Keto's Long-Term Viability: Is It Sustainable?

The ketogenic, or keto, diet is a low-carb, high-fat eating plan. It involves eating mostly fat (60 to 90% of calories) and very few carbohydrates (20 to 50 grams per day). This puts the body into a state of ketosis, where it uses fat for energy instead of carbohydrates. While keto can lead to quick weight loss, it is unclear how effective it is in the long term. There are also potential health risks associated with the diet, including nutrient deficiencies, liver and kidney problems, constipation, and fuzzy thinking. Some people may also experience keto flu in the initial stages of the diet, which involves extreme fatigue and foggy-headedness.

Weight loss

The keto diet is a high-fat, low-carbohydrate, and moderate-protein diet. It is advertised as a weight-loss solution and has gained traction among celebrities. The diet forces the body to use a different type of fuel. Instead of relying on glucose from carbohydrates, the keto diet relies on ketone bodies, which are produced by the liver from stored fat.

Short-Term Benefits

The keto diet has been shown to aid weight loss in the short term. In one study, participants lost 2.2 times more weight on a keto diet than on a low-calorie, low-fat diet. Another study found that a low-carb group lost 15.2 pounds, while a low-fat group lost only 4.6 pounds over three months.

Long-Term Concerns

However, there are concerns about the keto diet as a long-term solution. Firstly, it can be challenging to adhere to the strict guidelines over an extended period. Relaxing the rules and increasing carbohydrate intake can lead to weight regain.

Secondly, the keto diet may have negative health impacts. It can lead to vitamin and mineral deficiencies, as well as reduced athletic performance due to the body being in a more acidic state. There are also concerns about the impact on heart health, with some studies suggesting an increased risk of atrial fibrillation and early death.

Recommendations

Health professionals recommend that if someone chooses to try the keto diet, they should strive for balance. It is important to ensure you are getting adequate nutrients and that the diet is sustainable for you. Additionally, combining the keto diet with a reduced-calorie Mediterranean-style diet and increased physical activity may help manage weight loss in the long term.

Health benefits

The ketogenic diet, or keto, is a popular eating plan that involves eating mostly fat (60 to 80 percent of calories) and very few carbohydrates, starting with 20 to 30 grams per day. This shift in diet forces the body to use fat for energy instead of carbohydrates, a state called ketosis. While keto can lead to quick weight loss, it is unclear if this is a long-term solution. Here are some of the potential health benefits of the keto diet:

Weight Loss

People on the keto diet often experience rapid weight loss, which is one of the main reasons for its popularity. This weight loss may be due to reduced calorie intake and the body's use of fat for energy. However, it is important to note that this weight loss may be temporary, and many people regain the weight once they stop the diet.

Improved Blood Sugar Control

The keto diet has been shown to improve blood sugar control in people with type 2 diabetes, at least in the short term. This is likely due to the reduction in carbohydrate intake, as carbohydrates are broken down into glucose, which can raise blood sugar levels.

Improved Cholesterol Levels

Some studies have shown that the keto diet can lead to improved cholesterol levels, with a decrease in LDL ("bad") cholesterol and an increase in HDL ("good") cholesterol. However, there is conflicting evidence, and more long-term research is needed to understand the effects of keto on cholesterol over time.

Neuroprotective Effects

The keto diet has been used to treat drug-resistant epilepsy, especially in children, and there is solid evidence that it reduces seizures. This has raised questions about the potential benefits of keto for other brain disorders such as Parkinson's, Alzheimer's, and multiple sclerosis. However, there is currently no human research to support recommending keto for these conditions.

Other Potential Benefits

The keto diet may also have other health benefits, such as improved gut health, reduced hunger, and a lower risk of certain cancers. However, more research is needed to understand the long-term effects of the keto diet, as it is challenging to follow over extended periods.

Long-term health risks

The ketogenic or "keto" diet is a low-carb regimen that has gained massive popularity due to its ability to promise quick weight-loss results. The diet is extremely strict and difficult to maintain, and there are concerns about its long-term health risks.

• Vitamin or mineral deficiencies: Restricting carbohydrates to 50 grams a day or less means cutting out fruits and certain vegetables, which are essential sources of antioxidants, vitamins, and minerals. This may lead to nutritional deficiencies over time.
• Impaired athletic performance: Research has shown that athletes on the keto diet may experience reduced strength and fitness. A 2019 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.
• Weight regain: The keto diet's strict guidelines may be challenging to maintain long-term, and relaxing the rules can lead to weight regain. The weight regain may include more fat and less lean muscle, affecting metabolism and making future weight loss more difficult.
• Blood vessel damage: A 2019 study found that indulging in high-sugar treats while on a high-fat, low-carb diet can damage blood vessels. Consuming a high-sugar treat while on the keto diet may undo some of the positive impacts on blood vessels.
• Increased risk of chronic diseases: Health experts are concerned about the long-term impact of a keto-style diet on the heart and arteries. Studies have linked low-carb diets to an increased risk of atrial fibrillation, heart disease, stroke, and heart failure. Additionally, low-carb dieters who consumed large amounts of meat and dairy had a higher risk of early death and cancer.
• Liver problems: With a high-fat requirement, the keto diet may overload the liver and worsen any existing liver conditions.
• Kidney problems: The kidneys help metabolize protein, and the high protein intake on the keto diet may overload them. This is especially concerning for those with chronic kidney disease (CKD), as the high protein intake can place excess stress on the kidneys and worsen long-term internal damage.
• Constipation: The keto diet is low in fibrous foods like grains and legumes, which can lead to digestive issues such as constipation.
• Fuzzy thinking and mood swings: The brain functions optimally when it has a sufficient energy source from healthy carbohydrates. Low-carb diets may cause confusion and irritability.

Short-term side effects

The keto diet is a very low-carb, high-fat diet. While it may lead to short-term weight loss, it is a restrictive diet that can be challenging to stick to. Here are some of the short-term side effects of the keto diet:

• Fatigue: Following the keto diet can lead to feelings of fatigue and low energy. This is often due to the body's adjustment to using fat instead of glucose as its primary fuel source.
• Headache: Headaches are a common short-term side effect of the keto diet and are often related to the body's transition to a state of ketosis.
• Dizziness: Some people may experience dizziness or lightheadedness when starting the keto diet. This is usually related to fluid and electrolyte imbalances caused by the diet's restrictive nature.
• Nausea: Nausea is another common short-term side effect, which may be due to the body's adjustment to the high-fat content of the keto diet.
• Constipation: The keto diet can lead to constipation due to the reduced intake of fibre-rich foods, such as whole grains, fruits, and starchy vegetables.
• Low exercise tolerance: The keto diet may result in a temporary decrease in exercise performance as the body adjusts to using fat for fuel instead of carbohydrates.

It is important to note that these short-term side effects typically resolve within a few days to a few weeks as the body adjusts to the keto diet. However, it is always recommended to consult with a healthcare professional before starting any new diet, especially one as restrictive as the keto diet.

Long-term side effects

The ketogenic or "keto" diet is a low-carb, high-fat eating plan. While it can lead to quick weight loss, it is not a long-term solution as it can be restrictive and hard to follow. There is also a lack of research on its long-term effects, with some studies suggesting potential health risks. Here are some potential long-term side effects of the keto diet:

• Vitamin or mineral deficiencies: Restricting carbohydrates to 50 grams or less per day means cutting out fruits and certain vegetables, which are good sources of antioxidants, vitamins, and minerals. This can lead to nutrient deficiencies over time.
• Impact on athletic performance: Some researchers worry that keto may sabotage strength and fitness in athletes. A 2019 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.
• Weight regain: Relaxing the strict keto guidelines and incorporating more carbohydrates can lead to weight regain. This can result in a yo-yo pattern of weight loss and gain, which is linked to a higher risk of early death.
• Damage to blood vessels: Indulging in high-sugar treats while on a high-fat, low-carb diet can damage blood vessels, according to a 2019 study. This can have long-term consequences and may undo some of the positive impacts of the keto diet.
• Increased risk of heart disease: Health experts worry about the long-term effects of a keto diet on the heart and arteries. Studies have found that people on low-carb diets are more likely to develop atrial fibrillation (AFib) and have an increased risk of blood clots, stroke, and heart failure.
• Potential increase in cancer risk: A 2018 study found that low-carb dieters who consumed large amounts of meat and dairy had a higher risk of early death compared to those consuming moderate amounts of carbs or plant-based protein. Another study suggested that the keto diet may help mitigate the risks of certain cancers, but more research is needed.
• Liver problems: The keto diet involves metabolizing large amounts of fat, which could worsen existing liver conditions.
• Kidney problems: The high protein content of the keto diet may overload the kidneys, which are responsible for metabolizing protein.
• Constipation: The keto diet is low in fibrous foods like grains and legumes, which can lead to constipation.
• Fuzzy thinking and mood swings: The brain functions optimally when it uses sugar from healthy carbohydrates as its energy source. Low-carb diets may lead to confusion and irritability.
• Metabolic dysfunction-associated steatotic liver disease (MASLD): Animal studies have suggested a potential link between long-term adherence to the keto diet and MASLD, formerly known as nonalcoholic fatty liver disease.

Frequently asked questions