Celebrity fitness expert Jillian Michaels recently said she found the ketogenic diet to be dangerous and unhealthy.
UAB Assistant Professor and keto expert Amy M. Goss says her recent research suggests the keto diet is a safe and effective way to older adults with obesity to improve body composition and improve metabolic health.
Below are comments from Goss:
A well-formulated ketogenic diet does not starve the body. There is no “essential” carbohydrate. Our liver is able to convert other substrates in glucose through gluconeogenesis and glycogenolysis to maintain normal circulating levels in the absence of carbohydrate intake. Yes, some carbohydrate containing foods do provide essential vitamins and minerals — vegetable, fruits and dairy — but that is different from saying that the carbohydrates in the foods are essential for health. A well-formulated ketogenic diet includes all of these food groups therefore provides adequate intake of micronutrients. There is ample scientific evidence from randomized clinical trials supporting the therapeutic effects of the diet in treating a number of chronic disease conditions including obesity, Type 2 diabetes, epilepsy, non-alcoholic fatty liver disease, etc. I have yet to see any clinical trial suggesting the ketogenic diet is "dangerous."
Studies show that some individuals respond particularly well to carbohydrate-restricted diets such as the ketogenic diet in terms of reducing total and abdominal fat, reducing HbA1c, and improving the lipid profile. Even a ketogenic diet incorporates a wide variety of carbohydrate containing foods such as non-starchy vegetables, nuts, dairy, and some fruits. It is not as black and white as saying one diet is superior to another in every case. If the answer were simple, we would not have the rates of obesity and diabetes we are observing in our population. A number of physiological factors likely determine which diet is superior for an individual’s health including insulin secretory response, peripheral and hepatic insulin sensitivity, metabolic flexibility, and other hormonal factors.
Our recent research suggests the ketogenic diet is a safe and effective way for older adults with obesity to improve body composition and improve metabolic health. We saw significant reduction in body fat while lean mass was preserved and significant improvements in insulin sensitivity and the lipid profile in response to a ketogenic diet when compared to a standard “balanced” diet. So, benefits of the diet may extend far beyond weight loss among some groups.
If you are interested in practing the ketogenic diet, it may be important to work with a practitioner or registered dietitian that has experience in prescribing a ketogenic diet to ensure proper nutrition is achieved. Individuals taking medications for diabetes or hypertension should consult with a physician prior to starting a ketogenic diet.
Goss is an assistant professor in the UAB Department of Nutrition Sciences and has expertise in the areas of adult and childhood obesity and energy metabolism, with an emphasis on glucose metabolism, Type 2 diabetes risk and non-alcoholic fatty liver disease. She also specializes in medical research image analysis for assessment of body composition and adipose tissue distribution.