Long-term effects of a ketogenic diet in obese patients

yaryrosa
yaryrosa Posts: 65 Member
edited November 8 in Health and Weight Loss
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2716748/

I would love to read some of your reactions to this.

This is an extract for you:

BACKGROUND:
Although various studies have examined the short-term effects of a ketogenic diet in reducing weight in obese patients, its long-term effects on various physical and biochemical parameters are not known.
OBJECTIVE:
To determine the effects of a 24-week ketogenic diet (consisting of 30 g carbohydrate, 1 g/kg body weight protein, 20% saturated fat, and 80% polyunsaturated and monounsaturated fat) in obese patients.
PATIENTS AND METHODS:
In the present study, 83 obese patients (39 men and 44 women) with a body mass index greater than 35 kg/m2, and high glucose and cholesterol levels were selected. The body weight, body mass index, total cholesterol, low density lipoprotein (LDL) cholesterol, high density lipoprotein (HDL) cholesterol, triglycerides, fasting blood sugar, urea and creatinine levels were determined before and after the administration of the ketogenic diet. Changes in these parameters were monitored after eight, 16 and 24 weeks of treatment.
RESULTS:
The weight and body mass index of the patients decreased significantly (P<0.0001). The level of total cholesterol decreased from week 1 to week 24. HDL cholesterol levels significantly increased, whereas LDL cholesterol levels significantly decreased after treatment. The level of triglycerides decreased significantly following 24 weeks of treatment. The level of blood glucose significantly decreased. The changes in the level of urea and creatinine were not statistically significant.
CONCLUSIONS:
The present study shows the beneficial effects of a long-term ketogenic diet. It significantly reduced the body weight and body mass index of the patients. Furthermore, it decreased the level of triglycerides, LDL cholesterol and blood glucose, and increased the level of HDL cholesterol. Administering a ketogenic diet for a relatively longer period of time did not produce any significant side effects in the patients. Therefore, the present study confirms that it is safe to use a ketogenic diet for a longer period of time than previously demonstrated.

Replies

  • ldrosophila
    ldrosophila Posts: 7,512 Member
    edited November 2014
    i wonder what the average calorie intake was before and during the trial?
  • sodakat
    sodakat Posts: 1,126 Member
    I think the last sentence pretty much sums it up: "Therefore, the present study confirms that it is safe to use a ketogenic diet for a longer period of time than previously demonstrated."

    So?
  • erickirb
    erickirb Posts: 12,294 Member
    edited November 2014
    I think the piece missing here is what would happen if they followed the same caloric intake on a balance diet of 40/30/30 or something similar to that effect.

    This study shows a ketogenic diet can help with certain things and seems to be safe, but fails to say if it is better or worse, less or more safe, than other ways of eating, using the same caloric intake.
  • rainbowbow
    rainbowbow Posts: 7,490 Member
    24 weeks is long-term now?
  • TimothyFish
    TimothyFish Posts: 4,925 Member
    It appears that the study was making no attempt to test the merits of the diet itself, but to see if it was safe.
  • Kalikel
    Kalikel Posts: 9,603 Member
    24 weeks isn't what I think of when I think of the long-term. But I suppose for a diet, it is a while.
  • fuelednfit
    fuelednfit Posts: 177 Member
    I was curious about a VERY long term effect of being on a ketogenic diet. 24 weeks is barely 6months. For example as a diabetic you might want to stay on a VLCHF diet for the rest of your life to avoid taking drugs. MFP is full of people doing the keto as anyone adopted keto as a full time life style as anyone been on it more then a year? How are your blood analysis? Does it still fit the conclusion of this 24 week study? I am sure we could make our own study here
  • DeguelloTex
    DeguelloTex Posts: 6,652 Member
    Yeah, at first glance I can't find anything about the actual deficits, but I'm not sure what's supposed to be worthy of much reaction. They got thinner and healthier. LCHF is one way to get there.
  • juggernaut1974
    juggernaut1974 Posts: 6,212 Member
    edited October 2015
    Even though this is a necro thread, I'm not sure I'm finding the results particularly interesting.

    I've never doubted that keto is a viable option for weight loss. That's really all this study seems to show (though admittedly, I'm basing my comments only on the abstract, without reading the entire study). Personally, I'd chalk up a lot of the health markers improving to the overall weight loss as well.

    I also have a hard time calling 24 weeks"long-term", as to me diet choice should be a choice for life.
  • nvmomketo
    nvmomketo Posts: 12,019 Member
    I think the longest studies I've seen have been two years. I've seen a few 1 year studies. At that point the HDL, triglycerides, blood glucose, and types of LDL was still improved, although weight loss between those on a LCHF diet was similar to that of people on other diets (LCHF appears t be more aintainable - fewer drop out).

    My n=1 of about 3 months, shows it is beneficial for me. I'm assuming that won't change.

    There are a few people in the Low Carber Daily and Keto groups who have been doing keto over a year. (Not many low carbers post on the main boards because it tends to produce inflammatory threads.) Since those keto'ers are still happily doing keto, the benefits (health) must still outweigh the drawbacks (limited tasty carbs).

    Attia, Volek and Phinney are long term keto'ers who are all doctors. I think Phinney has been at least 6 years.
    These are not studies but their own experiences:
    http://authoritynutrition.com/low-carb-long-term/
    http://www.truehealthunlimited.com/blog/q-a-with-jeff-volek-phd-rd-the-nations-leading-low-carb-expert-scientific-researcher
    http://eatingacademy.com/nutrition/ketosis-advantaged-or-misunderstood-state-part-ii
  • senecarr
    senecarr Posts: 5,377 Member
    "In this diet, the fat to carbohydrate ratio is 5:1"
    "All 83 subjects received the ketogenic diet consisting of 20 g to 30 g of carbohydrate in the form of green vegetables and salad, and 80 g to 100 g of protein in the form of meat, fish, fowl, eggs, shellfish and cheese. Polyunsaturated and monounsaturated fats were also included in the diet. Twelve weeks later, an additional 20 g of carbohydrate were added to the meal of the patients to total 40 g to 50 g of carbohydrate. "

    Assuming 5 to 1 is in terms of calories, than this diet would only be 1120 calories at most at the start. On a per gram basis, this would be a maximum of 2140 calorie diet. Neither one of those sound right, though the later would probably still be weight loss for obese starting individuals.
  • GaleHawkins
    GaleHawkins Posts: 8,159 Member
    I do not think there are any long term studies but you can read the accounts of people that have been in nutritional ketosis for 5-10 years.

    I have only been doing it for one year and all my health markers are still improving. The Very Low Carb High Fat Way of Eating (WOE) we know appears to be fine for life.

    While I did not start this to lose weight but to manage my pain without starting Enbrel injections that beats down one natural immune system that can lead to an early death. 2600 calories daily results in a slow weight loss and I can maintain at 3000 calories daily weighing around 200 pounds.

    The pain was managed within 30 days after I went off of sugars and all grains a year ago. The IBS was cured after six months as well as my blood labs markers indicate improving health. I now can get in and out of vehicles with help from others. I am able to walk daily unaided which means a lot to me.

    I do not recommend LCHF simply most say they are too far into carbs to be willing to walk away from them (eat <50 grams of carbs daily in my case). When I learned there is no health requirements to eat carbs to have total health it helped me leave them cold turkey. In my case death was rushing my way if I kept abusing carbs so that helped me get through the first two hellish weeks. After that the cravings just faded away. I did not lose a pound the first six weeks of VLCHF but I did loss a lot of fat. No, I do not know how one can lose a lot of fat and not lose a pound.
  • RockstarWilson
    RockstarWilson Posts: 836 Member
    edited October 2015
    "Choice for life" is an anecdotal phrase that gets overused. It is saying "I am going to do this for the rest of my life!" Yeah, right.

    What will stick is knowing what foods give the body the nutrients it needs for different situations. Right now, I am eating more fat (not ketogenically). That will change as my body, schedule and goals change later on down the road.

    Just out of curiosity...what would be a long enough study for you to accept it as long enough? What qualifies as a "change for life"? This study did what none have done in this arena. It costs a lot of money to do. You kind of give science the brush-off by saying it is too short. Science is about gathering data for hypotheses we have no formal data for.
  • Unknown
    Unknown
    edited October 2015
    This content has been removed.
  • RockstarWilson
    RockstarWilson Posts: 836 Member
    revertt2d wrote: »
    I was curious about a VERY long term effect of being on a ketogenic diet. 24 weeks is barely 6months. For example as a diabetic you might want to stay on a VLCHF diet for the rest of your life to avoid taking drugs. MFP is full of people doing the keto as anyone adopted keto as a full time life style as anyone been on it more then a year? How are your blood analysis? Does it still fit the conclusion of this 24 week study? I am sure we could make our own study here

    In the land of "I dont care what your results are, you are wrong"? Good luck.
  • DeguelloTex
    DeguelloTex Posts: 6,652 Member
    edited October 2015
    RockstarWilson wrote: »
    "Choice for life" is an anecdotal phrase that gets overused. It is saying "I am going to do this for the rest of my life!" Yeah, right.

    What will stick is knowing what foods give the body the nutrients it needs for different situations. Right now, I am eating more fat (not ketogenically). That will change as my body, schedule and goals change later on down the road.

    Just out of curiosity...what would be a long enough study for you to accept it as long enough? What qualifies as a "change for life"? This study did what none have done in this arena. It costs a lot of money to do. You kind of give science the brush-off by saying it is too short. Science is about gathering data for hypotheses we have no formal data for.
    Well, if the standard for the NWCR is losing the weight and keeping it off for a year, then 18 months seems like a reasonable minimum time.

  • juggernaut1974
    juggernaut1974 Posts: 6,212 Member
    RockstarWilson wrote: »

    Just out of curiosity...what would be a long enough study for you to accept it as long enough? What qualifies as a "change for life"? This study did what none have done in this arena. It costs a lot of money to do. You kind of give science the brush-off by saying it is too short. Science is about gathering data for hypotheses we have no formal data for.

    If the study is designed to study "long-term" effects, then I would say it should be a "long-term" study. A couple years would be a good start, and I would love to see one over an even longer time frame.

    I'm not brushing off the science - as I said, I've never denied that keto is a perfectly good option for losing weight, nor have I ever believed that it's particularly harmful, even over a long term.

    I'm just not sure that I find this study very interesting or groundbreaking.
  • lemurcat12
    lemurcat12 Posts: 30,886 Member
    juggernaut1974 wrote: »
    I'm not brushing off the science - as I said, I've never denied that keto is a perfectly good option for losing weight, nor have I ever believed that it's particularly harmful, even over a long term.

    I'm just not sure that I find this study very interesting or groundbreaking.

    This.
  • fuelednfit
    fuelednfit Posts: 177 Member
    Caitwn wrote: »
    This article was published in 2004. It's not an article I'd look to for any clear indications of what keto does or does not do. There are many subsequent studies with better methodology - and there are quite a range of diverse conclusions about the effects of keto in these more recent studies.

    I believe there is a study (2012 at least) looking at use of this diet over 5 years in persons with glucose transporter 1 deficiency syndrome (a genetic disorder where less glucose is available to the brain). I am getting ready to leave for work at the moment, so maybe someone else can find it in the meantime. If not, I'll access it once I am at work and post it here.

    I found this article but I was looking for a study in healthy subject. If I find the link before I will post it
    RockstarWilson wrote: »
    revertt2d wrote: »
    I was curious about a VERY long term effect of being on a ketogenic diet. 24 weeks is barely 6months. For example as a diabetic you might want to stay on a VLCHF diet for the rest of your life to avoid taking drugs. MFP is full of people doing the keto as anyone adopted keto as a full time life style as anyone been on it more then a year? How are your blood analysis? Does it still fit the conclusion of this 24 week study? I am sure we could make our own study here

    In the land of "I dont care what your results are, you are wrong"? Good luck.

    No. It's pure curiosity for the sake of knowledge and not for the sake of crediting or discrediting a type of diet. I understand low carb is not for everybody but high carb is not for everybody either. We all want to find our niche. To find mine I like to gather knowledge. I was actually satisfied when I read this paper and appreciated their conservative down to earth conclusions in line with the data they showed. Still I would love to see a long term study done over years. I understand the limitation for such a study...mainly cost but I am looking forward to see results from such a study. That's why I prompted people to tell us about their own (longer) journey so I can get a glimpse now instead of waiting for the scientific paper to come out.
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