Researchers say the ketogenic diet does a better job controlling metabolic syndrome. Dietitians aren’t so sure.

Is the ketogenic diet more effective for people with metabolic syndrome than a standard American diet with exercise?

Researchers from Bethel University in Minnesota think so.

But dietitians say it may not be that simple.

The researchers set out to discover if a sustained, controlled ketogenic diet would reduce the impact of metabolic syndrome as well as decrease the weight, body mass index (BMI), and body fat mass of study participants.

They brought together a group of 30 adults who had been diagnosed with metabolic syndrome, a cluster of conditions that occur at the same time.

The conditions can include high blood pressure, high blood sugar, excess body fat around the waistline, and abnormal cholesterol levels.

People with metabolic syndrome are at an increased risk of heart attack and stroke.

The researchers randomly split participants into three groups.

One group followed a sustained ketogenic diet with no exercise.

Another undertook a standard U.S. diet with no exercise.

The third followed a standard U.S. diet with 30 minutes of exercise for three to five days per week.

At the end of the 10-week period, those in the ketogenic group saw the best results for reduction of weight, body fat percentage, and BMI.

“All variables for the ketogenic group outperformed those of the exercise and non-exercise groups, with five of the seven demonstrating statistical significance,” the authors wrote.

Theory behind the keto diet

The ketogenic diet (sometimes called “keto”) is a low-carb, high-fat diet that involves drastically reducing the amount of carbohydrates you eat and replacing them with fats.

The body responds to this reduction by going into a state called ketosis.

“Carbohydrates are the main fuel our body was designed to use and the only fuel that the brain and heart muscles use. When we don’t eat enough carbohydrates, the body looks for other forms of energy to satisfy that role. Without carbs, our insulin levels drop and fat is released from our cells. The liver turns the fat into ketones, our body’s second choice for energy,” Lauri Wright, PhD, an assistant professor in public health at the University of South Florida, told Healthline.

The keto diet has been used in medicine in conjunction with other therapies to help children with epilepsy. This is done under supervised conditions with a medical professional.

Whether the diet can be used safely for weight loss, however, remains to be seen.

“The ketogenic diet appears to be safe in the short term (like this 10-week study). However, we don’t have much evidence that it’s safe in the long term, or sustainable,” Jennifer McDaniel, a registered dietician and spokesperson for the Academy of Nutrition and Dietetics, told Healthline.

Wright notes there’s a concern a long-term keto diet could be damaging.

“Because ketone excretion can increase the pressure in the kidneys, there is a concern about the effects on renal function. There is also a concern about loss of muscle mass that results from relying on ketones for fuel,” she said.

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