An overlooked danger of ketogenic diets Making the case that ketone bodies induce vascular damage by the same mechanisms as glucose
Mark J.Burkitt Nutrition 14 February 2020
Highlights
• Low-carbohydrate, ketogenic diets are associated with increased mortality
• Ketone bodies form adducts with proteins by the same mechanisms as glucose
• Ketone bodies and glucose may lead to vascular injury through common pathways
• Dietary ketosis as a means of avoiding glucose-induced vascular damage is futile
Intense debate surrounds the use of low-carbohydrate, ketogenic diets for the promotion of weight loss and avoidance of cardiovascular disease. The rationale behind these diets is that they promote fat oxidation and minimise the addition of glucose to proteins in the formation of adducts that trigger inflammation.
Although nutritional ketosis is widely assumed to be a safe metabolic condition, proper consideration has not been given to the fact that ketones are reactive towards proteins through the same mechanisms as glucose. In this Hypothesis article, the case is made that ketone bodies are more potent than glucose in bringing about the protein modifications to which the harmful effects of glucose have been attributed. It is suggested, therefore, that attempts to minimise such protein modifications through nutritional ketosis are futile and may lead to adverse health outcomes.
