The Keto Diet’s Long Term Effects on the Liver. Hint: If it sounds too good to be true, it probably is.
History
The term “ketogenic diet” was first coined in 1921 when Russel Wilder first used it to treat epilepsy. For nearly a decade, the diet was widely practiced in the medical world as a therapy for pediatric epilepsy until antiepileptic medications came to rise. It then disappeared for a while, resurging recently as a rapid weight-loss formula employed by everyone from celebrities to fitness trainers, creating a hype [R].
What is the Ketogenic Diet?
A ketogenic diet is a plan that centers on fat. The diet consists of high-fats (55%-60%), a moderate amount of protein (30%-35%), and extremely low carbohydrates (5%-10%).
The Physiology Behind it
Glucose is the main source of energy for cells and it’s primarily derived from carbohydrates. When carbohydrate levels are low, the body enters a catabolic state wherein it starts to breakdown glycogen, or stored glucose, in the liver. After glycogen is depleted, and glucose intake continues to be low, the body moves into another metabolic process called ketogenesis. This involves the breakdown of fats into ketone bodies which then replace glucose as the primary source of energy, leading to the metabolic state of nutritional ketosis.
Long Term Effects on The Body
The short-term effects of this rather drastic change to the body’s metabolism are positive and include weight-loss, improved insulin sensitivity, and enhanced liver function. However, the long-term health implications have finally started coming to light. They include vitamin and mineral deficiencies, hypoproteinemia, kidney stones, and perhaps the most significant - hepatic steatosis [R] which is just fancy way of saying – excess fat in the liver.
The Ketogenic Diet and Liver Disease
One of the defining features of a ketogenic diet is that it’s very high in saturated fats. This puts a lot of metabolic pressure on the liver to metabolize all the fat, which can lead to stress and damage. The first stage of non-alcoholic fatty liver disease (NAFLD) is hepatic steatosis and it occurs when triglyceride concentrations in the liver exceed a certain threshold [R]. NAFLD develops quickly and can develop into cirrhosis (liver damage) and ultimately liver cancer.
Ironically, the ketogenic diet is often thought to improve liver health, but studies on mice revealed the opposite. One study looked at the long term effects of ketogenic diets on liver metabolism [R]. Although the mice on the ketogenic diet lost a significant amount of weight, their livers ultimately showed similar traits as those of mice with NFALD.
Why the Ketogenic Diet is Not the Solution
Strict diets that limit the consumption of some macronutrients and encourage the consumption of others in high amounts often lead to side-effects in the long term. In the case of the ketogenic diet, consuming a large portion of one’s caloric intake (up to 80%) from fat causes disbalance in the liver and ultimately NFALD. A sluggish or toxic liver that is overburdened with saturated fat can lead to many of the conditions that I see in my practice every day. Some of these conditions are hormonal imbalances both PCOS and Estrogen Dominance, IBS, SIBO, dysbiosis, migraines, chronic fatigue, and overall toxicity of the body because the liver is too “clogged” to process toxins. So, while the Keto Diet (and other high fat/low carb trends) may lead to rapid weight loss at first, is it really worth the long-term effects that could ultimately lead to weight gain and chronic health conditions? Do your research before implementing a new diet. Or better yet, don’t diet! Feed your body a big range of nutrients and implement daily detox practices. That is the key to sustainable health.