The ketogenic diet helps you lose weight but also increases cholesterol levels

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Written By Margonoe Tumindax

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Ketogenic diets involve getting the majority of your calories from fat.

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Eating a Ketogenic Diet dietwhich involves getting most of your calories from fat and very few from carbohydrates, leads to fat loss, but can also clog your arteries and negatively impact your gut microbiome.

Also known as the ketogenic diet, this way of eating forces the body to use a different type of fuel. Instead of relying on glucose from carbohydrates, it begins to rely on ketone bodies, a type of fuel the liver produces from stored fat, leading to weight loss.

Previous studies have tracked health outcomes in people on a ketogenic diet than those who do not, suggesting that both have both negative and positive effects.

Now, Javier Gonzalez at the University of Bath in the United Kingdom and his colleagues conducted a randomized controlled trial, the best kind of medical trial. The researchers recruited 53 people with an average age of 34, none of whom were obese. They randomly assigned about a third to follow a ketogenic diet, in which all carbohydrates made up less than 8 percent of their energy intake and fat made up more than 70 percent.

Another third of the participants were asked to follow a low-sugar diet, in which “free” sugars – a type of carbohydrate found in foods such as syrups, cakes and cookies – made up 5 percent of their energy intake, while carbohydrates and fats not containing free sugars made up 45 percent and 35 percent, respectively.

The remaining third ate a diet with moderate levels of free sugars, which accounted for just under 20 percent of their energy intake, while their intake of carbohydrates and fats not containing free sugars was about 30 and 35 percent, respectively. These participants served as a control group. Protein intake ranged from 15 to 18 percent across all diets.

A month later, X-rays revealed that those on the ketogenic diet had lost an average of 1.6 kilograms of fat. The team confirmed that the participants had followed the ketogenic diet by measuring levels of ketone bodies in their blood, urine, and breath. Food diaries also measured adherence to the diet.

Meanwhile, those on the low-sugar diet lost an average of 1 kg of fat, while those on the moderate diet lost no fat. By having participants wear intermittent motion monitors and estimating their energy intake, the team found that the fat loss was caused by consuming fewer calories, rather than exercising more, which had previously been unclear, Gonzalez says.

But while the ketogenic group experienced greater fat loss, these individuals had 16 percent higher levels of “bad” low-density lipoprotein (LDL) cholesterol than those in the control group. They also had 26 percent higher levels of a protein called apolipoprotein B, which clogs arteries, increasing the risk of heart disease. In contrast, those on the low-sugar diet had 10 percent lower levels of LDL cholesterol and no change in their apolipoprotein B levels, compared with those in the control group.

The researchers also found that, compared to the moderate-sugar diet, those on the ketogenic diet had reduced levels of a type of gut bacteria called BifidobacteriumWhich helps produce B vitamins AND has been linked to a stronger immune system. The same was not true for those on a low-sugar diet. This is likely because those on a ketogenic diet ate less fiber, which increases Bifidobacterium levels, says Gonzalez.

But it’s unclear whether a ketogenic diet actually negatively affects the gut microbiome, because no one is entirely sure what constitutes an optimal diet or what the full effects are. Bifidobacterium I am, he says Natasha Schoeler at Great Ormond Street Hospital in London.

Furthermore, while elevated levels of apolipoprotein B are concerning, the increased cholesterol levels seen in the study are not necessarily harmful unless they reach dangerous thresholds, Schoeler says.

Long-term research is also needed to determine whether the weight loss benefits of the ketogenic diet outweigh potential concerns about cholesterol and gut health. Health among obese people, Schoeler says.

Ultimately, the main challenge to losing weight among those who are obese or overweight is sticking to a diet, Schoeler says. “Whether it’s a normal-carb, low-calorie diet, or the same amount of calories with fewer carbs, if you stick to it, you’ll generally lose weight.”

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