In the 1960s, it was discovered that medium-chain triglycerides (MCTs) produce more ketone bodies per unit of energy than normal dietary fats (which are mostly long-chain triglycerides).[15] MCTs are more efficiently absorbed and are rapidly transported to the liver via the hepatic portal system rather than the lymphatic system.[16] The severe carbohydrate restrictions of the classic ketogenic diet made it difficult for parents to produce palatable meals that their children would tolerate. In 1971, Peter Huttenlocher devised a ketogenic diet where about 60% of the calories came from the MCT oil, and this allowed more protein and up to three times as much carbohydrate as the classic ketogenic diet. The oil was mixed with at least twice its volume of skimmed milk, chilled, and sipped during the meal or incorporated into food. He tested it on twelve children and adolescents with intractable seizures. Most children improved in both seizure control and alertness, results that were similar to the classic ketogenic diet. Gastrointestinal upset was a problem, which led one patient to abandon the diet, but meals were easier to prepare and better accepted by the children.[15] The MCT diet replaced the classic ketogenic diet in many hospitals, though some devised diets that were a combination of the two.[10]
In recent years, the ketogenic diet has been attracting a lot of attention for the management of numerous health conditions, as well as for weight loss. Some controversy still exists about its safety and efficacy, largely stemming from a lack of longitudinal and mechanistic studies, inconsistencies in diet composition in different cohorts, and disagreement in conclusions between research conducted on animal vs. human populations.

The Keto diet versus Plate Method study triggered some challenges and a bit of criticism. In an editorial, Andrew Reynolds, PhD, a postdoctoral research fellow at the University of Otago, New Zealand, suggests that the much better results in those on the ketogenic diet may be due not to the diet itself but to the lifestyle changes and ongoing support that keto diet group received.5
3. Diabetes prevention. In a new Annals of Internal Medicine study, 215 type 2 diabetics were asked to follow either a low-fat or a Mediterranean diet. After four years only 44 percent of the Mediterranean group needed diabetes medication -- but 70 percent of the low-fat eaters did. The Med dieters also lost more weight. Other research shows that the diet helps people with pre-diabetes lower their blood sugar enough to avoid developing full-blown type 2 diabetes.
Reduced hunger. Many people experience a marked reduction in hunger on a keto diet. This may be caused by an increased ability of the body to be fueled by its fat stores. Many people feel great when they eat just once or twice a day, and may automatically end up doing a form of intermittent fasting. This saves time and money, while also speeding up weight loss.
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