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Hey /fit/,
After reading up on the ketogenic diet, I've come up with a couple of questions and qualms about it.
I know a couple of you here are firm adherents to the keto diet, so can you explain these please?
1- The brain works on glucose, and will have no substitute. Your body metabolizes the fats into ketone bodies, which can cause ketoacidosis if unmonitored. This state of constant mild hypoglycemia, I'm sure, leads to defects in mental function (named the "keto-mind-fog"). This is not as unsignificant as websites would have you believe, such a mind-fog would be devastating for people whose jobs require high mental output.
2- A high-fat diet means chylomicrons, VLDL, LDL, and HDL; bubbles of lipids and lipoproteins in your bloodstream, transporting the fuel to wherever it is needed. The problem is, a high LDL amount is linked and causative with vascular diseases like atherosclerosis. Conversely, a high HDL is linked with a reduction in such diseases. The function of HDL is to bring fats back to the liver to be metabolized during the fasting/hunger state. Does the (presumed) increase in HDL make up for the increase in LDL? Is it even safe to have so much lipids in the bloodstream to begin with? A high fat diet increases the expression of inflammatory mediators, which leads to all sorts of health problems, and also causes insulin resistance (the pivotal point of developing metabolic syndrome).
3- Besides supplements, you can only get a certain percentage of necessary micronutrients from a ketogenic diet, like minerals, folic acid, fat-burning phytochemicals like adiponectin. Also you consume a low amount of dietary fibre. Diets rich in fibre have been shown to reduce the risks of breast and colonic cancer. While red meat (especially the processed kind) has been shown to do the opposite. Is this trade-off for better physique/weight loss favorable?
4- Just making your portions smaller (calorie counting) combined with regular exercise should work with everyone (unless they have a medical condition - though I cannot think of any). Why should people try to adapt to such a drastic change in eating routine? It might be useful from a public health perspective to promote this in countries like the US where people drink sugary "soda"s to oblivion, but the Mediterranean diet provides a much better (though perhaps not as efficient) alternative in terms of overall nutrition. Wouldn't it be better to remove simple carbohydrates (like potato starch or simply sugar in the form of sweets, chocolate bars, etc.) from the diet in such countries?
Please don't get angry with me, I'm just trying to find out if there is something I've missed.
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