The History of the Ketogenic Diet

The buzz around keto might lead you to believe it’s the latest trend. But in fact, the opposite is true. One could argue that the Ketogenic diet has been around since our great ancestors were hunting down animals with sharpened sticks.  

The use of agriculture to grow and maintain crops for food is a relatively new part of human existence. Look a little further in history and you see a predominantly hunter/gatherer type of lifestyle.  Aside from cultures living along the equator, many of the inhabited regions on earth were too cold to produce fruit-bearing vegetation in abundance.  Taking that into consideration, the majority of our ancestors were surviving on a diet consisting mostly of animal fat, meat, and occasional leafy vegetables. There are still populations (the Inuits among them) that eat a primarily meat and fat-based diet.

Today we’re exploring the history of the Ketogenic diet; how Ketosis was discovered and how this diet has been used throughout history for a variety of purposes.

Ketosis and Food Scarcity

We know that Ketosis was key to our evolution as humans. For a vast majority of human evolution, food scarcity was a major problem, so it was critical that even during scarcity, we would be able to support the energy needs of the brain. Ketones are a really big part of how we survived that. Ketones are important because they’re the only other primary energy substrate for the brain outside of glucose.

Without the presence of glucose (the first energy source we will always pull from), the body begins relying on stored fat as energy. Scientists would later hypothesize that one that one could mimic the state of fasting by eating a diet high in fat and low in carbs—starving it of its normal fuel source.

Fasting as Epilepsy Treatment

Epilepsy has confounded humanity since its earliest manifestations. Once attributed to supernatural attacks from evil spirits, the disease soon came under the scrutiny of Hippocrates, who was one of the first physicians to vocalize that epilepsy is biological and not spiritual. It was also Hippocrates who would use fasting as a means of correcting the disease.

Hippocrates wasn’t alone; as history unfolded, other physicians like Rollin Woodyatt cited fasting as a means for combating epilepsy. This track would lead to the Ketogenic diet breakthrough of the 20th century.

In the early 1920s, scientists took a close look at fasting in epileptic children. What they found was that after a few days of not eating, the body started breaking down fat to fuel your body’s processes — and for whatever reason, this metabolic shift was the key to fasting’s minimizing effect on seizures.

What they realized was that when you’re fasting, you are eating a high-fat diet in a sense— but the fat is coming from storage, not the food you’re eating.

This idea ultimately led one Mayo Clinic physician named Russell Wilder to an interesting idea for a fasting workaround: Perhaps they could design a specialized diet, one that was high in fat and low in carbs, which would starve the body of its normal fuel and thereby mimic the state of fasting. Dr. Wilder’s discovery of the Ketogenic Diet opened the doors for innovation.

1921: Early Roots of The Ketogenic Diet

Another physician named Dr. Peterman from the Mayo Clinic was the first to standardize the Ketogenic diet by developing the following calculations:

• 1g of protein per kilogram of bodyweight

• 10 – 15 g of carbs per day

• Fill the rest of the remaining calories with fat

The Ketogenic diet quickly became the best weapon in the fight against epilepsy. It’s so effective that it has been in competition with the pharmaceutical industry since 1938, when the first antiepileptic drugs came to the market.

1971: The Modified Ketogenic Diet

In 1971, a scientist named Huttenlocher developed an easier to follow Medium-Chain Triglyceride oil diet in hopes of getting people who were on the fence about the diet to give it a shot. Unfortunately, Keto was still viewed as beneficial only for the sake of epilepsy patients. Few had thought that it could be utilized for other dieting purposes.

Compared to the traditional Keto diet, the Medium-Chain Triglyceride Ketogenic Diet allowed for more carbohydrate and protein to be included while maintaining Ketosis.

1994: The Resurgence of The Ketogenic Diet

Credit for bringing Keto back into the spotlight goes to an episode of Dateline NBC that aired in 1994. The episode focused on a high-profile case of epilepsy that was successfully controlled using the Keto diet. This story was also made into a movie called First Do No Harm starring Meryl Streep. By the mid-2000s, the diet was accepted as an uncontroversial, successful method for reducing epileptic seizures.

The main reason for Keto’s surging popularity today is due to its impact on weight loss with minimal side effects than a more traditional low-fat diet. Studies have also shown Keto to be particularly useful for those struggling to lose weight due to metabolic disorders like insulin resistance and even polycystic ovary syndrome (PCOS).

The Future of Keto

For thousands of people across the country—among them, patients in our own practice—employing a Ketogenic or modified Ketogenic diet has lead to dramatic weight loss and reversal of chronic diseases like hypertension and type 2 diabetes. We utilize the Ketogenic diet with close monitoring by our medical weight loss staff to ensure patients are losing weight safely while maintaining their health and wellbeing.

The great thing about Keto is that it is continually being studied in conjunction with other diseases. Currently, a variety of trials are ongoing to determine Keto’s usefulness as part of treatment for certain types of cancer, as well as for other neurological disorders like Parkinson’s, Alzheimer’s, and multiple sclerosis. Research is still in its infancy, but we expect to see the Ketogenic diet used for decades to come.

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