Adverse Reactions to Ketogenic Diets: Caution Advised

For every anecdotal story of someone who has regained their health with a ketogenic diet, there’s a counterpoint story of someone who derailed their health with an identical diet. I’m not here to trade anecdotes. I’m here to cite a collection of scientific papers, including results from clinical trials, case studies, and mechanistic studies that show a potential dark side to the ketogenic diet.  And that dark side is one that everyone needs to be aware of while they perform their own individual cost-benefit analysis to decide whether this dietary strategy is worth attempting for them.

Where Do Ketogenic Diets Come From?

The origins of the ketogenic diet were the observations of Hippocrates in 500BC that fasting could reduce and even cure epileptic seizures (fasting is also a ketogenic state, more on that in a future post). However, it wasn’t until 1911 that the first scientific study on starvation as epilepsy treatment was published. Two French doctors, Guelpa and Marie, observed that a 4-day fast decreased seizure frequency in 20 epileptic children and adults, which led to “La cure du Dr. Guelpa”, a prescribed treatment for epilepsy that consisted of fasting followed by a very limited vegetarian diet. Dr. Hugh Conklin popularized fasting (three days to three weeks) as a way to cure numerous illnesses, including epilepsy. The banner was taken up in 1921 by endocrinologist Dr. H. Rawle Geyelin, who was the first to document cognitive improvement resulting from fasting in a scientific study performed on 26 epileptic patients.

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