Keto Dieting: Does Going Low Really Work?

The ketogenic diet, or keto, is a low-carb, high-fat diet that has gained popularity in recent years. It is advertised as a weight-loss wonder, but it is actually a medical diet that comes with serious risks and should be followed under medical supervision. While it can be effective for weight loss and certain health conditions, it is best as a short-term dietary change.

Keto diets are very restrictive, limiting carbs to 20-50 grams per day, and getting 70-80% of daily calories from fats. This puts the body in a state of ketosis, where it burns through available carbs and then starts breaking down fat to produce energy.

Keto diets have been shown to be effective for weight loss, blood sugar control, and managing type 2 diabetes. They may also have therapeutic benefits, such as managing epilepsy and potentially impairing the growth of certain types of cancer.

However, keto diets can be difficult to stick to and may cause side effects like the keto flu, which includes headaches, fatigue, brain fog, irritability, and lack of motivation. They can also be low in certain nutrients and are associated with an increased risk of heart disease due to higher bad LDL cholesterol.

Before starting a keto diet, it is important to consult a healthcare provider to reduce the risk of complications.

What is a keto diet?

A keto diet is a low-carb, high-fat diet. It involves drastically reducing your carbohydrate intake and replacing it with fat. This reduction in carbs puts your body into a metabolic state called ketosis. In this state, your liver turns fat into small energy molecules called ketones, which your brain and other organs can use for energy.

The keto diet is advertised as a weight-loss solution, but it is actually a medical diet that comes with serious risks. It is best to make this only a short-term dietary change to help jump-start weight reduction. The keto diet can also be used to help reduce the frequency of epileptic seizures in children.

The keto diet is a very restrictive diet. It involves limiting your carbohydrate intake to around 20 to 50 grams per day and filling up on fats, such as meat, fish, eggs, nuts, and healthy oils. You should also moderate your protein consumption, as too much protein can interfere with ketosis.

The keto diet has many potential health benefits, including weight loss, improved metabolic health, and reduced risk of certain diseases. However, it also has some potential side effects and risks, including nutrient deficiency, liver problems, kidney problems, constipation, and fuzzy thinking and mood swings. Therefore, it is important to talk to a doctor and a registered dietitian before attempting a ketogenic diet.

How does it work?

The keto diet is a low-carb, high-fat diet. It involves drastically reducing your carbohydrate intake and replacing it with fat. This reduction in carbs puts your body into a metabolic state called ketosis.

When this happens, your body becomes very efficient at burning fat for energy. It also turns fat into ketones in the liver, which can supply energy for the brain.

Here's how it works:

The keto diet aims to force your 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.

To reach a state of ketosis, you need to deprive yourself of carbohydrates. This means consuming fewer than 20 to 50 grams of carbs per day. A medium-sized banana, for example, has about 27 grams of carbs. It usually takes a few days to reach ketosis.

Once in ketosis, your body will start breaking down protein and fat for energy, which can lead to weight loss. This is because it takes more calories to change fat into energy than it does to change carbs.

In addition, a high-fat, high-protein keto diet may satisfy you more, so you eat less. However, this hasn't been proven yet.

The keto diet typically includes foods that are high in fat and protein and low in carbohydrates. Here are some examples:

• Animal proteins: Fatty fish like salmon, meat, and poultry are good sources of protein and contain no carbs.
• Dairy: Cheese, plain Greek yogurt, and cottage cheese are suitable dairy options on the keto diet.
• Vegetables: Green leafy vegetables, peppers, summer squashes like zucchini, avocados, and olives are low in carbs and suitable for the keto diet.
• Plant-based foods: Nuts, seeds, berries, dark chocolate, and cocoa powder are good plant-based options.
• Fats and oils: Olive oil, butter, ghee, coconut oil, and avocado oil are recommended fats and oils on the keto diet.
• Drinks: Unsweetened coffee, tea, and sparkling water are suitable beverage options.

To stay in ketosis, it's important to limit or avoid high-carb foods. These include starchy vegetables like potatoes and sweet potatoes, high-sugar fruits, honey, syrup, sugar, baked goods, cereal, crackers, rice, pasta, and bread.

It's also important to note that gluten-free does not mean carb-free, so gluten-free baked goods should also be limited.

There are several versions of the keto diet, including:

• Standard ketogenic diet (SKD): This is a very low-carb, moderate-protein, and high-fat diet, typically consisting of 70% fat, 20% protein, and only 10% carbs.
• Cyclical ketogenic diet (CKD): This involves periods of higher-carb refeeds, such as five ketogenic days followed by two high-carb days.
• Targeted ketogenic diet (TKD): This allows for the addition of carbs around workouts.
• High-protein ketogenic diet: Similar to SKD but includes more protein, with a ratio of 60% fat, 35% protein, and 5% carbs.

The keto diet has been shown to be effective for weight loss and may provide other health benefits, including:

• Improved blood sugar control: Keto diets may help lower blood sugar levels and improve insulin sensitivity.
• Management of certain medical conditions: The keto diet has been used to help manage epilepsy and may also benefit people with heart disease, certain brain diseases, polycystic ovary syndrome, and even acne.
• Improved metabolic health: Keto diets may improve several markers of metabolic health, including blood pressure, HDL cholesterol, and triglyceride levels.
• Endurance training: The keto diet may benefit endurance athletes by improving their muscle-to-fat ratio and increasing the amount of oxygen their bodies can use during training.

While the keto diet has potential benefits, there are also some risks and side effects to consider:

• Micronutrient deficiencies: The keto diet restricts many nutrient-rich foods, which may lead to deficiencies in vitamins and minerals.
• Kidney problems: The high protein intake associated with the keto diet may overload the kidneys.
• Constipation and digestive issues: The low-fiber content of the keto diet may lead to constipation and other digestive issues.
• "Keto flu": The initial transition to the keto diet may cause symptoms like difficulty focusing, fatigue, headache, weakness, irritability, and indigestion.
• Increased cholesterol levels: The high-fat content of the keto diet may lead to elevated cholesterol levels, potentially increasing the risk of heart disease.
• Restrictive nature: The keto diet is highly restrictive, which may be challenging for some people to follow and can negatively impact their relationship with food.

It's important to note that more research is needed to fully understand the long-term effects of the keto diet. If you're considering the keto diet, it's recommended to consult with a healthcare professional to ensure it's safe and suitable for you.

What are the health benefits?

The ketogenic diet has been used in medicine for almost 100 years, particularly to treat drug-resistant epilepsy in children. It is a low-carb, high-fat diet that offers many health benefits. Here is a detailed look at some of these health benefits:

Weight Loss

The ketogenic diet is an effective way to lose weight and lower the risk of certain diseases. Studies show that this type of diet can help with weight loss and improve overall health. Research indicates that a ketogenic diet may be as effective for weight loss as a low-fat diet. A review of 13 studies found that a ketogenic diet led to a loss of 2 pounds more than a low-fat diet over a year. Another review of 11 studies showed that people following a ketogenic diet lost 5 pounds more than those on low-fat diets after 6 months.

Improved Brain Function

The ketogenic diet has been shown to have neuroprotective effects, leading to questions about its potential benefits for other brain disorders such as Parkinson's, Alzheimer's, multiple sclerosis, sleep disorders, autism, and even brain cancer. While there is no human study to support these benefits, some studies suggest that the ketones produced during the keto diet provide neuroprotective benefits, strengthening and protecting the brain and nerve cells. As a result, a keto diet may help prevent or manage conditions such as Alzheimer's disease.

Reduced Risk of Certain Cancers

Some researchers have examined the effects of the ketogenic diet in helping prevent or treat certain cancers. One study found that the ketogenic diet may be a safe and suitable complementary treatment to use alongside chemotherapy and radiation therapy, as it causes more oxidative stress in cancer cells than in normal cells, leading to their death. Another study suggests that because the ketogenic diet reduces blood sugar, it could lower the risk of insulin complications, which may be linked to some cancers.

Improved Heart Health

Some evidence shows that eating healthful fats, such as avocados, instead of less healthy fats, such as pork rinds, can help improve heart health by reducing cholesterol. A 2017 review of studies on animals and humans on a keto diet showed that some people experienced a significant drop in total cholesterol, "bad" LDL cholesterol, and triglycerides, and an increase in "good" HDL cholesterol. As high cholesterol levels can increase the risk of cardiovascular disease, the keto diet's positive impact on cholesterol levels may reduce the risk of heart complications.

Reduced Seizures

The Epilepsy Foundation suggests that ketosis, a metabolic process where the body uses ketone bodies for fuel, can reduce seizures in people with epilepsy, especially those who have not responded to other treatment methods. A 2019 review supports this hypothesis, stating that the ketogenic diet may reduce epilepsy symptoms through several mechanisms.

Improved PCOS Symptoms

Polycystic ovary syndrome (PCOS) is a hormonal disorder that can lead to excess male hormones, ovulatory dysfunction, and polycystic ovaries. A high-carbohydrate diet can cause adverse effects in people with PCOS, such as skin problems and weight gain. A pilot study from 2005 examined five women over 24 weeks and found that a ketogenic diet improved several markers of PCOS, including hormone ratios and fasting insulin levels. A 2019 review of studies also found that a keto diet had beneficial effects for people with hormonal disorders, including PCOS and type 2 diabetes.

While the ketogenic diet offers these health benefits, it is important to consult a healthcare professional before starting this or any other diet, especially for those trying to manage a specific health condition. Additionally, the ketogenic diet may be challenging to sustain due to its stringent food restrictions, and there is limited research on its long-term effects.

What are the risks?

The keto diet is a low-carb, high-fat diet that has gained popularity in recent years. While it may lead to quick weight loss, it also has several risks and side effects that should be considered before starting this diet. Here are some of the potential dangers associated with the keto diet:

• Kidney problems: The keto diet may increase the risk of kidney stones due to the high intake of animal-based and high-fat foods, which can make urine more acidic. People with chronic kidney disease should avoid the keto diet as it can worsen their condition.
• Digestive issues and constipation: The keto diet restricts carbohydrates, making it difficult to meet daily fiber needs. This can lead to digestive discomfort and constipation.
• Nutrient deficiencies: The keto diet restricts several nutrient-dense foods, including fruits, whole grains, and legumes. This may lead to deficiencies in vitamins and minerals such as calcium, vitamin D, magnesium, and phosphorus.
• Low blood sugar: The keto diet may cause dangerously low blood sugar levels, especially in individuals with type 1 diabetes. This can lead to hypoglycemia, which is marked by confusion, shakiness, fatigue, and sweating.
• Bone health: The keto diet has been associated with impaired bone health and reduced bone mineral density.
• Increased risk of chronic diseases and early death: Some evidence suggests that high-fat, low-carb diets that focus on animal foods may lead to poor health outcomes, including an increased risk of heart disease, cancer, and all-cause mortality.
• Keto flu: As the body adjusts to using ketones and fats as its primary energy source, individuals may experience flu-like symptoms such as headaches, dizziness, fatigue, nausea, and constipation.
• Social isolation and disordered eating: The strict nature of the keto diet could lead to social isolation and disordered eating patterns.
• Liver problems: The high-fat content of the keto diet could overload the kidneys and make existing liver conditions worse.
• Fuzzy thinking and mood swings: Low-carb diets may cause confusion and irritability as the brain functions best with glucose from healthy carbohydrates as its energy source.
• Dehydration: The keto diet can cause water loss before fat loss, leading to dehydration.
• Gastrointestinal issues: Common side effects include gastrointestinal problems like constipation, diarrhea, nausea, and vomiting.

Who should avoid it?

A keto diet may not be suitable for everyone. It is always recommended to consult a doctor or a dietitian before making any significant changes to your diet.

Pregnant women, people with diabetes, and those with a history of kidney stones should avoid the standard keto diet. The standard keto diet involves getting 75% of your calories from fat, 20% from protein, and 5% from carbs. This means limiting your carb intake to about 20 to 30 grams of carbs per day.

The strict keto diet, which is the original version of the keto diet, is also not suitable for pregnant women, people with diabetes, and those with a history of kidney stones. It is also not recommended for people with a history of kidney disease or heart conditions. The strict keto diet is even more restrictive than the standard keto diet, allowing only 4% of calories from carbs.

The targeted keto diet, which involves consuming carbs before a workout, is not suitable for people with diabetes who are insulin-dependent.

The high-protein keto diet may not be appropriate for those with kidney issues, as increasing protein intake can lead to waste buildup in the blood.

The cyclical keto diet, which involves cycling in and out of keto, may not be suitable for those with cardiac conditions, as it can cause fluctuations in body water and dizziness.

The lazy keto diet, which only involves tracking carbs, is not recommended for pregnant women, people with diabetes, and those with type 1 diabetes who are at risk of ketoacidosis.

Overall, it is important to consult a healthcare professional before starting any version of the keto diet, especially if you have any pre-existing health conditions.

Frequently asked questions