The ketogenic diet (or keto diet, for short) is a low-carb, high-fat diet that many people use to lose weight and for some potential health benefits. It is touted to have benefits against diabetes, cancer, epilepsy and Alzheimer's disease.
The ketogenic diet is a very low-carb, high-fat diet that shares many similarities with the Atkins and low-carb diets. The keto diet that has been rising in popularity involves cutting out foods like bread, pasta, rice, and sugar, so one will take in less than 50g of carbohydrates per day. The standard keto diet is usually made up of 75% fat, 20% protein, and 5% carbohydrates.
It involves drastically reducing carbohydrate intake and replacing it with fat. This reduction in carbs puts a person’s body into a metabolic state called ketosis. Unlike other low-carb diets, which focus on protein, a keto plan centers on fat, which supplies as much as 90% of daily calories.
The keto diet is primarily used to help reduce the frequency of epileptic seizures in children. While it also has been tried for weight loss, only short-term results have been studied, and the results have been mixed.
How the Keto diet works and risks associated with it
The keto diet aims to force one’s body into using a different type of fuel. Instead of relying on sugar (glucose) that comes from carbohydrates (such as grains, legumes, vegetables, and fruits), the keto diet relies on ketone bodies, a type of fuel that the liver produces from stored fat. However, there are some caveats in getting the liver to make ketone bodies. First, it requires that the individual deprive himself of carbohydrates, fewer than 20 to 50 grams of carbs per day. Second, it typically takes a few days to reach a state of ketosis. Third, eating too much protein can interfere with ketosis.
A ketogenic diet has numerous risks. First, it is high in saturated fat, which means there are increased risks of heart diseases. The ketogenic diet is often described as a ‘cardiologist’s nightmare.’ An additional point is that it is associated with an increase in "bad" LDL cholesterol, which is also linked to heart disease.
Second, nutrient deficiency. If one is not eating a wide variety of vegetables, fruits, and grains, one may be at risk for deficiencies in micronutrients, including selenium, magnesium, phosphorus, and vitamins B and C.
Third, with so much fat to metabolize, the diet could make any existing liver conditions worse.
Fourth, kidney problems. The kidneys help metabolize protein, and the keto diet may overload them. There is also a risk of kidney stones due to higher meat intake and potential dehydration.
Fifth, constipation. This comes as no surprise as the keto diet is low in fibrous foods like grains and legumes.
Sixth, diarrhea. The gallbladder, the organ that produces bile to help break down fat in the diet, may be overactive. Another contributing factor is that some individuals have an intolerance to dairy or artificial sweeteners.
Seventh, fuzzy thinking and mood swings. The brain needs sugar from healthy carbohydrates to function. Low-carb diets may cause confusion and irritability. Keto flu includes poor energy and mental function, increased hunger, sleep issues, nausea, digestive discomfort and decreased exercise performance. Common side effects of the keto diet include bad breath, constipation, indigestion, and low blood sugar. In the first few days of the diet, one may also experience nausea, insomnia, and a general feeling of being unwell.
Eighth, reduced athletic performance. Participants performed worse on high-intensity cycling and running tasks after four days on a ketogenic diet, compared to those who had spent four days on a high-carb diet. The body is in a more acidic state when it is in ketosis, which may limit its ability to perform at peak levels.
Ninth, risk of ketoacidosis. If one has type 1 or type 2 diabetes, it is not advisable to follow the keto diet. Ketosis can actually be helpful for people who have hyperglycemia issues, but one has to be very mindful of his blood sugar and check the glucose levels several times a day. For people with diabetes, ketosis can trigger a dangerous condition called ketoacidosis. This occurs when the body stores up too many ketones and the blood becomes too acidic, which can damage the liver, kidneys, and brain. Left untreated, ketoacidosis can be fatal.
Do other low-carb diets work?
The popular low-carb diets (such as Atkins or Paleo) modify a true keto diet. But they come with the same risks if one were to overdo it on fats and proteins and lay off the carbs. Theories about short-term low-carb diet success include lower appetite because fat burns slower than carbs. However, there are few long term outcome studies. Eating a restrictive diet, no matter what the plan, is difficult to sustain. Most people will regain a lot of the weight they lost as soon as they go back on carbs. Once an individual resumes a normal diet, the weight will likely return.
Because the keto diet is so restrictive, it is not an appropriate plan to follow long-term. These types of back-and-forth weight fluctuations can contribute to disordered eating, or can worsen an already unhealthy relationship with food. Ultimately, the keto diet appeals to people who have issues with portion control and binge eating. In many cases, what they really need is therapy, which is sessions with a mental health professional who can focus on healthy eating and explore their issues with weight, diet, and relationships.
