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We difine a ketogenic diet as daily daily consumption of less than 20 grams of carbohydrate, regardless of fat, protien and caloric intake. However the addition Of 5 table   spoon olive oil is added to the person diet every day.  As we increase the amount of carbohydrate by 20 grams in order to reach to 40 grams in order to sustain cells with no or few mitochondria with the glucose, such cells are erythrocytes, cornea,, lens, renal medulla and leukocyte (Eric, westian et al ( 1).

Energy produced often inclusion of ketogenic diet delivered from adipose tissue and or from dietery fat consumed by the subject, the production of keton bodies and acetoacetic acid, B- hydroxybutyrate and acetone, substitute for glucose; is in addtion 1 gram of protien can give away 0.5 gram of glucose whenever patient is on ketogenic diet (1), therfore it sustain positive nitrogen balance and ultimaetely preserve the lean body mass (19).

1. Westman EC, Mavropoulos J, Yancy WS, Volek JS. A review of low-carbohydrate ketogenic diets. Curr Atheroscler Rep. 2003 Nov;5(6):476-83.

19 Volek JS, Sharman MJ, Love DM, Avery NG, Gomez AL, Scheett TP, Kraemer WJ.Body composition and hormonal responses to a carbohydrate-restricted diet. Metabolism. 2002 Jul;51(7):864-70
 

Ketogenic diet has been around in the medical literature for well over 70 years (8). The diet mimics the effects of starvation. It has been known for many years that fasting has beneficial effects on seizure control. For many years, it is used as an anti-convulsant for controlling seizures. In some cases it is actually better than the modern anti-convulsants at controlling seizures. Mild ketosis is a natural phenomenon that occurs in man during fasting and lactation. Post-exercise ketosis is a well known phenomenon in mammals,  the diet mimics the effects of starvation

Obesity is a complex multifactoial chronic disease that claims up to 300,000 U.S. adults annually. Nearly 2 of every three adults in US are either overweight (BMI of 25 to 29.9 kg/m2) or obese (BMI of 30 and above). During the last decade the prevalence of obesity was increased by 15.4% in Kuwait.

Obesity is closely linked to the incidence of type II diabetes. High blood glucose level leads to complications of vasculopathy, retinopathy, nephropathy, neuropathy and cardiomyopathy. The management of the obese diabetic patient involves changes to nutritional habits especially with regard to the carbohydrate content and glycaemic index of the diet

Over weight and obesity develops from an intraction of genetic and environmental factors. Recent studies have shown that obesity substantially increases the risk of morbidity from various chronic diseases. Previous studies from our laboratory show that weight loss reduces the risk factors for cardiovascular diseases. 

Obesity poses a major public health problem in various countries. Previously, we have convincingly shown the long term beneficial effects of ketogeneic diet in reducing weight in obese subjects.

It is shown that there is a tendency for type-2 diabetes and obesity to occur together. This could be due to an overlap between the mechanisms that regulate carbohydrate metabolism and adiposity. Therefore, we hypothesize that unleashing these two phenomenon using ketogenic diet may be more effective in controlling diabetes and obesity.

Our body requires cholesterol for the synthesis of cell membranes, steroid hormones and bile acids. However, high cholesterol level leads to heart attack, heart disease, stroke and other cardiovascular diseases(1-3). About 75% of the cholesterol in the blood stream is synthesized in the liver. The remaining comes from the diet. In the liver the cholesterol is processed into three types of lipoproteins. They are VLDL (very low density lipoprotein), LDL (low density lipoprotein) and HDL (high density lipoprotein). VLDL is involved in the transport of fat from the liver to other parts of the body. VLDL becomes LDL, once the fat is unloaded. LDL is refereed to as “bad” cholesterol as it carries large amount of cholesterol through the blood stream and the unused residues are deposited on the artery walls. On the other hand, HDL is involved in transporting back the cholesterol from artery walls to the liver, where it is excreted out. The HDL, therefore, is known as “good” cholesterol. Due to the above mentioned reasons, a low level of LDL and a high level of HDL are desirable in the body (4-7).

            Various factors lead to the development of high cholesterol levels in the body. One of the major causes of increased cholesterol level is obesity. Diet, weight reduction and exercise are the major components of a low cholesterol lifestyle (4). Although dietary cholesterol and saturated fat is not the major cause of high cholesterol level in the blood, the usual tendency is to modify the diet so as to eliminate cholesterol and unsaturated fat. Decreased intake of foods containing cholesterol and saturated fat may reduce the level of cholesterol, but does not eliminate the problem (1-4). It is reasonable to believe that the best alternative in such a situation is to enable the cells to use excess lipids to produce energy, which also reduces obesity. The cells can be primed to this type of metabolism by using a high fat diet and by not providing carbohydrate, which is the usual source of fuel for the energy requirements in the body.

  Obesity has become a serious chronic disease in both developing and developed countries (10-14). Furthermore, it is associated with a variety of chronic diseases. It is estimated that in United States alone about 300,000 people die each year from obesity related diseases. There is a gradual increase in the number of obese people in United States (11-14). A similar trend is observed in Kuwait and other Middle East countries. The different attempts for reducing weight by reduced calorie and fat intake combined with exercise has failed to show a sustained long term effect.

          Recent studies from various laboratories, including ours have shown that a high fat diet rich in polyunsaturated  fatty acids (ketogenic diet) is quite effective in reducing body weight and risk factors associated with various chronic diseases (8, 15). This study also shows the beneficial effects of ketogenic diet following its long term administration in patients with high level of total cholesterol. It significantly reduces the body weight and body mass index. Furthermore, it decreases the level of triglycerides, LDL- cholesterol and increases the HDL- cholesterol. Administering ketogenic diet for a relatively longer period did not produce any significant side effects in patients with high level of total cholesterol