Keto Diet: Friend Or Foe?

The ketogenic, or keto, diet has become increasingly popular in recent years, with 23 million Americans choosing to follow the diet in 2022. The keto diet is a high-fat, low-carbohydrate eating plan that is advertised as a weight-loss solution. While it can lead to initial weight loss, this is mostly due to a loss of water weight, and the restrictive nature of the diet makes it difficult to follow long-term. The keto diet is associated with several health risks, including nutrient deficiencies, constipation, kidney problems, and an increased risk of heart disease due to higher consumption of saturated fats. It can also cause keto flu, with symptoms such as an upset stomach, dizziness, and decreased energy, during the first few weeks. Given these risks, it is important to consult a doctor and a registered dietitian before starting the keto diet.

Keto may lead to high cholesterol and an increased risk of heart disease

The ketogenic diet is a high-fat, moderate-protein, and very low-carbohydrate diet. It involves getting 70-80% of your calories from fat, 10-20% from protein, and 5-10% from carbohydrates. This means that people on the keto diet will be eating a lot of fat, and in order to meet this quota, they may end up consuming unhealthy options such as butter, coconut oil, and animal fat. These are all sources of saturated fat, which has been linked to poor heart health by the American Heart Association (AHA).

The worry that the keto diet will lead to a spike in cholesterol levels, which will in turn increase the risk of heart disease, is valid. The keto diet is associated with an increase in "bad" LDL cholesterol, which is also linked to heart disease. However, the effect of keto on heart health is not straightforward. Some studies have shown that the keto diet produces modest reductions in triglycerides, modest changes in heart-protective high-density lipoprotein (HDL, or "good" cholesterol), and minimal changes in low-density lipoprotein (LDL, or "bad" cholesterol). Other studies have shown a rise in LDL levels, while some have shown no change.

The impact of the keto diet on your LDL levels depends on the quality of your diet and your genetic factors. If you consume a lot of saturated fat on the keto diet, your LDL levels will likely rise. An increase in saturated fat intake has been shown to increase LDL. Additionally, if you have an inherited genetic mutation that affects the way LDL particles are regulated, your LDL levels can skyrocket.

Therefore, while the keto diet may not be inherently harmful, it is important to be aware of the potential risks and make sure you are consuming heart-healthy fats and getting enough fiber and nutrients. It is also crucial to talk to your doctor before starting the keto diet, especially if you have existing health conditions.

It can cause constipation

The keto diet can cause constipation due to the significant reduction in carbohydrate intake. Carbohydrates, such as fruits and whole grains, are common sources of dietary fibre, which is essential for maintaining regular bowel movements. A low-carbohydrate diet can, therefore, lead to digestive issues like constipation.

The keto diet recommends consuming 20 to 50 grams of carbohydrates per day, which is significantly lower than the recommended daily intake of 225 to 325 grams. This drastic reduction in carbohydrates can result in a lack of fibre, causing constipation. Additionally, the high-fat content of the keto diet may also contribute to gastrointestinal upset.

To prevent constipation while on the keto diet, it is important to ensure adequate fibre intake from keto-friendly, high-fibre foods. These include non-starchy vegetables, berries, avocados, nuts, and seeds. Introducing the keto diet gradually can also help reduce the risk of constipation. Starting with a higher daily carb intake and slowly reducing it allows the digestive system to adjust and may lessen the likelihood of constipation.

It is also recommended to drink plenty of water, exercise regularly, and choose whole, high-fibre foods over processed meals and fast food to support healthy bowel function.

It can be difficult to follow and may lead to yo-yo dieting

The keto diet is extremely strict and difficult to maintain. It requires a person to eat 75% of their calories from fat, 5% from carbohydrates, and 15% from protein. This means that people on the keto diet have to eat fat at every meal.

The diet is so restrictive that it is unlikely that people will follow it correctly. In fact, over 50% of people fail to adhere to a ketogenic diet in many medical studies. This means that any short-term weight loss effects are negated.

The keto diet is also likely to lead to yo-yo dieting, a term used to describe the cycle of weight loss and regain. This is because the keto diet is unsustainable. Once a person resumes a normal diet, their body composition has changed, meaning they will have to consume fewer calories than before the diet to maintain their weight. This leads to a vicious cycle of weight loss and weight gain.

The keto diet is not a long-term solution for weight loss and can be difficult to follow due to its restrictive nature. It is important to consult a doctor and a registered dietitian before attempting a ketogenic diet.

It may result in nutrient deficiencies

The keto diet is a high-fat, low-carbohydrate eating plan that has gained popularity in recent years. While it may be effective for short-term weight loss, it is not a sustainable long-term solution and comes with several health risks. One of the potential dangers of the keto diet is nutrient deficiencies, which can have various negative impacts on overall health.

The keto diet typically involves drastically reducing carbohydrate intake and increasing fat consumption. This shift in macronutrient ratios can lead to a general nutrient imbalance and deficiencies. Many people on the keto diet limit or eliminate fruits, vegetables, whole grains, and legumes, which are excellent sources of essential vitamins and minerals. As a result, adherents to the keto diet may experience deficiencies in thiamin, folate, vitamin A, vitamin E, vitamin B6, calcium, magnesium, iron, and potassium.

For example, common symptoms of potassium deficiency include constipation, heart palpitations, and extreme fatigue. Magnesium deficiency can lead to fatigue, muscle twitches and cramps, apathy, and high blood pressure. Even when dieters focus on nutrient-dense foods, a ketogenic diet is often lacking in vitamin K, linolenic acid, and most water-soluble vitamins.

The keto diet is also typically low in fiber, which is necessary for healthy intestinal function, nutrient absorption, and immune function. Additionally, the high-fat content of the keto diet can increase the risk of kidney stones and may negatively impact kidney function.

Furthermore, the keto diet may be particularly risky for pregnant women or those planning to become pregnant. Carbohydrate-restricted diets have been associated with an increased risk of birth defects, such as neural tube defects like anencephaly and spina bifida.

To mitigate the risk of nutrient deficiencies, it is essential to include a variety of nutrient-dense foods in your diet, such as leafy greens, nuts, seeds, and lean proteins. It may also be beneficial to take supplements, especially if you are considering a restrictive diet like keto. However, it is always advisable to consult with a healthcare professional before starting any new diet or supplement regimen.

It can cause kidney stones

The keto diet can cause kidney stones. This is because the keto diet involves eating a lot of high-fat animal foods, such as eggs, meat, and cheese, which can make your blood and urine more acidic. This increased acidity leads to greater excretion of calcium in your urine, which can cause kidney stones.

Some studies also suggest that the keto diet reduces the amount of citrate in your urine. Citrate usually binds to calcium and prevents the formation of kidney stones. Therefore, reduced levels of citrate may also increase your risk of developing kidney stones.

The keto diet is particularly risky for people with chronic kidney disease (CKD). The high levels of animal products in the keto diet can cause a build-up of acid in the blood, which can worsen CKD. Additionally, people with CKD are often recommended lower-protein diets, while the keto diet is moderate to high in protein.

The keto diet's restriction of high-carb fruits, starchy vegetables, whole grains, and beans can also lead to digestive issues and constipation, which may further increase the risk of kidney stones.

The incidence of kidney stones among those on the keto diet ranges from 3% to 10%, compared to about 0.3% per year in men and 0.25% per year in women in the general population. Uric acid stones are the most common type of kidney stones in people on the keto diet, followed by calcium-based stones.

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