By now, many have heard of the keto (ketogenic) diet. This diet focuses on high fat, moderate protein, and low/no carb intake to improve health and lose weight. However, where did this diet originate exactly? And who is responsible for connecting ketones to weight loss? Keep reading to learn more about the origin story of the keto diet!
Greek Olympians and Meat Diets
Low-carb diets have existed for over 150 years (and maybe even longer). Some accounts suggest that Greek Olympians were consuming a low-carb, protein-heavy diet to maintain their strength, muscle mass, and sports performance as far back as 776 BC.
Diogenes Laertius, a biographer of popular philosophers, wrote that "Greek athletes trained on dried figs, moist cheese, and wheat; then the pattern changed and focused on meat." Pythagoras is thought to be the first to train athletes on a meat diet, starting with Eurymenes, a successful heavyweight boxer. Physicians even went so far as to align specific types of meat with specific athletic goals, for example, "beef as the most suitable when strength performance was required, while goat meat and pork were preferred for the good condition of the muscular system and long-lasting contests in heavy events, respectively.
Patient 0, the First Documented Case of a Low-Carb Diet
Fast forward a couple of thousand years to the first formal documentation of a low-carbohydrate diet. The account was published in 1869 in A Letter on Corpulence (Obesity), Addressed to the Public by William Banting, a retired undertaker living in London. Banting stood 5' 5" tall and weighed 202 pounds, making his BMI (body mass index) 34 today, which is considered obese.
With the help of Dr. William Harvey, Banting began a diet low in sugars and high in animal products. This was "the first time anyone had formally prescribed a low-carbohydrate diet for weight loss." And it worked! Banting lost 46 pounds in just under a year. This new diet spread quickly, inspiring more applications and studies into the 20th century.
Seizure Prevention in the 1920s
By 1921 Dr. Russel Wilder, a very prominent endocrinologist from the Mayo Clinic, developed what we now know as the modern ketogenic diet for the "management of refractory seizures in pediatric patients" with epilepsy. His goal was to introduce a non-pharmacological approach to managing epilepsy in children. At the time, the available medications for epilepsy were limited, and some patients did not respond well to them; Dr. Wilder was determined to find another way, and he did!
In the early 1900s, researchers observed that fasting had shown positive effects on seizures, lowering their occurrence. However, no physician had intentionally created a state of ketosis in a patient to test this theory. Dr. Wilder aimed to replicate fasting benefits through a controlled diet, being the first to intentionally induce ketosis in his patients.
The ketogenic diet is designed to mimic the metabolic state of fasting. It is a high-fat, low-carbohydrate, and moderate-protein diet with the primary goal of inducing ketosis. In this metabolic state, the body produces ketones from fats as an alternative fuel source when glucose (from carbohydrates) is unavailable.
When the body is in ketosis, it becomes more efficient at using fats for energy, including the brain, which typically relies on glucose. It was believed that this shift in metabolism helps reduce epileptic seizures. When Dr. Wilder's epileptic patients began running on ketones for energy, seizure activity significantly diminished, and his theory was celebrated. An observed side effect outside of lowered seizure threshold was weight loss. Although the weight loss side effect was noted, it was not really explored until much later.
Keto in the Modern World
Throughout the 20th century, the use of the ketogenic diet for epilepsy management waned with the introduction of more effective antiepileptic drugs. However, in recent years, the keto diet has experienced a resurgence in popularity, mainly due to its potential benefits for weight loss and various health conditions. It is now widely adopted by people seeking to lose weight, improve insulin sensitivity, and address certain metabolic disorders.
The keto diet is the most effective for weight loss, especially body fat loss. A study published in Nutrition & Metabolism found that after 8 weeks, participants who followed a ketogenic diet lost nearly five times as much body fat as those who ate a low-fat diet. Although the long-term effects of the keto diet still aren't clear, the short-term benefits seem very promising.
It is important to note that while the ketogenic diet has gained popularity and is researched for other potential benefits, its effectiveness and safety in various contexts are still subjects of ongoing scientific exploration. As with any diet or lifestyle change, consulting with a healthcare professional is recommended before embarking on the keto diet, especially for individuals with pre-existing health.