Keto Diet: Why Does It Fail For Some?

The ketogenic, or keto, diet is a low-carb, high-fat, and high-protein diet that aims to induce ketosis, a metabolic state in which the body burns fat for energy instead of glucose. While keto can be effective for weight loss, it doesn't work for everyone. Here are some reasons why keto may not be working for some people:

- Not Achieving Ketosis: Some people may not be reducing their carbohydrate intake enough to enter ketosis. Carbohydrates should only make up about 5-10% of total calories on a keto diet.

- Eating Too Much Protein: A common misconception is that keto is a high-protein diet. However, consuming too much protein can prevent ketosis as the body can convert excess protein into glucose.

- Eating Too Many Carbs: It's important to carefully track carbohydrate intake, as carbs can be hidden in unexpected foods. Even keto-friendly foods like nuts and dairy contain carbs and should be consumed in moderation.

- Not Counting Calories: To lose weight, a person needs to be in a calorie deficit. Eating too many calories, even if they are from keto-friendly foods, can hinder weight loss.

- Constant Snacking: Frequent snacking can lead to increased calorie intake, resulting in weight gain. This is especially true for alcoholic drinks, which are often high in calories and carbohydrates.

- Lack of Exercise: Exercise is crucial for weight loss as it stimulates the body's metabolism and burns calories. Incorporating physical activity into a keto diet can boost weight loss.

- Stress and Lack of Sleep: Chronic stress and inadequate sleep can negatively impact weight loss. Stress can increase cortisol levels, leading to weight gain, while lack of sleep can disrupt hunger-regulating hormones, increasing appetite.

- Medical Conditions and Medications: Undiagnosed medical conditions or certain medications can affect weight loss. Conditions like hypothyroidism, PCOS, and depression can make it difficult to lose weight, and some medications may cause weight gain or hinder weight loss.

- Inflammatory Foods: Consuming inflammatory foods can hinder weight loss. Common inflammatory foods include sugar, wheat, alcohol, and dairy, but it can vary for individuals.

- Weekend Bingeing: Returning to a high-carb diet on the weekends can sabotage weight loss efforts. Staying consistent with keto is crucial for maintaining ketosis and achieving long-term success.

Not achieving ketosis

Reducing Carbohydrate Intake

The recommended amount of carbohydrates per day varies between 20 and 50 grams for a 2000-calorie diet. This equates to 5–10% of your total calorie intake. However, the amount of carbohydrates needed to reach ketosis varies from person to person and can be affected by factors such as exercise.

To ensure you are entering ketosis, you can purchase home testing kits that check for ketones in your urine or breath. Alternatively, you can use a blood ketone meter, although the strips are very expensive.

Other Factors Affecting Ketosis

In addition to reducing your carbohydrate intake, there are other factors that can impact whether you achieve ketosis:

• Sleep quality: Lack of sleep can affect weight loss and ketosis.
• Hormone levels: For example, high levels of cortisol, the stress hormone, can lead to weight gain and disrupt digestion.
• Protein intake: Eating too much protein can prevent ketosis, as the body can convert excess protein into sugar. However, it is important to eat a moderate amount of protein to maintain muscle mass.
• Calorie intake: Eating too many calories, even if they are from keto-friendly foods, can prevent weight loss.

Eating too many carbs

On the keto diet, carbohydrates should make up only 5-10% of your total calorie intake, which is a stark contrast to the standard dietary recommendation of 45-65%. This usually means consuming no more than 20-50 grams of carbs per day.

However, it can be challenging to cut out carbs completely, especially when adjusting to the keto diet for the first time. Even a small amount of carbs can be enough to provide the body with the glucose it needs for energy, reducing the rate at which the body burns fat.

To ensure you are in ketosis, you can use home testing kits that check for ketones in the urine or breath. Additionally, some common signs that you are in ketosis include increased energy and focus, fewer cravings, and an easier time losing weight.

To help reach your carb intake goals, consider tracking your macronutrients through an app like MyFitnessPal. This can help you learn how many servings of carbs you can include in your diet each day based on your calorie needs.

It's important to note that not all carbs are created equal. Some carbohydrates, such as nuts and dairy, are considered acceptable on the keto diet as they are typically high-fat and nutrient-dense. However, they still contain carbohydrates, and consuming too many of these foods can prevent you from achieving and maintaining ketosis.

In addition, some types of sugar alcohols, such as maltitol, can affect blood sugar levels and prevent you from entering ketosis. Therefore, it's crucial to be mindful of your total carbohydrate intake and choose your carb sources wisely to ensure the keto diet is effective for you.

Eating too much protein

Protein is an essential macronutrient with a wide range of functions in the body, from creating hormones to supporting healthy skin, hair, and nails. However, it is possible to eat too much protein, especially on a keto diet.

The ideal amount of protein for someone on a keto diet depends on their level of activity and their body composition. For example, someone who is sedentary should consume a minimum of 0.8 grams of protein per pound of lean body mass. On the other hand, athletes or those looking to build muscle should aim for 1-1.2 grams of protein per pound of body weight.

Why Eating Too Much Protein Can Be a Problem on Keto

The main concern for keto dieters is that eating too much protein will kick them out of ketosis, as the body can break down excess protein into glucose. However, this is a myth. Gluconeogenesis (GNG) is a natural process that occurs regardless of protein intake, and studies suggest that extra protein does not lead to an increase in GNG production.

That being said, it is still important to monitor your protein intake on keto, as it can affect your weight loss goals. If protein makes up more than 35% of your diet, you may not go into ketosis. Additionally, if you are in a calorie deficit and trying to lose weight, a higher protein intake of 2.4 to 3 grams per kg of body weight may be beneficial.

Keto-Friendly Protein Sources

Not all protein sources are created equal. Processed meats, for example, have been linked to an increased risk of heart disease and other health issues. Instead, opt for full-fat dairy, collagen or whey protein supplements, and healthy, whole foods like:

• Pasture-raised eggs
• Grass-fed, fatty cuts of meat (beef, lamb, etc.)
• Poultry (chicken, turkey, etc.)
• Fish (salmon, tuna, etc.)
• Shellfish (oysters, mussels, etc.)
• Organ meats (heart, liver, etc.)
• Nuts and seeds

Eating too many calories

Even if you're on the keto diet, it's still possible to eat too many calories, which can prevent you from losing weight. To lose weight, you need to create a calorie deficit, which means eating fewer calories than you burn. However, this can be tricky on the keto diet, as many keto-friendly foods are high in calories. For example, avocados, olive oil, full-fat dairy, and nuts are all calorie-dense foods.

To avoid eating too many calories, pay attention to portion sizes and increase your physical activity levels. Snacking in moderation can also help create the calorie deficit needed for weight loss. Additionally, consider using a food tracker app to log what you eat and monitor your calorie intake.

It's also important to remember that not all calories are created equal. Focus on consuming high-quality, nutrient-dense foods, such as unprocessed whole foods like full-fat dairy, eggs, fish, poultry, and healthy fats like avocado and olive oil. These foods will provide your body with the nutrients it needs while also helping you feel more satisfied after meals.

In addition to watching your calorie intake, make sure you're also getting enough physical activity. Exercise helps to burn calories and build muscle, which can boost your metabolism and increase the number of calories you burn at rest. Creating a workout schedule and sticking to it can help you stay on track with your exercise routine.

By combining a reduced-calorie keto diet with regular physical activity, you can maximize your weight loss efforts and achieve your health goals.

Underlying medical conditions

The keto diet is not suitable for everyone and may be harmful to some people with underlying medical conditions. It is important to consult a doctor or dietitian before starting the keto diet, especially for those with pre-existing health issues.

The keto diet is not recommended for people with the following conditions:

• Eating disorders or a history of eating disorders: Restrictive diets can trigger relapses and cause disordered eating.
• Fat metabolism disorders: The keto diet's high-fat content may be dangerous for those with fat storage or metabolism issues.
• Liver conditions or liver failure: The liver plays a crucial role in metabolising fat, and the keto diet's high-fat content may worsen existing liver conditions.
• Thyroid problems, such as hypothyroidism: The keto diet may suppress thyroid hormone levels, although evidence is conflicting.
• Gallbladder removal: Without a gallbladder, the body loses its bile reservoir, which aids in fat digestion. Attempting the keto diet without a gallbladder can lead to adverse effects.
• Type 1 diabetes: Restricting carbohydrates while taking insulin can result in dangerously low blood sugar levels (hypoglycaemia).
• Chronic kidney disease: The keto diet's high animal food content can increase the risk of kidney stones and worsen metabolic acidosis.
• Chronic stress: Stress can cause hormonal changes, leading to weight gain and cravings for comfort foods, which are incompatible with the keto diet.

Additionally, the keto diet may negatively impact bone health, leading to decreased bone mineral density and triggering bone breakdown over time. This is based on studies conducted on children with epilepsy and elite walkers.

Frequently asked questions