The ketogenic diet turns conventional nutrition advice upside down. Instead of limiting fats, it encourages them — while slashing nearly all carbohydrates. The result is a dramatic metabolic shift: with sugar largely unavailable, the body begins breaking down fat into ketone bodies for energy. This switch often leads to rapid weight loss, helping explain why the diet has become so popular.
Research tracking the health effects of the diet in mice, published in Science Advances, has shown that health risks arise with long-term adherence to the diet. “I think a lot of people look at a ketogenic diet and think, ‘I’ll lose weight, I’ll be healthier,’” said physiologist Molly Gallop of Earlham College. While weight loss can bring certain benefits, the research suggests a cautionary approach.
A Mouse’s Tale—and a Warning
The researchers tracked four groups of mice on different diets — low-fat, high-fat, Western, and ketogenic — for almost 12 months. Gallop and her colleagues found that the mice fed a ketogenic diet for this duration, which translates to decades in human time, developed a range of health problems. Although the keto-fed mice weighed less than those on a Western diet, their blood showed high levels of fat, and male mice developed fatty, malfunctioning livers. In addition, all mice on the keto diet had severe glucose intolerance.
“It’s a cautionary tale,” said study co-author Amandine Chaix, a physiologist at the University of Utah in Salt Lake City. People adhering to this high-fat plan need to be careful, she said, “because this is not a magical dietary approach.”
From Medicine to Mainstream
Long before it became a popular weight-loss strategy, the ketogenic diet was developed as a medical treatment for epilepsy. Physicians found that a high-fat, low-carbohydrate regimen could help control seizures when used for short periods. That therapeutic use continues today under careful supervision.
The classic keto diet typically provides about 90% of calories from fat—nearly double the proportion in a standard American diet. Johns Hopkins University neurologist Tanya McDonald still uses ketogenic diets as a treatment option for epilepsy patients but cautions against unsupervised use. “We don’t recommend that the general public use ketogenic diets without medical supervision,” she said.
A Reversible Risk
One bright spot emerged from the study: when the mice were taken off the keto diet, their ability to manage blood sugar returned to normal. This suggests that the health effects are reversible, which, Chaix noted, “is a really good thing.”
Still, the research points to a clear message: the ketogenic diet may work for short-term weight loss or medical management, but over time, it could strain the body’s organs and metabolism in unexpected ways.
Proceed with Caution
The study offers a reminder that popular diet trends can carry unforeseen risks. High-fat, low-carb eating may help people shed pounds quickly, but sustaining it for years could have hidden costs. Researchers stress the importance of medical oversight and moderation for anyone attempting the diet.
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