As mentioned, there are a few reasons why the keto diet usually equals weight-loss gold, says Keatley. For starters, people usually reduce their daily caloric intake to about 1,500 calories a day because healthy fats and lean proteins make you feel fuller sooner—and for a longer period of time. And then there’s the fact that it takes more energy to process and burn fat and protein than carbs, so you're burning slightly more calories than you did before. Over time, this can lead to weight loss.
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Ketosis has been shown to have anti-inflammatory properties while also assisting with pain relief. Reducing glucose metabolism influences pain, so this could be one potential mechanism of action. In the review The Nervous System and Metabolic Dysregulation: Emerging Evidence Converges on Ketogenic Diet Therapy the authors look at numerous ways that a ketogenic diet can assist with pain and inflammation.
Physicians of ancient Greece treated diseases, including epilepsy, by altering their patients' diet. An early treatise in the Hippocratic Corpus, On the Sacred Disease, covers the disease; it dates from c. 400 BC. Its author argued against the prevailing view that epilepsy was supernatural in origin and cure, and proposed that dietary therapy had a rational and physical basis.[Note 3] In the same collection, the author of Epidemics describes the case of a man whose epilepsy is cured as quickly as it had appeared, through complete abstinence of food and drink.[Note 4] The royal physician Erasistratus declared, "One inclining to epilepsy should be made to fast without mercy and be put on short rations."[Note 5] Galen believed an "attenuating diet"[Note 6] might afford a cure in mild cases and be helpful in others.
Finally, a feasibility study was done on 10 cancer patients in 2012. All patients followed a ketogenic diet for 28 days after exhausting every other cancer treatment option. The results of the study found that 1 had a partial remission of their cancer, 5 stabilized and 4 continued progressing. It’s important to remember that these individuals had tried all other forms of cancer treatment. 60% of these individuals then stalled or improved their cancer rates by following a ketogenic diet for 4 weeks.
Conklin's fasting therapy was adopted by neurologists in mainstream practice. In 1916, a Dr McMurray wrote to the New York Medical Journal claiming to have successfully treated epilepsy patients with a fast, followed by a starch- and sugar-free diet, since 1912. In 1921, prominent endocrinologist Henry Rawle Geyelin reported his experiences to the American Medical Association convention. He had seen Conklin's success first-hand and had attempted to reproduce the results in 36 of his own patients. He achieved similar results despite only having studied the patients for a short time. Further studies in the 1920s indicated that seizures generally returned after the fast. Charles P. Howland, the parent of one of Conklin's successful patients and a wealthy New York corporate lawyer, gave his brother John Elias Howland a gift of $5,000 to study "the ketosis of starvation". As professor of paediatrics at Johns Hopkins Hospital, John E. Howland used the money to fund research undertaken by neurologist Stanley Cobb and his assistant William G. Lennox.
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By cutting carbs, you’ll also cut sugar and simple, refined carbohydrates, which means a steadier supply of energy. (No more sugar highs and crashes!) Once their bodies are used to the diet, “The first thing people report is, ‘Oh my gosh, I have this steady energy and I don’t have the need to snack at 3 p.m. because my energy is waning,’” Nisevich Bede says. Research published in January 2015 in the journal Obesity Review showed that the keto diet may lead to fewer hunger pangs and a lower desire to eat. (3)
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The ketogenic diet has recently been investigated a great deal for how it may help prevent or even treat certain cancers. One study found that the ketogenic diet may be a suitable complementary treatment to chemotherapy and radiation in people with cancer. This is due to the fact that it would cause more oxidative stress in cancer cells than in normal cells.
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Children who discontinue the diet after achieving seizure freedom have about a 20% risk of seizures returning. The length of time until recurrence is highly variable, but averages two years. This risk of recurrence compares with 10% for resective surgery (where part of the brain is removed) and 30–50% for anticonvulsant therapy. Of those who have a recurrence, just over half can regain freedom from seizures either with anticonvulsants or by returning to the ketogenic diet. Recurrence is more likely if, despite seizure freedom, an electroencephalogram shows epileptiform spikes, which indicate epileptic activity in the brain but are below the level that will cause a seizure. Recurrence is also likely if an MRI scan shows focal abnormalities (for example, as in children with tuberous sclerosis). Such children may remain on the diet longer than average, and children with tuberous sclerosis who achieve seizure freedom could remain on the ketogenic diet indefinitely.
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The ketogenic diet has been studied in at least 14 rodent animal models of seizures. It is protective in many of these models and has a different protection profile than any known anticonvulsant. Conversely, fenofibrate, not used clinically as an antiepileptic, exhibits experimental anticonvulsant properties in adult rats comparable to the ketogenic diet. This, together with studies showing its efficacy in patients who have failed to achieve seizure control on half a dozen drugs, suggests a unique mechanism of action.
The ketogenic diet reduces seizure frequency by more than 50% in half of the patients who try it and by more than 90% in a third of patients. Three-quarters of children who respond do so within two weeks, though experts recommend a trial of at least three months before assuming it has been ineffective. Children with refractory epilepsy are more likely to benefit from the ketogenic diet than from trying another anticonvulsant drug. Some evidence indicates that adolescents and adults may also benefit from the diet.
It takes more work to turn fat into energy than it takes to turn carbs into energy. Because of this, a ketogenic diet can help speed up weight loss. And since the diet is high in protein, it doesn't leave you hungry like other diets do. In a meta-analysis of 13 different randomized controlled trials, 5 outcomes revealed significant weight loss from a ketogenic diet.