Why ketogenic diets have long-

term complications
By: Jemps Gallegos Yuvienco
Philippine Daily Inquirer / 05:05 AM August 28, 2018

In search of a more sustainable and lasting approach to reversing, or at least delaying the onset of
type 2 diabetes, I have returned recently to a vegetarian diet.

This had me listening to a webinar, “Reverse Diabetes with a High-Carb Diet,” broadcast by the
Forks over Knives community.

The resource speaker, Cyrus Khambatta, received his PhD in Nutritional Biochemistry from the
University of California at Berkeley. He started Mangoman Nutrition and Fitness in 2013 to teach
people suffering from diabetes how to measure, track and reverse insulin resistance through plant-
based nutrition and strategic exercise.

Through nutrition education, exercise coaching and his experience with type 1 diabetes, he spoke
compellingly about the topic.

Khambatta said, “If there’s one thing you should remember from this webinar, it’s this: insulin
resistance is caused by the storage of fat in tissues that are not designed to store fat. It is a dysfunction
of your muscle and liver tissue. The accumulation of fat in your muscle and liver traps glucose in
your blood.”

Diet

What food causes insulin resistance?

“Everything, if the total proportion of refined carbohydrates in your diet is too high. The biggest
culprits are red and white meat, dairy, oils, fish and eggs. Common triggers are high dietary fat and
protein,” he said.

Khambatta added that autoimmune diseases like type 1 diabetes, type 1.5 diabetes, lifestyle diseases
like type 2 diabetes and prediabetes, and conditions that lead to diabetes such as gestational diabetes
and polycystic ovarian syndrome (PCOS) all have a common thread: insulin resistance.
“Aside from diabetes, insulin resistance also leads to cancer, obesity, fatty liver, coronary artery
disease, atherosclerosis, high cholesterol, Alzheimer’s (cognitive decline), neuropathy (nerve
damage), hyperthyroidism, blindness, kidney failure, erectile dysfunction and retinopathy. So, it
affects metabolic health in general, not just the different flavors of diabetes per se,” he said.

Why do low-carb diets work to lower blood glucose?

Khambatta said, “Low-carb diets have been around for about half a century and have many names.

Low-carb, high-fat diets

“In the ’70s, it was the Atkins diet, which was repopularized in the ’90s. Then it was called the South
Beach diet, The Zone and then the Paleo diet and finally, today’s trendy ketogenic diet. Low-carb,
high-fat diets promote short-term health improvements such as rapid weight loss, reduced blood
glucose variability, hemoglobin A1C, total insulin use, LDL cholesterol and triglycerides. This is the
main reason doctors love to prescribe these diets because of the almost instantaneous results.”

However, he warned, ketogenic diets have long-term complications. So, six months to five years
later, will those improvements remain or will the picture change?

“Low-carb diets significantly increase chronic disease in the long term: heart disease (including
hypertension, LDL cholesterol, triglycerides and atherosclerosis), glucose metabolism (increased
insulin resistance, low-carbohydrate tolerance and fatty liver), inflammation (increased risk for
cancer, kidney failure and total body inflammation) and overall health (weight gain, inability to lose
weight, low energy, impaired indigestion and food cravings).”

He spoke about two Harvard studies that concluded how a low-carb diet based on animal sources was
associated with higher all-cause mortality (increased risk for premature death) in both men and
women, while a vegetable-based low-carb diet was associated with lower all-cause and
cardiovascular disease mortality rates.

Khambatta also revealed a Public Library of Science study of over 270,000 people in four cohort
studies, that showed the risk of premature death among those with high low-carb scores as
significantly elevated.

In a Journal of the American Medical Association internal medicine investigation, high animal
protein intake was positively associated with cardiovascular mortality while high plant protein intake
was inversely associated with premature death.

How does our protein intake affect our risk for cancer and diabetes?
“Low protein intake is associated with a major reduction in IGF-1, cancer and overall mortality in
people ages 65 years and below. Among subjects in the study with no diabetes at baseline, those in
the high protein group had a 73-fold (7300 percent) increase in risk, while those in the moderate
protein category had an almost 23-fold (2300 percent) increase in the risk of diabetes mortality,” said
Khambatta.

“Anything you do that increases insulin resistance minimizes your chances of reversing diabetes
altogether. Prediabetes and type 2 diabetes are reversible conditions in over 90 percent of situations.
But if you’re eating yourself into an insulin resistant state, it’s not gonna happen,” he warned.

Fruits, vegetables

What types of food reverse insulin resistance?

“Fruits, starchy and nonstarchy vegetables, beans, lentils and peas, green leafy vegetables, intact
whole grains, herbs and spices are those you can eat in abundance. It’s not the banana’s fault or the
quinoa’s fault or the potato’s fault why your sugar is clocking in at high figures,” said Khambatta.

“It’s what came before that. What’s in common? They are all low fat and low protein.”

He also advised to eat less of the following: nuts, seeds, avocados, coconuts, olives, pasta and bread
(even sprouted). They may be plant-based but they are high in fat and must be taken in moderation.

What should be avoided?

“Dairy, eggs, red and white meat, fish and shellfish, oils, refined sugars, pastries and bread. These
food store large amounts of fatty acids in your muscles and liver, which aren’t designed to store fat,
and thus lead to insulin resistance,” he said.

How can we reverse insulin resistance?

Khambatta recommended: “Be consistent with your food choices and be patient. Within as little as 48
hours, changes can happen and be sustained for years.”