Ketogenic diet shows promise for military personnel

A ketogenic diet could be useful in the military, where obesity is an ongoing challenge, for recruiting soldiers and keeping them fit for service, according to a new study by researchers at Ohio State University in Columbus, which published in the journal Military Medicine.

Researchers looked at 29 study participants, most of whom were members of the campus Reserve Officer Training Corps. For three months, 15 participants followed a ketogenic diet, while 14 participants maintained their normal diet.

The ketogenic diet participants had daily check-ins during which they reported blood ketone measurements from a self-administered finger-prick test and received feedback, usually through text messages, from the research team. Ketosis was defined as a blood concentration of ketones, chemicals made in the liver, between 0.5 and 5.0 millimolar.

All study participants were required to keep a food diary and participate in a prescribed exercise regimen with regular resistance training, according to the study abstract.

Participants on the ketogenic diet lost an average of almost 17 pounds and were able, with support of counselors, to maintain ketosis for 12 weeks. As a group, they lost more than 5 percent of their body fat, almost 44 percent of their visceral fat, and had a 48 percent improvement in insulin sensitivity, a marker that predicts risk of diabetes.

The comparison group of participants, who, according to the food diaries, consumed diets that were at least 40 percent carbohydrates, experienced none of those changes. However, both groups showed comparable physical performance levels at the end of the study. This was important because it's difficult to lose weight without losing some lean muscle mass and physical function, the researchers said.

The study results come with some caveats. The group that followed the ketogenic diet chose to be in the test group. Studies in which participants are randomized are preferred, but the research team said they wanted to use self-selection for the pilot study in a group eager to adhere to the diet. The ketogenic group also had a higher average body mass index at the start of the study, 27.9 versus 24.9 in the comparison group, and therefore had more fat to lose.

About seven in 10 people who are otherwise eligible to enter military service in the U.S. are considered unfit because of their weight, researchers said. Officers or trainees on military bases likely could maintain a ketogenic diet based on the various foods that are already offered at typical meals, but more options could be added to support this weight-loss strategy, they said.

Ketogenic diets are low in carbohydrates and emphasize moderate high amounts of healthy fat and moderate protein. They aim to create a state of nutritional ketosis, which occurs when the body burns fat, rather than carbohydrates, for energy. The ketogenic diet is often used to control seizures in epilepsy and is currently being studied and applied in a variety of other areas, including endurance sports and diabetes management.