The ketogenic diet, an extremely low-carbohydrate diet, is used to treat certain medical conditions, such as epilepsy and type 2 diabetes, but isn’t recommended as a long-term diet or for the general population, despite recent media-hype.

Instead, a mild-ketogenic diet may offer a safer alternative to many individuals who want to achieve significant weight-loss, reversal of long-term chronic health disorders, clearer skin, improved mental health and wellbeing, improved sleep and increased energy, according to Practicing Dietician Kate Save.

What is a mild-ketogenic diet?

Mild-keto is a low-carbohydrate diet (50-70 grams per day) to achieve a mild state of nutritional ketosis, which effectively burns fat, resulting in rapid weight loss.

An advocate for the mild-ketogenic diet, Ms Save maintains that it is more sustainable than a traditional ketogenic diet, which can be damaging to the body long-term.

“Mild-keto ensures people can eat from the five food groups and get all of their nutrients and vitamins.

“Mild nutritional ketosis is a state in which the ketone levels in our body are only slightly elevated (0.3-1.5mmol/l), in comparison to other more extreme ketogenic diets that reach a higher level of ketosis," said Ms Save. 

The mild-ketogenic diet and weight loss

A dietitian-guided mild ketogenic diet is equally effective in achieving weight-loss as its more extreme counterpart.

“Evidence demonstrates that the effects of mild nutritional ketosis on weight loss are similar to that of the more extreme levels of ketosis without severe side effects.

“Placing individuals into a mild state of nutritional ketosis means we can manage side effects.

“Mild nutritional ketosis is a state in which your body switches from using sugar as a primary energy source to using our stored body fat.

“This involves limiting the amount of sugar consumed in the diet, such as eliminating refined sugar and decreasing carbohydrates. And by doing so, your body begins to deplete sugar stores (glycogen).

“Your body then needs to source energy from elsewhere, thus targeting stored body fat. This process produces ketones," said Ms Save.


What’s it like to be on a ketogenic diet?

Adam Johnson, a recent keto-convert, said while weight-loss wasn’t his primary motivation for trying a ketogenic diet, he has lost seven kilograms in two months.

“I can honestly say I’ve never felt better.

“The idea of returning to a whole food diet similar to our ancestors, really made sense.

"The first two weeks were the most difficult, cravings for carbohydrates and sugar did test my resolve to continue.

"The second week, I was lacking in energy and had flu-like symptoms.

"When I entered week three, the symptoms and cravings were gone, energy levels increased, and I haven't looked back," said Mr Johnson.

"It was a different experience for Natalie Gumz, who said while she didn't have food cravings on the ketogenic diet, her energy levels dropped significantly.

"I enjoyed the food and didn't have any cravings for high carbohydrate foods, but the first three weeks were hard with an extreme lack of energy.

“I couldn’t maintain my pre-keto exercise routines.

“I also developed digestive issues and bloating, but probiotics helped me through this stage.

"After three weeks my energy returned, digestion returned to normal, and I started to feel great.

"I have to admit that the first three weeks made me question if I had made the right decision.

“After my body adjusted to a keto lifestyle, I have experienced better gut health, higher energy and my mental clarity seems to have improved,” said Ms Gumz.

Therapeutic benefits of prescribing a traditional ketogenic diet

There are many variations of the ketogenic diet which have been successfully used to treat health conditions, including Type 2 diabetes, obesity, non-alcoholic fatty liver disease, polycystic ovarian syndrome and, increasingly, brain disorders such as autism and Parkinson’s Disease.

“Low-calorie ketogenic diets have been used widely for the treatment of obesity and obesity-related co-morbidity.

“Studies have found that ketogenic diets can lower blood pressure, improve cholesterol, decreasing the level of triglycerides, LDL cholesterol and blood glucose, and increasing the level of HDL cholesterol.

“Low-calorie ketogenic diets have also been implemented for the dietary management of Type 2 diabetes.

“Studies have shown this can significantly decrease body weight, fasting plasma glucose, serum cholesterol and triglycerides, and blood pressure.

“Non-alcoholic fatty liver disease is also nutritionally treated through adherence to a ketogenic diet. Studies have shown improvements in weight loss, steatosis, inflammation and fibrosis.

“Polycystic ovarian syndrome (PCOS) can also be nutritionally treated with the implementation of a ketogenic diet. Mild nutritional ketosis targets abdominal (visceral) fat, which is an area in which women with PCOS have difficulty with regard to holding weight.

“Results have shown a significant improvement in weight, per cent free testosterone, and fasting insulin in women with obesity and PCOS.

“Research is also emerging to support the potential beneficial role of a ketogenic diet for brain conditions such as Autism and Parkinson’s.

“In mice and rat studies, the ketogenic diet has been shown to have protective effects on the brain and nervous system, resulting in improved motor function and protectiveness against nerve damage.

“However, there hasn’t been enough research in humans in this area - but it is becoming increasingly researched,” said Ms Save.

Prescribing the ketogenic diet for children

A mild ketogenic diet that is well balanced, including the five food groups, and managed under the care of a health professional can be safe for use in children, explained Ms Save.

“Studies have started to demonstrate behavioural improvements in attention and social functioning in children administered with a ketogenic diet.

“A small pilot study in autistic children consuming a ketogenic diet demonstrated an improvement in ASD behaviour patterns.”

If the ketogenic diet is provided under the guidance of a medical professional and it is used appropriately for specific medical conditions, such as epilepsy suffers who are non-responders to anti-epileptic medications, then it can be done safely using regular monitoring, explained Ms Save.

“The traditional ketogenic diet has been demonstrated clinically to significantly reduce seizure incidence in children in both randomised and non-randomised acute studies.

“It has been used to treat children with epilepsy since the 1920s and is mainly prescribed for those children who continue to have seizures despite treatment with anti-epileptic drugs.

“Studies have found a reduction in seizure frequency, with some case-studies even becoming seizure free. This is because the keto diet increases the effectiveness of conventional therapies.

Whether prescribing the mild-ketogenic diet to promote weight-loss and increase wellbeing, or the traditional ketogenic diet to address serious health conditions, it's essential to consult a dietician and not media-hype, said Ms Save.

“A dietitian-guided approach to the ketogenic diet, including balanced nutrients from five food groups, is different from the ketogenic diets often promoted in the media.

"A dietitian designed mild ketogenic diet can contain up to 60g of carbohydrates per day provides healthy mono- and polyunsaturated fats and is low in saturated fat.

“Other keto diets may exclude whole food groups, promote a high intake of saturated fat, such as butter, cream, bacon, and provide only up to 20g of carbohydrates per day.

“Dietitians also ensure ketogenic diets are calorie controlled, as typical media-advertised ketogenic diets promote high intakes of fat which are energy dense.

“So, despite being in ketosis, this can reduce the amount of fat burning and even prevent weight loss due to consuming a calorie surplus.”