I'm often asked my opinion about the cause or treatment of some medical condition,

but the question to instead ask is, what does the science say?

What is the best available balance of evidence published in the peer-reviewed medical

literature you have to say right now?

Welcome to the Nutrition Facts podcast.

I'm your host, Dr. Michael Greger.

Today we take a look at the popular keto diet, the high-fat low-carb diet that puts the body in a metabolic state called ketosis.

And we start with the effect of the keto diet on LDL cholesterol with Dr. Dennis, our new senior research scientist.

The effect of a plant-based low-fat diet versus an animal-based ketogenic diet on caloric intake and weight loss. A plant-based diet without sugary, refined grain foods, versus a keto diet with a lot of vegetables.

After two weeks randomized to one of the two diets, the participants were switched

to the other one for another two weeks. Looking at the scale, guess who lost more body weight?

Those on the low-carb diet. But guess who lost more body fat? Those on the low-fat diet.

In fact, there was no significant fat loss on the low-carb diet, whereas two pounds of fat were lost on the low-fat diet. In fact, there was no significant fat loss on the low-carb diet,

whereas 2 pounds of fat were lost on the low-fat diet.

What they were losing on the low-carb diet was fat-free mass,

like water weight but muscle too.

While fat-free mass was relatively preserved while on the low-fat diet, fat-free mass decreased on the low-carb diet.

And there was evidence that participants were losing muscle mass, despite eating more protein than when they were on the plant-based diet.

But when they were eating almost no carbs, their blood sugars were certainly lower.

Does a ketogenic diet have a place within diabetes clinical practice?

It's even been suggested that low-carb diets could put type 2 diabetes into remission,

which can be defined as an HBA1C, a marker of blood sugar control, lower than 6.5% for at least three months after stopping any blood sugar

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