The ketogenic diet (KD) is a nutritional approach that is high in fat, low in carbohydrates, and contains adequate protein, metabolically aiming for a state of ketosis. The body produces ketone bodies to meet its energy needs as a result of carbohydrate restriction. This condition is used as a therapeutic tool, especially in the treatment of epilepsy.
Medical Uses
The ketogenic diet is primarily used in the treatment of resistant epilepsy, but it can also be used in some metabolic diseases (glucose transporter type 1 deficiency, pyruvate dehydrogenase complex deficiency), some neurological disorders, and rarely in oncological diseases. It is known to be effective in reducing the frequency and severity of seizures by allowing ketones to be used as an energy source instead of glucose. The diet is generally applied to children over two years of age, and the treatment process is carried out by neurology and dietetics specialists.
Application Method and Diet Types
- Classic ketogenic diet: Generally has a 4:1 or 3:1 ratio of fat to carbohydrate + protein content.
- MCT (medium-chain fatty acid) diet: Most of the energy is provided by medium-chain fatty acids.
- Modified Atkins diet and low glycemic index treatment: Alternative approaches where carbohydrate intake is regulated with more flexible limits.
Before applying the diet, a comprehensive clinical evaluation is performed, and then the diet is initiated in hospital conditions. A fasting period may be applied if deemed necessary for the onset of ketosis. Afterwards, personalized meal plans are prepared according to the planned macronutrient ratios.
Side Effects
The ketogenic diet has both acute and long-term side effects. In the initial period, hypoglycemia, dehydration, nausea, vomiting, and lethargy may be observed. In the long term, complications such as constipation, growth retardation, vitamin and mineral deficiencies (especially vitamin D, calcium, selenium), osteopenia, kidney stones, pancreatitis, low albumin, and carnitine are reported.
Kidney stone development can vary between 3-10%. To reduce this risk, adequate fluid intake and potassium citrate use are recommended. Increases in total cholesterol, LDL, and triglyceride levels, and decreases in HDL levels, especially within the first six months, may occur in the serum lipid profile.
There are also effects on bone health. The risk of osteopenia may increase due to the effects of antiepileptic drugs on vitamin D metabolism and the effects of the Ketogenic diet on mineral balance. Bone mineral density should be monitored in long-term applications.
Use for Weight Loss
The ketogenic diet has become one of the popular diets used for weight loss in recent years. However, scientific data on its long-term effectiveness, safety, and potential health effects for this purpose are limited. The effects of the ketogenic diet on weight loss are not yet definitive, and there is insufficient evidence regarding its applicability to the general population. The expectation of short-term results in the fight against obesity can direct individuals to these and similar popular diets with limited scientific basis. This situation brings some risks. Especially problems such as excessive energy restriction, inadequate protein, and micronutrient intake can lead to eating disorders. Therefore, it is recommended that the ketogenic diet be applied only with a medical indication and under expert supervision.【1】
