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== The ketogenic diet FAQ is wrong according to published papers and this article should be expanded to include weight loss uses ==
== any articles on carnivore diet? ==


Summary: Like it or not, not only the common usage of the term "ketogenic diet", '''but also the use of that term in scientific literature''' has evolved to mean a diet which produces measurably elevated levels of blood ketones.
Links to any article(s) on ("pure") carnivore diet(s) - or experiments on it?
Would be very interesting to say the least. [[Special:Contributions/84.211.240.52|84.211.240.52]] ([[User talk:84.211.240.52|talk]]) 16:39, 3 July 2022 (UTC)


There is also a significant amount of emerging research that shows ketogenic diets for weight loss are not a "fad diet" but rather have proven scientific evidence showing that they work also for treatment of fatty liver disease (as one example). The use of a keto diet for weight loss should be merged into this page as the accepted medical definition of a ketogenic diet is one that produces elevated levels of blood ketones in non-diabetics. Even if those diets are not as extreme as the ones for treatment of epilepsy, words and phrases change meaning over time and this definition has been used by many peer reviewed articles and should be accepted.
:See [[monotrophic diet]] for the carnivore diet. [[User:Psychologist Guy|Psychologist Guy]] ([[User talk:Psychologist Guy|talk]]) 20:20, 3 July 2022 (UTC)
:See the categories listed at the bottom of the (article) page, where you can explore other diets. [[User:SandyGeorgia|'''Sandy'''<span style="color: green;">Georgia</span>]] ([[User talk:SandyGeorgia|Talk]]) 21:11, 3 July 2022 (UTC)


I'm not going to provide an exhaustive list of sources showing this is the accepted scientific definition, but a few for example are listed below, e.g.
== "See Low-Carbohydrate Diet" ==


Bueno NB, de Melo IS, de Oliveira SL, da Rocha Ataide T. Very-low-carbohydrate ketogenic diet v. low-fat diet for long-term weight loss: a meta-analysis of randomised controlled trials. Br J Nutr. 2013 Oct;110(7):1178-87.
The Low-Carbohydrate Diet that we're supposed to refer to for the weight-loss version of the ketogenic diet refers directly back to this page. So why not add a section here, with an opportunity to cite medical discussions of the use of the ketogenic diet for weight loss? As of now, that opportunity is lost.
https://en.wikipedia.org/wiki/Low-carbohydrate_diet#Ketogenic_diet
:[[User:Kortoso|Kortoso ]] ([[User talk:Kortoso|talk]]) 00:38, 25 July 2022 (UTC)
::The focus of this article is the dietary epilepsy treatment. We are a hyperlinked encyclopaedia, so the "opportunity" to discuss diets for weight loss that may be ketogenic can be fully explored in another article. -- [[User:Colin|Colin]]°[[User talk:Colin|<sup>Talk</sup>]] 08:40, 25 July 2022 (UTC)


Paoli A, Rubini A, Volek JS, Grimaldi KA. Beyond weight loss: a review of the therapeutic uses of very-low-carbohydrate (ketogenic) diets. Eur J Clin Nutr. 2013 Aug;67(8):789.
== Ketogenic diets in other applications ==


Masood W, Annamaraju P, Khan Suheb MZ, et al. Ketogenic Diet. [Updated 2023 Jun 16]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK499830/
Look at the sources I added. They specifically describe ''ketogenic'' diets, not generic low carb. <span style="font-family:Georgia, serif;">[[User:Steven Walling|Steven Walling]]&nbsp;&bull;&nbsp;[[User talk:Steven Walling|<span style="color: #8080b0">talk</span>]]</span> 03:24, 8 August 2022 (UTC)


A quick google search will find the plethora of other papers that does not consider the definition to be a diet used only for epilepsy treatment or 90% fat content. [[Special:Contributions/2001:558:6045:10D:EC97:D297:9502:B579|2001:558:6045:10D:EC97:D297:9502:B579]] ([[User talk:2001:558:6045:10D:EC97:D297:9502:B579|talk]]) 04:30, 29 April 2024 (UTC)
:Not the medical ketogenic diet; the term has come to be used generically. Also, please see [[WP:FAOWN]] and discuss ''before'' reinstating content. [[User:SandyGeorgia|'''Sandy'''<span style="color: green;">Georgia</span>]] ([[User talk:SandyGeorgia|Talk]]) 03:26, 8 August 2022 (UTC)
:This is not correct. Medical organizations do not recommend the keto diet for weight loss, nor do any health guidelines. The StatPearls source you cited admits that there is no long-term health outcome data on keto and weight loss. The evidence is only short term, much more clinical data is needed if you are going to make those claims. The same source says that a ketogenic diet increases the risk of heart disease and kidney stones. Due to the increased CVD risk, cardiology organizations do not recommend keto. As for your claims about keto improving liver disease, there is not any good clinical evidence for this. Your source does list some papers but there are no good systematic reviews on this because again the evidence is limited and not conclusive. Harvard Health says that keto could be worse for the liver [https://www.health.harvard.edu/staying-healthy/should-you-try-the-keto-diet]. [[User:Psychologist Guy|Psychologist Guy]] ([[User talk:Psychologist Guy|talk]]) 08:29, 29 April 2024 (UTC)
::It's the usual [[Wikipedia:Article titles and scopes]] problem.
::You could just as easily write "Like it or not, not only the common usage of the term ''influenza'', '''but also the use of that term in scientific literature''' has evolved to mean not just the influence of astrology on the body, but also a contagious disease, so we should merge [[Astrology]] into [[Influenza virus]]" – because "the accepted medical definition", and the original source of the word, was astrology, and only later did it come to mean a disease caused by a particular group of viruses, so they're all the same thing, right?
::A voluntarily chosen diet for adults hoping to lose weight is not a diet for kids who are at risk of dying from uncontrolled seizures. These are different subjects. Therefore, they get separate articles. If you are jealous because the article about the pediatric epilepsy treatment got written first, and thus got this name, then that's entirely understandable but not a reason to think that kids who could die are the same as adults who want to shed a few pounds.
::It might interest you to know that the names of articles can change. This one could be renamed, e.g., to [[Ketogenic diet (epilepsy treatment)]]. Maybe that would stop people from thinking that "their" title is used on the "wrong" subject, or that epilepsy treatments and weight loss are the same thing. In the meantime, the information you seek is at [[Low-carbohydrate diet#Ketogenic diet]]. There is a link to this at [[Keto diet]]. [[User:WhatamIdoing|WhatamIdoing]] ([[User talk:WhatamIdoing|talk]]) 16:51, 29 April 2024 (UTC)
::This has been discussed many times on this page (see archive). I don't think a name change is likely to win approval because nobody has shown any inclination to write a proper article on e.g. ketogenic diet for weight loss. It's all well and good saying Wikipedia should have an article about X(a) that should be called X, if nobody in the history of Wikipedia has written such an article. Write that article and we can discuss names. It has been noted many times that the professional literature does not discuss epilepsy treatments and weight loss treatments together (vs mentioning one in passing). Wrt Psychologist Guy's comments, I think one of the problems is the hostility shown towards weight loss options, as demonstrated by the carb article calling it a fad diet. Pejorative terms just inflame things unnecessary and there are no weight loss treatments (outside of drugs and surgery) that work long term on a reliably significant number of people, so I think pulling out KD as one option to scorn is hypocritical. The American Heart Association can recommend certain diets all it likes, but there isn't really evidence people choose them and stick to them any more than any other diet. -- [[User:Colin|Colin]]°[[User talk:Colin|<sup>Talk</sup>]] 08:45, 30 April 2024 (UTC)


== Confusion on grammar. ==
::So what article describes ketogenic diets in a non medical setting? There isn't one. <span style="font-family:Georgia, serif;">[[User:Steven Walling|Steven Walling]]&nbsp;&bull;&nbsp;[[User talk:Steven Walling|<span style="color: #8080b0">talk</span>]]</span> 03:26, 8 August 2022 (UTC)
:::I think there is, but {{u|Colin}} can better explain which is which. [[User:SandyGeorgia|'''Sandy'''<span style="color: green;">Georgia</span>]] ([[User talk:SandyGeorgia|Talk]]) 03:33, 8 August 2022 (UTC)
:::Actually, it's built in to the [[Template:Editnotices/Page/Ketogenic diet|edit notice]] when you edit the page, but it's at the very bottom and probably gets missed very often. <blockquote>'''This article is ''not'' about weight loss and body-building diets'''; it is about the [[physician]]-ordered [[medical nutrition therapy]] used to treat severe, refractory [[epilepsy]] in children by producing very high levels of ketone bodies. '''Non-medical''' diets that encourage moderate levels of ketone production are described in the article [[low-carbohydrate diet]].</blockquote> [[User:SandyGeorgia|'''Sandy'''<span style="color: green;">Georgia</span>]] ([[User talk:SandyGeorgia|Talk]]) 03:36, 8 August 2022 (UTC)
Your comment
::::Yeah for context, I added it because the scientific reviews--one of which is literally titled "Ketogenic low-CHO, high-fat diet: the future of elite endurance sport?"--are smart enough to discuss the difference between ketogenic and non-ketogenic LCHF diets and both have been studied fairly extensively. So the sources aren't about weight loss and body building, they're real science about other applications. <span style="font-family:Georgia, serif;">[[User:Steven Walling|Steven Walling]]&nbsp;&bull;&nbsp;[[User talk:Steven Walling|<span style="color: #8080b0">talk</span>]]</span> 03:38, 8 August 2022 (UTC)
:::::Yes, but not ''this specific'' medical diet, which has to be used under strict medical supervision. Colin will explain better (or you can read through the article if you'd rather not wait for him to show up-- I'm off for the night!). [[User:SandyGeorgia|'''Sandy'''<span style="color: green;">Georgia</span>]] ([[User talk:SandyGeorgia|Talk]]) 03:44, 8 August 2022 (UTC)
::::::Ok so then the title of the article needs to be changed, to something like "Ketogenic diet (medicine)" or "Ketogenic diets in medicine", because there is clearly scientific literature discussing real application of a ketogenic diet outside medicine, so the flat title is misleading. Just saying "ketogenic diet" is [https://www.merriam-webster.com/dictionary/ketogenic%20diet defined by Merriam-Webster] as "a diet that supplies large amounts of fats, moderate amounts of proteins, and minimal amounts of carbohydrates and that is undertaken for weight loss or to control seizures in treatment-resistant epilepsy" so you can see how the generic title is deceptive. I understand wanting to keep medical information separate from weight loss fad info. <span style="font-family:Georgia, serif;">[[User:Steven Walling|Steven Walling]]&nbsp;&bull;&nbsp;[[User talk:Steven Walling|<span style="color: #8080b0">talk</span>]]</span> 04:07, 8 August 2022 (UTC)
:::::::There are rules about article titles, and for 100 years the dominant subject of "ketogenic diet" was as an epilepsy treatment mainly used in children. Recent years have shown a high interest in related diets for weight loss or sports in adults. There's not really a degree of overlap between those studying and writing about the former and the latter, hence Wikipedia handles them in separate articles too. The "other uses" section exists because (usually neurologists) writing about the KD in epilepsy ''do'' briefly note the research into that diet for other neurological disorders. Hence it has [[WP:WEIGHT]] here. There isn't really any literature-weight to suggest that when writing about an epilepsy diet, authors also digress into the latest research on sports nutrition or on weight loss.
:::::::You and I can see an overlap, but I can also see an overlap between a saline drip and my gran's salty chicken and leek soup. Both will provide the body salt and water nutrients, but the former needs to be sterile and is used in sick people, and the latter merely warmed up and served to anyone. -- [[User:Colin|Colin]]°[[User talk:Colin|<sup>Talk</sup>]] 10:35, 8 August 2022 (UTC)
:::::::::We are writing for here and now, not for 100 years ago. Wikipedia is not just an encyclopedia for doctors or people with medical conditions, and ''the English dictionary'' disagrees with your definition of scope of the term. <span style="font-family:Georgia, serif;">[[User:Steven Walling|Steven Walling]]&nbsp;&bull;&nbsp;[[User talk:Steven Walling|<span style="color: #8080b0">talk</span>]]</span> 15:41, 8 August 2022 (UTC)
::::::::::Our encyclopaedia articles are not written such that they cover all possible meanings of a term in one article. I suggest you read some of the MOS about article titles and scope. The content of articles is determined by what reliable sources write about, not by dictionary definitions, and reliable sources do not make a habit of writing about epilepsy treatments and sports nutrition at the same time.
::::::::::The point about 100 years is that there is a body of literature on the ketogenic diet for epilepsy that is huge and has endured and is still very much relevant. This isn't a historical treatment.
::::::::::I accept that some readers will encounter this article while expecting to read about weight loss or sports diets. That is not a unique problem, and I guess most people searching about "Apple" are interested in the tech company, not the fruit. We can't please everyone. There's more discussion about this in the archives. -- [[User:Colin|Colin]]°[[User talk:Colin|<sup>Talk</sup>]] 18:08, 8 August 2022 (UTC)
::::::::::::The preponderance of reliable source material most definitely does not justify ''zero'' coverage of non-medical diet interventions on the main article about ketogenic diets. Even just this [https://physoc.onlinelibrary.wiley.com/doi/10.1113/JP278928 one narrative review from 2020] in the [[Journal of Physiology]] notes that there is over 40 years of peer-reviewed research on the topic of ketogenic diets in sports nutrition. [[WP:TITLE]] clearly states that "The title indicates what the article is about and distinguishes it from other articles" so when there are decades of peer-reviewed studies (not to mention lay literature) with the term "ketogenic diet" in reference to non-medical interventions your argument for zero coverage doesn't hold water, unless the article is titled specifically in reference to medical treatment. <span style="font-family:Georgia, serif;">[[User:Steven Walling|Steven Walling]]&nbsp;&bull;&nbsp;[[User talk:Steven Walling|<span style="color: #8080b0">talk</span>]]</span> 18:43, 8 August 2022 (UTC)
:::::::::::::You aren't looking at the right thing. There are 46 years of literature about [[Apple Inc.]] and yet weirdly there is zero coverage (beyond the hatnote) of computers and mobile phones in our [[apple]] article. This is because when reliable sources write about round fruit, they don't write paragraphs about little black rectangles with rounded corners. It isn't the quantity of articles that counts, but the fact that they are independent of each other.
:::::::::::::If you think there is merit in expanding this article to discuss all diets that are wholly or partly ketogenic, and used for any purpose in any population group, then we need to know the literature that actually does that? This would be literature that thinks there is a core subject of "ketogenic diet" that is worth talking about in all its various forms. The closest I've found is [https://academic.oup.com/book/29504 Ketogenic Diet and Metabolic Therapies: Expanded Roles in Health and Disease] which spends 9 pages out of 408 talking about sports nutrition (and 13 pages on diabetes). The rest is neurology and nearly all of that epilepsy. That's one book. Pretty much everything else I've seen is solely neurological with anything other than epilepsy as a briefly mentioned research matter, or similarly focused on sports or on weight loss or life extension or recipes or whatever.
:::::::::::::Merging topics that the reliable sources keep distinct is bad for many reasons but a big one is original research. It makes it too likely that we'd claim something was true of "ketogenic diets" but in fact was only true of one kind of ketogenic diet in one kind of population group.
:::::::::::::Currently, this article is not the "main topic" on ketogenic diet because the literature does not support the idea of there being a main topic. -- [[User:Colin|Colin]]°[[User talk:Colin|<sup>Talk</sup>]] 20:45, 8 August 2022 (UTC)
::::::::::::::"Currently, this article is not the "main topic" on ketogenic diet because the literature does not support the idea of there being a main topic" Right, which is why this should be specifically titled to refer to "(medicine)" or "in medicine" and then have a "Ketogenic and low carbohydrate diets" article about non-medical applications. I agree the split makes sense, but what doesn't is the current article title that reads like it's generic. <span style="font-family:Georgia, serif;">[[User:Steven Walling|Steven Walling]]&nbsp;&bull;&nbsp;[[User talk:Steven Walling|<span style="color: #8080b0">talk</span>]]</span> 03:10, 9 August 2022 (UTC)
:::::::::::::::We do not always add qualifiers after an article title just because there are subjects that could be in scope for that title. Please read the MOS on this. There is a reason [[apple (fruit)]] or [[Houston, Texas]] are redirects. Neither are the "main topic" on all things named "apple" or all dwellings called "Houston". -- [[User:Colin|Colin]]°[[User talk:Colin|<sup>Talk</sup>]] 07:20, 9 August 2022 (UTC)
::::::::::::::::You don't need a qualifier for apple because the scope of the article matches the general understanding of the term. That's not the case here. The scope of the article is a specific medical application that's covered a lot in medical literature and isn't actually the commonly understood definition. <span style="font-family:Georgia, serif;">[[User:Steven Walling|Steven Walling]]&nbsp;&bull;&nbsp;[[User talk:Steven Walling|<span style="color: #8080b0">talk</span>]]</span> 08:29, 9 August 2022 (UTC)
:::::::::::::::::And what do you think is the "commonly understood definition"? Could we write an article for that? Perhaps your view is influenced by how you got here (diets for exercise). See [[Wikipedia:Disambiguation]]. There isn't an algorithm for this. All choices have costs and benefits. While adding a qualifier to the name might appeal to your desire for precision, it has a cost in terms of searching and linking to this page, and it isn't like we have significant alternative articles like "ketogenic diet (sports medicine)" or "ketogenic diet (weight loss)" or "ketogenic diet (wellness fad)" to link to. We ''do'' have [[Keto diet]] that is a DAB page and uses a common short form of the name, and despite all the interest in directing readers towards content about sports or weight loss uses of a "ketogenic diet", we don't have any significant content that has been written about it. I wonder why. -- [[User:Colin|Colin]]°[[User talk:Colin|<sup>Talk</sup>]] 10:01, 9 August 2022 (UTC)
::::::::::::::::::The commonly defined meaning in sources is clearly "a diet that produces ketones" and there are various reasons why an individual would adhere to the diet. It's only your obsession with a focus on the medical application that excludes 100% of other ketogenic diet applications, not the source material. <span style="font-family:Georgia, serif;">[[User:Steven Walling|Steven Walling]]&nbsp;&bull;&nbsp;[[User talk:Steven Walling|<span style="color: #8080b0">talk</span>]]</span> 05:55, 10 August 2022 (UTC)
:::::::::::::::::::Perhaps revisit that remark ? [[User:SandyGeorgia|'''Sandy'''<span style="color: green;">Georgia</span>]] ([[User talk:SandyGeorgia|Talk]]) 07:17, 10 August 2022 (UTC)
:::::::::::::::::::I wonder if at this point we are going round in circles. The "source material" does not cover all diets that produce ketones. Each source covers one aspect of the diet, that those authors are "obsessed" about, not me. If there were books and books and articles and articles that each covered "a diet that produces ketones" as a whole topic and comprehensively discussed contrasted and compared all the different uses of such diets then sure, [[ketogenic diet]] could mirror that. But there aren't and so we don't. -- [[User:Colin|Colin]]°[[User talk:Colin|<sup>Talk</sup>]] 07:58, 10 August 2022 (UTC)
::::::::::::::::::::A literature search for [[WP:MEDRS|reliable sources]] on "ketogenic diet" overwhelmingly returns articles on epilepsy and the conditions listed in the article under the heading "Other medical applications".[https://pubmed.ncbi.nlm.nih.gov/?term=ketogenic+diet&filter=pubt.review&filter=datesearch.y_5&size=100] There is little of value to a featured article on "other applications". We can only write what can be verified by reliable sources. Until sources are found, which I doubt exist, there is indeed no point in "going round in circles", in my view. [[User:Graham Beards|Graham Beards]] ([[User talk:Graham Beards|talk]]) 08:28, 10 August 2022 (UTC)


@[[User:Psychologist Guy|Psychologist Guy]] "This article is about a dietary therapy for epilepsy. For information on ketogenic diets as a lifestyle choice or for weight loss, see Very low-carbohydrate ketogenic diet."
I'm a little confused by this. "Ketogenic diet (medical treatment for epilepsy)" and "Ketogenic diet (weight-loss intervention)" are the same actual diet, are they not? By contrast, "Apple (company)" and "Apple (fruit)" are completely different things. Or are they two different diets?


The problem is, why the word "or" should not in be case when the 2 choice available? Heres my choice:
If they are the same food recommendations, then they are the same thing and surely belong in the same article? On the other hand, if they are different sets of food recommendations, then fair enough, they're not the same diet. &mdash;[[User:Ashley Y|Ashley Y]] 05:52, 8 January 2023 (UTC)


"For information on ketogenic diets as a lifestyle choice or for weight loss, see Very low-carbohydrate ketogenic diet."
:[[User:Ashley Y|Ashley Y]], there's some info in the FAQ at the top of the talk page. Yes they are more closely related than those two examples. They have some things in common but while both might seek very few carbs, they vary a lot on protein, which is typically high on a weight loss or body-builder diet (to make you feel full and slow release energy, or to build muscle) but set only at a "necessary for growth" level for the epilepsy diet. And clearly on one, the purpose is weight loss (or muscle gain) in a fully developed body, whereas on the the other, which is typically used in children, the aim is normal growth and the weight gain that goes with that. The biggest issue which keeps the articles from merging is that our sources do not (other than as an aside) talk about them together. So all the stuff here about how the diet is started, monitored, side effects, health benefits, are very much only drawn from medical practice and research on epilepsy diets. If we combined in the weight loss and body building (of which there are numerous variants) then we'd find it very hard to not mislead the reader in thinking some fact applied to that but which we only really know applies to very sick children with epilepsy. [[WP:SYNTH]]. -- [[User:Colin|Colin]]°[[User talk:Colin|<sup>Talk</sup>]] 12:47, 8 January 2023 (UTC)


Means there are two choice
== Infobox ==


"For information on ketogenic diets as a lifestyle choice"
{{Infobox medical intervention (new)|name=Ketogenic diet|synonyms=|image=File:Ketonuria.jpg|caption=Testing for [[ketonuria|ketone bodies in urine]]|alt=A test strip is compared with a colour chart that indicates the degree of ketonuria|pronounce={{IPA|/ˌkiːtəʊˈd͡ʒɛnɪk/}}|specialty=Neurology, endocrinology|uses=Refractory paediatric epilepsy|complications=Stunted growth, bone fractures, kidney stones, constipation, dyslipidemia, dysmenorrhea, low-grade acidosis|approach=Dietary intervention|types=|recovery time=|other options=Anti-epileptic drugs, brain surgery|outcomes=Seizure reduction|frequency=|cost=}}
"For information on ketogenic diets asfor weight loss,"
help me for the problem.
[[Special:Contributions/203.190.54.67|203.190.54.67]] ([[User talk:203.190.54.67|talk]]) 09:53, 24 May 2024 (UTC)


:"As for" is not correct grammar. The first part of the sentence as written is structured like this:
I haven't found any previous discussions about adding an infobox in the archives. This is the only FA-class disease or therapy article connected to WikiProject Medicine that doesn't have an infobox, which makes it a bit unusual. On the other hand, there's no rule requiring one. Do we want an infobox at the top of this article? It could look something like this. [[User:WhatamIdoing|WhatamIdoing]] ([[User talk:WhatamIdoing|talk]]) 17:42, 30 April 2023 (UTC)
:* For information on ketogenic diets
:I think when the article was developed, many medical infoboxes looked like the one at [[Hepatorenal syndrome]]: a list of codes only a medical professional would care about (on a project no medical professional should trust to get codes from) and all external links. I'm not sure what the above example is offering the general reader. It is such a primary region of the article, I'm loathe to distract the reader with stuff that isn't jump-out-at-you vital and easy to describe. Our lead sentence is more lay-friendly than "Refractory paediatric epilepsy" and if you know what epilepsy is, then the outcome should be obvious. We know it is a dietary intervention from the article title and lead sentence already. The "complications" are listed in a take-it-or-leave-it form, rather than explaining their frequency or degree of seriousness. One might imagine stunted-growth could be [[dwarfism]] but is more subtle than that (and may resolve when the child comes off the diet). Btw, [[Water fluoridation]] doesn't have one either, though whether that is a medical therapy is up for debate. -- [[User:Colin|Colin]]°[[User talk:Colin|<sup>Talk</sup>]] 13:10, 2 May 2023 (UTC)
:** as a lifestyle choice or
::You are correct about the history of the infobox. I don't feel strongly either way myself. It's normal for disease articles to have an infobox, but it's not required.
:** for weight loss...
::I don't think that infoboxes need to contain solely vital information. The contents I've mocked up here are just an example. A lot of them have little more than the specialty identified. I think, for this article, that the "Uses" line might help reinforce the not-about-the-fad-diet theme (as could the "Complications" list). [[User:WhatamIdoing|WhatamIdoing]] ([[User talk:WhatamIdoing|talk]]) 14:55, 4 May 2023 (UTC)
:Some adults follow a high-fat diet as a lifestyle choice, and some other adults follow a high-fat diet for weight loss. There are two main reasons why adults follow a high-fat diet. The word ''or'' is used to indicate that different adults have different reasons. [[User:WhatamIdoing|WhatamIdoing]] ([[User talk:WhatamIdoing|talk]]) 01:29, 26 May 2024 (UTC)
:::Yes, I thought the same about the "Uses". [[User:Graham Beards|Graham Beards]] ([[User talk:Graham Beards|talk]]) 17:22, 4 May 2023 (UTC)
:::The "not-about-the-fad-diet" is only really a ''problem'' with editors. Readers already get a hat note and the lead sentence is pretty clear what the topic is. And we have a FAQ for the editors, should any of them care to read it. I'm not keen to have either medical jargon (uses) or a frightening list of complications just to scare off the health fad folk and say "this is a serious medical intervention for a serious medical condition".
:::I think that we have done everything we can to highlight to readers and editors what the scope is, without distracting readers who want to learn about this medical intervention. What we know is that editors who want this article to be about the fad diet, don't and won't care what the article says or what we write in a faq, because they either don't read it or think it is wrong. -- [[User:Colin|Colin]]°[[User talk:Colin|<sup>Talk</sup>]] 07:29, 5 May 2023 (UTC)
::::Do you think that infoboxes are distracting? [[User:WhatamIdoing|WhatamIdoing]] ([[User talk:WhatamIdoing|talk]]) 00:19, 6 May 2023 (UTC)
:::::You didn't ask me, but, yes. [[User:SandyGeorgia|'''Sandy'''<span style="color: green;">Georgia</span>]] ([[User talk:SandyGeorgia|Talk]]) 00:33, 6 May 2023 (UTC)
:::::Yes but distraction isn't always bad, if the content is worth grabbing someone's attention for. Magazines frequently publish pictures and captions to grab a reader's attention and draw them to consider reading the body text. I can't think of any other publication aimed at general readers that would squander the real-estate at the top of the article to include a list of jargon terms and medical codes. -- [[User:Colin|Colin]]°[[User talk:Colin|<sup>Talk</sup>]] 19:05, 8 May 2023 (UTC)


== Ketones are not used by the brain at all, the brain runs on glucose even in ketosis ==
==First umbrella review published==


In the first part of the article it says that ketone bodies are used by the brain but the brain runs on glucose even in ketosis. Even when eating no carbs your body converts some of the protein you eat to glucose in order to power the brain. This is called gluconeogenesis. [[Special:Contributions/174.109.243.90|174.109.243.90]] ([[User talk:174.109.243.90|talk]]) 07:12, 5 August 2024 (UTC)
The first umbrella review of 68 randomized clinical trials on the effects of the ketogenic diet has been published. The results of high-quality evidence were a reduction in seizure frequency, triglycerides and a significant increase in low-density lipoprotein cholesterol. Moderate-quality evidence included a decrease in weight and an increase in total cholesterol. If the article is to be cited it's probably only worth citing the high-quality results. There is no long-term clinical data because the trials were between 8weeks and 9 months. But these findings suggest that the ketogenic diet is not heart healthy long-term, as they raise LDL-c and total cholesterol which will increase the risk of cardiovascular disease and events. Here is a link to the paper [https://pubmed.ncbi.nlm.nih.gov/37231411/], in full [https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-023-02874-y]. High-quality evidence supports a reduction in seizure frequency but this is already stated on the article. If anyone wants to add this umbrella review to the article please add it. I wouldn't say there is anything ground-breaking here that we did not know already but this is the biggest review to date that has looked at 68 trials. [[User:Psychologist Guy|Psychologist Guy]] ([[User talk:Psychologist Guy|talk]]) 11:05, 22 June 2023 (UTC)

:The article says "These ketone bodies enter the brain and ''partially'' substitute for blood glucose as a source of energy." You need to read past the introduction. Also, "Most organs and tissues can use ketone bodies as an alternative source of energy. The brain uses them as a major source of energy during periods where glucose is not readily available. This is because, unlike other organs in the body, the brain has an absolute minimum glucose requirement." (Dhillon KK, Gupta S. Biochemistry, Ketogenesis. 2023 Feb 6. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan–. PMID: 29630231.) [[User:Graham Beards|Graham Beards]] ([[User talk:Graham Beards|talk]]) 09:40, 5 August 2024 (UTC)
::Yes, the brain always requires a minimum amount of glucose to function. Also I read the entire article, my critique is about the way it is worded in the head of the article because I feel like it is misleading people to think the brain can run on only ketones, which is impossible.
::I also don't understand why the first paragraph of the article only describes ketogenetic diets as a therapy for epilepsy, when emerging evidence is showing it can be helpful in a variety of conditions, including traumatic brain injury: https://www.ncbi.nlm.nih.gov/books/NBK209323/ [[Special:Contributions/174.109.243.90|174.109.243.90]] ([[User talk:174.109.243.90|talk]]) 08:48, 7 August 2024 (UTC)
:::There is no evidence that it is helpful for traumatic brain injury, the link you cited noted no clinical trials have been done, it even says "''there are no human short- or long-term studies evaluating the ketogenic diet for TBI''". In other words no evidence, just speculation. The same link also notes that patients on the ketogenic diet drop out after a few years. The ketogenic diet has a very high drop out rate. [[User:Psychologist Guy|Psychologist Guy]] ([[User talk:Psychologist Guy|talk]]) 18:04, 7 August 2024 (UTC)
::::PG, while you are correct, I don't think there is a need to be quite so harsh on every visitor to this page who has read something promising about this diet in an area outside of epilepsy. There are lots of things one could take a hardline no-evidence/speculation approach to. Lots of very very bright people "speculate" on what the planets in our solar system or further afield are made of but good luck persuading the folk editing those articles to accept your "it is just speculation and should be deleted" approach. I think currently the "Other medical applications" section is out of step [[WP:WEIGHT]] wise, with what reliable sources say when discussing the ketogenic diet as a medical therapy. We are here to write encyclopaedically about a subject, with weight according to what reliable sources do. We aren't here to restrict information solely to what is in current clinical practice. -- [[User:Colin|Colin]]°[[User talk:Colin|<sup>Talk</sup>]] 07:46, 14 August 2024 (UTC)
:::::If the ketogenic diet was effective outside of epilepsy then it would be recommended by the [[American Heart Association]], [[Academy of Nutrition and Dietetics]], [[British Dietetic Association]], [[European Society of Cardiology]], [[National Lipid Association]], [[American Cancer Society]], [[Cancer Research UK]], [[National Cancer Institute]], [[World Heart Federation]], European Atherosclerosis Society, [[European Association for the Study of Diabetes]], HEART UK, [[World Cancer Research Fund]], [[World Health Organization]] etc but as we all know it isn't. All these organizations are up to date with the latest research and most put out consensus statements. They advise against the keto diet for the general population because it raises ApoB/LDL which we know increases cancer and heart disease risk. There is no conspiracy. It's dangerous to be promoting misinformation that this diet might help traumatic brain injuries. [[User:Psychologist Guy|Psychologist Guy]] ([[User talk:Psychologist Guy|talk]]) 12:39, 14 August 2024 (UTC)
::::::But "effective" to the degree that anything becomes a recommended therapy by multiple organisations is an extremely narrow focus for "can be mentioned at all on Wikipedia". I agree we should not be a dumping ground for every piece of speculative research ever mentioned by nutritionists and wellbeing websites. But there are serious scientists researching this diet beyond epilepsy and their work is covered by reliable secondary sources. That is what counts on Wikipedia. For example, have multiple articles on cancer research, both on prevention and cure, that cover topics that are a long long way from being proven by systematic reviews of randomised controlled double blind trials. -- [[User:Colin|Colin]]°[[User talk:Colin|<sup>Talk</sup>]] 09:28, 24 August 2024 (UTC)

== Adding LDH inhibition in section on mechanism of action of ketogenic diet ==

Proposed addition:

Inhibition of [[lactate dehydrogenase]] has been proposed as a possible mechanism of action of the ketogenic diet for seizures. Lactate dehydrogenase is a component of the [[astrocyte]]-[[neuron]] lactate shuttle. This inhibition could be pharmacologically achieved using [[stiripentol]] analogs.<ref>Sada N, Lee S, Katsu T, Otsuki T, Inoue T. Epilepsy treatment. Targeting LDH enzymes with a stiripentol analog to treat epilepsy. Science. 2015 Mar 20;347(6228):1362-7. doi: 10.1126/science.aaa1299. {{PMID|25792327}}.</ref><ref>Cho CH. Commentary: Targeting LDH enzymes with a stiripentol analog to treat epilepsy. Front Cell Neurosci. 2015 Jul 7;9:264. doi: 10.3389/fncel.2015.00264. {{PMID|26217188}}; {{PMCID|4493394}}.</ref> [[User:Allthemilescombined1|Allthemilescombined1]] ([[User talk:Allthemilescombined1|talk]]) 00:57, 21 August 2024 (UTC)
:I think we'd need a secondary source focused on the ketogenic diet in a quality journal before we can mention this theory. These are also both nearly 10 years old papers, so if this was a notable thing then we should be able to find current publications mentioning it. -- [[User:Colin|Colin]]°[[User talk:Colin|<sup>Talk</sup>]] 09:33, 24 August 2024 (UTC)
::THank you. This article says several studies indicate that STP could regulate glucose energy metabolism and inhibit lactate dehydrogenase.<ref>{{Cite journal |last=Bacq |first=Alexandre |last2=Depaulis |first2=Antoine |last3=Castagné |first3=Vincent |last4=Le Guern |first4=Marie-Emmanuelle |last5=Wirrell |first5=Elaine C. |last6=Verleye |first6=Marc |date=2024-04 |title=An Update on Stiripentol Mechanisms of Action: A Narrative Review |url=https://pubmed.ncbi.nlm.nih.gov/38443647 |journal=Advances in Therapy |volume=41 |issue=4 |pages=1351–1371 |doi=10.1007/s12325-024-02813-0 |issn=1865-8652 |pmc=PMC10960919 |pmid=38443647}}</ref> [[User:Allthemilescombined1|Allthemilescombined1]] ([[User talk:Allthemilescombined1|talk]]) 01:21, 25 August 2024 (UTC)

{{reflist-talk}}

Latest revision as of 17:26, 11 September 2024

The ketogenic diet FAQ is wrong according to published papers and this article should be expanded to include weight loss uses

[edit]

Summary: Like it or not, not only the common usage of the term "ketogenic diet", but also the use of that term in scientific literature has evolved to mean a diet which produces measurably elevated levels of blood ketones.

There is also a significant amount of emerging research that shows ketogenic diets for weight loss are not a "fad diet" but rather have proven scientific evidence showing that they work also for treatment of fatty liver disease (as one example). The use of a keto diet for weight loss should be merged into this page as the accepted medical definition of a ketogenic diet is one that produces elevated levels of blood ketones in non-diabetics. Even if those diets are not as extreme as the ones for treatment of epilepsy, words and phrases change meaning over time and this definition has been used by many peer reviewed articles and should be accepted.

I'm not going to provide an exhaustive list of sources showing this is the accepted scientific definition, but a few for example are listed below, e.g.

Bueno NB, de Melo IS, de Oliveira SL, da Rocha Ataide T. Very-low-carbohydrate ketogenic diet v. low-fat diet for long-term weight loss: a meta-analysis of randomised controlled trials. Br J Nutr. 2013 Oct;110(7):1178-87.

Paoli A, Rubini A, Volek JS, Grimaldi KA. Beyond weight loss: a review of the therapeutic uses of very-low-carbohydrate (ketogenic) diets. Eur J Clin Nutr. 2013 Aug;67(8):789.

Masood W, Annamaraju P, Khan Suheb MZ, et al. Ketogenic Diet. [Updated 2023 Jun 16]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK499830/

A quick google search will find the plethora of other papers that does not consider the definition to be a diet used only for epilepsy treatment or 90% fat content. 2001:558:6045:10D:EC97:D297:9502:B579 (talk) 04:30, 29 April 2024 (UTC)[reply]

This is not correct. Medical organizations do not recommend the keto diet for weight loss, nor do any health guidelines. The StatPearls source you cited admits that there is no long-term health outcome data on keto and weight loss. The evidence is only short term, much more clinical data is needed if you are going to make those claims. The same source says that a ketogenic diet increases the risk of heart disease and kidney stones. Due to the increased CVD risk, cardiology organizations do not recommend keto. As for your claims about keto improving liver disease, there is not any good clinical evidence for this. Your source does list some papers but there are no good systematic reviews on this because again the evidence is limited and not conclusive. Harvard Health says that keto could be worse for the liver [1]. Psychologist Guy (talk) 08:29, 29 April 2024 (UTC)[reply]
It's the usual Wikipedia:Article titles and scopes problem.
You could just as easily write "Like it or not, not only the common usage of the term influenza, but also the use of that term in scientific literature has evolved to mean not just the influence of astrology on the body, but also a contagious disease, so we should merge Astrology into Influenza virus" – because "the accepted medical definition", and the original source of the word, was astrology, and only later did it come to mean a disease caused by a particular group of viruses, so they're all the same thing, right?
A voluntarily chosen diet for adults hoping to lose weight is not a diet for kids who are at risk of dying from uncontrolled seizures. These are different subjects. Therefore, they get separate articles. If you are jealous because the article about the pediatric epilepsy treatment got written first, and thus got this name, then that's entirely understandable but not a reason to think that kids who could die are the same as adults who want to shed a few pounds.
It might interest you to know that the names of articles can change. This one could be renamed, e.g., to Ketogenic diet (epilepsy treatment). Maybe that would stop people from thinking that "their" title is used on the "wrong" subject, or that epilepsy treatments and weight loss are the same thing. In the meantime, the information you seek is at Low-carbohydrate diet#Ketogenic diet. There is a link to this at Keto diet. WhatamIdoing (talk) 16:51, 29 April 2024 (UTC)[reply]
This has been discussed many times on this page (see archive). I don't think a name change is likely to win approval because nobody has shown any inclination to write a proper article on e.g. ketogenic diet for weight loss. It's all well and good saying Wikipedia should have an article about X(a) that should be called X, if nobody in the history of Wikipedia has written such an article. Write that article and we can discuss names. It has been noted many times that the professional literature does not discuss epilepsy treatments and weight loss treatments together (vs mentioning one in passing). Wrt Psychologist Guy's comments, I think one of the problems is the hostility shown towards weight loss options, as demonstrated by the carb article calling it a fad diet. Pejorative terms just inflame things unnecessary and there are no weight loss treatments (outside of drugs and surgery) that work long term on a reliably significant number of people, so I think pulling out KD as one option to scorn is hypocritical. The American Heart Association can recommend certain diets all it likes, but there isn't really evidence people choose them and stick to them any more than any other diet. -- Colin°Talk 08:45, 30 April 2024 (UTC)[reply]

Confusion on grammar.

[edit]

@Psychologist Guy "This article is about a dietary therapy for epilepsy. For information on ketogenic diets as a lifestyle choice or for weight loss, see Very low-carbohydrate ketogenic diet."

The problem is, why the word "or" should not in be case when the 2 choice available? Heres my choice:

"For information on ketogenic diets as a lifestyle choice or for weight loss, see Very low-carbohydrate ketogenic diet."

Means there are two choice

"For information on ketogenic diets as a lifestyle choice" "For information on ketogenic diets asfor weight loss," help me for the problem. 203.190.54.67 (talk) 09:53, 24 May 2024 (UTC)[reply]

"As for" is not correct grammar. The first part of the sentence as written is structured like this:
  • For information on ketogenic diets
    • as a lifestyle choice or
    • for weight loss...
Some adults follow a high-fat diet as a lifestyle choice, and some other adults follow a high-fat diet for weight loss. There are two main reasons why adults follow a high-fat diet. The word or is used to indicate that different adults have different reasons. WhatamIdoing (talk) 01:29, 26 May 2024 (UTC)[reply]

Ketones are not used by the brain at all, the brain runs on glucose even in ketosis

[edit]

In the first part of the article it says that ketone bodies are used by the brain but the brain runs on glucose even in ketosis. Even when eating no carbs your body converts some of the protein you eat to glucose in order to power the brain. This is called gluconeogenesis. 174.109.243.90 (talk) 07:12, 5 August 2024 (UTC)[reply]

The article says "These ketone bodies enter the brain and partially substitute for blood glucose as a source of energy." You need to read past the introduction. Also, "Most organs and tissues can use ketone bodies as an alternative source of energy. The brain uses them as a major source of energy during periods where glucose is not readily available. This is because, unlike other organs in the body, the brain has an absolute minimum glucose requirement." (Dhillon KK, Gupta S. Biochemistry, Ketogenesis. 2023 Feb 6. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan–. PMID: 29630231.) Graham Beards (talk) 09:40, 5 August 2024 (UTC)[reply]
Yes, the brain always requires a minimum amount of glucose to function. Also I read the entire article, my critique is about the way it is worded in the head of the article because I feel like it is misleading people to think the brain can run on only ketones, which is impossible.
I also don't understand why the first paragraph of the article only describes ketogenetic diets as a therapy for epilepsy, when emerging evidence is showing it can be helpful in a variety of conditions, including traumatic brain injury: https://www.ncbi.nlm.nih.gov/books/NBK209323/ 174.109.243.90 (talk) 08:48, 7 August 2024 (UTC)[reply]
There is no evidence that it is helpful for traumatic brain injury, the link you cited noted no clinical trials have been done, it even says "there are no human short- or long-term studies evaluating the ketogenic diet for TBI". In other words no evidence, just speculation. The same link also notes that patients on the ketogenic diet drop out after a few years. The ketogenic diet has a very high drop out rate. Psychologist Guy (talk) 18:04, 7 August 2024 (UTC)[reply]
PG, while you are correct, I don't think there is a need to be quite so harsh on every visitor to this page who has read something promising about this diet in an area outside of epilepsy. There are lots of things one could take a hardline no-evidence/speculation approach to. Lots of very very bright people "speculate" on what the planets in our solar system or further afield are made of but good luck persuading the folk editing those articles to accept your "it is just speculation and should be deleted" approach. I think currently the "Other medical applications" section is out of step WP:WEIGHT wise, with what reliable sources say when discussing the ketogenic diet as a medical therapy. We are here to write encyclopaedically about a subject, with weight according to what reliable sources do. We aren't here to restrict information solely to what is in current clinical practice. -- Colin°Talk 07:46, 14 August 2024 (UTC)[reply]
If the ketogenic diet was effective outside of epilepsy then it would be recommended by the American Heart Association, Academy of Nutrition and Dietetics, British Dietetic Association, European Society of Cardiology, National Lipid Association, American Cancer Society, Cancer Research UK, National Cancer Institute, World Heart Federation, European Atherosclerosis Society, European Association for the Study of Diabetes, HEART UK, World Cancer Research Fund, World Health Organization etc but as we all know it isn't. All these organizations are up to date with the latest research and most put out consensus statements. They advise against the keto diet for the general population because it raises ApoB/LDL which we know increases cancer and heart disease risk. There is no conspiracy. It's dangerous to be promoting misinformation that this diet might help traumatic brain injuries. Psychologist Guy (talk) 12:39, 14 August 2024 (UTC)[reply]
But "effective" to the degree that anything becomes a recommended therapy by multiple organisations is an extremely narrow focus for "can be mentioned at all on Wikipedia". I agree we should not be a dumping ground for every piece of speculative research ever mentioned by nutritionists and wellbeing websites. But there are serious scientists researching this diet beyond epilepsy and their work is covered by reliable secondary sources. That is what counts on Wikipedia. For example, have multiple articles on cancer research, both on prevention and cure, that cover topics that are a long long way from being proven by systematic reviews of randomised controlled double blind trials. -- Colin°Talk 09:28, 24 August 2024 (UTC)[reply]

Adding LDH inhibition in section on mechanism of action of ketogenic diet

[edit]

Proposed addition:

Inhibition of lactate dehydrogenase has been proposed as a possible mechanism of action of the ketogenic diet for seizures. Lactate dehydrogenase is a component of the astrocyte-neuron lactate shuttle. This inhibition could be pharmacologically achieved using stiripentol analogs.[1][2] Allthemilescombined1 (talk) 00:57, 21 August 2024 (UTC)[reply]

I think we'd need a secondary source focused on the ketogenic diet in a quality journal before we can mention this theory. These are also both nearly 10 years old papers, so if this was a notable thing then we should be able to find current publications mentioning it. -- Colin°Talk 09:33, 24 August 2024 (UTC)[reply]
THank you. This article says several studies indicate that STP could regulate glucose energy metabolism and inhibit lactate dehydrogenase.[3] Allthemilescombined1 (talk) 01:21, 25 August 2024 (UTC)[reply]

References

  1. ^ Sada N, Lee S, Katsu T, Otsuki T, Inoue T. Epilepsy treatment. Targeting LDH enzymes with a stiripentol analog to treat epilepsy. Science. 2015 Mar 20;347(6228):1362-7. doi: 10.1126/science.aaa1299. PMID 25792327.
  2. ^ Cho CH. Commentary: Targeting LDH enzymes with a stiripentol analog to treat epilepsy. Front Cell Neurosci. 2015 Jul 7;9:264. doi: 10.3389/fncel.2015.00264. PMID 26217188; PMC 4493394.
  3. ^ Bacq, Alexandre; Depaulis, Antoine; Castagné, Vincent; Le Guern, Marie-Emmanuelle; Wirrell, Elaine C.; Verleye, Marc (2024-04). "An Update on Stiripentol Mechanisms of Action: A Narrative Review". Advances in Therapy. 41 (4): 1351–1371. doi:10.1007/s12325-024-02813-0. ISSN 1865-8652. PMC 10960919. PMID 38443647. {{cite journal}}: Check date values in: |date= (help)CS1 maint: PMC format (link)
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