Low-carb diets and dehydration

It is well known that dehydration is a potential adverse effect of a ketogenic diet, which is one higher in fat with adequate protein and lower in carbohydrates.
Nutritionists should be watchful, in particular, of those who use ketogenic diets as therapy for certain conditions such as epilepsy and type 2 diabetes.
A study in epileptic children on ketogenic diets, for example, found dehydration to be the “most common early-onset compllication”and higher in those who fasted (1-2). The dehydration could be partly blamed on the incidence of GI tract adverse effects (1).
When treating those with type 2 diabetes with a ketogenic diet, it is advisable to instruct drinking up to eight 8 oz. glasses of water daily. There may also be need for adjusting those recommendations if certain medications were used such as diuretics.
According to the researchers who performed an intervention trial on those with type 2 diabetes and a ketogenic diet that resulted in a few adverse effects, the following was concluded: “Until we learn more about using low carbohydrate diets, medical monitoring for hypoglycemia, dehydration, and electrolyte abnormalities is imperative in patients taking diabetes or diuretic medications” (1).
The lower carbs can have a diuretic effect on the body, which should lead clinicians to be aware and make recommendations for increased water intake as necessary.

1. Duschowny MS. Food for thought: The ketogenic diet and adverse effects in children. Epilepsy Curr. 2005 July;5(4):152-154. Available at: Available at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1198735/?tool=pmcentrez

2. Kang HC, Chung da E, Kim DW, Kim HD. Epilepsia 2004;45:1116-1123. Available at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1198735/?tool=pmcentrez

Published by David Despain, MS, CFS

David is a science and health writer living on Long Island, New York. He's written for a variety of publications including Scientific American, Outside Online, the American Society for Nutrition's (ASN) Nutrition Notes Daily, and Institute of Food Technologists' (IFT) Food Technology magazine and Live! blog. He's also covered new findings reported at scientific meetings including Experimental Biology, AAAS, AOCS, CASW, Sigma Xi, IFT, and others on his personal blog "Evolving Health." David is also an active member of organizations including the National Association of Science Writers (NASW), the American Association for the Advancement of Science (AAAS), the American Society for Nutrition, the Institute of Food Technologists, and the National Audubon Society. David has a master's degree in human nutrition from the University of Bridgeport, and a bachelor's degree in English from University of Illinois at Springfield. He also earned his Certified Food Scientist credential from the Institute of Food Technologists.

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