During the 2000s, there was ample confusion and controversy around Berry's diabetes diagnosis. Initially, the actress was diagnosed with type 1 diabetes, but in 2007, she reportedly said she had weaned herself off insulin by maintaining a healthy lifestyle and was now in the type 2 category. Her comments drew backlash from doctors and diabetics, who quickly explained that type 1 diabetes is incurable and quitting insulin is simply not an option.
Fast-forward to 2018—like many others, Halle Berry is promoting the ketogenic diet, which she says helped "reverse" her type 2 diabetes over several years. In January, she took to Instagram to explain why the high-fat, low-carb diet has improved her overall health. "I believe it's largely responsible for slowly down my aging process," she wrote. "The keto lifestyle offers so many benefits such as weight loss, (moms that's how we get rid of our baby bellies), appetite control, more energy and better mental performance. If you're like me, you can possibly reverse type 2 diabetes, you'll experience better physical endurance, better skin and also less acne if that's an issue."
Can the keto diet improve diabetes?
Berry is still a controversial figure in the diabetic community, but she may be onto something when it comes to the keto diet. Because carbohydrates are converted to sugar when digested, going on a high-fat, low-carb diet like keto forces your body to break down fat instead, producing an alternate energy source known as ketones. The keto lifestyle is thought to benefit people with diabetes by improving glycemic control (blood sugar levels) and reducing their need for insulin.
"On the keto diet, it's common to have improved triglycerides, which are helpful in heart disease prevention & management," says Lori Zanini, RD, CDE, author of the Diabetes Cookbook and Meal Plan for the Newly Diagnosed. "Additionally, with a higher protein and fat intake, individuals feel less hungry (since protein and fat take longer to digest than carbohydrates) and are often able to lose weight as well."
One of the first studies supporting this idea was published in 2005, when researchers found that the ketogenic diet lowered blood sugar and reduced or eliminated the need for diabetes medications in most overweight participants with type 2 diabetes. Other studies have also concluded that keto has benefits for diabetics. However, it's important to note that most research has focused on type 2 diabetes, not type 1, says Zanini.
Are there any risks for diabetics on the keto diet?
If you're diabetic, there are some potential risks to keep in mind before going on the ketogenic diet:
Diabetic ketoacidosis is a serious, potentially fatal complication that can occur when diabetic people start producing a very high level of ketones, according to the Mayo Clinic. This condition is triggered when the body doesn't receive enough insulin to properly convert sugar into energy, so it goes into starvation mode and begins breaking down fat for fuel at an alarming fast rate. This risk is generally much higher in type 1 diabetes patients, but you should still notify your doctor before starting the keto diet so they can monitor you and help prevent ketoacidosis from occurring.
Cutting carbs too quickly can also have negative results, says Zanini. "It's not recommended to cut carbohydrate intake dramatically, especially if you are taking oral diabetes medications or insulin, since this could result in hypoglycemia (low blood glucose)." Instead, try to reduce the amount of carbs you're eating gradually.
It's also easy to eat too many carbs. "In my experience, my clients who report eating a ketogenic or low-carb diet are almost always consuming higher amounts of carbs than they realize," Zanini says. "To be sure you are following a plan that is best for you, seek out the expertise of a registered dietitian who specializes in diabetes."
These are in addition to the wider risks and side effects of the keto diet, such as keto flu, dehydration, and constipation. Keep in mind that while keto has short-term health benefits, it may have detrimental health effects down the road.
So should you go keto if you're diabetic?
The ketogenic diet has proven benefits for people with type 2 diabetes—even Jillian Michaels, who firmly opposes the keto diet, has said it works well for that purpose—but you may want to be more cautious if you have type 1 diabetes as there isn't sufficient research around the effects of keto on other types of diabetes.
Keto is a rather severe diet that wasn't intended to be followed long-term, and you may want to consider a more sustainable and balanced approach to eating, Zanini says. "It's more important we look at the quality and quantity of carbs we eat; we certainly don't need to cut them out entirely. Look for carbs that are unrefined and high in fiber, then pair them with protein, healthy fats, and plenty of non-starchy vegetables," she says. "At the end of the day, a diabetes meal plan is simply a healthy eating plan—anyone can benefit from eating like this."
Having a talk with your doctor about major lifestyle changes like keto is crucial, she added. "It's important to realise that managing diabetes is a personal and daily decision. It should be discussed with your healthcare team in an effort to follow evidenced-based guidelines."
This article originally appeared on Prevention