The Ketogenic Diet must be taken only under Expert Supervision

We have just heard about the sad and unfortunate passing away of actress Ms. Mishti Mukherjee. However, what concerns us are the media reports that claim she passed away due to kidney failure caused by the ketogenic diet (KD). No mention is made of whether she had a pre-existing kidney problem and whether all relevant blood tests had been conducted prior to the keto diet and at regular intervals after that. This information may trigger undue panic and anxiety amongst many individuals on the KD. We are writing to refute that a properly administered KD can cause kidney failure. Our KD centre has been using a scientifically calculated and regularly monitored KD since 1996. Around 700 patients with uncontrolled epilepsy, Cancers, Dementia and other neurodegenerative disorders have been managed by us with patients ages ranging from a few months to over 80 years.  None of them have had any major side-effects leave alone kidney or liver failure.

Over the years, two concerns about ketogenic diet and kidney health have surfaced:

  1. Do ‘higher levels’ of protein intake from KD potentially stress the kidneys?

Ans: The KD provides a normal protein intake as recommended by the WHO. There has been no report in scientific literature on kidney failure caused by such a properly instituted KD. KD is a high fat low carbohydrate diet with normal protein consumption. A well-formulated ketogenic diet is, therefore, not high in protein. Recommendations of the WHO are to eat 0.8 grams – 1 gram of protein for each kilogram of desired body weight in adults.  If the KD used by Ms. Mishti Mukherjee did not conform to this and had a higher protein component then that could lead to kidney failure. This could happen either because the diet was prescribed by someone without a deep knowledge of KD, or it was unsupervised, or both of the above.

In fact, KD has been proven to control blood glucose levels and to control and reduce blood pressure, thereby helping to prevent the future development of kidney disease.

Unfortunately, the keto diet has become a fad diet these days for weight loss. People taking KD by reading the internet, or self-administering, or taking it as prescribed by gym trainers, run a real risk of major side-effects. Most gym trainers do not have basic qualifications in dietetics and nutrition.

2. Do low-carb diets increase the risk of kidney stone formation, especially when the diet is first started?

Ans: Kidney stones have been reported in children with epilepsy who use special, highly-restrictive versions of ketogenic diets, but supplementing with potassium citrate may reduce the risk of kidney stones five-fold.  However in our centre, we haven’t observed any cases of kidney stones in epilepsy patients till date, as we supplement with potassium citrate.

Finally, the ketogenic diet is a THERAPEUTIC DIET and should be followed under strict supervision of a trained keto doctor and dietitian team. The keto team will closely supervise the clinical and blood parameters at regular intervals to ensure there are no major side-effects. A full battery of 20 biochemical parameters for every patient and also regular 3 monthly follow-up of blood tests is conducted by our centre. It is essential that prior to the initiation of KD all possible co-morbid diseases which may affect the general health should be excluded like, renal & liver diseases.

Hundreds of scientifically conducted clinical trials all over the world including our centre over several years have shown that KD therapy is safe and efficacious. Our website www.ketogenicdietindia.org gives valid scientific information on KD. The bottom line is do not self-administer or take the KD from an untrained medical professional. It would have been better if the media had taken our inputs and scientific data available with us as we are the pioneers of the ketogenic diet in India.