Keto Diet: Does It Really Work?

The keto diet is a low-carb, high-fat, and moderate-protein diet that aims to force the body into a state of ketosis, where it burns fat for energy instead of carbohydrates. While the keto diet has become popular for weight loss, it also comes with some potential side effects, including hot flashes. Many people have reported experiencing hot flashes during the initial stages of the keto diet, and there are several possible reasons for this. One reason could be the thermogenic effect of food (TEF), where the body burns more calories to digest protein, leading to increased heat production. Additionally, keto diets have been shown to increase brown adipose tissue (brown fat), which is more metabolically active and provides heat when the body is cold. Dehydration and electrolyte imbalances, which are common during the early stages of a keto diet, can also contribute to hot flashes. Lowered blood sugar, or hypoglycemia, may also trigger hot flashes as the body adjusts to using ketones for energy instead of glucose. While hot flashes on keto may be concerning, they typically resolve within a few weeks as the body becomes fat-adapted.

Hot flashes

There are several reasons why keto may lead to hot flashes:

• Dehydration and Electrolyte Imbalance: The keto diet is diuretic in nature, which means people may be urinating more frequently and losing vital electrolytes, especially sodium. This can lead to dehydration, which is a common issue when starting a ketogenic diet and can cause hot flashes.
• Lowered Blood Sugar (Hypoglycemia): The keto diet restricts carbohydrates, which can lead to lowered blood sugar levels. When blood sugar drops, ketone production increases to compensate. However, in the initial stages of the diet, the body may not be efficient at producing or utilising ketones, leading to a potential imbalance that can trigger hot flashes.
• Hormonal Changes: While the exact trigger of hot flashes is not clear, scientific literature suggests that hormonal changes are a likely culprit. The keto diet can affect hormone levels, especially in women going through menopause or individuals with hormonal imbalances.
• Thermogenic Effect of Food (TEF): Protein causes the most thermogenesis, with up to 30% of the calories from protein being burned through digestion. This can lead to increased heat production and sweating, often referred to as "meat sweats."
• Brown Adipose Tissue Stimulation: Ketogenic diets have been shown to increase brown adipose tissue (brown fat). Brown fat is considered "good" fat as it is more metabolically active and provides heat when the body is cold. The activation of brown adipose tissue can lead to increased heat production and potentially contribute to hot flashes.

To alleviate keto-related hot flashes, here are some suggestions:

• Supplement with Electrolytes: Replace essential minerals, especially sodium and potassium, by salting your food liberally and consuming keto-friendly sources like avocados and green leafy vegetables. You can also try electrolyte supplements specifically formulated for ketogenic diets.
• Limit Caffeine and Alcohol: These substances can trigger hot flashes and have adverse effects on the body, especially in excess.
• Increase Carb Intake: Experiment with your carb tolerance and find your sweet spot. Most people can tolerate 20-50 grams of net carbs per day while maintaining ketosis, and more active individuals may need more carbohydrates.
• Supplement Exogenous Ketones: Using exogenous ketones as a bridge during the transition phase of the diet may help stabilise blood sugar and ketone levels, reducing the likelihood of hot flashes.

Dehydration

Additionally, as your body switches from using carbs for fuel, the liver releases its glycogen stores, which are a form of glucose stored with a lot of water. This water is also lost through urination. A low-carb diet also leads to reduced insulin production, which signals the kidneys to excrete sodium at a higher rate. Since sodium helps the body retain water, reduced sodium levels can further contribute to dehydration.

The keto diet can also affect hydration by reducing salt intake compared to a standard American diet. Salt helps the body retain water, so consuming less salt can lead to decreased fluid retention.

• Muscle cramps or spasms
• Fatigue and weakness
• Dizziness and lightheadedness
• Dark-coloured urine
• Increased thirst
• Headaches
• Constipation
• Kidney stones
• Urinary tract infections
• Kidney damage
• Cognitive issues such as confusion or brain fog

To avoid dehydration while on the keto diet, it is crucial to maintain proper hydration levels and ensure adequate electrolyte intake. Here are some tips to help you stay hydrated:

• Start your day with a glass of water and aim to drink around eight glasses throughout the day.
• Keep a full glass of water nearby to remind yourself to drink regularly.
• Use a tracking cup or download a water-tracking app to monitor your daily water intake.
• Include other hydrating liquids such as low-sugar broths, juices, sports drinks, and popsicles.
• Eat whole foods like leafy vegetables, avocados, cucumbers, and berries, which have a high water content and are rich in electrolytes.
• Consume electrolyte-rich foods like leafy greens, avocados, nuts, seeds, and low-carb options like cucumbers and celery.
• Monitor your urine colour; it should be pale yellow or clear if you are well-hydrated.
• Incorporate electrolyte supplements or electrolyte-rich foods and beverages to help maintain proper electrolyte levels.

Weight loss

The keto diet is a low-carb, high-fat diet that has been shown to offer various health benefits, including weight loss. While the exact weight loss mechanisms are still being studied, it appears that weight loss is caused by a calorie deficit, a reduction in hunger levels, and water weight loss.

The keto diet forces your body to use a different type of fuel. Instead of providing your body with glucose from carbohydrates, the keto diet relies on the liver to break down stored fat into molecules called ketones. This process is called ketogenesis, where the diet gets its name.

One of the main weight loss mechanisms related to the keto diet is likely its ability to reduce hunger. Following the ketogenic diet has been linked to decreased levels of ghrelin, one of the body's main hunger hormones. Reducing ghrelin levels and hunger can cause you to eat fewer calories throughout the day, which may result in weight loss.

Another potential weight loss mechanism of the keto diet is the loss of water weight that accompanies the significant reduction in carb intake. This is because carbs, in their stored form in the body, hold water. Thus, when you reduce your carb intake, stored carbs are released along with additional fluid, resulting in weight loss of varying amounts.

While the keto diet's weight loss benefits may seem promising, it's important to consider its potential side effects, downsides, and the lack of long-term research. The keto diet is quite restrictive, and some people may find it difficult to adhere to, especially when dining out or gathering with family and friends.

Furthermore, studies on the health effects of following the keto diet for long periods are lacking. It's also important to note that the keto diet is high in saturated fat, which has been linked to heart disease. Other potential risks of the keto diet include nutrient deficiency, liver problems, kidney problems, and constipation.

• Keep track of your exact carb intake to ensure you enter ketosis relatively quickly and avoid symptoms associated with the "keto flu," such as headaches and brain fog.
• Get enough sleep. Studies show that a lack of sleep and chronic stress can negatively impact weight loss outcomes, even when following the keto diet.
• Be physically active. Combining the keto diet with a proper exercise regimen can enhance weight loss.
• Choose healthier sources of fat and protein, such as olive oil, avocados, and nuts.
• Practice intermittent fasting to help enter ketosis faster.
• Use supplements like MCT oil, exogenous ketones, keto protein powders, and keto electrolytes to aid in transitioning to the diet and reducing side effects.

In conclusion, the keto diet can be an effective tool for weight loss, but it's important to consider the potential downsides and lack of long-term research. It's always recommended to consult with a doctor or registered dietitian before starting any new diet, especially a restrictive one like keto.

Ketosis

The ketogenic, or keto, diet encourages ketosis by limiting carbohydrate intake to less than 50 grams per day. This forces the body to rely on fat for energy instead of carbohydrates. The keto diet is typically high in fat, with moderate protein and low carbohydrate content. The standard keto diet consists of 70% to 80% fats, 10% to 20% proteins, and 5% to 10% carbohydrates.

However, ketosis and the keto diet may also have some side effects. One common side effect is "keto flu," which includes symptoms such as an upset stomach, headache, and fatigue. Other possible side effects include bad breath, constipation, muscle cramps, and increased thirst. High levels of ketones in the body can lead to dehydration and an electrolyte imbalance, which may result in further complications. Additionally, the keto diet may increase the risk of low bone density and high cholesterol.

While ketosis can be beneficial for some individuals, it is important to consult with a healthcare professional before starting the keto diet, as it may not be suitable for everyone.

Electrolyte imbalance

Electrolytes are minerals that carry an electric charge and are vital for the proper functioning of your body. They include sodium, potassium, magnesium, chloride, calcium, phosphate, and bicarbonate. An electrolyte imbalance can cause a range of problems, from headaches to muscle cramps to convulsions.

When transitioning to a keto diet, you can become deficient in electrolytes due to carb restriction leading to lower insulin levels. Additionally, people who are keto-adapted and lead very active lifestyles may experience electrolyte losses through excessive sweating if they are not consuming enough electrolytes.

Symptoms of Electrolyte Imbalance

• Muscle cramps and spasms: Dehydration and electrolyte imbalances can cause muscle cramps. Electrolytes such as calcium and magnesium play a role in regulating muscle contraction, and imbalances can lead to disrupted electrical messages that cause muscle contractions and spasms.
• Headaches: Dehydration and electrolyte imbalances are common side effects of switching to a ketogenic diet and can trigger headaches.
• Fatigue and weakness: In the initial stages of a ketosis diet, people may feel more tired and weaker than usual due to the body switching from burning carbohydrates to burning fat for energy.
• Stomach complaints: Dietary changes can increase the risk of stomach upset and other digestive issues.
• Keto flu: The keto flu is a group of symptoms that occur within the first few weeks of starting a keto diet, including headaches, fatigue, brain fog, increased cravings, muscle cramping, thirst, diarrhea, and constipation.

Preventing and Treating Electrolyte Imbalance

• Consume electrolyte-rich foods: Eat a balanced diet that includes natural, whole foods rich in electrolytes, such as meat, poultry, seafood, avocados, broccoli, nuts, and seeds.
• Stay hydrated: Drink plenty of water and other fluids to prevent dehydration, which can exacerbate electrolyte imbalances.
• Take electrolyte supplements: If you are unable to meet your electrolyte needs through diet alone, consider taking a keto-friendly daily electrolyte supplement.
• Transition gradually: Instead of drastically reducing carb intake, try a low-carb diet of up to 150 grams of carbs per day for a week before fully committing to keto.
• Consult a doctor: If you are taking medications or have underlying health conditions, speak with your doctor before starting a keto diet or taking electrolyte supplements.

Frequently asked questions