats and ladles of fatty calories that are way over what your body needs. Don’t turn your back on fibre and vitamin-rich food.

Don’t turn to supplements which aren’t tested. And don’t replace obsessing over calories and the number on the weighing scales for an obsession with levels of ketones and grams of carbs. And remember, there is a lot more to managing your health and weight than the food you choose, or don’t choose, to eat!