Here's references supporting Quentin's note (in a recent thread) of
the superiority of Non-Keto diets over equal calorie Keto diets.

Randy

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Metabolic effects of substituting carbohydrate for protein in a low-
calorie diet: a prolonged study in obese patients.Yang MU, Barbosa-
Saldivar JL, Pi-Sunyer FX, Van Itallie TB.
Obese individuals maintained for 64 days on either of two low-calorie
diets (600-800 kcal/day), consisting of protein alone or protein plus
carbohydrate, varied widely in the extent of their cumulative nitrogen
deficits. Rates of weight loss showed little correlation with rates of
nitrogen loss after the first 28 days of the study. The low-calorie
diet consisting entirely of protein increased blood beta-
hydroxybutyrate concentrations far more than did a diet consisting of
equal parts of protein and carbohydrate. The diet which consisted
almost entirely of protein did not spare body protein better or induce
a greater rate of weight loss than did the mixture of protein and
carbohydrate.

PMID: 7275460 [PubMed - indexed for MEDLINE]

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J Clin Invest. 1976 Sep;58(3):722-30. Links
Composition of weight lost during short-term weight reduction.
Metabolic responses of obese subjects to starvation and low-calorie
ketogenic and nonketogenic diets.Yang MU, Van Itallie TB.
The effects of starvation, an 800-kcal mixed diet and an 800-kcal
ketogenic (low carbohydrate-high fat) diet on the composition of
weight lost were determined in each of six obese subjects during three
10-day periods.The energy-nitrogen balance method was used to quantify
the three measurable components of weight loss; protein, fat, and
water. On the 800-kcal ketogenic diet, subjects lost (mean +/- SE)
466.6 +/-51.3 g/day; on the isocaloric mixed diet, which provided
carbohydrate and fat in conventional proportions, they lost 277.9+/-
32.1 g/day. Composition of weight lost (percentage) during the
ketogenic diet was water 61.2, fat 35.0, protein 3.8. During the mixed
diet, composition of loss was water 37.1, fat 59.5, protein 3.4...

PMID: 956398 [PubMed - indexed for MEDLINE]

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Protein metabolism during weight reduction with very-low-energy diets:
evaluation of the independent effects of protein and carbohydrate on
protein sparing.Vazquez JA, Kazi U, Madani N.
Department of Medicine, University of Pittsburgh School of Medicine,
USA.

The aim of this study was to assess the independent effects of
carbohydrate and protein intakes in protein sparing during weight
reduction. Forty-eight obese women were randomly assigned to consume
isoenergetic (2500 kJ/d) liquid diets that provided the following
amounts (g/d) of protein and carbohydrate, respectively, for 28 d: 50
and 10, 50 and 76, 70 and 10, and 70 and 86. The effects of
carbohydrate and protein were analyzed by repeated-measures analysis
of variance (ANOVA). Carbohydrate significantly affected daily urinary
ammonia and total nitrogen excretion, stool nitrogen, and nitrogen
balance. Protein, independently of carbohydrate, significantly
affected daily urinary ammonia, urea, and total nitrogen excretion but
had no effect on nitrogen balance. Cumulative nitrogen losses (mmol/28
d) were lower in the high-carbohydrate groups than in the low-
carbohydrate groups (1869 +/- 392 and 3611 +/- 328, P = 0.003) but
were similar in the groups receiving 50 and 70 g protein/d (3171 +/-
327 and 2326 +/- 430, respectively, P = NS). These results indicate
that carbohydrate and protein have independent but additive protein-
sparing effects during weight reduction.

PMID: 7598072 [PubMed - indexed for MEDLINE]

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Protein sparing during treatment of obesity: ketogenic versus
nonketogenic very low calorie diet.Vazquez JA, Adibi SA.
Department of Medicine, Montefiore University Hospital, Pittsburgh, PA
15213.

Although it is generally agreed that both ketogenic and nonketogenic
very low calorie diets promote weight reduction, there is no consensus
on a preference of one diet over the other in regard to protein
sparing. In the present study, we compared the effects of isocaloric
(600 kcal/d) and isonitrogenous (8 g nitrogen/d) ketogenic (low
carbohydrate) and nonketogenic diets on parameters of protein and
amino acid metabolism, in 16 morbidly obese women maintained on these
diets for 4 weeks while confined to a metabolic ward. Cumulative
urinary nitrogen excretion (g/4 wk) was significantly (P less than .
01) greater (248 +/- 6 v 207 +/- 12, mean +/- SEM, n = 8), and
cumulative nitrogen balance significantly (P less than .02) more
negative (-50.4 +/- 4.4 v -18.8 +/- 5.7), during treatment with the
ketogenic than with the nonketogenic diet. Plasma leucine
concentration (mumol/L) was significantly higher (P less than .05)
during treatment with the ketogenic than with the nonketogenic diet at
day 14 (210 +/- 17 v 150 +/- 8), but not at day 28 (174 +/- 9 v 148
+/- 8). Whole-body rates of leucine oxidation (mmol/h) were
significantly higher (P less than .05) during treatment with the
ketogenic than with the nonketogenic diet at day 14 (1.29 +/- 0.20 v
0.92 +/- 0.10) and at day 28 (1.00 +/- 0.16 v 0.75 +/- 0.10).
Conversely, proteolysis, as measured by leucine turnover rate and
urinary excretion of 3-methylhistidine, was not significantly
different between the diets.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID: 1556948 [PubMed - indexed for MEDLINE]
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Ketogenic low-carbohydrate diets have no metabolic advantage over
nonketogenic low-carbohydrate diets1,2,3
Carol S Johnston, Sherrie L Tjonn, Pamela D Swan, Andrea White,
Heather Hutchins and Barry Sears
1 From the Department of Nutrition, Arizona State University, Mesa, AZ
(CSJ, PDS, and AW); Conscious Cuisine, Scottsdale, AZ (SLT); and
Inflammation Research Foundation, Marblehead, MA (HH and BS)

Background:Low-carbohydrate diets may promote greater weight loss than
does the conventional low-fat, high-carbohydrate diet.

Objective:We compared weight loss and biomarker change in adults
adhering to a ketogenic low-carbohydrate (KLC) diet or a nonketogenic
low-carbohydrate (NLC) diet.

Design:Twenty adults [body mass index (in kg/m2): 34.4 ± 1.0] were
randomly assigned to the KLC (60% of energy as fat, beginning with 5%
of energy as carbohydrate) or NLC (30% of energy as fat; 40% of energy
as carbohydrate) diet. During the 6-wk trial, participants were
sedentary, and 24-h intakes were strictly controlled.

Results:Mean (±SE) weight losses (6.3 ± 0.6 and 7.2 ± 0.8 kg in KLC
and NLC dieters, respectively; P = 0.324) and fat losses (3.4 and 5.5
kg in KLC and NLC dieters, respectively; P = 0.111) did not differ
significantly by group after 6 wk. Blood ß-hydroxybutyrate in the KLC
dieters was 3.6 times that in the NLC dieters at week 2 (P = 0.018),
and LDL cholesterol was directly correlated with blood ß-
hydroxybutyrate (r = 0.297, P = 0.025). Overall, insulin sensitivity
and resting energy expenditure increased and serum -
glutamyltransferase concentrations decreased in both diet groups
during the 6-wk trial (P < 0.05). However, inflammatory risk
(arachidonic acid:eicosapentaenoic acid ratios in plasma
phospholipids) and perceptions of vigor were more adversely affected
by the KLC than by the NLC diet.

Conclusions:KLC and NLC diets were equally effective in reducing body
weight and insulin resistance, but the KLC diet was associated with
several adverse metabolic and emotional effects. The use of ketogenic
diets for weight loss is not warranted.

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Metabolic effects of substituting carbohydrate for protein in a low-
calorie diet: a prolonged study in obese patients.Yang MU, Barbosa-
Saldivar JL, Pi-Sunyer FX, Van Itallie TB.
Obese individuals maintained for 64 days on either of two low-calorie
diets (600-800 kcal/day), consisting of protein alone or protein plus
carbohydrate, varied widely in the extent of their cumulative nitrogen
deficits. Rates of weight loss showed little correlation with rates of
nitrogen loss after the first 28 days of the study. The low-calorie
diet consisting entirely of protein increased blood beta-
hydroxybutyrate concentrations far more than did a diet consisting of
equal parts of protein and carbohydrate. The diet which consisted
almost entirely of protein did not spare body protein better or induce
a greater rate of weight loss than did the mixture of protein and
carbohydrate.

PMID: 7275460 [PubMed - indexed for MEDLINE]

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Dear Sir:

We thank Krilanovich for his comments regarding our recent study (1).
Low-carbohydrate diets have withstood recent scientific scrutiny (2,
3) and may soon become the "diet of choice" for effective weight loss.
We challenged the view that the metabolic advantage of these diets is
related to ketosis, and we showed that dietary protein (1.2 g/kg body
wt) generates the metabolic milieu for efficient weight loss (1). That
is, dietary protein--not ketosis or dietary fat or carbohydrate--
corresponds to reduced hunger and elevated energy expenditure during
active weight loss (1, 4).

The protein-sparing modified fast (PSMF) developed in the 1970s by
Bistrian et al (5) permits the consumption of only lean meat, fish,
and poultry at a level to provide 1.2-1.4 g protein/kg ideal body wt.
Dietary carbohydrate is prohibited, dietary fat is restricted to that
present in the protein source, and vitamin and mineral supplementation
is necessary. Although Krilanovich agrees that ketogenic diets high in
saturated fat and cholesterol (eg, the Atkins diet) may be
unhealthful, he suggests that ketogenic PSMF diets would be the
preferred diet for weight reduction because these diets promote "rapid
weight loss and low hunger." Yet, the rate of weight loss with a PSMF
diet, 1 kg/wk at energy intakes near 800-900 kcal/d (6, 7), is similar
to that reported for nonketogenic, low-carbohydrate, high-protein
diets (1, 8), and both diets appear to effectively control hunger (4,
8, 9).

Thus, there is no apparent advantage to restricting dietary
carbohydrates to a level that is ketogenic. Vegetables and low-fat
dairy products contain numerous nutrients and phytochemicals that
reduce the risk of chronic disease; therefore, the restriction of
these foods in the diet is simply not wise. Furthermore, a recent
article provides evidence that ketosis increases blood methylglyoxal
concentrations 2-fold (10). Methylglyoxal and its byproducts are
considered a significant cause of blood vessel damage. We continue to
claim that the use of ketogenic diets for weight loss is not
warranted.