Following a ketogenic diet—which emphasizes high fat intake and minimal carbohydrates—has been shown to promote fat loss, but it may also pose risks such as arterial clogging and adverse effects on gut health.
This low-carbohydrate approach forces the body to shift its energy source from glucose to ketone bodies generated from stored fat, ultimately aiding in weight reduction.
Recent research, led by a team at the University of Bath, involved a rigorous randomized controlled trial to provide solid medical evidence of the diet’s effects. In the study, 53 participants, averaging 34 years old and all non-obese, were assigned to different dietary regimens. Approximately one-third of them followed a ketogenic diet in which carbohydrates accounted for less than 8 percent of their caloric intake, while over 70 percent came from fats.
Another group adhered to a low-sugar diet, limiting “free” sugars to 5 percent of total energy intake, complementing their diet with carbohydrates at 45 percent and fats at 35 percent. The final group served as a control, incorporating moderate sugar levels, totaling just under 20 percent of daily caloric intake.
After one month, participants on the ketogenic diet lost an average of 1.6 kilograms of fat. The research team confirmed adherence to the ketogenic diet by analyzing blood, urine, and breath for ketone bodies and keeping food diaries.
Participants on the low-sugar diet lost approximately 1 kilogram of fat, while those in the moderate sugar group experienced no fat loss. The research indicated the weight loss stemmed from lower calorie intake rather than increased exercise, clarifying a previously uncertain relationship.
However, while fat loss was greater in the ketogenic group, they exhibited a 16 percent increase in low-density lipoprotein (LDL) cholesterol compared to controls. Additionally, levels of apolipoprotein B—a protein linked to arterial blockage—were 26 percent higher in the ketogenic group. Conversely, those on the low-sugar diet showed a 10 percent reduction in LDL cholesterol without any change in apolipoprotein B levels.
Interestingly, the ketogenic diet resulted in lower levels of beneficial gut bacteria, specifically Bifidobacterium, which is associated with vitamin production and immune health. This decline was not observed in the low-sugar group, likely due to their higher fiber intake compared to those on the ketogenic diet.
The long-term implications of ketogenic diets on gut microbiomes are still uncertain, as researchers have yet to define what constitutes an optimal gut flora composition. While elevated apolipoprotein B levels raise concerns, it remains unclear if the observed increases in cholesterol are harmful, provided they do not reach dangerously high levels.
Long-term studies are necessary to evaluate the balance between the ketogenic diet’s weight-loss efficacy and potential risks regarding cholesterol and gut health, especially among those classified as obese. Adherence to any diet, whether a standard low-calorie plan or a modified carbohydrate ratio, remains the most crucial factor in successful weight loss.
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