Keto And Bowel Movements: What's The Connection?

The ketogenic diet, or keto, is a popular dieting trend that involves a high-fat, low-carb, and moderate-protein eating pattern. While it is known for its weight loss effects, it can also cause gastrointestinal issues. Many people on the keto diet experience constipation due to the lack of fiber-rich foods, increased dairy intake, and decreased water intake. However, some people may have the opposite problem and experience diarrhea due to the high-fat content, artificial sweeteners, and sugar alcohols in keto-friendly foods. These side effects are usually temporary as the body adjusts to the new diet, but they can be a deal-breaker for some individuals.

Keto diet is low in fiber

The keto diet is a very high-fat, low-carb, and moderate-protein eating pattern. This diet induces ketosis, a phenomenon where the body burns fat instead of glucose for energy. While the keto diet may help burn fat, it can also cause side effects, particularly related to the gastrointestinal (GI) tract.

One of the most common side effects of the keto diet is constipation, which is often called "keto constipation." Constipation refers to having fewer than three bowel movements per week, with stools that are hard, dry, or lumpy and difficult to pass. This condition is a direct result of the keto diet's restriction of carbohydrates, which are typically found in fiber-rich foods like fruits, whole grains, and starchy vegetables.

The keto diet is typically low in fiber because it restricts many fiber-rich food sources. Fiber is essential for maintaining regular bowel movements, and a lack of it can lead to constipation. The recommended daily fiber intake is 25-38 grams, but it is challenging to meet this requirement when following a keto diet.

However, it is important to note that not all fiber-rich foods are off-limits on the keto diet. There are still some keto-friendly, fibrous food options available, such as:

• Avocados: Half an avocado contains 1.4 net carbs and 5 grams of fiber.
• Chia seeds: One ounce offers 9.6 grams of fiber and 2.2 grams of net carbs.
• Nuts, especially pecans and almonds: Pecans offer 1.2 net carbs per ounce and 2.7 grams of fiber. Almonds provide 2.5 grams of net carbs and 3.5 grams of fiber per ounce.
• Cauliflower: A cup of cauliflower has about 3 grams of net carbs and 2 grams of fiber.
• Artichokes: One canned artichoke heart has 1.7 grams of fiber and less than 1.9 grams of net carbs.
• Raspberries and blackberries: These berries are high in fiber and low in net carbs.
• Leafy green vegetables: Spinach, kale, and collard greens are excellent sources of fiber.

While the keto diet may be low in fiber, it is possible to include these fibrous food options to help prevent constipation and promote a healthier digestive system.

Dairy intolerance

• Choose hard and long-aged dairy products: These products, such as Swiss cheese, cheddar, and Parmesan, have lower lactose content and are generally better tolerated by those with lactose intolerance.
• Use Ghee: Ghee is clarified butter, which means the milk solids have been removed. It is an ideal alternative for people with dairy sensitivities.
• Confirm lactose intolerance vs casein sensitivity: Lactose is often the main culprit for dairy intolerance, but casein, another protein in milk, could also be the cause. It is important to determine which one is causing the issue to effectively manage your intolerance.
• Consider dairy-free alternatives: If dairy intolerance persists despite trying different types of dairy, consider switching to dairy-free alternatives like unsweetened coconut, almond, or cashew milk. These alternatives can also be used in yogurts and cheeses but tend to be higher in carbs and lower in protein.
• Be mindful of portion sizes: Even if you can tolerate some dairy, it is important to consume it in moderation. Excessive consumption of dairy products, especially those high in fat and calories, can lead to weight gain and other health issues.
• Read labels carefully: When purchasing dairy products, always read the labels to check for added sugars and carbohydrates. These can not only impact your keto diet but also exacerbate digestive issues for people with lactose intolerance.

Dehydration

The keto diet can cause dehydration, which can lead to constipation. This is because the diet involves a reduction in carbohydrate intake, which can cause the body to retain less water and excrete more. Dehydration can also cause other symptoms such as headaches, fatigue, and irritability. To avoid dehydration, it is recommended to drink at least eight to ten glasses of water per day. Water is the best option, but other low-carb beverages such as sugar-free coffee, herbal tea, tea, or sparkling water can also help with hydration.

Additionally, adding a bit more salt to your food (about 1/2 teaspoon per day) can help the body retain more water and prevent dehydration. However, it is important to consult a doctor before making any changes to fluid or sodium intake, especially if you have been advised to limit these in the past.

It is important to note that dehydration can have serious health consequences, so it is crucial to monitor your fluid intake and watch for signs of dehydration, such as dark-colored urine, dry skin, dizziness, or light-headedness. If you experience any of these symptoms, it is important to seek medical advice.

In summary, the keto diet can increase the risk of dehydration due to reduced carbohydrate intake and the associated water loss. This can lead to constipation and other health issues. To prevent dehydration, it is essential to stay well-hydrated by consuming adequate water and electrolytes, and seeking medical advice if concerned.

Gut microbiome changes

The keto diet can also impact the composition of your gut microbiome, which has implications for digestion. Some studies have found that after three months on the ketogenic diet, the bacteria in the gut change quite a bit, and this could cause diarrhea in some people. If your body is not used to eating more fats, this could alter the gut bacteria, causing diarrhea and looser stools from poor digestion.

A 2020 study evaluating the effects of high-versus-low dairy consumption on the gut microbiome found that people following a high dairy diet experienced a reduction in specific butyrate bacteria. This is a type of bacteria that is produced when you break down and digest fiber, which helps keep you regular.

The keto diet is typically low in fiber, but individuals following the diet may consume more dairy and drink less water occasionally. The combination of these factors can lead to constipation.

Reducing your fiber intake may also alter your intestinal microbiota, which is partly responsible for the breakdown of food. This lack of fiber means up to 50% of people following a keto diet will experience constipation at some point.

Lack of whole grains and fruits

The keto diet is a very high-fat, very low-carb, and moderate protein eating pattern. This way of eating induces a phenomenon called ketosis, where the body burns fat instead of glucose for energy.

The keto diet is typically low in fiber, but it is also often void of fiber-rich foods like fruits and whole grains, which help keep you regular. This lack of fiber can lead to digestive issues like constipation, which is a common complaint for people on the keto diet.

Fiber is essential for maintaining healthy bowel movements. The recommended daily value of carbohydrates is 300 g per day, but people on the keto diet usually consume 20-50 g of carbohydrates per day. Since high-carb, fiber-rich foods like fruits, whole grains, and starchy vegetables are off-limits or significantly restricted for those following a keto diet, it can be challenging to get enough fiber in the diet.

Whole grains, in particular, are a good source of fiber, vitamins, minerals, and protein. They have been linked to a reduced risk of obesity, heart disease, diabetes, and cancer. However, there is a lack of high-quality evidence comparing diets high in whole grains to grain-free diets.

Some keto professionals and advocates believe that grains, in general, are not suitable for a ketogenic diet, while others say it depends on the grain, the person, and how often they eat it. People who are more fat-adapted may be able to remain in ketosis while consuming some grains.

If you are considering adding grains to your keto diet, it is important to choose unprocessed, unrefined, and lower-carb whole grains like wild rice, popcorn, and bulgur. These grains have a lower carb content and are higher in fiber.

In conclusion, the lack of whole grains and fruits on the keto diet can lead to an increased number of bowel movements due to the reduced fiber intake. It is important to be mindful of this potential side effect and take steps to ensure adequate fiber intake, such as by incorporating keto-friendly, high-fiber foods.

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