Swedish doctors saved the life of a 32-year-old nursing mother who suffered from ketoacidosis after being on a low carb, high fat (Banting) diet.
A Swedish mother developed a dangerous condition called ketoacidosis as a result of a low-carbohydrate diet (LCHF) – or Banting diet – while she was breastfeeding.
In a medical report, published on 1 October 2015 in the Journal of Medical Case Reports, authors Louise von Geijer and Magnus Ekelund discuss the case of a 32-year-old woman who arrived at a Swedish hospital suffering from nausea, vomiting, heart palpitations, trembling and extremity spasms.
Ketones can be poisonous
The woman, who was breastfeeding her 10-month-old son, had no family history of diabetes. She had started a strict LCHF diet (aka Banting diet), with an estimated carbohydrate intake of less than 20g per day, 10 days before admittance, lost 4 kilograms and had felt growing malaise.
Ketoacidosis normally affects people with diabetes and occurs when sugar cannot be used by the body because of a lack of insulin.
Fat is then used for fuel, and acidic waste products called ketones build up in the body. High levels of ketones in the body can be poisonous.
According to the authors, ketoacidosis can on rare occasions be caused by a low-carbohydrate diet. This was, however, to their knowledge “the first reported case in the literature of ketoacidosis in a non-diabetic patient, associated with a combination of low carbohydrate, high fat diet and lactation”.
The report mentions that “ketosis during lactation is a well-known phenomenon in lactating cattle and is well described in veterinary literature”.
In humans, however, non-diabetic ketoacidosis is usually caused by starvation where “lack of glucose can force the body into ketogenesis, causing a metabolic acidosis”.
The ‘Tim Noakes diet’
Low carbohydrate, high protein/fat diets are currently a popular way to lose weight.
In South Africa the “Tim Noakes diet”, as described in his book “The Real Meal Revolution”, is currently very popular.
A low carbohydrate diet is, however, nothing new and there have been numerous variations on the theme over the last fifty years like “The Atkins Diet” and “The Dukan Diet”.
However, the authors warn that a lactating woman has a high demand of substrate to produce milk. A LCHF diet limits the amount of substrate and results in a negative energy balance. This kind of diet should thus be avoided during lactation.
They suggest that medical services should be aware of the fact that a strict LCHF diet often leads to ketosis and in rare cases even into ketoacidosis which is a dangerous condition that must be immediately diagnosed and treated to avoid the loss of human life.
They also warn that lactation might further aggravate the condition and can perhaps even be the trigger into ketoacidosis.
In this case the story had a happy ending – the Swedish mother was given intravenous fluids as well as human insulin. She was found not to be suffering from diabetes and was discharged from hospital three days later.
What are the symptoms of diabetic ketoacidosis?
- frequent urination or frequent thirst for a day or more
- nausea and vomiting
- muscular stiffness or aching
- mental stupor that may progress to coma
- rapid breathing
- fruity breath (breath odour)
Additional symptoms that may be associated with this disease:
- decreased consciousness
- breathing difficulty while lying down
- low blood pressure
- decreased appetite
- abdominal pain