The ketogenic diet is a very low-carbohydrate diet that’s been popular for many years now. It works by tricking the body into thinking it’s fasting, triggering it to break down fat into ketones for energy – also known as ketosis. There’s been a recent uptick in the number of supplements, or “keto diet pills,” on the market claiming to cause the same effect. Most contain a combination of beta-hydroxybutyrate (BHB), medium chain triglycerides (MCTs) and 1,3-butanediol. (Note: don’t confuse 1,3-butanediol with 1,4- butanediol, an unsafe ingredient). So do they actually help people lose weight?
At this point, the evidence doesn’t match the marketing claims. BHB is a type of ketone body that circulates at higher levels in the blood when the body has reached ketosis. 1,3-Butanediol is a chemical that breaks down into BHB. Supplement manufacturers claim that taking BHB or 1,3-butanediol allows you to reach ketosis without sticking to a strict keto diet. But clinical data doesn’t currently back this up.
Similarly, when following a keto diet, MCTs are sometimes incorporated as the main source of fat. MCTs are smaller molecules than other forms of fat, so the body can process them more easily into ketones. But like BHB, there’s no evidence that just taking MCTs in supplement form will help trigger or maintain ketosis. There’s also concern that taking extra ketones might actually stop the body from producing them, essentially backfiring.
For now, tell patients there’s no substitute for just sticking to a keto diet – most require consuming a high-fat diet and less than 50 grams of carbs daily. Simply taking a supplement without limiting carb intake won’t trigger the body to break down fat into ketones. Also, remind patients that the keto diet isn’t for everyone, nor does it need to be. Many diets have shown at least some benefit for weight loss in clinical research, but moderation and individual preference are crucial when choosing a dietary strategy. Long-term adherence and healthy lifestyle choices are key. Check out our monographs on Diets and Dietary Modifications to learn more.
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