Chennai: Although among the most popular fad diets, the death of actor Mishti Mukherjee earlier this week due to renal failure — rumoured to have been triggered by the high-fat low-carb ketogenic diet she was on — has doctors and nutritionists in Chennai trying to, quite literally, veto the keto on a war footing.
Dr Viswanathan Mohan, director of Chennai-based Madras Diabetes Research Foundation, calls it among the “unhealthiest diets”, and explains that the unbalanced nature of the keto diet, which advocates less than 50g of carbohydrate a day, can have oxidative stress on the body, push up cholesterol levels and cause irregularities in the heart due to deficiencies of essential micronutrients such as magnesium and selenium.
He says people are enamoured by the diet that is 55%-60% fat, 30%-35% protein and 5%-10% carbohydrates, because it results in immediate weight loss of 15kg to 20kg. “When you don’t eat carbohydrates, your body uses fat as a source of energy, which is known as a state of ketosis. So, you are basically melting the fat away,” says Dr Mohan, adding that several of his patients with diabetes have gone on the diet, lost lots of weight, and therefore gone off insulin. “But then because the diet is difficult to sustain, they’ve fallen off the wagon resulting in almost immediate weight gain and uncontrolled sugar levels,” he says. Similarly, some overweight people see it as an alternative to bariatric surgery.
Two years ago, Praneeth Arem decided to try the keto diet to lose weight fast. But after two cycles of the diet, the 28-year-old pilot-in-training says though he lost 20kg, his cholesterol levels shot up and his physician found he had gall bladder stones. “He told me both were because of the nature of diet. I had to undergo surgery to remove the stones. I decided to quit keto and try a less drastic more sustainable weight loss programme.”
For a diet to be successful it needs to be sustainable, says nutritionist Shiny Surendran. “The ketogenic diet is a highly specialised diet and needs to be medically supervised. Not everyone should embark on it. And yet, people download instructions off the internet and get on it,” she says. The average Indian diet consists of 50% carbohydrates, which makes the keto diet unsustainable in the long term.
The diet is sometimes used as a treatment option for people with epilepsy whose seizures are not controlled with medication, says Shiny. “It is also recommended in some cases by neurologists for tumour management. That is how specialised this diet is and one must be careful with it.” She says there are around 17 medical conditions for which the keto diet is not recommended as it can have adverse effects that range from diarrhoea to fatigue, renal failure, and ketoacidosis (that can damage the liver, kidneys, and brain), which can be fatal. “The diet is not recommended for those with diabetes or have a family history of high cholesterol,” says Shiny.
The other danger, says Dr Mohan, is that people get on and off the diet as they place, which can have disastrous results. “It can result in sudden death because of the stress it puts on the body.”