The present study shows the beneficial effects of a long-term ketogenic diet. It significantly reduced the body weight and body mass index of the patients. Furthermore, it decreased the level of triglycerides, LDL cholesterol and blood glucose, and increased the level of HDL cholesterol. Administering a ketogenic diet for a relatively longer period of time did not produce any significant side effects in the patients. Therefore, the present study confirms that it is safe to use a ketogenic diet for a longer period of time than previously demonstrated.
The US approach to eating is characterised by the fundamentally puritan notion of self-denial as a means of improvement. To be healthy, one has to eliminate tempting, enjoyable foods from one’s diet. The process complies with the basic puritan operation of rejecting – indeed transcending – pleasure in order to become a better person. Many people in the US see value in denying the desire and controlling the body, which could earn them the reward of a better, healthier and, ultimately, more moral life. This explains a number of self-disciplining US obsessions: meaningless knee-destroying marathons, gluten-free nutrition, 0% milk, kale, yoga etc. This is where the wretchedness of traditional US cuisine comes from, as does the overreaction of compulsive eating and obesity. The basic choice is between puritan discipline of self-denial and total, unchecked, addictive indulgence – in either direction, there is little but joylessness.