Some eating plans promote weight loss; others encourage whole-body wellness. The ketogenic diet—keto for short—is a diet that emphasizes both, and this has contributed to its popularity.

What Is The Ketogenic Diet?

The keto diet’s strict low-carbohydrate eating plan is based on consuming high amounts of fat, moderate amounts of protein, and low amounts of carbs. On this eating plan, about 70 to 75 percent of caloric intake is derived from fats, 20 percent from protein, and 5 to 10 percent from carbs.

• Grass-fed and wild animal meats, wild-caught fish and seafood, and poultry and eggs are some of the protein sources on the keto diet.
• Nuts, seeds, and some vegetables are OK, but most fruits and starchy veggies are excluded.
• Consumption of healthy fats is encouraged, such as:
  • ghee and clarified butter
  • healthy oils:
    • coconut
    • avocado
    • macadamia
    • olive
• Strictly avoided:
  • processed foods
  • grains and high-carb foods
  • sugar and other sweeteners
  • tropical fruits / juices
  • most soy products
  • refined fats and oils

How Does the Keto Diet Work?

The keto diet encourages weight loss by introducing a metabolic state known as ketosis. This state causes the liver to create ketone bodies, which are molecules the body produces during starvation, fasting, or carbohydrate restriction.

Ketosis shifts the body’s metabolism away from glucose—an energy source originating from carbs—and toward fat burning.

How Long Does Ketosis Take?

Ketosis usually begins three to four days after the start of the diet, forcing the body to begin burning stored fats.

Benefits of The Keto Diet

Those following the keto diet don’t usually experience the slowdown in metabolism that typically occurs when people follow a low-fat diet.

Benefits of the diet also include the ability to build and preserve muscle tissue, reduce weight, and control the appetite.

Other Reasons for The Keto Diet

• Epilespy

  Historically, the keto diet was prescribed for treating challenging cases of epilepsy, particularly in children.

• Blood Sugar

  Some recent studies have found that the diet can help those with diabetes better control their blood sugar.

• Tumor Inhibition

  Experimental research has shown a link between the keto diet and slowed growth of certain tumors.

  Human studies involving brain tumors indicate promising results as well.

Drawbacks of The Ketogenic Diet

For many, weight loss is one of the most appealing benefits of the keto diet.

Yet some surmise it may not be the healthiest way to drop pounds.

• Effects on Body Chemistry

  When starved of carbs, the body’s liver makes and then delivers ketones to the bloodstream.

  An overabundance of ketones can change the blood’s chemical balance and lead to dehydration.

• High in Fat and Protein

  High-fat diets are associated with obesity and heart disease. Rich in fats, the keto diet emphasizes the consumption of animal proteins like red meat. Eating large amounts of this protein may increase cancer risk in some people.

  The keto diet may have the potential to help some cancer patients. However, depending on the type of cancer and treatment, some individuals may not be able to break down the protein and fat amounts, leading to digestive issues.

• Effects on Cholesterol

  An analysis of over a dozen clinical trials found that those on keto diets tended to lose more weight and keep it off than those on low-fat diets.

  • Those following a keto diet had lower blood pressure and triglycerides and higher HDL (good) cholesterol.
  • The trials also found that the subjects’ LDL (bad) cholesterol levels increased.

  Since the keto diet is generally high in saturated fat, this result was not surprising.

• Limited Food Selection

  Eliminating food groups can be difficult, so sticking to this eating plan can be challenging.

  Certain people have found that the weight comes back once they go off the plan and return to their old way of eating.

Check with Your Physician

Discuss this or any new diet with your healthcare provider or a dietitian before starting.

People with kidney disease should not follow high-protein versions of the keto diet.

US News & World Report recently ranked the Mediterranean diet as the best overall diet seven years in a row. 

Adopting this style of eating is healthy for many reasons. Those who follow the diet's basic principles lose a lot more than weight; they also reduce inflammation, blood pressure, and LDL (bad) cholesterol.

The best part? Dieters are anything but deprived; they can choose from a wide array of delicious, satisfying foods.

Following the Mediterranean Diet

The Mediterranean diet centers around fresh plant foods—as much as a pound of day of veggies and fruit.

In addition, followers enjoy:

• whole grains
• pulses
  • beans
  • peas
  • chickpeas
  • lentils
• nuts
• seeds
• olive oil
• fish
• herbs
• spices

Poultry and dairy products can be enjoyed in moderation—along with red wine.

More Tips

• Choose whole grain breads, cereals and pastas.
• Eat two servings of fish a week.
• Use spices and herbs to flavor your food instead of salt.
• Cook with olive oil instead of butter. Don't overdo it, though: each tablespoon contains about 120 calories.

Benefits of the Mediterranean Diet

Research shows that when it comes to heart health, a diet high in vegetable fat may be dramatically preferable to a low-fat diet.

In 2018, a review of 29 studies that looked at almost 13 million people found that those who followed the Mediterranean diet had a lower risk of:

• cardiovascular disease
• coronary heart disease
• heart attack
• Type 2 diabetes
• overall cancer occurrences
• neurodegenerative diseases

For these reasons, the American Health Association (AHA) endorses the Mediterranean diet. Researchers believe the benefits of the diet stem from its emphasis on monounsaturated fats (from avocado, fish, and olive oil) as well as its high fiber, which slows digestion and prevents blood sugar spikes.

• Weight Loss

  A review of studies shows that overweight people who adopted this style of eating lost between 5 and 18 pounds over a period ranging from one to two year.

  Those who incorporated exercise into their routine are the ones who lost the most weight.

• Cardiovascular Health

  A new major clinical trial shows that 30 percent of heart attacks, strokes, and deaths from heart disease can be prevented in those at high risk by following a Mediterranean diet, rich in extra-virgin olive oil, nuts, fish, legumes, fruits and veggies, and wine.

  Researchers followed 7,447 people, ages 55 to 80, who were at high risk for cardiovascular disease. People were broken into 3 groups:

  • One group ate a Mediterranean diet supplemented with extra-virgin olive oil (at least 4 tablespoons a day).
  • Another group followed the Mediterranean diet supplemented with a nut mix consisting of walnuts, almonds, and hazelnuts. Each day, they ate a generous handful (about a quarter cup).
  • The third group ate a low-fat diet.

  Of the 288 people who died during the study, 109 came from the group following the low-fat diet. Those on the Mediterranean diets were 30 percent less likely to die of a heart attack or stroke.

  In fact, the results were so clear that researchers ended the study early for ethical reasons.

  This research is part of a larger project called PREDIMED— a multi-center trial conducted between 2003 and 2011 to study the Mediterranean diet’s effect on cardiovascular disease.

• Stress and PTSD

  Researchers at Brigham and Women’s Hospital and the Harvard T.H. Chan School of Public Health found that women who followed the Mediterranean diet were less likely to experience post-traumatic stress disorder (PTSD) than those who ate more red and processed meats.

  PTSD occurs when a person has difficulty in recovering from having experienced or witnessed traumatic events. Not all people exposed to traumatic events develop PTSD.

  Findings suggest that a healthy gut microbiome supported by the Mediterranean diet may contribute to a more modulated stress response.

  Fiber and omega-3 essential fatty acids, key components of the Mediterranean diet, reduce inflammation (a risk factor for PTSD) and support the gut microbiome.

  The gut microbiome, in turn, influences the responses of the amygdala, the region of the brain that processes fear.

  Certain beneficial gut bacteria are well-supported by foods found in the Mediterranean diet, including:

  • fish and other seafood
  • fiber-rich fruits and vegetables:
    • apples
    • tomatoes
    • zucchini
    • spinach

Americans have long been phobic about consuming fats, even the good kinds. While this attitude is changing, most American diets remain deficient in omegas, and this lack contributes to disease.

What Are The Omega Fatty Acids?

Omega 3s—along with omega 6s—are considered “essential” fatty acids. This means the body can’t make them, so they must be constantly replenished for good health. Our bodies can synthesize omega 9s from food, so they are not considered “essential” like omegas 3 and 6.

• Omega 3s

  • Sources of Omega 3s

    Fish oil is rich in two omega-3 polyunsaturated fatty acids called eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). To increase your intake, consider eating anchovies, herring, wild salmon, mackerel, and sardines. Other choices include grassfed meat, flaxseeds and flax oil, chia seeds, and walnuts. Experts advise that healthy people consume 250 to 500 milligrams (mg) of omega 3 per day. If you’re not a fan of fish, consider omega-3 supplements.

  • Benefits of Omega 3s

    Omega 3 is cardioprotective and linked to lower levels of inflammation. Increased intake of omega 3s lowers triglyceride levels and the risk for high blood pressure and diabetes. Fish oil supplements may help reduce joint pain in rheumatoid arthritis. Studies have also found that omega 3 intake can help prevent depression and anxiety and improve symptoms of ADHD.

    Omega 3s can also help prevent atopic dermatitis, lessen the risk for macular degeneration, protect visual and neurological development in infants, fight certain cancers, and help with conditions such as asthma, Crohn’s, inflammatory bowel disease, and psoriasis.

• Omega 6s

  • Sources of Omega 6s

    Ideally, we should consume about twice as many omega 6s as omega 3s. However, because so many processed foods (such as commercially processed vegetable oils and grains) contain omega 6s, the ratio is currently 17:1. This can lead to an excess of inflammation in the body. The key is to cut down on processed foods and focus instead on gamma linolenic acid (GLA), a high-quality omega 6. GLA is a powerful anti-inflammatory and can be found in supplements made from the oils of the black currant, borage, and evening primrose plants.

  • Benefits of Omega 6s

    In addition to promoting weight loss by increasing the body’s fat-burning ability, GLA helps fight allergy symptoms and inflammatory diseases such as arthritis, asthma, eczema, and psoriasis. It’s also useful for diabetes, PMS, osteoporosis, and ulcerative colitis.

    A study from researchers at Ohio State showed that improving the ratio of omega 6 to omega 3 decreased the risk of hip fractures. Omega 6s are also effective for lowering total and LDL (lousy) cholesterol levels. Used in combination with omega 3s, omega 6s can significantly lower deaths from heart disease and help protect vision.

• Omega 9

  • Sources of Omega 9

    Omega 9, an oleic acid, can be found in olives, olive oil, avocado oil, macadamia nuts, and almond butter.

  • Benefits of Omega 9

    Omega 9 can help lower blood pressure and LDL cholesterol while increasing HDL cholesterol. It may help boost memory.

Herbs and other natural therapies, by and large, are safe to use by themselves and even in combination with many items in your medicine cabinet. But herbs can, in a few cases, interact adversely with prescription and over-the-counter drugs.

Conventional Medications and Herbal Remedy Interactions

When you have questions about how to safely use conventional medications with herbal supplements, it makes sense to rely on the expertise of someone like Patrick Fratellone, MD. Dr. Fratellone is both a physician with offices in New York City and Fairfield, CT, and a registered herbalist with the American Herbalists Guild. In terms of conventional medicine and traditional remedies, he stands with a foot in each world.

As Dr. Fratellone puts it: “One should realize that herbs are drugs.” This is because many of our conventional medicines—metformin and digoxin, for example—first came from plants. In addition, many items considered foods also serve as herbs with medicinal qualities: Think of garlic, parsley, ginger, and thyme.

The good news? You don’t need to be overly concerned about herb-medication interactions, since for the most part “there are very limited known drug-herb reactions, whether the herb is in a capsule or as a food,” says Dr. Fratellone. Of course, it’s always prudent to let your doctor or pharmacist know about all herbs and dietary supplements you are taking to guard against potential interactions.

Check Your Medication List

One medication that always tops the list of potential herb interactions is the blood thinner Coumadin (warfarin). Caution should be taken with herbs that also thin the blood. These include garlic and ginkgo, as well as omega-3 oils.

The birth control pill is another medication that warrants consideration. Women taking the pill who also use 

St. John’s wort can experience breakthrough bleeding and the possibility of ovulation—which means the risk goes up for unintended pregnancy. Thus, taking oral contraceptives for birth control (as opposed to using the pill for management of periods, acne, or a condition such as polycystic ovarian syndrome) would mean that St. John’s wort should definitely be avoided.

Another red flag, according to Dr. Fratellone, concerns the Parkinson’s disease medication levodopa. “Studies have shown that kava kava, an herb used for anxiety, can reduce the effects of levodopa,” he says.

Friendly Herbal & Conventional Medicine Interactions

When considering herb-medication interactions, it’s worth noting that along with potential negative interactions there are also friendly interactions. In other words, sometimes taking an herb or dietary supplement can ease the undesirable side effects of a prescription or over-the-counter drug. In other cases, they can make a drug work better than it would have alone.

For instance, taking acetaminophen (Tylenol) regularly or in large doses can cause problems for the liver. However, adding silymarin (the active ingredient in milk thistle) each day may help neutralize these negative effects on the liver.

Of course, antibiotics are well known for killing the friendly bacteria in your gut, often triggering a bout of diarrhea (or ongoing diarrhea that lasts after antibiotic treatment). It’s a sound idea to recolonize your GI tract with probiotics, both while using antibiotics and continuing after you finish the course. The two should be taken a few hours apart.

Taking this even further, Dr. Fratellone points out that there are herbal remedies that can take the place of drugs in select situations. For example, he notes that the herbs uva ursi and juniper are as effective as the prescription medication macrodantin, which is used for urinary tract infections. Another example is mastica—the resin from a tree in Greece—that may eradicate H. pylori infection and may be used in place of the two antibiotics and one antacid that are generally prescribed.

As Dr. Fratellone sums things up: “Plants for centuries have provided the cure to many illnesses and diseases.”