Milly Gaines
The ketogenic diet is a high-fat, high-protein, low-carbohydrate diet. It is well known that the keto diet comes with some drawbacks, one of which is bloating, which is caused by a build-up of gas in the gastrointestinal tract. This is a common side effect of transitioning to a low-carb diet, as the body adjusts to the metabolic changes induced by ketosis. There are several causes of gas on the keto diet, including a sudden increase in fiber, sluggish fat digestion, and overconsumption of sugar alcohols. In addition, some people may experience keto gas due to preexisting hypochlorhydria (low stomach acid).
| Characteristics | Values |
|---|---|
| Temporary side effect | Common during the transition to a low-carb ketogenic diet |
| Cause | A sudden increase in fiber, sluggish fat digestion, and overconsumption of sugar alcohols |
| Vegetables | Onions, garlic, mushrooms, Brussels sprouts, broccoli, and cabbage |
| Dairy products | Cheese, butter, and certain artificial sweeteners |
| High-FODMAP foods | Onions, garlic, mushrooms |
| Sugar alcohols | Erythritol, xylitol, sorbitol, mannitol |
| Low stomach acid | Hypochlorhydria |
| Pre-existing conditions | Diabetes, asthma, thyroid dysfunction, skin conditions, osteoporosis, autoimmune disorders, inflammatory bowel issues |
| Dehydration | Lack of optimal water intake |
| Gut health | Dying off of unfavorable bacteria that prefer carbohydrates as food |
| Metabolic changes | Electrolyte imbalance, loss of stored fluid from muscles and organs |
| Nutritional ketosis | Faster transition with Medium Chain Triglyceride (MCT) oil |
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What You'll Learn
High-FODMAP foods, e.g. onions, garlic, mushrooms, and dairy
The keto diet is a low-carb, high-fat diet. It can cause temporary side effects, such as low energy, headache, brain fog, irritability, and digestive issues like bloating, constipation, and gas. These side effects are due to the body adapting to the metabolic changes induced by ketosis.
High-FODMAP foods are a common culprit of intestinal symptoms, including gas, bloating, and abdominal pain. FODMAP is an acronym for a certain class of carbohydrates called fermentable short-chain carbohydrates, which are harder for people to digest. These include fruits, vegetables, grains, cereals, nuts, legumes, lentils, dairy foods, and manufactured foods.
Onions, garlic, and mushrooms are high-FODMAP foods. Onions are a concentrated source of fructans, a type of FODMAP, and all varieties of onions contain high amounts. Garlic is one of the most concentrated sources of FODMAPs, and it is added to many sauces, gravies, and flavorings, making it difficult to restrict. Mushrooms are also high in FODMAPs, and they can cause digestive issues for certain groups.
Dairy products are the main source of the FODMAP lactose, and they are considered high-FODMAP foods. However, not all dairy foods contain lactose, and some are naturally low in lactose, such as hard and matured cheeses. Beverages can also be high in FODMAPs, even if they are made from low-FODMAP ingredients. For example, orange juice is high in FODMAPs due to the number of oranges used to make one glass.
To mitigate intestinal symptoms caused by high-FODMAP foods, it is recommended to introduce vegetables gradually and be mindful of portion sizes. Taking note of how you feel after eating different vegetables can help identify which ones cause digestive issues. Replacing high-FODMAP vegetables with more easily digestible options, such as leafy greens, cucumbers, or zucchini, or trying fermented options like sauerkraut, can also help relieve symptoms. Cooking vegetables can also make them easier to digest.
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Excess protein intake
Excessive protein intake can cause gas, abdominal pain, and bloating. This is because low-carb diets can lack fibre, whole grains, and prebiotics, which serve as fuel sources for healthy gut bacteria.
The keto diet is a high-fat, moderate-protein, and low-carbohydrate diet. To compensate for the reduction in carbohydrates, the keto diet involves an increase in protein and fat intake. This increase in protein intake can lead to gastrointestinal issues, especially for those with low stomach acid or inadequate bile production.
Stomach acid and bile fluid are crucial for breaking down food in the digestive tract and maintaining a balanced gut microbiome, which is essential for digestive health. When there is a lack of stomach acid, it can lead to hypochlorhydria, which is associated with various chronic illnesses, including digestive issues such as gastric inflammation, diarrhoea, and constipation.
To support healthy stomach acid levels, it is recommended to incorporate small amounts of raw apple cider vinegar diluted in water before meals. Additionally, adding fermented foods like sauerkraut or kefir and bitter vegetables like arugula, dandelion greens, and radicchio to your diet can help stimulate digestive fluids and promote more comfortable digestion.
It is important to note that the keto diet may lead to temporary changes in gut flora composition, which can contribute to mild digestive discomfort. These issues often resolve within a few weeks as the body adapts to the new diet.
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Sugar alcohols
To avoid consuming too many sugar alcohols, it is recommended to cut out packaged foods and focus on incorporating more whole foods into your diet. When reading food labels, ingredients ending in "-ol" are likely to be sugar alcohols.
Overall, while sugar alcohols can be a helpful sweetener for those on the keto diet, they should be consumed in moderation to avoid digestive issues.
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Gut bacteria die-off
The ketogenic diet is a high-fat, very low-carb diet. Meals typically consist of 70–80% fat and only 5-10% carbohydrates. This shift in diet forces the body to burn fat instead of glucose, which is called ketosis.
The keto diet has a dramatic impact on the microbes in the human gut, collectively referred to as the microbiome. In particular, the beneficial Bifidobacteria species decrease the most in response to reductions in carbohydrates rather than reduced fat intake. This may be because consuming less fibre, which fuels gut bacteria, causes this change.
The largest gut health study to date, called The Microsetta Initiative, surveyed over 11,000 people and found that the number one predictor of a healthy microbiome was the variety of plant foods consumed. However, a low-carb diet can lack fibre, whole grains and prebiotics, which serve as a fuel source for the healthy gut bugs in your intestines.
When starting the keto diet, many people experience gas, bloating, and abdominal pain. This is due to the body adjusting to a new diet and the dying off of bacteria that prefer carbohydrates as food. This is a temporary side effect of transitioning to a low-carb ketogenic diet, and it is recommended to gradually introduce vegetables and be mindful of portion sizes.
To summarise, the keto diet can cause a die-off of gut bacteria that prefer carbohydrates, which can lead to temporary gas and bloating. However, the long-term effects of the keto diet on gut health are still unknown.
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Low stomach acid (hypochlorhydria)
Gas, belching, or bloating within an hour of eating could be a sign of low stomach acid, or hypochlorhydria. This is a common condition that can lead to poor digestion and malabsorption of nutrients, causing digestive problems such as irritable bowel issues, gastric inflammation, and constipation.
Low stomach acid is often associated with chronic illnesses such as diabetes, asthma, thyroid dysfunction, skin conditions, osteoporosis, and autoimmune disorders. It can also cause an overgrowth of harmful bacteria, which can lead to bloating and gas.
If you suspect you have low stomach acid, it is important to consult a healthcare provider, who can suggest stomach acid tests such as the Heidelberg pH test, the SmartPill test, or the gastric string test.
There are several ways to improve low stomach acid levels, including:
- Taking a hydrochloric acid (HCI) supplement, although it is important to consult a doctor before doing so.
- Taking a digestive enzyme supplement, especially for people over the age of 40.
- Eating smaller meals and chewing thoroughly to aid digestion.
- Eating protein first.
- Incorporating whole foods, such as nutrient-rich, low-carb, and high-fiber non-starchy vegetables like spinach, broccoli, and cauliflower.
- Consuming ginger, which helps stimulate digestion and keep the intestines toned.
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Frequently asked questions
Keto gas is a common side effect of transitioning to a low-carb ketogenic diet. It is caused by a sudden increase in fiber, sluggish fat digestion, and the overconsumption of sugar alcohols during the adaptation phase.
Common triggers of keto gas include dairy and gluten, which are common food sensitivities. Vegetables high in dietary fiber, such as Brussels sprouts, broccoli, and cabbage, can also cause excess gas. Additionally, sugar alcohols like xylitol, sorbitol, and erythritol, which are often used as sugar alternatives on a keto diet, can lead to gas and other gastrointestinal issues.
To reduce keto gas, it is recommended to gradually introduce high-fiber vegetables and incorporate gut-friendly foods such as raw or fermented vegetables, bitter greens, apple cider vinegar, and peppermint. Keeping a food diary can also help pinpoint specific foods that may cause digestive issues. Additionally, spacing out meals and avoiding large portions can reduce the risk of bloating and gas.
