Keto's Dark Side: Uncovering The Negative Health Impacts

The keto diet is a popular nutrition trend that involves eating a high-fat, low-carb diet. While it can be effective for quick weight loss, there are several bad side effects to be aware of before giving it a go.

The keto diet can cause keto flu, which includes symptoms such as headaches, fatigue, muscle aches, nausea, and diarrhea. It can also lead to constipation, dehydration, nutrient deficiencies, kidney stones, and high cholesterol. The diet is also extremely restrictive, which can make it difficult to stick to and cause social isolation. In addition, the long-term effects of the keto diet are not yet well understood, and it may increase the risk of heart disease.

For these reasons, it's important to consult a doctor or dietitian before starting the keto diet.

Dehydration and loss of electrolytes

The keto diet is a low-carb, high-fat diet that puts the body into a metabolic state called ketosis, where it burns fat for energy instead of sugar. While this diet can lead to weight loss, it also has some side effects, including dehydration and loss of electrolytes.

Dehydration

Dehydration is a common issue on the keto diet, especially when first starting. This is because the body loses water and electrolytes when in ketosis, and the diet's nature can cause an electrolyte imbalance, leading to dehydration. The keto diet involves eliminating carbohydrates, which are what help the body retain water and sodium. As a result, it is easier to sweat and lose necessary electrolytes such as sodium, magnesium, potassium, and calcium.

Additionally, when you start the keto diet, you will likely lose several pounds of water weight in the first week or two. This is because, when your body stops storing carbs, it no longer needs to absorb as much water.

Signs of dehydration include:

• Dry mouth and throat
• Fatigue and weakness
• Dizziness and lightheadedness

To combat dehydration, it is important to increase your water intake and incorporate electrolyte-rich foods and drinks into your diet.

Loss of Electrolytes

Electrolytes are vital for the proper functioning of the body, and a keto diet can cause a deficiency. Electrolytes include sodium, potassium, magnesium, chloride, calcium, phosphate, and bicarbonate. A loss of electrolytes can lead to an electrolyte imbalance, causing problems such as:

• Headaches
• Muscle cramps
• Convulsions
• Irregular heartbeat
• Confusion
• Loss of alertness
• Poor judgment
• Seizures

To maintain proper electrolyte levels, it is important to eat keto-friendly foods that contain electrolytes, such as leafy greens, avocados, and nuts. You can also take supplements like magnesium and potassium to replenish lost electrolytes.

Preventing Dehydration and Loss of Electrolytes on Keto

• Start your day with a glass of water and drink throughout the day.
• Keep a full glass of water nearby to remind yourself to drink.
• Buy a tracking cup or download a water-tracking app to monitor your intake.
• Incorporate other hydrating liquids such as low-sugar broths, juices, sports drinks, and popsicles.
• Eat whole foods like leafy vegetables, which have a high water content, and nuts and seeds, which are high in electrolytes.
• Eat more magnesium and potassium to prevent muscle cramps.
• Salt your food liberally to increase sodium intake.
• Drink bouillon, which is high in sodium.
• Drink mineral water to supplement magnesium and calcium.
• Drink tea, coffee, and sparkling water, which also count as hydration.

Nutritional deficiencies

Calcium

People on long-term keto diets often lose too much calcium due to increased acid production and acidic urine. This can lead to lower bone density and an increased risk of kidney stones. Keto-friendly foods high in calcium include sardines, salmon, spinach, and turnip greens.

Magnesium

Magnesium is important for energy production and nerve and brain function. A deficiency can cause muscle cramps, headaches, anxiety, nervousness, and constipation. Avocados, almonds, spinach, and salmon are good keto-friendly sources of magnesium.

Iron

Iron is needed for energy production and red blood cell formation. A deficiency can cause fatigue and trouble breathing during exercise. Evidence suggests that the high-fat content of the keto diet may reduce iron absorption. Vitamin C-rich foods can help increase iron absorption.

Sodium

The keto diet can lead to increased sodium loss due to reduced insulin levels. Low sodium levels can cause fatigue, muscle cramping, headaches, and heart palpitations. Electrolyte supplements and keto-friendly foods like sea salt, bouillon, beef jerky, and salted pumpkin seeds can help replenish sodium levels.

Potassium

Potassium is important for fluid balance, blood pressure regulation, and nerve and muscle function. A deficiency can lead to high blood pressure, salt sensitivity, and an increased risk of kidney stones. Spinach, cabbage, parsley, walnuts, hazelnuts, and Brazil nuts are good keto-friendly sources of potassium.

Selenium

The keto diet can lead to lower selenium levels as high-fat foods tend to be low in this mineral. Brazil nuts, sardines, and shrimp are good keto-friendly sources of selenium.

Carnitine

Carnitine is important for burning fat, and the keto diet can lead to a temporary decrease in carnitine levels. Long-term deficiencies may require supplementation.

Vitamins and Minerals

In addition to the above, the keto diet may also result in deficiencies of various vitamins and minerals, including:

• Vitamin A: Found in meat, liver, fish, poultry, and dairy.
• Vitamin B complex: Found in dark green vegetables, bone-in pork chops, and eggs.
• Vitamin C: Found in bell peppers, broccoli, and citrus fruits.
• Vitamin D: Fatty fish, sun exposure, and vitamin D supplements can help meet requirements.
• Vitamin K: Found in leafy greens and meat products.
• Zinc: Found in meat, shellfish, pumpkin seeds, and hemp seeds.
• Phosphorus: Found in meat, seafood, sunflower seeds, and pumpkin seeds.

Kidney problems

The keto diet may stress your kidneys and increase your risk of kidney stones. This is because the keto diet involves eating a lot of high-fat animal foods, such as meat, eggs, and cheese, which can cause your blood and urine to become more acidic. This can lead to an increased excretion of calcium in your urine, and a reduction in the amount of citrate in your urine. Citrate can bind to calcium and prevent the formation of kidney stones, so reduced levels of it may increase your risk of developing them.

People with chronic kidney disease (CKD) should avoid the keto diet, as weakened kidneys may be unable to remove the acid buildup in the blood that results from eating a lot of animal foods. This can lead to a state of acidosis, which can worsen the progression of CKD. The keto diet may also worsen metabolic acidosis, a common complication of CKD, which ultimately affects bone and muscle health.

The keto diet's emphasis on fat, which often comes from animal fat, increases the consumption of saturated fat, which may increase the risk of heart disease. High-fat animal foods can also lead to albuminuria (losing protein in urine) and the onset of chronic kidney disease. In addition, the diet has been associated with an increased risk of kidney stones in patients using it for the treatment of epilepsy.

Those with or at risk for kidney disease can find healthy alternative diets that can help with weight loss. For those with kidney disease, one of the best ways to maintain a healthy weight is to adopt a healthy lifestyle with balanced and portioned meals that include adequate amounts of protein, carbohydrates, fat, fiber, and other micronutrients. Restricting or reducing salt intake and ensuring proper hydration will also alleviate stress on the kidneys.

Gastrointestinal issues

Causes

There are several reasons why people on a keto diet may experience gastrointestinal issues:

• The keto diet is low in fibre, which is essential for digestion. Insufficient fibre intake could increase the risk of constipation.
• The keto diet may alter your gut microbiome, increasing inflammation and reducing beneficial fatty acids.
• The keto diet is high in fat, which requires the liver to release extra bile. Bile is a natural laxative, and an excessive amount may push waste through the digestive tract quicker than usual, leading to diarrhoea.
• The high-fat and low-carb content of the keto diet may lead to other gastrointestinal symptoms, such as nausea and bloating.
• Consuming more dairy products, which are high in fat, when starting a keto diet may lead to diarrhoea and other gastrointestinal issues.
• Consuming more artificial sweeteners and sugar alcohols to find low-carb alternatives to previously consumed items may cause a laxative effect, leading to diarrhoea.
• The keto diet may cause an intolerance to FODMAPs (a specific type of fibre found in low-carb keto staples like cauliflower, broccoli, garlic, onions, and cabbage).

Relief and Prevention

If you are experiencing gastrointestinal issues while on the keto diet, the following tips may help relieve your symptoms:

• Drink more water, especially mineral water. Fluids might be just as important as fibre in preventing constipation.
• Eat more fibre, especially from whole foods. Fibre can help relieve constipation or diarrhoea. Greens, cucumber, broccoli, and cabbage are some high-fibre foods that are suitable for a keto diet.
• Eat less dairy. This may help reveal an underlying intolerance to dairy, common symptoms of which are diarrhoea, bloating, and gas.
• Ease into the diet. A sudden change in diet may disrupt the gastrointestinal bacteria. Slowly reducing carbs and increasing fats may help the body adapt better.
• Stay hydrated. Drinking water and sugar-free electrolyte beverages can help replace lost fluids and electrolytes.
• Add probiotics and prebiotics. Taking a probiotic supplement or increasing the intake of probiotic- and prebiotic-rich foods may effectively support gut bacteria and reduce gastrointestinal effects.
• Eat fermented foods, such as sauerkraut and kimchi, which can help improve digestion and reduce constipation or diarrhoea.
• Consider reducing your intake of FODMAPs. In sensitive individuals, reducing FODMAPs can help manage problems like diarrhoea, flatulence, bloating, and gastrointestinal pain.
• Tone down the coconut products and other medium-chain triglycerides (MCTs). These can cause abdominal cramps and diarrhoea, especially if you are not used to them.

Risk of heart disease

The ketogenic diet is a high-fat, low-carbohydrate diet that has been associated with a heightened risk of heart disease. While the diet may lead to dramatic reductions in fat mass and weight over the short term, there is little evidence of any long-term benefit.

The keto diet can lead to higher levels of "bad" cholesterol, or LDL cholesterol, which is a known risk factor for heart disease. The extreme restrictions on carbohydrates may also lead people to avoid most vegetables and fruits, which can increase the risk of heart disease.

A study by Iulia Iatan, MD, PhD, found that people on a keto-like diet had more than twice the risk of having several major cardiovascular events, such as blocked arteries requiring stenting, heart attacks, and strokes. The study also found that those with the highest levels of LDL cholesterol were at the highest risk for a cardiovascular event.

The keto diet may not be suitable for people with a history of heart disease or high cholesterol, as it can lead to increased cholesterol levels and other risk factors for heart disease. It is important to consult a healthcare provider before starting the keto diet and to monitor cholesterol levels while on the diet.

The keto diet can be hard to maintain over the long term, and there is limited data on its long-term effects. It is important to consider the potential risks and benefits before starting the keto diet.

Frequently asked questions