Keto Diet: Long-Term Weight Loss Solution Or Fad?

The ketogenic diet, or keto, is a high-fat, low-carb, and moderate-protein eating pattern. It has gained popularity in recent years, with 23 million Americans choosing to follow the diet in 2022. While keto can lead to initial weight loss, it is not intended to be adhered to long-term, and can cause health issues such as nutrient deficiencies, constipation, and an increased risk of heart disease. There is also research to suggest that the diet could be dangerous for pregnant people, those who may become pregnant, and those with kidney disease.

Keto may lead to vitamin or mineral deficiencies

The keto diet is a high-fat, moderate-protein, and low-carbohydrate eating pattern. It involves reducing total carbohydrate intake to less than 50 grams per day, with some people consuming less than 20 grams per day. This typically means cutting out unhealthy foods like white bread and refined sugar, but it may also mean reducing your intake of fruits and certain vegetables, which are good sources of antioxidants, vitamins, and minerals.

Potential Vitamin Deficiencies

• Thiamin
• Folate
• Vitamin A
• Vitamin E
• Vitamin B6

Potential Mineral Deficiencies

• Calcium
• Magnesium
• Iron
• Potassium

These deficiencies can lead to a host of frustrating daily health issues. For example, common symptoms of potassium deficiency, or hypokalemia, include constipation, heart palpitations, and extreme fatigue. Magnesium deficiency can lead to fatigue, muscle twitches and cramps, apathy, and high blood pressure.

It could affect athletic performance

How the Keto Diet Could Affect Athletic Performance

The keto diet has become increasingly popular in recent years, with many people adopting it for weight loss and diabetes management. However, there are concerns about its potential long-term health risks, and some researchers worry about its impact on athletic performance.

The Impact on Athletic Performance

The keto diet's restriction of carbohydrates to less than 50 grams per day, and as low as 20 grams, means a reduction in the body's primary source of energy, glucose. This can affect athletic performance, as evidenced by a 2019 study published in the Journal of Sports Medicine and Physical Fitness. The study found that participants performed worse on high-intensity cycling and running tasks after four days on a ketogenic diet compared to those on a high-carb diet.

The body enters a state of ketosis when carbohydrate intake is minimal, breaking down ketone bodies (a type of fuel made from stored fat) for energy instead of glucose. While this can lead to weight loss, it may also affect athletic performance due to the body being in a more acidic state during ketosis.

The Body's Acidic State During Ketosis

Lead researcher Edward Weiss, PhD, associate professor of nutrition and dietetics at Saint Louis University, expressed concern that the body's more acidic state during ketosis may limit its ability to perform at peak levels. He also warned that the benefits of weight loss attributed to the keto diet could be cancelled out by reductions in athletic performance.

The Importance of Carbohydrates for Athletes

Carbohydrates are essential for athletes as they provide a readily available source of energy for the body. When carbohydrate intake is restricted, as in the keto diet, the body has to rely on alternative fuel sources, such as breaking down stored fat, which may not be as efficient for high-intensity activities.

Additionally, the keto diet's strict nature and the potential for nutrient deficiencies, including in potassium and magnesium, could further impact athletic performance. Deficiencies in these minerals can lead to fatigue, muscle cramps, and heart palpitations, all of which could affect an athlete's performance and overall well-being.

The Bottom Line

While the keto diet may offer some benefits, such as weight loss, it is important to consider its potential impact on athletic performance. The restriction of carbohydrates and the resulting shift to ketosis may affect the body's energy production and overall performance, especially in high-intensity activities. Therefore, athletes should carefully consider the potential benefits and drawbacks of the keto diet before adopting it as a long-term dietary approach.

Relaxing the rules can cause weight regain

The keto diet can be a great jump-start to weight loss, but it is not easy to stick to it for a long time. According to Annette Frain, RD, program director with the Weight Management Center at Wake Forest Baptist Health, "Keto can be a great jump-start to weight loss, but the reality is that most people can't adhere to it for very long. [...] In addition to being extremely frustrating, these types of weight fluctuations are also linked to a higher risk of early death."

People may transition to a more relaxed form of keto that allows for more carbohydrates or less monitoring—sometimes known as lazy keto, keto cycling, or "maintenance mode". The problem with this is that weight regain is almost inevitable.

If you lost weight when you first started on keto, you likely lost some muscle mass along with fat tissue. Now, since you're following a high-fat diet, you will probably gain back more fat and less lean muscle—which not only looks and feels different on the body but also burns calories at a slower rate. This can affect your metabolism and make it more difficult to lose weight again in the future.

It may damage blood vessels

The keto diet may damage blood vessels, according to researchers from the University of British Columbia. In a 2019 study, they found that indulging in a high-sugar treat while on a high-fat, low-carb diet can damage blood vessels. The study suggests that the sudden intake of glucose while on a keto diet may undo some of the positive impacts on blood vessels. Senior author Jonathan Little, an associate professor at the University of British Columbia, expressed concern that people on a keto diet may be undoing the positive effects on their blood vessels if they suddenly consume high amounts of glucose.

The study also found that the keto diet can lead to an increased risk of heart disease. In a study of young, fit CrossFit athletes, those who followed a keto diet for 12 weeks experienced an average weight loss of 6 pounds but a 35% increase in "bad cholesterol" (LDL-C). Long-term ketogenic dieting has been directly linked to a 2x higher risk of heart disease or other negative cardiac events.

The keto diet's restrictive nature and emphasis on animal products while limiting nutrient-rich vegetables, fruits, and whole grains can lead to nutrient deficiencies. These deficiencies can result in daily health issues such as constipation, heart palpitations, extreme fatigue, muscle twitches, and high blood pressure. The diet's low fiber content can also negatively impact intestinal function, nutrient absorption, and immune function.

Additionally, the keto diet has been associated with an increased risk of birth defects. Restricting carbohydrates before or during pregnancy is linked to an increased risk of birth defects and gestational diabetes. As 40% of pregnancies in the United States are unplanned, a low-carbohydrate diet is considered risky for anyone who could become pregnant.

It could increase the risk of chronic diseases

The keto diet has been linked to an increased risk of chronic diseases, including cancer, heart disease, and Alzheimer's disease. The diet's emphasis on animal products and restriction of nutrient-rich fruits, vegetables, and whole grains result in a deficiency of vitamins, minerals, and fiber. This can lead to constipation, heart palpitations, extreme fatigue, and high blood pressure.

The keto diet's high protein content can also be problematic for those with chronic kidney disease, as it places additional stress on the kidneys. Furthermore, for pregnant people or those who may become pregnant, the keto diet is associated with an increased risk of birth defects and gestational diabetes.

In addition, the keto diet's restriction of carbohydrates can lead to an increased risk of neural tube defects in newborns, even if the mother takes folic acid supplements. This is likely due to the reduced intake of folate-fortified carbohydrates.

The long-term health consequences of the keto diet are severe and should be carefully considered before starting this restrictive eating pattern.

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