Doctor Explains Why She Never Recommends The ‘Ketogenic Diet’

Michelle McMacken, an internal medicine physician, shares why she does not recommend the ketogenic diet at all for her patients.

The ketogenic diet has gained a tremendous amount of popularity over the past few years, and it’s become a trend that many people are adopting without doing their own research first. We’ve written multiple articles on the ketogenic diet, a diet that promotes a high fat/low carb intake in order to prolong the production of ketone bodies in one’s blood. The release of these ketone bodies happens when we fast and deplete our glucose reserves, which develop from eating carbohydrates that turn into sugar. One can prolong the production of these ketones by sticking to a low carbohydrate/high fat diet, and essentially run off of fat instead of their glucose reserves.

The ketogenic diet is being used as an intervention for cancer, and there are multiple studies showing how ketones can actually kill cancer. It’s becoming well known that cancer cells cannot efficiently process ketone bodies for energy. Essentially, the cell starves itself, and ketones help slow the proliferation of tumor cells. Dietary ketones have been shown to completely halt metastasis. For example, a study titled “The Ketogenic Diet & Hyperbaric Oxygen Therapy Prolong Survival in Mice with Systemic Metastatic Cancer” explains how it’s already known that the ketogenic diet elevates blood ketones and has been shown to slow cancer progression in both animals and humans. The study also revealed that the ketogenic diet “significantly decreased blood glucose, slowed tumor growth, and increased mean survival time by 56.8 percent in mice with systemic metastatic cancer.”

Fasting (when you fast you produce ketones) is also being used for cancer intervention, seizure prevention (epilepsy), and as a potential therapy for alzheimer’s disease, parkinson’s disease, and other neurodegenerative disorders.

A TEDx talk given by Mark Mattson, the current Chief of the Laboratory of Neuroscience, at the National Institute on Aging goes into detail about fasting, ketones, and how beneficial it is for the brain. He is also a professor of Neuroscience at Johns Hopkins University and one of the foremost researchers of the cellular and molecular mechanisms underlying multiple neurodegenerative disorders.

In 1923, scientist Otto Warburg hypothesized that cancer was caused by a metabolic process whereby cancer cells fuel their growth “by swallowing up enormous amounts of glucose [blood sugar] and breaking it down without oxygen.” Coined the Warburg Effect, the theory was considered controversial at the time, but the past few decades have sparked new interest in it and oncologists now use the dependence on glucose that cancer cells have to locate tumours within a patient’s body.

Warburg made his discovery around the same time the ketogenic diet was found to be beneficial for epilepsy. Studies have shown that when the body produces ketones, they form a protective barrier around the brain, which is why more and more paediatricians are recommending the diet for children with epilepsy. It has a huge success rate, but since fasting is neither marketable nor profitable, it receives little mainstream attention.

All of these are specific interventions for certain diseases, and they can be healthy. On a personal level, I believe fasting a few times a month is extremely healthy and can be very beneficial for the body. All of the studies in human and animal models show nothing but benefits.  Keep in mind that while you fast, you also get the benefits of ketones.

This is far different from continuing on with a no carb, high fat diet where you are constantly producing ketones and burning fat. It doesn’t seem normal unless you have to do it for a specific intervention, like cancer. Despite the potential health benefits, the ‘ketogenic diet’ has become a fad with potential dangers that people should also be aware of.

The Five Reasons

Below is a list of points regarding the ketogenic diet from Michelle McMacken, an internal medicine physician, Assistant Professor of Medicine at the NYU School of Medicine, and Director of Bellevue Hospital Weight Management Clinic.

I came across these via her Instagram, which make it clear she does not support the diet:

1. That we know of, no population in history has ever thrived on a very-low-carb/high-fat diet. There is exactly zero scientific evidence that a keto diet is conducive to longevity & longstanding vitality – unlike a plant-centric diet, the foundation of the longest-lived people on earth.

2. A keto diet may cause short-term weight loss, but possibly at a serious price. A 2010 review found that low-carb, animal-based diets increased cardiovascular death by 14%, cancer death by 28%, & all-cause mortality by 23%- trends confirmed in other large studies.

3. A keto diet hasn’t been shown to prevent, control, or reverse type 2 diabetes in the long run. Avoiding carbs will temporarily lower your blood sugar if you have diabetes. But this simply masks the underlying problem, which is insulin resistance – ie. glucose in our blood can’t enter our cells & the liver overproduces sugar. This is NOT the fault of carbs from healthy foods – whole grains, legumes, fruit, or even starchy vegetables. In fact, a high-carb, high-fiber, plant-based diet is exceptionally protective against diabetes & can actually REVERSE insulin resistance & lower diabetes complications. In contrast, low-carb diets can promote diabetes over time, as they foster inflammation & fat buildup in our cells, causing insulin resistance.

4. Keto diet research is in its infancy, focusing on short-term blood results & body weight – not actual rates of disease or death. And some findings are concerning. LDL cholesterol levels tend to rise (or at best, stay the same) on keto diets. An overwhelming wealth of research shows that the higher the LDL, the higher the risk of cardiovascular disease.

5. A keto diet is low in refined grains & added sugar, which is great. But it also can be low in phytonutrients, antioxidants, & fiber, all of which have profound benefits, and it forbids some of the most powerfully health-promoting foods on earth – whole grains, legumes, & many fruits. To me, that’s just not good medicine.

Her references:

Written by: Arjun Walia

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