Lately I’ve been hearing a lot about the ketogenic diet – what’s the point and does it give you bad breath?

I’ll tackle the simpler part first: bad breath.  It can come from two possible processes working independently or in conjunction with each other. 

  • The first is ketones being released through exhalation.  There are three common forms of ketone bodies: acetoacetate, beta-hydroxybutyrate, and acetone.  Depending on diet and lifestyle, the ratio of these ketones in the breath can vary.  If acetone holds the majority share, your breath will smell similar to that of nail varnish remover.
  • The second possible avenue is excessive protein intake.  The metabolic breakdown of protein produces ammonia which can negatively impact the smell of one’s urine and breath.  Also, Sulphur compounds, which are responsible for standard bad breath, is the product of bacteria in the mouth breaking down food.  Studies suggest that protein is the most common source for these Sulphur compounds.

Now on to the “what’s the point” part of your question; lots to consider there.  I’m charging forward with the assumption that you know what the ketogenic diet is (SPOILER: high fat, medium protein, very low carb).

  • The concept behind the ketogenic diet (KD) was founded in the early 1920’s in an effort to treat epilepsy.  It was researched and reports of its impressive effectiveness were shared until around 1938 when phenytoin (Dilantin) was discovered.
  • Drug companies encouraged physicians to focus on medication and therefore research into the KD was discontinued.  With fewer medical professionals trained in the “classical” KD, when diets were prescribed they were less precise which resulted in lower efficacy.  These failures fueled a widespread opinion that the diet no longer worked.
  • In the 1980’s the KD found attention when 58 recent patients of the John Hopkins Hospital who suffered from refractory seizures (i.e. seizures that aren’t improved via medication) saw the same success rate with the KD as had been reported decades earlier.
  • And then there’s Hollywood producer, Jim Abrahams, whose son suffered from refractory seizures.  Abrahams created the Charlie Foundation (named after his son), published a book, and made a film about the KD.  Soon after that Dateline ran a program about it in 1994 and Abrahams created “First Do No Harm” starring Meryl Streep.  If Meryl’s involved, you know it’s a big deal.

Tony Scartozzi

Author: Tony Scartozzi

Tony Scartozzi was born and raised in a small town in Eastern Washington. After moving to Seattle in 2001, he attended Bastyr University and graduated with a degree in Nutrition. Driven by his passion for public health, his career has spanned the nonprofit sector, senior housing resources, food service training, and now works for a nutraceutical company that produces market-leading plant extracts used for supplemental health. Observing the severe disparity between advertisement spin and research-based knowledge, Tony has spent many years trying to identify and reconcile the difference. With Tony’s parents’ age beginning to show, his desire to investigate health-related topics has become a very personal one.