A ketogenic diet can lead to several flu-like symptoms within the first few weeks on the diet, according to a new study published in Frontiers in Nutrition. These symptoms peak in the first 7 days and dwindle after four weeks and range in severity, as reported by users on social media. These reports reveal common but yet unknown symptoms, such as flu fatigue, nausea, dizziness, decreased energy, feeling faint and heartbeat alterations. Dr. Emmanuelle Bostock of the Menzies Institute for Medical Research of the University of Tasmania, in Australia. The effectiveness of the keto diet has only been established for intractable epilepsy, but despite this, a ketogenic diet is often self-administered for weight loss, cognitive and memory enhancement, type II diabetes or cancer. A commonly discussed side effect of this diet is the so-called "keto flu", a cluster of transient symptoms that occur within the first few weeks on the diet. To better understand how these symptoms evolve, Bostock and her collaborators identified 43 online forums referring to "keto flu" and manually gathered personal experiences of 101 people describing symptoms, severity and time course.
In line with prior medical research, Bostock and her colleagues found reports of headache, difficulty concentrating and gastrointestinal discomfort, following the initiation of a keto diet. Additionally, they reveal further common symptoms, such as flu, fatigue, nausea, dizziness, decreased energy, feeling faint and heartbeat alterations. Consumers often experienced more than one symptom, with differing degrees of severity. But there is also good news for people experiencing such a "keto flu". The results of this study highlight the sudden onset of symptoms, peaking in the first and dwindling after four weeks. Once symptoms manifested, most of them resolved within little more than two weeks. Online forum user conversations were generally supportive, sharing remedies to others based on popular beliefs, such as maintaining hydration and correcting electrolyte imbalances. The results of this study were limited to conversation threads in online forums and therefore lack of any confirmatory evidence that ketone levels were raised. Likewise, experiences of online forum users may not be representative of the larger pool of individuals on keto diet. Nevertheless, the symptom patterns yielded may indicate key lines of questioning for future survey-based approaches. Frontiers is an award-winning Open Science platform and leading Open Access scholarly publisher. Our mission is to make research results openly available to the world, thereby accelerating scientific and technological innovation, societal progress and economic growth. We empower scientists with innovative Open Science solutions that radically improve how science is published, evaluated and disseminated to researchers, innovators and the public. Access to research results and data is open, free and customized through Internet Technology, thereby enabling rapid solutions to the critical challenges we face as humanity. The Frontiers Forum has a tradition of visionary speakers - and 2020 will be no exception. They'll demonstrate the power of data - and that science has the solutions to enable every person on Earth to live a healthy life on a healthy planet. To request a media invitation, please contact Jamie Barclay.
Subjects were recruited from the Raleigh/Durham/Chapel Hill areas in North Carolina through a community PCOS support group and by word of mouth. After meeting initial eligibility criteria by phone, including replying "yes" to the question, "Have you been told by your health care provider that you have PCOS?," subjects were asked to attend a screening visit for a medical history and physical exam. Informed consent approved by the local Institutional Review Board was obtained. Baseline blood tests were also performed at the screening visit. There were no monetary incentives for participation. The inclusion criteria were age 18-45 years, diagnosis suggestive of PCOS based on history of chronic anovulation and/or hyperandrogenemia, no other serious medical condition requiring medical supervision, body mass index (BMI) greater than or equal to 27 kg/m2, willingness to use acceptable contraception, and a desire to lose weight. Exclusion criteria included pregnancy, nursing or positive pregnancy test during screening period, and rapid progression of hyperandrogenic signs and symptoms.
Subjects received an intensive group education program during monthly group meetings held every other week throughout the 6-month study period. During the first group meeting, subjects were instructed on both the rationale and implementation of the dietary intervention via use of a LCKD diet book and handouts containing suggestions on choice of appropriate foods. Subjects were then instructed to begin the diet the following day. During follow-up group meetings, study outcome measures were obtained, and continued dietary counseling, adjustment of individual medications, supportive counseling, sharing of food choices, and review of urinary ketones were performed. The duration of each meeting was approximately 1 hour. Subjects were instructed to follow the LCKD, consisting of fewer than 20 grams of carbohydrate per day, as tolerated throughout the 6-month study period. The diet includes unlimited consumption of animal foods (meat, chicken, turkey, other fowl, fish, shellfish), prepared and fresh cheeses (up to 4 and 2 ounces per day, respectively), unlimited eggs, salad vegetables (2 cupfuls per day), and low carbohydrate vegetables (1 cupful per day).
Subjects were strongly encouraged to drink at least six 8-ounce glasses of permitted fluids per day, and discouraged to drink caffeine and alcohol. Subjects were also encouraged to take one multivitamin per day and to exercise at least three times per week on their own, although this was not mandatory. At the screening visit, baseline variables included age, gender, race, height, weight, prior use of weight loss programs, blood pressure, and laboratory tests. During the study, dietary adherence was measured by food records, self-report, and urinary ketones. Five-day food records for the days immediately preceding an upcoming group meeting were collected at baseline and weeks 2, 4, 12, and 24. Most dieters not on an LCKD do not have urinary ketones. As the intake of fewer than 20 g/day of carbohydrate typically results in urinary excretion of ketones, the presence of ketonuria was used to verify dietary adherence. Body weight was measured at each visit on the same scale with the subject wearing light clothing but with shoes and socks removed. Two measurements were taken at each visit and averaged for the analysis.
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