The History of the Keto Diet

The history of the keto diet has come a very long way, starting from its recognition as a treatment for epilepsy. In this complete historical review, we will discuss the highlights of each timeline to provide a better understanding of the evolution of the keto diet as a way to improve overall health.

Key Takeaways:

• Though unintentional, the keto diet and fasting have been a part of the ancient survival adaptation.
• The origin of keto for epilepsy started in 1911, and the clinical research for keto’s potential to treat epilepsy started at Johns Hopkins in 1915.
• In 1921, Dr. Russell Wilder officially introduced the term “ketogenic diet” as a therapeutic intervention for epilepsy.
• From the early 2000s, scientific studies on the keto diet’s ability to manage other medical conditions started, including its effect on metabolic health and insulin sensitivity.
• Today, the keto diet has developed several variations and has proven its benefits, from weight management to cognitive health.

Table of Contents:

• The Early History of Keto and Fasting
  • Ancient Survival Adaptations:
  • Fasting as a Natural State:
  • Ancient Greece and Rome (800 BCE – 476 CE):
• Clinical History of the Keto Diet by Year
  • 1911: The First Recorded Use of Starvation
  • 1915: Pioneering Insights into the Keto Diet for Epilepsy
  • 1921: The Birth of the Ketogenic Diet for Epilepsy
  • 1936: Clinical Validation for Epilepsy Management
  • 1972: The Atkins Diet Emerges
  • 1993: The Charlie Foundation Advocates for Epilepsy Patients
  • 1994: The Epilepsy Diet Treatment book is first published
  • 1996: First Movie on Keto Diet Released
  • 2003: Metabolic Health and Insulin Sensitivity and Modified Atkins Diet
  • 2009: Further Recognition in Scientific Circles
  • 2010: Adult Epilepsy Center Established
  • 2013: Ketogenic Diet Beyond Weight Loss
• The Keto Diet Today
• The Bottom Line
  • Frequently Asked Questions (FAQ)
  • References

The Early History of Keto and Fasting

Ancient Survival Adaptations:

The early history of keto is deeply intertwined with the evolutionary adaptations that allowed our ancestors to thrive in environments where food availability was unpredictable.

Our ancestors followed an unintentional keto diet, especially during winter, when plants were not a viable food source and had to rely on meat products.

Fasting as a Natural State:

Fasting, a voluntary abstention from food, was an inherent part of the early human experience. Whether due to seasonal variations in food supply or other environmental factors, our ancestors routinely experienced periods of fasting.

Ancient Greece and Rome (800 BCE – 476 CE):

Philosophers like Hippocrates recognized the importance of moderation in food consumption.

Clinical History of the Keto Diet by Year

1911: The First Recorded Use of Starvation

In 1911, the first modern use of starvation for the treatment of epilepsy¹ was noted. Two physicians in Paris reported that seizures were less severe in periods of starvation.

1915: Pioneering Insights into the Keto Diet for Epilepsy

In 1915, John Howland, M.D., professor of pediatrics at Johns Hopkins University School of Medicine, was given a $5,000 donation from his wealthy New York lawyer brother Charles for a laboratory — one of the first at Johns Hopkins — to study why fasting helped Charles’ son overcome epilepsy.

Before this, the keto diet has been used to manage type 1 and type 2 diabetes mellitus, despite not having its proper name yet.

1921: The Birth of the Ketogenic Diet for Epilepsy

The year 1921 marks a pivotal moment in the history of the keto diet, as a breakthrough occurred at the Mayo Clinic. Dr. Russell Wilder, a physician and researcher, introduced the term “ketogenic diet” as a therapeutic intervention for epilepsy.²

This marked the formal recognition of the diet’s ability to reduce seizures, particularly in pediatric patients, laying the foundation for its clinical application in managing epilepsy.

1936: Clinical Validation for Epilepsy Management

Building on the early success of the ketogenic diet in epilepsy treatment, 1936 saw increased clinical validation.

Physicians at Johns Hopkins begin treating the first of more than 33,000 patients with epilepsy over the next 41 years. Medical professionals began documenting positive outcomes, further solidifying the diet as a viable and effective therapeutic option for individuals with epilepsy.

This period witnessed an expansion of research efforts to refine understanding of how the ketogenic diet exerts its anticonvulsant effects.

1972: The Atkins Diet Emerges

In 1972, Dr. Robert Atkins introduced the Atkins Diet,³ a low-carbohydrate diet that shares similarities with the ketogenic diet. Atkins’ approach gained popularity for its focus on restricting carbohydrates to induce ketosis and promote weight loss.

The emergence of the Atkins Diet contributed to renewed interest in low-carbohydrate dietary strategies, including the ketogenic diet, sparking a broader discussion on the metabolic effects of carbohydrate restriction.

At this time, the Johns Hopkins Pediatric Ketogenic Diet Center was also started by John Freeman, M.D., head of pediatric neurology, for research and clinical use.

1993: The Charlie Foundation Advocates for Epilepsy Patients

Founded in 1993, the Charlie Foundation played a crucial role in advocating for the ketogenic diet as a therapeutic option for epilepsy management.

Named after a child whose seizures were successfully controlled with the diet, the foundation aimed to raise awareness, provide resources, and support research on the ketogenic diet’s efficacy. This marked a significant step in promoting the diet beyond medical circles.

1994: The Epilepsy Diet Treatment book is first published

This year, the book Ketogenic Diet Therapies for Epilepsy and Other Conditions was published with funds from the Charlie Foundation.

Moreover, in the mid-1990s, research and clinical applications of the ketogenic diet continued to expand. Studies explored its effectiveness in various neurological disorders beyond epilepsy, including neurodegenerative conditions.

There are also studies suggesting its anti-tumor effects.⁴

The growing body of evidence supported the idea that the ketogenic diet could offer benefits beyond seizure control, paving the way for its consideration in a broader range of medical contexts.

1996: First Movie on Keto Diet Released

Starred by Meryl Streep, the movie First Do No Harm was released. This story was based on the seemingly miraculous benefits of the keto diet for Charlie Abraham, son of film writer/producer/director Jim Abrahams. 

2003: Metabolic Health and Insulin Sensitivity and Modified Atkins Diet

The year 2003 witnessed a pivotal study published in the Journal of Clinical Endocrinology and Metabolism,⁵ highlighting the positive effects of the ketogenic diet on insulin sensitivity.

This research shifted the narrative surrounding the diet, emphasizing its potential role in improving metabolic health and addressing insulin resistance.

The findings broadened the appeal of the ketogenic diet beyond epilepsy and weight loss, positioning it as a metabolic health intervention.

It was also this year that the Modified Atkins Diet was introduced as a treatment for epilepsy. The modified version was less restrictive and easier to follow for children, pioneered by a neurologist, Eric Kossoff, M.D.

2009: Further Recognition in Scientific Circles

In 2009, the scientific community continued acknowledging the ketogenic diet’s potential in various research domains. Studies explored its impact on neurological disorders,⁶ metabolic syndrome, and cardiovascular health.

The growing body of scientific literature further legitimized the keto diet as a subject of serious inquiry, encouraging both clinicians and researchers to explore its multifaceted applications.

2010: Adult Epilepsy Center Established

Mackenzie Cervenka, M.D., established the Johns Hopkins Adult Epilepsy Diet Center, the world’s first clinic to offer ketogenic diet therapy specially designed for adults with epilepsy.

2013: Ketogenic Diet Beyond Weight Loss

By 2013, the ketogenic diet had evolved beyond a focus on weight loss. Scientific research expanded its scope to include discussions on its potential benefits in anti-aging, neuroprotection, cognitive function, and longevity.

This marked a paradigm shift, positioning the keto diet as a comprehensive lifestyle approach with implications for both health and performance.

The Keto Diet Today

The keto diet, currently a subject of extensive scientific inquiry, has garnered attention for its potential health benefits, corroborated by numerous studies.

Aside from medical personnel, celebrities and influencers have openly embraced and endorsed the keto diet, bringing it into the spotlight. Online platforms and social media have given rise to dedicated communities where individuals share experiences, recipes, and success stories.

Research indicates that the ketogenic diet may be effective in weight management,⁷ metabolic health,⁸ and even certain medical conditions.

Studies have demonstrated its ability to improve insulin sensitivity, enhance lipid profiles, and contribute to weight loss by promoting the utilization of stored fat for energy.

Furthermore, the diet’s impact on neurological disorders, including epilepsy and neurodegenerative conditions,⁹ has been a focal point, with evidence suggesting positive outcomes in select cases.

Today, there are various implementations of the keto diet, each with nuances. Standard Ketogenic Diet (SKD), Targeted Ketogenic Diet (TKD), Cyclical Ketogenic Diet (CKD), and High-Protein Ketogenic Diet are among the variations, catering to different needs, lifestyles, and fitness goals.

The Bottom Line

The keto diet has been around since ancient times and has been proven effective in managing numerous medical conditions over the years. From epilepsy to metabolic health, the keto diet is an effective tool to improve overall health.

Frequently Asked Questions (FAQ)

References

¹McGaugh, E., & Barthel, B. (2022). A Review of Ketogenic Diet and Lifestyle. Missouri Medicine, 119(1), 84-88. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9312449/

²Batch, J. T., Lamsal, S. P., Adkins, M., Sultan, S., & Ramirez, M. N. (2020). Advantages and Disadvantages of the Ketogenic Diet: A Review Article. Cureus, 12(8). https://doi.org/10.7759/cureus.9639

³Miller, B. V., Bertino, J. S., Reed, R. G., Burrington, C. M., Davidson, L. K., Green, A., Gartung, A. M., & Nafziger, A. N. (2003). An evaluation of the atkins’ diet. Metabolic syndrome and related disorders, 1(4), 299–309. https://doi.org/10.1089/1540419031361426

⁴Nebeling, L. C., Miraldi, F., Shurin, S. B., & Lerner, E. (1995). Effects of a ketogenic diet on tumor metabolism and nutritional status in pediatric oncology patients: two case reports. Journal of the American College of Nutrition, 14(2), 202–208. https://doi.org/10.1080/07315724.1995.10718495

⁵Brehm, B. J., Seeley, R. J., Daniels, S. R., & D’Alessio, D. A. (2003). A Randomized Trial Comparing a Very Low Carbohydrate Diet and a Calorie-Restricted Low Fat Diet on Body Weight and Cardiovascular Risk Factors in Healthy Women. Retrieved from https://academic.oup.com/jcem/article/88/4/1617/2845298

⁶Maalouf, M., Rho, J. M., & Mattson, M. P. (2009). The neuroprotective properties of calorie restriction, the ketogenic diet, and ketone bodies. Brain Research Reviews, 59(2), 293-315. https://doi.org/10.1016/j.brainresrev.2008.09.002

⁷Ting, R., Dugré, N., Allan, G. M., & Lindblad, A. J. (2018). Ketogenic diet for weight loss. Canadian Family Physician, 64(12), 906. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6371871/

⁸Zhou, C., Wang, M., Liang, J., He, G., & Chen, N. (2022). Ketogenic Diet Benefits to Weight Loss, Glycemic Control, and Lipid Profiles in Overweight Patients with Type 2 Diabetes Mellitus: A Meta-Analysis of Randomized Controlled Trails. International Journal of Environmental Research and Public Health, 19(16). https://doi.org/10.3390/ijerph191610429

⁹Tao, Y., Leng, S. X., & Zhang, H. (2022). Ketogenic Diet: An Effective Treatment Approach for Neurodegenerative Diseases. Current Neuropharmacology, 20(12), 2303-2319. https://doi.org/10.2174/1570159X20666220830102628