Anyone who’s done keto or watched a loved one lose weight almost effortlessly while enjoying steaks, pork chops, roasted brussels sprouts and macadamia nuts knows that cutting carbs works like dynamite for body fat loss. Ketogenic diets—originally developed as a treatment for epilepsy—are now regarded as highly effective nutritional interventions for weight loss and both types 1 and 2 diabetes.1 The beneficial effect of carbohydrate restriction on lowering blood sugar and insulin levels is so powerful that many researchers propose that it should be the first approach in diabetes management and the default treatment for type 2 diabetes and metabolic syndrome.2,3
But the benefits of keto don’t stop there. A large and continually growing body of research indicates that keto eating is beneficial for conditions beyond weight loss and diabetes.
A surprisingly high number of people have normal blood sugar (glucose) levels in the presence of chronically high insulin levels. Being that their blood glucose level is normal, these people wouldn’t typically be considered suitable candidates for a ketogenic or low-carb diet. But a high glucose level isn’t a requirement for being diagnosed with metabolic syndrome, which is driven by high insulin—something we’ve known since the 1980s.4
Conditions and altered biomarkers resulting in part from chronically high insulin levels for which ketogenic or low-carb diets have proven beneficial include polycystic ovarian syndrome (PCOS)5, non-alcoholic fatty liver disease (NAFLD)6, and risk factors for cardiovascular disease. Keto reliably reduces triglycerides, raises HDL, and shifts LDL particles from the more harmful “small, dense” variety to the more benign “large, buoyant” variety, even in people who aren’t overweight.7 Even gout, a condition typically blamed on consumption of red meat and alcohol, has been shown to improve when people eat more protein as long as they keep carb intake low.8,9
Many people have reported that ketogenic diets reduce migraine frequency and severity. While anecdotes abound on social media, we don’t need to rely solely on these accounts. Researchers are catching on and medical journals now acknowledge that there’s a solid rationale for using keto in migraine patients.10 This was a pleasant surprise for a pair of twin sisters who tried keto for weight loss and had, as an unexpected side-effect, significant improvement in their frequent migraines.11
Moving south from the brain to the face, consumption of fatty foods has historically taken the blame for acne (and just about everything else, for that matter), but it looks like yet another case of fat taking the rap for excess carb intake. High-protein, low-glycemic diets have been shown to improve acne12, and there are numerous mechanisms by which ketogenic diets favorably affect hormonal imbalances and other factors implicated in causing acne.13 Don’t blame fat for what the carbs did!
Keto has a long, robust, proven track record for treating childhood and adult epilepsy.14 But perhaps the most intriguing areas of research for ketogenic diets are neurological and neurodegenerative disorders. Most of the research so far has been done in animals, but a growing number of human trials are starting to show encouraging results. It’s especially heartening because there are few to no effective interventions, pharmaceutical or otherwise, for these conditions.
Research is now expanding into Parkinson’s disease. A recent study comparing keto to a low-fat diet in patients with Parkinson’s found that both diet groups had improvements in motor and non-motor symptoms, but the keto group had greater improvements in non-motor symptoms, which are sometimes more debilitating and reduce quality of life more than the tremors and other motor issues.15 Moreover, emerging research suggests insulin resistance might be a driving factor in the development of Parkinson’s.16
Keto also has potential as a nutritional intervention for Alzheimer’s disease, which is often called “type 3 diabetes.”17 Alzheimer’s disease results when neurons in certain areas of the brain become unable to properly metabolize glucose. Ketones can serve as an alternative fuel for these otherwise starving cells.18
Traumatic brain injury (TBI) is another promising new frontier for ketogenic diets.19,20,21 Most of the research has been done in animals, but it’s encouraging and showing several mechanisms by which keto favorably influences brain energy generation and general neurological function that make it a reasonable thing to try.
When you consider these promising uses for ketogenic diets—especially for conditions that currently have no effective treatments—shedding a few pounds and bringing down blood sugar is just the (sugar-free) icing on the (coconut flour) cake.
- Lennerz BS, Barton A, Bernstein RK et al. Management of Type 1 Diabetes With a Very Low-Carbohydrate Diet. Pediatrics. 2018 Jun;141(6). pii: e20173349.
- Feinman RD, Pogozelski WK, Astrup A et al. Dietary carbohydrate restriction as the first approach in diabetes management: critical review and evidence base. Nutrition. 2015 Jan;31(1):1-13.
- Feinman RD, Volek JS. Carbohydrate restriction as the default treatment for type 2 diabetes and metabolic syndrome. Scand Cardiovasc J. 2008 Aug;42(4):256-63.
- Reaven GM. Syndrome x: a short history. Ochsner J. 2001;3(3):124-5.
- Mavropoulos JC, Yancy WS, Hepburn J, Westman EC. The effects of a low-carbohydrate, ketogenic diet on the polycystic ovary syndrome: a pilot study. Nutr Metab (Lond). 2005;2:35. Published 2005 Dec 16. doi:10.1186/1743-7075-2-35
- Mardinoglu A, Wu H, Bjornson E et al. An Integrated Understanding of the Rapid Metabolic Benefits of a Carbohydrate-Restricted Diet on Hepatic Steatosis in Humans. Cell Metab. 2018 Mar 6;27(3):559-571.e5.
- Sharman MJ, Kraemer WJ, Love DM et al. A ketogenic diet favorably affects serum biomarkers for cardiovascular disease in normal-weight men. J Nutr. 2002 Jul;132(7):1879-85.
- Dessein PH, Shipton EA, Stanwix AE, Joffe BI, Ramokgadi J. Beneficial effects of weight loss associated with moderate calorie/carbohydrate restriction, and increased proportional intake of protein and unsaturated fat on serum urate and lipoprotein levels in gout: a pilot study. Ann Rheum Dis. 2000;59(7):539-43.
- Lu N, Shai I, Zhang Y, Curhan G, Choi HK. High-Protein Diet (Atkins Diet) and Uric Acid Response. 2014 ACR/ARHP Annual Meeting.
- Barbanti P, Fofi L, Aurilia C, Egeo G, Caprio M. Ketogenic diet in migraine: rationale, findings and perspectives. Neurol Sci. 2017 May;38(Suppl 1):111-115.
- Di Lorenzo C, Currà A, Sirianni G, et al. Diet transiently improves migraine in two twin sisters: possible role of ketogenesis? Funct Neurol. 2014;28(4):305-8.
- Smith RN, Mann NJ, Braue A, Mäkeläinen H, Varigos GA. The effect of a high-protein, low glycemic-load diet versus a conventional, high glycemic-load diet on biochemical parameters associated with acne vulgaris: a randomized, investigator-masked, controlled trial. J Am Acad Dermatol. 2007 Aug;57(2):247-56.
- Paoli A, Grimaldi K, Toniolo L et al. Nutrition and acne: therapeutic potential of ketogenic diets. Skin Pharmacol Physiol. 2012;25(3):111-7.
- Gano LB, Patel M, Rho JM. Ketogenic diets, mitochondria, and neurological diseases. J Lipid Res. 2014;55(11):2211-28.
- Phillips MCL, Murtagh DKJ, Gilbertson LJ, Asztely FJS, Lynch CDP. Low-fat versus ketogenic diet in Parkinson’s disease: A pilot randomized controlled trial. Mov Disord. 2018;33(8):1306-1314.
- Athauda D, Foltynie T. Insulin resistance and Parkinson’s disease: A new target for disease modification? Prog Neurobiol. 2016 Oct – Nov;145-146:98-120.
- de la Monte SM, Wands JR. Alzheimer’s disease is type 3 diabetes-evidence reviewed. J Diabetes Sci Technol. 2008;2(6):1101-13.
- Cunnane SC, Courchesne-Loyer A, Vandenberghe C, et al. Can Ketones Help Rescue Brain Fuel Supply in Later Life? Implications for Cognitive Health during Aging and the Treatment of Alzheimer’s Disease. Front Mol Neurosci. 2016;9:53. Published 2016 Jul 8. doi:10.3389/fnmol.2016.00053
- Prins ML, Matsumoto JH. The collective therapeutic potential of cerebral ketone metabolism in traumatic brain injury. J Lipid Res. 2014;55(12):2450-7.
- Prins ML. Cerebral metabolic adaptation and ketone metabolism after brain injury. J Cereb Blood Flow Metab. 2007;28(1):1-16.
- Prins M. Diet, ketones, and neurotrauma. Epilepsia. 2008;49 Suppl 8(Suppl 8):111-3.