Does a Low Carb Keto Diet Help with Diabetes?

A nutrition friend of mine recently sent me a new study about how a low carb keto diet can help diabetes. It’s a great and fair point.  It’s evidence, right?  After all, it comes from a legit peer-reviewed study.  This study is clear that this low carb keto diet can help … but let’s look at the bigger picture.

My challenge with studies like this is that they only look at certain variables.  It’s fair from a research standpoint that they can’t look at EVERYTHING, but it leaves many questions…

So, it helps with diabetes (and weight loss or whatever else). I wouldn’t argue otherwise … but what are the consequences to the liver?  The kidneys?  The heart/cardiovascular system?  Is it mentally exhausting to comply with?  Does it have other side effects? Also, what are the consequences of doing this long term?  

Lots of diets work for a month or 2… Some even seem to work well for a year… But is it a sustainable diet to live on long-term (10 years, 20 years, 40 years, etc.)?  Even this study states that “few data are available about sustainability, safety, and efficacy in the long-term.”

The study also concludes with “Further large-scale, long-term, well-designed randomized trials are needed on this topic to assess the long-term safety, efficacy, and compliance of reducing dietary carbohydrates in patients with diabetes, and particularly with type 1 diabetes of all ages, and to find the best dietary composition as for glycemic control, weight loss, and cardiovascular risk in all patients with diabetes.”

I’m not sure the duration of this study, and perhaps the diet would indeed be helpful initially, but even the researchers of the study confess concern about long term safety and cardiovascular concerns.

I believe that there are essentially 3 reasons for the benefits of the keto diet and why it has become so popular:

1. Nearly any diet that eliminates processed junk food is likely to improve a person’s weight (and indirectly diabetic states) at least initially due to the fact that processed foods (among other things) tend to lead to overeating.²  This is not only true of the keto diet but also of the paleo diet, Mediterranean diet, whole food diet, etc.
2. As with nearly any diet there is a great deal of water weight loss initially as inflammation is reduced.  Excess weight nearly always brings inflammation³ along with it so therefore there will be more inflammation (and thus more water) that needs to be reduced.  Most diets help a person lose more weight at first due to water weight that comes off quickly; however, the keto diet appears to help a person lose more water initially as compared to other diets.⁴
3. Due to the fact that being in ketosis reduces the appetite⁵ coupled with the fact that processed foods are eliminated, it is likely that a person on this diet will simply be eating fewer calories.  Reducing calories reduces weight for most people.

The traditional keto diet is mostly animal products so naturally they bring with them excessive cholesterol,⁶ bacteria⁷, lowered/acidic pH,⁶ saturated fat, protein, etc. and are associated with nutrient deficiencies⁸, dysbiosis,⁹ heart disease,¹⁰ cancer, NAFLD¹¹ and many other issues.  

Doctors know that this diet is not good for the kidneys, so much so that they recommend having your kidneys checked regularly if you’re on this diet for longer than 1 year.¹² Point being, even if it was great for weight loss and blood sugar, the detriments far outweigh the benefits according to the evidence.  You never want to trade pancreas health and weight loss in exchange for non-alcoholic fatty liver disease (NAFLD) and kidney failure.  Although the keto diet may produce weight loss and help with diabetes in the short term, it is also associated with morbidity and mortality and are not sustainable as a long term food plan.¹³

I am always wanting to see the big picture and help you to do the same.  Sometimes, even in research, we have to really look at the study to extrapolate what is really proven versus deduced or assumed.  Researchers have egos too which can sometimes spin the data a bit.

As a holistic doctor, I am spending time every week looking at research and using it to draw informed conclusions.  There is still much to learn and more studies that need to be done.  I will always adjust to the evidence.  

If you need help, consider calling my clinic and joining the New Hope Health family!  269-204-6525

Resource List:

1. Bolla AM, Caretto A, Laurenzi A, Scavini M, Piemonti L. Low-carb and ketogenic diets in type 1 and type 2 diabetes. Nutrients. 2019. doi:10.3390/nu11050962
2. Hall KD, Ayuketah A, Brychta R, et al. Ultra-Processed Diets Cause Excess Calorie Intake and Weight Gain: An Inpatient Randomized Controlled Trial of Ad Libitum Food Intake. Cell Metab. 2019. doi:10.1016/j.cmet.2019.05.008
3. Ellulu MS, Patimah I, Khaza’ai H, Rahmat A, Abed Y. Obesity & inflammation: The linking mechanism & the complications. Arch Med Sci. 2017. doi:10.5114/aoms.2016.58928
4. Yang MU, Van Itallie TB. Composition of weight lost during short term weight reduction. Metabolic responses of obese subjects to starvation and low calorie ketogenic and nonketogenic diets. J Clin Invest. 1976. doi:10.1172/JCI108519
5. Gibson AA, Seimon R V., Lee CMY, et al. Do ketogenic diets really suppress appetite? A systematic review and meta-analysis. Obes Rev. 2015. doi:10.1111/obr.12230
6. Rosenbaum M, Hall KD, Guo J, et al. Glucose and Lipid Homeostasis and Inflammation in Humans Following an Isocaloric Ketogenic Diet. Obesity. 2019. doi:10.1002/oby.22468
7. Cousens G. Consious Eating. North Atlantic Books; 2000.
8. Calton JB. Prevalence of micronutrient deficiency in popular diet plans. J Int Soc Sports Nutr. 2010. doi:10.1186/1550-2783-7-24
9. Brinkworth GD, Noakes M, Clifton PM, Bird AR. Comparative effects of very low-carbohydrate, high-fat and high-carbohydrate, low-fat weight-loss diets on bowel habit and fecal short-chain fatty acids and bacterial populations. Br J Nutr. 2009. doi:10.1017/S0007114508094658
10. Virtanen HEK, Voutilainen S, Koskinen TT, Mursu J, Tuomainen T-P, Virtanen JK. Intake of Different Dietary Proteins and Risk of Heart Failure in Men. Circ Hear Fail. 2018. doi:10.1161/circheartfailure.117.004531
11. Alferink LJM, Kiefte-De Jong JC, Erler NS, et al. Association of dietary macronutrient composition and non-alcoholic fatty liver disease in an ageing population: The Rotterdam Study. Gut. 2019. doi:10.1136/gutjnl-2017-315940
12. Masood W, Annamaraju P, Uppaluri KR. Ketogenic Diet. StatPearls. 2020.
13. Shilpa J, Mohan V. Ketogenic diets: Boon or bane? Indian J Med Res. 2018. doi:10.4103/ijmr.IJMR_1666_18
14. Photo by Natasha Spencer from Pexels

Nothing said or implied in this post is intended to treat, cure, diagnose or prevent any disease.  It does not take the place of a qualified health care practitioner and is intended for educational purposes only.