Due to an ever growing availability of processed foods and as the number of people living in ” Food deserts” increases across the globe, access to healthy produce is being shifted towards processed meals, ready to eat packaged foods and ultra high sugar containing drinks. The media makes a good job of promoting such ultra processed meals in advertising campaigns.
The end result is that we have a population which is becoming more obese and at an increased risk of heart disease, diabetes type 2, cancer and general poor quality of living.
Obesity is becoming a global pandemic and economically the impact of socioeconomic status on obesity plays a big role in the outcomes on families and on the healthcare system of a country.
Malta, my home country has a massive obesity problem. According to published data from the World Health Organisation (WHO) Malta has an estimated 35% of adults being overweight and 26% of adults being obese. This was also correlated to education level  with individuals with lower education levels having higher rates of obesity.
So what about the Keto Diet? why the Hype?
The Ketogenic diet has historical origins, as fasting and diet modifications have been present for the treatment of disease since at least 500 BC. In the 1920s doctors started to use a high fat low carbohydrate diet in the treatment of epilepsy and this helped to “medicalize” the current dietary regimen.
So how does the ketogenic diet actually work?
The actual way the diet seems to work is by utilizing our fat as a source of energy when the main glucose and glycogen stores are depleted.
The mechanism of how actually this works is that in order to overcome the loss of energy from glucose and with the brain being a major consumer of sugar in the human body the body in these circumstances needs to create an alternative source of energy.
As we eat fewer carbohydrates so do the cells,until the level of glucose is depleted. The brain being especially dependent on sugar has to find alternative ways of obtaining a source of nutrition. As the brain cant use directly fats as a source of nutrition it switches over to using fat break down products called “Ketones“, where the term Keto originated from!
This lack of glucose is what drives the body to break down fats into usable forms of energy called ketones that eventually help fuel the body’s needs. This ketone state of the body is called Ketosis.
Although Ketosis helps in creating weight loss and some reversal of diabetic states it is uncertain that the body can maintain this state in the very long term.
What are the benefits of a Keto diet?
As many western diets have a huge amount of processed and refined carbohydrates, that negatively impact our health and appearance a variety of diets have sprouted to try and counteract the side effect of consuming easy ready made meals.
Consuming a diet that is lower in “processed carbs” and higher in fats (healthy fats) might have some benefits. These benefits include better control of blood sugar, improvement in weight and lowering of triglycerides, on the other hand diets that are high in ultra processed white sugar and carbohydrates have been linked to worsening of blood sugar control and increases in obesity and cholesterol.
From what we can deduce, the major benefits of a ketogenic diet is using them for populations that they have been designed for, such as epilepsy suffers and possibly patient’s who might be at risk of dementia. 
The major issue when eating a diet rich in processed carbohydrates is that it tends to leave little room for beneficial food groups that have been shown to reduce mortality such as nuts/seeds, fruits and vegetables and due to the fact that our diets are so full of highly processed carbohydrates likes white bread, white rice, and processed grains and cereals no wonder carbs get a bad rep!
ketogenic diets have been shown to be effective as they are able to cause weight-loss rapidly and maintain muscle bulk causing a loss of body water and body fat a rapid rate.
Of course if i personally would go on to a keto diet i would stick to good sources of plant- based fats such as nuts, seeds, avocados, tahini, peanut butter, hummus consumed with a side of greens.
Personally a plant-based keto diet that includes a good portion of greens might not be so detrimental compared to eating unhealthy fats. In fact its not the fat the problem its what is the type of fat. Whether the fats are saturated animal derived fats or plant-based unsaturated fats. Possibly including the latter might have actually benefits
What are the negatives?
Even though a keto diet might be beneficial as a medical therapy making it into a lifestyle change might not have the benefits in the long run! overall evidence regarding using the keto diet in the long term is lacking.
The adverse effects can vary and can include muscle cramps, fatigue and weakness, headaches and can result in a keto flu which may produce symptoms such as:
Contrary to the common belief that low-carb diets might have negative effects. One study observed that the consumption of low-carbohydrate diets may actually be detrimental to health and increase the formation of a bad form of cholesterol called low-density lipoprotein (LDL) resulting in a greater increased risk and overall increased chances of long term adverse health outcomes.
Overall dietary modification might have some minor benefits in the short run but due to the lack of evidence supporting the claims on benefits it difficult to say what the effects of such dietary change can have in the long term.
The message in my opinion is to moderate. Eating large volumes of carbs on a daily basis is not beneficial and neither is the consumption of a high fat diet. An overall balanced diet that focuses on vegetables, fruits and healthy sources of fat like nuts, seeds, avocados seems to have the best health benefit in the long run.