Soldier on with keto: Following a ketogenic diet may boost wellness within the military

06 May 2019 --- The ketogenic diet (keto) is the optimal way to combat obesity in the military and promote soldiers’ fitness levels, according to a new study from Ohio State University (OSU), US. The research found that participants who followed a ketogenic diet for three months lost five percent of their body fat, 44 percent of which was visceral fat, and demonstrated a 48 percent improvement in insulin sensitivity, a diabetes risk marker. As a result, the researchers note that more keto-friendly food options should be offered in the military to support keto diets.

The ketogenic diet is low in carbohydrates and emphasizes moderate consumption of protein, with fat consumed to satiety. The aim is to create a state of nutritional ketosis – which occurs when the body burns fat, rather than carbohydrates, for energy. The ketogenic diet is often used to control epileptic seizures and is also being studied in relation to endurance sports and diabetes management, among other areas.

In addition, Keto is enjoying a rise in popularity as a weight management tool and is one of the most trending diets for 2019. Innova Market Insights reports that new food and beverage launches with selected dietary claims have seen a 76 percent rise in “keto” product launches (Global, 2017 vs. 2016). Moreover, an Innova Market Insights Trends Survey (2018) found six percent of respondents followed a ketogenic diet.

Keto study findings
The new OSU study is published in the journal Military Medicine and involved 29 people, the majority of whom were members of the campus ROTC. For three months, 15 of the participants followed a ketogenic diet and a comparison group of 14 peers ate their normal diet.

Participants on the keto diet lost an average of almost 17 pounds and were able to maintain ketosis for 12 weeks, with support from counselors. The comparison group of participants, who consumed diets that were at least 40 percent carbohydrates (based on food diaries they kept), experienced none of those changes.

Low carb foodsThis was a small-scale one, however, it is the largest study published so far involving a well-formulated ketogenic diet in military personnel, notes senior author Jeff Volek, a Professor of Human Sciences at OSU.

Seven out of ten people who are otherwise eligible to enter military service in the US are considered unfit because of their weight, says lead author Richard LaFountain, Postdoctoral Researcher at OSU.

Officers or trainees on military bases likely could maintain a ketogenic diet based on the various foods that are already offered at typical meals, but more options could be added to support this weight-loss strategy, he notes.

“The military has called obesity a national security crisis. One of the potential benefits of this diet in the military is that you can lose weight without having to count calories, which could be difficult in training or while on active duty. The participants ate as much as they wanted, they just ate differently,” explains Volek.

Specifics of the process
The ketogenic diets in the study included no caloric restrictions, just guidance about what to eat and what to avoid. Carbs were restricted to about 30 to 50 grams daily, with an emphasis on nuts and non-starchy vegetables. Food was also provided, either as groceries, the keto dieters could use to prepare meals themselves or as pre-prepared frozen meals.

Keto diet participants had near-daily check-ins during which they reported blood ketone measurements from a self-administered finger-prick test and received feedback, usually through text messages, from the research team. Ketosis was defined as a blood concentration of ketones, chemicals made in the liver, between 0.5 and 5.0 mM (millimolar).

“Depending on their readings, we would talk about their food and drink choices and suggest they adjust their diet to maintain ketosis,” explains LaFountain.

Both groups, whose schedules included regular resistance training, showed comparable physical performance levels at the end of the study. This was important because it's difficult to lose weight without losing some lean muscle mass and physical function, Volek says.

“We showed that a group of people with military affiliation could accept a ketogenic diet and successfully lose weight, including visceral adipose tissue, a type of fat strongly associated with chronic disease. This could be the first step toward a bigger study looking at the potential benefits of ketogenic eating in the armed forces,” says Volek, who has authored books on the benefits of low-carb diets and is a founder of a company seeking to help people with Type 2 diabetes through ketogenic diets and a virtual health care model.

Study limitations
The results of the study, however, come with limitations. The group following the ketogenic diet chose to be in the test group, something that scientists call self-selection. Studies in which participants are randomized are preferred, but the research team said they wanted to do this pilot study in a group eager to adhere to the diet. The keto group also had a higher average body mass index (BMI) at the beginning of the study – 28 versus 25 in the comparison group – meaning they had more fat to lose.

Opposing research on Keto diets
Despite the wave of followers and research pointing to its benefits, the keto diet is very low in carbs, a fact which several studies have flagged as potentially perilous to wellbeing.

Keto diets may cause an increased risk of Type 2 diabetes in the early stage of the diet, according to research published in The Journal of Physiology. Zurich-based researchers found that even though ketogenic diet fed animals appear healthy in the fasted state, they exhibit decreased glucose tolerance to a greater extent than high carbohydrate, high fat, western style diet (HFD) fed animals.

According to a study presented at the ESC Congress 2018, the annual meeting of the European Society of Cardiology, low carbohydrate diets, such as keto, are unsafe and should be avoided. “We found that people who consumed a low carbohydrate diet were at greater risk of premature death. Risks were also increased for individual causes of death including coronary heart disease, stroke and cancer. These diets should be avoided,” says Professor Maciej Banach, study author and Professor of the Medical University of Lodz, Poland.

Additional research published in The Lancet Public Health suggests that following a low-carb diet could shorten life expectancy by four years. The high levels of animal fats and proteins that often replace carbohydrates in typical low-carb diets appear to be associated with higher risk of mortality. Eating more plant-based proteins and fats in place of carbohydrates was linked to lower mortality and even reversed the greater mortality risk.