Q. I've heard the ketogenic diet is very popular these days. How should I approach it from a Traditional Korean Medicine (TKM) perspective? I'd like to know how to do it effectively.

The ketogenic diet focuses on using fat as the primary energy source. However, in Traditional Korean Medicine, we do not look solely at nutrient ratios because digestive capacity and metabolic states vary by individual. For instance, those who experience indigestion or bloating after consuming cold foods likely have Spleen Deficiency (Bi-heo). If you consume a high-fat diet while the Spleen is weak, it can lead to the accumulation of Damp-Phlegm (Seup-dam), potentially turning your body into a constitution that gains weight more easily. In clinical practice, many patients report bloating and constipation after three months of ketogenic dieting. Therefore, the first step is to warm the Spleen and promote the circulation of Qi and Blood. By using medicinal herbs such as Astragalus (Hwang-gi) and Atractylodes (Baek-chul) to treat Spleen Deficiency, the body can produce energy efficiently even with low carbohydrate intake. Once the digestive foundation is set, gradually increasing the fat ratio is a safer approach. Secondly, one must be cautious of Phlegm-Fluid (Dam-eum). Prolonged ketosis can cause metabolic by-products to accumulate, leading to symptoms such as fatigue, headaches, and a sticky feeling in the mouth. In such cases, adjuvant therapy using herbs like Pinellia (Ban-ha) and Dried Tangerine Peel (Jin-pi) can help resolve these accumulations. Lastly, we emphasize 'Yin-Yang Balance' over the diet itself. Not everyone is suited for a ketogenic lifestyle. Instead of forcing the diet, combining a personalized meal plan with TKM herbal medicine based on your constitution can prevent the 'yo-yo effect' and ensure sustainable weight management. In conclusion, if you are considering a ketogenic diet, I recommend starting with a professional TKM diagnosis through pulse and tongue examination. Adjusting your diet based on these clinical findings will prevent unnecessary trial and error and ensure a healthier transition.