Keto's Unwanted Side Effects: Diarrhea And Loss Of Appetite

The ketogenic diet is a popular eating plan that has been hailed as an effective way to lose weight. The diet is low-carb, high-fat, and moderate in protein. While it has been successful for many, it also has some unfortunate side effects, including keto diarrhea. This is caused by the body's struggle to adjust to the high-fat content of the diet, which can lead to an increase in watery stools. Other factors that contribute to keto diarrhea include the use of artificial sweeteners and changes in gut bacteria. The good news is that keto diarrhea tends to be temporary, and there are remedies available to help alleviate the symptoms, such as increasing fiber intake and staying hydrated. However, if the symptoms persist or become severe, it is recommended to consult a doctor.

High-fat content

The keto diet is a high-fat, low-carbohydrate, and moderate-protein diet. The diet restricts carbohydrates so that the body switches from burning glucose for energy to burning fat, including stored body fat and dietary fat. This shift in metabolism is known as ketosis.

The high-fat content of the keto diet can cause keto diarrhea, which is a common side effect of the diet. The main reason for keto diarrhea is the incredibly high-fat content of the diet. Fat takes longer to break down in the body than carbohydrates or protein. When you suddenly start eating a lot of fat, your digestive system can struggle to keep up. Some of the fat may be malabsorbed and not completely absorbed by your body. This can lead to steatorrhea, a type of diarrhea caused by too much fat in the stool.

Another cause of keto diarrhea is the sudden lack of fiber that comes with cutting out carbohydrates. Insoluble fiber bulks up your stools and helps prevent diarrhea. By cutting out carbohydrates, you are also likely cutting out fiber-rich foods such as fruits, legumes, starchy foods, and grains. A decrease in fiber intake can lead to diarrhea and other gut-related problems like changes to the gut microbiome.

Artificial sweeteners and sugar alcohols, which are often used in keto-friendly products, can also cause diarrhea when consumed in excess. These sweeteners are harder to digest and can cause bloating and diarrhea.

The keto diet can also impact the composition of your gut microbiome, which has implications for digestion. There is some research that suggests that after three months on the ketogenic diet, the bacteria in the gut change, and this could cause diarrhea in some people.

To relieve keto diarrhea, it is recommended to add more fiber to your diet, drink more water and electrolytes, and add probiotics and prebiotics to support gut bacteria.

Lack of fibre

The keto diet is a low-carb, high-fat diet that restricts daily non-fibre carbohydrate intake to 20 to 50 grams, compared to a typical intake of 150 to 250 grams. This drastic reduction in carbohydrates leads the body to switch its fuel source from glucose to fatty acids.

The keto diet is often criticised for its lack of fibre. This is because many fibre-rich foods are also rich in carbohydrates. By trying to avoid carbohydrates, people on the keto diet often inadvertently avoid fibre.

Fibre is essential for maintaining healthy bowel movements. It passes through your system and keeps you regular by softening and adding bulk to your stools. It also has benefits beyond bowel movements: it feeds the good bacteria in your gut, aiding healthy digestion and nutrient absorption.

So, what can you eat on the keto diet to ensure you're getting enough fibre? Here are some ideas:

• Avocados: Half an avocado contains just 1.4 net carbs but a whopping 5 grams of fibre.
• Chia seeds: One ounce of chia seeds offers 9.6 grams of fibre and a net carb total of 2.2 grams.
• Nuts: Pecans and almonds are good choices, offering fibre and fat.
• Flaxseeds: One tablespoon of ground flax boasts 2 grams of fibre and 0 net carbs.
• Vegetables: Collards, broccoli, cauliflower, asparagus, and cabbage are all good sources of fibre.
• Fruits: Raspberries, in particular, are a good choice as their fibre content helps to offset their carbohydrate content.

While it can be challenging to get enough fibre on the keto diet, it is possible with some planning and consideration of your taste preferences. If you find that you're still not getting enough fibre through diet alone, you can also try adding a fibre supplement like Metamucil.

Artificial sweeteners

There is a theory that artificial sweeteners cause weight gain by triggering an insulin release without providing any sugar for it to remove, leading to a blood sugar crash and increased hunger. However, studies on this theory have shown conflicting results, with some finding that sweeteners like aspartame and sucralose do not affect blood glucose or insulin levels.

Another theory suggests that artificial sweeteners confuse the body by separating the taste of sweetness from the caloric reward, impairing the body's natural ability to regulate food intake. Some studies have supported this idea, finding that rats fed with artificially sweetened yogurt ate more calories and gained more weight than those fed with regular yogurt. However, evidence for this theory in humans is less clear, with some studies showing that artificial sweeteners make people feel hungrier, but do not lead to increased food consumption.

Overall, while artificial sweeteners may not directly cause weight gain, they can have other negative effects on the body, such as impairing the body's ability to regulate food intake and causing gut problems. More research is needed to fully understand the effects of artificial sweeteners on human health.

Gut microbiome changes

The keto diet can cause changes to the gut microbiome, which can have implications for digestion. The gut microbiome refers to the microorganisms in the gastrointestinal tract, mainly consisting of bacteria that are important for health in many ways, including helping the body digest food.

Some studies have found that the keto diet can cause changes in the gut bacteria, which could lead to diarrhea in some people. For example, a 2020 study found that after three months on the ketogenic diet, the bacteria in the gut changed significantly, which may have caused diarrhea in some participants.

The keto diet can also lead to a decrease in beneficial fatty acids and an increase in inflammation in the digestive tract, which may be linked to the high-fat content of the diet.

However, it is important to note that more high-quality research is needed to fully understand the effects of the keto diet on gut health.

How to Reduce the Risk of Gut Microbiome Changes

If you are experiencing gut microbiome changes or gastrointestinal problems while on the keto diet, there are some things you can do to try and reduce these side effects:

• Add more fiber to your diet: Soluble fiber can help to calm diarrhea as it absorbs water. Good sources of soluble fiber on a keto diet include citrus fruits, berries, avocado, broccoli, and chia seeds.
• Drink more water and electrolytes: Diarrhea can lead to a loss of fluids and electrolytes, so it is important to replenish these by drinking water and consuming electrolytes through soups and fruit juice.
• Eat less dairy: The keto diet may include more dairy products, which can be high in fat. Reducing dairy intake may help to alleviate gastrointestinal problems as it could indicate an intolerance to dairy.
• Ease into the diet: Instead of making a sudden change, try slowly reducing carbs and increasing fats to give your body more time to adjust to the new diet.
• Add probiotics and prebiotics: Taking a probiotic supplement or eating more probiotic- and prebiotic-rich foods may support gut health and reduce gastrointestinal side effects.
• Eat fermented foods: Eating fermented foods, such as sauerkraut and kimchi, can improve digestion and help reduce constipation or diarrhea.
• Reduce intake of sugar substitutes: Cutting back on sugar substitutes, such as artificial sweeteners and sugar alcohols, may help to relieve gastrointestinal symptoms.

If you are experiencing severe or persistent diarrhea, it is recommended to consult a healthcare professional. They can help determine if the keto diet is appropriate for you and advise on any necessary dietary changes.

Malabsorption

There are several reasons why malabsorption occurs as a result of the keto diet:

• The keto diet is high in fat, which takes longer to break down in the body than carbohydrates or protein. When someone starts eating a lot of fat, their digestive system can struggle to keep up, leading to malabsorption.
• The keto diet is also low in carbohydrates, which means a lack of fibre. Fibre bulks out stools and helps to prevent diarrhoea.
• The keto diet can also lead to changes in the gut microbiome, reducing the number of good bacteria in the gut. This can cause diarrhoea and inflammation in the gut.
• The keto diet often includes artificial sweeteners and sugar alcohols, which can be hard to digest and lead to diarrhoea.

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