Keto Diet: How Long Can You Sustain It?

The ketogenic diet is a popular eating plan that involves eating mostly fat (60 to 80 percent of calories) and very few carbohydrates (20 to 50 grams per day). The goal is to reach a metabolic state called ketosis, where the body uses fat instead of glucose as its primary fuel source. While the keto diet is touted for its weight loss benefits, there is limited research on its long-term effects, and some experts warn that it could be dangerous. So, how long do people stay on the keto diet?

How long does it take to enter ketosis?

It usually takes between two and four days to enter ketosis, but for some people, it can take up to a week or longer. The time it takes to enter this state varies based on several factors, including:

• Age (younger people tend to enter ketosis faster)
• Basal metabolic rate
• Carbohydrate, fat and protein intake
• Physical activity level
• Current health issues

If you eat a high-carb diet before starting a keto diet, it may take you longer to reach ketosis than someone who consumes a low-carb diet. That's because your body needs to exhaust its glucose stores first.

You may be able to get into ketosis faster by trying the following:

• Intermittent fasting
• Fasting for 12 hours
• Limiting carbs to under 50 grams a day
• Taking medium-chain triglyceride (MCT) oil supplements
• Increasing your intake of high-quality fats
• Trying a short-term fast
• Tracking your carb intake
• Exercising more

Signs you're in ketosis

The best way to know if you're in ketosis is to test your ketone levels with a breath meter, urine strips or a blood ketone meter. However, you may also experience some symptoms, sometimes known as the "keto flu", including:

• Headaches
• Fatigue
• Nausea
• Bad breath
• Increased thirst
• Constipation or diarrhoea
• Dehydration
• Gastrointestinal distress
• Subpar exercise performance

How long should you stay in ketosis?

The ketogenic diet is a popular, effective way to lose weight. It involves eating mostly fat (60 to 80 percent of your calories) and very few carbohydrates (starting with 20 to 30 grams per day). This sends your body into a state called ketosis, where it uses fat instead of carbohydrates for energy.

But how long should you stay in ketosis? The answer depends on your goals and your body's response to the diet.

Set clear goals and monitor your progress

The key to making keto work for you is to set clear goals and monitor your progress. Stay in ketosis long enough to achieve those goals. This might be a certain amount of weight loss, improved blood sugar control, or lower risk factors for heart disease or cancer.

The minimum time to stay in ketosis

At a minimum, you should stay in ketosis long enough to experience the benefits of the keto diet. This might be a few weeks to several months. It takes time for the health benefits of keto to occur, and some are more measurable than others. For example, improvements in blood sugar and lower risk factors for heart disease don't happen overnight. On the other hand, some benefits, like easier fat loss and a brighter mood, may be noticeable right away.

Staying in ketosis long-term

Some people choose to stay on the keto diet long-term, and it appears to be safe. A 2018 randomised controlled trial found that staying keto for a year was equally safe or safer than following a non-keto diet. There is no evidence that nutritional ketosis is dangerous in the short or long term.

However, there are some potential downsides to staying on the keto diet long-term. It can be challenging to follow due to its restrictive nature, and there is a risk of nutrient deficiencies if you don't get enough fruits and vegetables. There are also concerns about the potential impact on athletic performance, as the body is in a more acidic state during ketosis, which may limit its ability to perform at peak levels.

Coming off the keto diet

If you decide to come off the keto diet, it's best to do so gradually. A slow transition allows you to avoid pitfalls like binge eating or rapid weight regain, and gives you time to gauge how your body responds. You can gradually increase your carbohydrate intake over a few months and monitor your weight and health markers.

Remember, there is no one-size-fits-all answer to how long you should stay in ketosis. The best approach is to set clear goals, monitor your progress, and adjust as needed.

Do you have to stay in ketosis to keep weight off?

The ketogenic diet is a popular way to lose weight, but it is not a long-term solution for everyone. While some people may choose to stay on the keto diet permanently, others may find it too restrictive or unsustainable. So, do you have to stay in ketosis to keep the weight off?

Weight Maintenance After Keto

Not everyone has to stay in ketosis to maintain their weight after losing weight. However, credible evidence suggests that staying in ketosis can help with weight maintenance. In theory, if you keep calories relatively low and avoid overeating, it is possible to stop the keto diet without regaining all the weight you lost.

But in practice, research shows that counting calories is not a very effective way to maintain weight loss. Studies suggest that for people who have lost significant amounts of weight, the body can become sluggish, reduce calorie burn, and increase appetite. Staying in ketosis could help bypass these problems by keeping the body in a state of fat-burning with minimal cravings.

Health Risks of Long-Term Keto

There are potential health risks associated with long-term adherence to the keto diet. Some experts warn that the diet could lead to vitamin or mineral deficiencies, as it often involves cutting back on fruits and vegetables, which are good sources of antioxidants, vitamins, and minerals. It may also be challenging to get enough fiber while on the keto diet, as whole grains are a significant source of this nutrient.

The keto diet may also affect athletic performance. Some researchers have found that participants performed worse on high-intensity exercises after being on the keto diet for a short period. Additionally, long-term keto may damage blood vessels. A study found that indulging in a high-sugar treat while on a high-fat, low-carb diet can damage blood vessels.

Furthermore, health experts worry about the impact of a long-term keto diet on the heart and arteries. Some studies have found that people on low-carb diets are more likely to develop atrial fibrillation and have an increased risk of early death, cancer, and other health issues. However, most of this research is still observational, and more long-term research is needed to understand the effects of the keto diet fully.

Tips for Maintaining Weight Loss After Keto

If you decide to stop the keto diet, it is important to transition gradually. Here are some tips to help you maintain your weight loss:

• Stick to healthy, organic whole foods whenever possible.
• Increase your carb intake incrementally over a few months, adding around 50-75 grams of carbs per week.
• Weigh yourself regularly and track your results, paying close attention to areas where you noticed improvements while on keto.
• Listen to your body and make adjustments as needed based on your energy levels, mood, sleep quality, and stress levels.
• Avoid making up your mind ahead of time and be open to the idea of experimenting with different diets.
• Avoid the "cheating" mindset and maintain a healthy, balanced mindset around food.
• Ensure you are getting enough high-quality protein and healthy fats, which are essential for a healthy diet.

Is ketosis safe long-term?

There are conflicting opinions on the safety of ketosis in the long term. Some sources claim that there is not enough research to determine the safety of ketosis over an extended period, while others claim that it is safe and even beneficial.

Arguments for Safety

A 6-month study of the keto diet in obese patients found that it was safe to use a ketogenic diet for a longer period of time than previously demonstrated. The study concluded that the diet did not produce any significant side effects and had beneficial effects on the patients' weight and body mass index.

A year-long randomized controlled trial published in 2018 found that a healthy low-carb diet was equally safe or safer than a low-fat diet, with less than 3% of participants experiencing adverse events, most of which were unrelated to the diet.

Arguments Against Safety

Health experts warn that the long-term effects of the keto diet are still largely unknown and that it could be dangerous. Some specific concerns include:

• Vitamin or Mineral Deficiencies: Limiting carbs to 50 grams or less per day may result in a lack of fruits and vegetables, leading to potential vitamin and mineral deficiencies.
• Athletic Performance: The body is in a more acidic state during ketosis, which may limit its ability to perform at peak levels. Some athletes on keto have reported worse performance in high-intensity tasks.
• Weight Regain: Many people cannot adhere to the keto diet for very long and may regain weight when transitioning to a less restrictive diet. The type of weight gained back may also affect metabolism and make it harder to lose weight again.
• Blood Vessel Damage: Indulging in high-sugar treats while on a keto diet may damage blood vessels, undoing some of the positive impacts of the diet.
• Chronic Disease Risk: Long-term keto diets have been linked to an increased risk of atrial fibrillation, early death, cancer, and other chronic diseases.

While some studies suggest that ketosis is safe in the long term, there is a lack of comprehensive long-term research. Therefore, it is important for individuals to carefully consider their own circumstances and consult with medical experts before deciding to adopt the keto diet.

How do you reincorporate foods after keto?

The keto diet is a low-carb, high-fat diet that can be challenging to stick to. It involves limiting carbs to 20-50 grams per day and filling up on fats, such as meat, fish, eggs, nuts, and healthy oils. While it can be an effective way to lose weight and improve health, it may not be suitable for everyone and can be difficult to maintain in the long term.

If you decide to transition off the keto diet, it is important to do so gradually. Here are some tips on how to reincorporate foods after following a keto diet:

• Stick to healthy, organic whole foods: Whether you are on or off the keto diet, choosing healthy foods is essential for maintaining good health.
• Record your macros and increase carbs gradually: After following a strict keto diet, your body needs time to adjust. Add around 50-75 grams of daily carbs each week, at most.
• Weigh yourself regularly and track your results: Keep track of your weight, body fat percentage, blood sugar, and physical performance during and after your transition. This will help you understand how your body is responding to the changes.
• Listen to your body: In addition to quantifiable health markers, pay attention to your mood, energy levels, sleep quality, productivity, and stress levels. These factors can also impact your quality of life.
• Make adjustments as needed: Depending on your results, you may need to adjust your macros, calories, or food selections. If you are not seeing the results you want, you may even decide to return to a keto diet.
• Avoid common mistakes: Don't be too rigid or have a "cheating" mindset. View going off keto as an experiment and keep a healthy, balanced mindset around food. Continue to prioritise high-quality protein and healthy fat sources.

Remember, the keto diet may not be suitable for everyone, and it is always a good idea to consult with a healthcare professional before making any significant changes to your diet.

Frequently asked questions