The ketogenic diet, commonly known as the keto diet, has gained popularity among diabetics and people looking to lose weight. This surge is attributed to its notable effects on lowering blood sugar and promoting weight loss. However, the diet remains a subject of controversy, as long-term adherence may increase the risks of certain conditions, such as hypoglycemia (low blood sugar) and osteoporosis.

In contrast, a balanced diet that includes carbohydrates like rice can effectively manage blood sugar, potentially improving and even reversing diabetes. This approach delivers results comparable to the keto diet but is safer and more sustainable. On the “Health 1+1” program, Dr. Chien-Te Hung, an attending physician at Taiwan’s 17 Beauty Clinic and a metabolic specialist, introduced a rice-based dietary approach.

The keto diet is characterized by high fat intake and very low carbohydrate consumption (less than 50 grams per day), prompting the body to break down fat for energy.

Potential Risks of the Keto Diet

Numerous studies have raised concerns regarding the long-term safety of the keto diet.

A 2021 review conducted by experts from the United States suggested that the keto diet often yields only temporary improvements. Given its potential adverse effects and the lack of data supporting its long-term safety, the risks of the keto diet may outweigh its benefits for many people. Some of these risks include:

• Accelerated Organ Aging: An animal study published in Science Advances showed that the keto diet caused cellular aging in multiple organs, including the heart and kidneys, in mice.
• Low Blood Sugar: Long-term adherence to the keto diet may impair glucose metabolism, increasing the risk of hypoglycemia.
• Osteoporosis: A clinical case report published in the New England Journal of Medicine highlighted that a high-fat, low-carbohydrate diet could lead to ketoacidosis—a severe condition marked by excessive acid buildup in the blood. Prolonged ketoacidosis accelerates calcium loss in bones, potentially leading to osteoporosis.
• Fatty Liver Disease: A 2023 study on mice found that the keto diet worsened glucose intolerance and can induce non-alcoholic steatohepatitis (a severe form of fatty liver disease) and fibrosis (a condition in which too much collagen, a protein that forms connective tissue, is formed as a response to an injury, leading to the formation of scar tissue)
• Vascular Damage: A 2020 review indicated that ketone bodies, which are molecules produced by the liver when the body doesn’t have enough sugar for energy,  can form adducts with proteins, contributing to vascular injury, akin to protein glycation caused by glucose but with an even stronger effect.

Managing Blood Sugar With a Rice-Based Diet

Many people with blood sugar issues are hesitant to eat rice. The truth is, according to Hung, that with the right approach, a balanced diet that includes carbohydrates, proteins, and fats can effectively control blood sugar.

With a family history of diabetes, Hung has managed to maintain healthy blood sugar levels by including rice in every meal, alongside other natural foods.

This balanced approach not only stabilizes blood sugar levels and reduces the risks linked to the keto diet but also improves insulin resistance, thus decreasing the need for medication.

Here are four key points of this rice-based dietary approach:

• Choose Whole, Unprocessed Foods: Opt for whole-grain rice, which retains its intact starch structure. It provides balanced nutrition and digests at a slower rate, preventing rapid spikes in blood sugar.
• Cool Your Rice Before Eating: After cooking, let the rice cool for at least 15 minutes. Cooling increases resistant starch, which reduces absorption in the small intestine and provides nutrients for probiotics in the large intestine.
• Follow an Optimal Eating Order: Eat in this sequence: meat, vegetables, mushrooms, rice, and fruit. For vegetarians, substitute meat with legumes. Starting with protein-rich foods like meat or beans kickstarts digestion and absorption, allowing the body to better process the cooled rice, Hung noted.
• Maintain Consistent Meal Portions: Include a consistent portion of rice with each meal. Hung recommends eating about 450 grams of rice daily (roughly 2.5 bowls), based on the recommendation of the U.S. Food and Nutrition Board that adults should consume 130 grams of carbohydrates per day.

A review indicated that the long-term efficacy, safety, and health benefits of the keto diet currently lack sufficient supporting data. On the other hand, a non-keto diet with a daily intake of 100 to 150 grams of carbohydrates, when well-managed, may prove to be more practical, according to Hung.

A Remarkable Success Story

Hung has shared hundreds of clinical success stories regarding diabetes remission on his Facebook page. One notable case involves a renowned American surgeon living in Taiwan.

The surgeon had developed a habit of indulging in large meals after performing surgeries that lasted over 10 hours. As a result, his HbA1c levels soared to an alarming 18 percent, leaving him unable to work. For context, an HbA1c level above 6.5 percent is classified as diabetes.

Without taking any medication, the surgeon adopted the balanced dietary approach with rice introduced by Hung. Within a week, his HbA1c levels dropped to around 5.8 percent, and his blood sugar fell below 160 mg/dL. Now, a year and a half later, he continues to manage his blood sugar effectively by simply eating three regular meals a day.

The surgeon’s success in managing his blood sugar was due to his complete trust in the doctor and his meticulous preparation of meals, Hung said. Additionally, since his blood sugar levels had been elevated for only a short period, his risk of developing diabetes-related complications in the future is significantly lower.