Effects+of+ketogenic+diet+on+Child+obesity

 The[| ketogenic diet] consists of high fats, adequate protein, and low carbohydrates. This diet causes the body to produce ketones that use fats instead of carbohydrates to produce energy.The ketogenic diet has proven to effective in weight loss and in the management of other health risks such as diabetes, and cardiovascular diseases. The ketogenic diet has shown improved sleep and energy levels. Also, appetite reduction is observed in the ketogenic diet. These effects of ketogenic diet make it an ideal candidate for the treatment of childhood obesity.

Child obesity is a condition that negatively affects children’s well-being due to excess body fat and weight. Child obesity is caused by a combination of various factors, like lifestyle, genetic disorders, and social-economic status, which is also called ‘’ [|Obesogenic environment]”. Obesity leads to a variety of health risks such as heart diseases, type 2 diabetes, and cancer. Children suffering from obesity tend to be more emotionally unstable because of body shaming by other students or family members. Also, obese children tend to display lower self-esteem and depression. Obese children tend to remain overweight in their adulthood as well. Hence, costing an additional $19000 in medical cost over a lifetime compared to a healthy individual. The impact of childhood obesity on health, economy, and society has become evident making its prevention plan an important topic for researchers.  toc

=**Background **=

In 1920, the ketogenic diet was first used as a measure to control [|epilepsy in children]. It was observed in these trials that it leads to weight loss. The mechanism of fat loss through ketogenic diet is still not clear. Original hypothesis of Atkin suggested that the fat loss is due to extra energy used for excretion of ketones. While another theory suggests, it is a due energy consuming process called [|gluconeogenesis]. However, It can be concluded that the mechanism of fat loss due ketogenic diet is due to one or combination of the following. =**Weight loss **=
 * 1) 1. Reduced appetite due to high satiety of protein,  and appetite suppressant action of ketone bodies.
 * 2) 2. Reduction in[| lipogenesis] and increased lipolysis.
 * 3) 3. Higher metabolic efficiency in consuming fats.
 * 4) 4. Increased metabolic costs of gluconeogenesis and [|thermic effect] of proteins.

The ketogenic diet has proved to be more efficient that traditional low-fat diets in fat and weight loss. Also, the ketogenic diet has a better participant retention compared to low-fat diet. However, it is important to note that most of these studies were conducted for short research period. Studies suggest that a ketogenic diet and low-fat, calorie-restricted diet have the same effect on weight loss over an extended period. However, the ketogenic diet is initially faster at weight loss. In a study, Morbidly obese adolescents treated with a high protein ketogenic diet lost weight rapidly without significant loss of lean body mass.

=**Improved sleep **=

A plethora of studies indicates that less amount of sleep leads to obesity in children. Shorter sleep influences hormone regulation associated with energy balance, eating patterns and activity level. Also, obesity, in turn, could affect sleep due to poor health, sleep apnoea, and insomnia. This indicates toward a bidirectional relation between obesity and sleep.  The ketogenic diet has shown improved sleeping pattern via reduced apnea and a significant increase in rapid eye movement (REM). However, Improved sleep may be not induced directly due to ketogenic diet but might be a by-product of weight loss due to a ketogenic diet.

=**Reduced appetite **=

[|Leptin] and [|ghrelin] are two hormones responsible for our hunger. Leptin decreases hunger while ghrelin increases appetite thereby determining satiety level. Protein, which is a major part of the ketogenic diet, increases leptin levels and decreases ghrelin levels leading to higher satiety level. In a study, high protein low carbohydrate ketogenic diet proved to reduce hunger and lower food intake significantly when compared to high protein, medium carbohydrate nonketogenic diets. However, It is important to note that excess protein consumption leads to gluconeogenesis that leads to fat gain. Additionally, high protein diet causes acid load on the kidneys.

=**<span style="font-family: Arial,sans-serif;">Reduced visceral fats **=

<span style="font-family: Arial,sans-serif;">[|Visceral fats] are excess intra-abdominal adipose tissue accumulation. Visceral fats are associated with diseases such as cancer, obesity, sleep disorders, diabetes Type 2, and coronary heart diseases. Additionally, Increased visceral fat leads to reduced executive functioning in adolescents. The ketogenic diet has been proven to precisely target reduction of visceral fat leading to overall health improvement. =**<span style="font-family: Arial,sans-serif;">Other health benefits **=

<span style="font-family: Arial,sans-serif;">The ketogenic diet has shown to reduce blood sugar level and insulin sensitivity in obese and diabetic subjects. Additionally, the diet has demonstrated reduced cardiovascular disease risk by a reduction in total cholesterol and triglyceride levels. Also, the diet has proven to stabilize[| hypoglycemia].

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=<span style="font-family: Arial,Helvetica,sans-serif;">Growth stunt =

<span style="font-family: Arial,sans-serif;"><span style="color: #353535; font-family: Arial,sans-serif;">The ketogenic diet may not be suitable for young children and toddlers as it can cause stunted growth. <span style="font-family: Arial,sans-serif;"> <span style="color: #353535; font-family: Arial,sans-serif;">It is also observed that children on a ketogenic diet for more than six years were typically in less than 10th percentile for height and weight. <span style="font-family: Arial,sans-serif;"> <span style="color: #353535; font-family: Arial,sans-serif;">Bone density also decreases with ketogenic diet leading to higher risk of skeletal fractures in children. <span style="font-family: Arial,sans-serif;"> <span style="color: #353535; font-family: Arial,sans-serif;">It is also observed that children undergo rapid growth after discontinuing ketogenic diet. <span style="font-family: Arial,sans-serif;"> <span style="font-family: Arial,sans-serif;"> <span style="color: #353535; font-family: Arial,sans-serif;">It is important to note that all the above research studies on growth were conducted on children who have [|cerebral palsy]. Children with cerebral palsy do not grow as well as typically developing children. <span style="font-family: Arial,sans-serif;"> <span style="color: #353535; font-family: Arial,sans-serif;">Hence determining the effects of a ketogenic diet on growth based on these studies alone will not be accurate. =<span style="font-family: Arial,Helvetica,sans-serif;">Conclusion =

<span style="color: #353535; font-family: Arial,sans-serif;">Child obesity is on the rise. Child obesity leads to not only various high-risk diseases like diabetes, cancer, and cardiovascular diseases but also have a psychological impact on children. It is important to understand that obesity needs medical supervision and lifestyle changes. <span style="color: #353535; font-family: Arial,sans-serif;"> Ketogenic Dieting is a short-term rapid solution to obesity. It can improve the quality of life of an obese individual by enhancing quality sleep, reducing visceral fats, improving satiety, and boosting healthy lipid profile. However, self-administration of this diet is not recommended due to lack of mineral and vitamin rich food groups in this diet. Ketogenic diet should be incorporated along with mineral and vitamin supplementation to avoid stunt growth and under medical supervision. <span style="color: #353535; font-family: Arial,sans-serif;"> Clinical research including an obese group of pre-puberty and during puberty age group on a ketogenic diet supplemented with minerals and vitamins would give us valuable insights. It will help us determine the delay in puberty and growth due to ketogenic diet as well as the amount of mineral and vitamins needed for adequate growth.