Managing Chronic Conditions with the Keto Diet

“Let food be thy medicine and medicine be thy food,” a quote often credited to Hippocrates.

A variety of diets have come and gone. Still, the Keto diet has been providing health benefits for one hundred years, due to its effective weight loss and lesser-known, management of serious conditions such as Epilepsy. Research continues at USF Health on the Keto diet and its ability to improve patient outcomes with a comprehensive care approach that includes nutrition.

Dominic D’Agostino, PhD, an associate professor at the USF Health Morsani College of Medicine’s Department of Pharmacology and Physiology and his team of researchers, conduct studies exploring the potential impact of the Keto diet and exogenous ketone supplementation on managing complex medical and neurological conditions, cancer, and diabetes, as well as weight loss and management. Funding for this research originated from the Office of Naval Research to explore the anti-seizure and neuroprotective effects of nutritional ketosis. This research is impacting patient care at USF Health.

“Obesity is one of the highest risk factors for type 2 diabetes, heart disease, hypertension, and other metabolic diseases. Maintaining a healthy lifestyle and weight is critical to the long-term management of chronic disease.  Work with your provider to find a dietary program that helps control your chronic condition. A change in lifestyle may enable a reduction or alleviate the need for long term medications,” said Dr. Crystal Jacovino of the USF Health Department of Internal Medicine.

What is the Keto diet? What is Ketosis?

The Keto diet is a low carb, high-fat diet, similar to Atkins and other low carb diets. Nutritional ketosis, which is caused by the Keto diet, is a metabolic state in which fat is the primary fuel of the body.

“Construct a diet that consists of 60-80% fat, a moderate amount of protein, and carbohydrate intake under 10% from nuts, avocado, and green leafy vegetables. If you are trying to lose weight or control diabetes, the Keto diet is very strict and just restricting carbohydrates alone can make a big difference,” Dr. D’Agostino said. “Although the Keto diet is classically associated with bacon and eggs, there are plant-based options to be considered too.”

Are there other diet approaches recommended by the health community?

Improvements in your diet can be made with a few tweaks like reducing processed foods, filling half your plate with non-starchy vegetables, and eliminating sugar-sweetened beverages and fried foods. There is no one most effective diet to promote weight loss, although in the short-term ketogenic diets and intermittent fasting can be helpful as a jump start,” said Dr. Crystal Jacovino of the USF Health Department of Internal Medicine. “Other diets such as the DASH diet, a diet rich in fruits, vegetables,  and lean proteins are promoted by the NIH to prevent and control hypertension, and the Mediterranean diet has shown to improve heart health. The most important thing is that your provider knows the dietary lifestyle you are trying and any supplements you are currently taking.”

How do I get started? Anything I should know?

If you have been diagnosed with a health condition that is being metabolically managed by the Keto diet, it is important to be monitored by a registered dietician or CNS (a certified nutrition specialist).  If you are interested in weight loss or managing your glucose levels, it is recommended to consult a nutritionist to get going initially, especially the first two to three weeks. There is a wealth of information readily accessible from books, apps, and YouTube videos, as well as Keto diet plans and supplements.

“Although increased energy and suppression of appetite are benefits of the Keto diet, initial “keto-adaptation” may cause feelings of fatigue during the first few weeks. It’s good to keep this in mind when starting the Keto diet,” Dr. D’Agostino said.

What are the benefits of the Keto diet to patients facing serious health conditions?

The ketogenic diet works with other medical treatments or can be the primary source of treatment for patients.

  • Neurological conditions – The use of a prescribed ketogenic diet can replace anti-seizure drugs for Epilepsy and other serious seizure disorders.
  • Cancer – There are pre-clinical studies at the Moffitt Cancer Center on a wide range of cancer types and cancer-induced conditions, like muscle wasting, which causes a loss of strength and weakness in cancer patients. There are numerous registered clinical trials using the ketogenic diet as an adjuvant to cancer therapies.
  • Diabetes – Low carbohydrate diets such as the Keto diet effectively lower glucose and insulin levels in type 2 diabetics, and can reduce the need for medication.
  • Genetic disorders –Nutritional ketosis is being studied for the treatment of genetic disorders such as Angelman and Kabuki syndrome.

Future of the Keto diet? Nutrition as medicine?

Through his research at the USF Health Morsani College of Medicine’s Department of Pharmacology and Physiology, D’Agostino is actively working to incorporate more nutrition knowledge as medicine into his teaching and, ultimately, patient care at USF Health.  “We are harnessing nutrition to improve health by engineering diets for treating specific disorders,” said Dr. D’Agostino. “There’s no better prevention tool than nutrition to promote good health.”

The USF Health Department of Family Medicine and Internal Medicine hosts a multidisciplinary weight loss group clinic that meets the second Friday of every month led by Dr. Crystal Jacovino and Drs. Olivia Pane PharmD, Rachel Franks CDE PharmD, and Jerry Brown DMD, CDE, where we explore aspects of healthy dieting and weight loss to support patients.

To find out more about the ketogenic diet and its effective management of serious conditions, such as Epilepsy, watch our USF Health and Wellness series Facebook LIVE with Dominic D’Agostino, PhD, or go to Keto Nutrition.

To make an appointment with USF Health’s Family Medicine and Internal Medicine team of care providers, please call (813) 974-2201.

Written By: Kathleen Rogers

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