
The ketogenic diet, also known as the keto diet, is a low-carb, high-fat diet that has been used to treat specific medical conditions. While it has gained popularity as a weight-loss strategy, there are several potential risks and side effects associated with this diet. The keto diet restricts carbohydrates, forcing the body to burn fat for fuel and resulting in weight loss. However, it can be challenging to maintain due to stringent food restrictions, and may lead to unhealthy 'yo-yo' dieting behaviour. Additionally, the keto diet can cause dehydration, loss of electrolytes, and a drop in blood pressure. It is also high in saturated fat, which has been linked to heart disease. Furthermore, the diet may not provide all the necessary nutrients, vitamins, minerals and fibres that the body requires. Before starting the keto diet, it is essential to consult a doctor or a registered dietitian to ensure it is safe and suitable for your individual needs.
| Characteristics | Values |
|---|---|
| Food restrictions | Sugary foods, grains or starches, fruits, beans or legumes |
| Difficult to maintain | Yes |
| Dehydration | Possible |
| Loss of electrolytes | Possible |
| Kidney stress | Possible |
| Weight regain | Likely |
| Blood pressure drop | Possible |
| Psychological distress | Possible |
| Nutritional deficiencies | Possible |
| High in saturated fat | Yes |
| Increase in "bad" LDL cholesterol | Yes |
| Risk of diabetic ketoacidosis | Yes |
| Not suitable for | Most children, pregnant or breastfeeding women, people with kidney disease or eating disorders |
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What You'll Learn

Potential weight regain after stopping the diet
The keto diet is restrictive, and many people gain weight once they stop it. This is partly due to the diet being difficult to stick to, and partly because of the body's metabolic response to the reintroduction of carbohydrates. When you stop following the keto diet, you will need to transition to a less restrictive form of healthy eating.
When you reintroduce carbohydrates, you will start to restore glucose reservoirs in the form of glycogen in your muscles and liver. Each gram of glycogen carries three grams of water, so this is where immediate weight gain comes from. This is not fat regain, but water weight.
To maintain your new weight, you will need to match your total daily energy expenditure. You can do this by matching your consumption with the energy expenditure of your body.
You can also prepare for post-keto weight gain by working with a registered dietician, nutritionist, or medical provider to develop a personalized post-keto diet plan. You can also continue to track your weight and how you feel as you reintroduce carbohydrates.
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Dehydration and loss of electrolytes
Dehydration is a common issue on the keto diet. This is because the diet is low in carbohydrates, which hold water and sodium in the body, helping to ensure hydration. The keto diet also causes the body to eliminate glycogen, which holds water in the bloodstream.
The keto diet is high in fat, and when the body burns fat instead of glucose for energy, it enters a metabolic state called ketosis. In this state, the body breaks down fats into molecules called ketones, which serve as an alternative fuel source. This process leads to the loss of water and electrolytes, resulting in dehydration. Electrolytes are minerals that help the body maintain the proper balance of fluids and prevent dehydration. Sodium, potassium, and magnesium are the electrolytes that are most likely to become imbalanced on a keto diet.
Electrolyte imbalances can lead to dehydration and cause a range of unpleasant symptoms, including muscle cramps, headaches, keto flu, fatigue, constipation, increased thirst and hunger levels, and even more dangerous symptoms in some cases. Therefore, it is important to meet the daily recommended intake requirements for sodium, potassium, and magnesium, and even exceed these requirements to meet the body's increased need for electrolytes.
To avoid dehydration on the keto diet, it is recommended to increase water intake to at least 2-3 liters per day, or at least half of your body weight in ounces of water. Eating whole foods such as leafy vegetables, which have a high water content, can also help to keep you hydrated, while nuts and seeds are high in electrolytes.
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High levels of saturated fat
The ketogenic diet is a low-carbohydrate, high-fat eating plan. It is often referred to as a weight-loss diet, but it is actually a medical diet that comes with serious risks. The keto diet can be effective for weight loss, especially in the short term, but it is not recommended as a long-term solution.
The keto diet is high in saturated fat, which is linked to an increased risk of heart disease. McManus recommends that saturated fats should make up no more than 7% of daily calories. However, on the keto diet, fat can supply up to 90% of daily calories. Sources of saturated fat include fatty cuts of meat, processed meats, lard, butter, and oils such as palm and coconut oil. Animal proteins like bacon are also high in saturated fat.
To reduce the risk associated with high levels of saturated fat, it is recommended to prioritize unsaturated fats, which can be found in nuts, seeds, avocados, plant oils, and oily fish.
The keto diet can be challenging to stick to due to stringent food restrictions. It may also cause side effects such as dehydration, kidney problems, constipation, and fuzzy thinking or mood swings. It is important to talk to a doctor and a registered dietitian before attempting the keto diet.
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Lack of essential nutrients
The ketogenic diet is a low-carbohydrate, high-fat diet that has been around since the 1920s. It was initially used to reduce seizures in children with epilepsy but has since become a popular weight-loss diet. While the keto diet can be effective for weight loss, it is important to be aware of potential nutrient deficiencies.
The keto diet restricts carbohydrates and replaces them with large amounts of healthy fats that the body burns for energy. This metabolic state is called "nutritional ketosis" or "ketosis". While in ketosis, the body breaks down fats into molecules called ketones, which serve as an alternative fuel source for vital organs such as the heart, muscles, kidneys, and even the brain.
However, due to the restrictive nature of the keto diet, it is easy to become deficient in essential vitamins, minerals, and phytochemicals. Specifically, a lack of fruits, vegetables, and grains in the diet can lead to deficiencies in micronutrients such as selenium, magnesium, phosphorus, and vitamins B and C. This can have negative consequences for overall health and well-being.
In addition to nutrient deficiencies, the keto diet has been linked to other risks, including high levels of saturated fat, increased "bad" LDL cholesterol, digestive issues, kidney stones, heart disease, muscle loss, cognitive decline, and liver and kidney problems. It is also important to note that the keto diet can be difficult to stick to due to its restrictive nature, and that weight regain is common once the diet is stopped.
Therefore, it is crucial to speak to a doctor and a registered dietitian before starting a ketogenic diet to ensure that you are getting all the essential nutrients your body needs and to mitigate any potential risks. Additionally, rotating the vegetables and meat in your diet can help ensure you are getting a variety of nutrients. Vitamin and mineral deficiency tests are also available to help monitor your nutrient levels while on the keto diet.
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Risk of diabetic ketoacidosis
Diabetic ketoacidosis (DKA) is a rare but serious complication that can occur for people with diabetes who are on a ketogenic diet. It is a medical emergency that requires immediate treatment. DKA occurs when the body produces dangerously high levels of ketones, which can lead to a sharp drop in blood pH levels, a condition called ketosis. This can be life-threatening.
People with type 1 diabetes are at the highest risk of developing DKA, but it can also occur in people with type 2 diabetes who are taking a sodium-glucose cotransporter 2 (SGLT2) inhibitor. In rare cases, ketoacidosis has also been reported in individuals without a diagnosis of diabetes who were following a low-carbohydrate ketogenic diet.
The symptoms of DKA include:
- Dry mucous membranes
- Abdominal tenderness
- An acetone-like scent on the breath
- Positive urine ketones and glucose
- Elevated serum ketones
- A blood glucose level of 424 mg/dL or higher
- A pH level of 6.97 or lower
If you are experiencing any of these symptoms, seek medical attention immediately. To avoid DKA, it is recommended that individuals on a ketogenic diet consume at least 100 grams of carbohydrates per day. Additionally, individuals who are pregnant, lactating, or have certain hereditary defects of fat metabolism or enzyme deficiencies should not participate in this diet due to the increased risk of ketoacidosis.
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Frequently asked questions
The ketogenic diet is a low-carb, high-fat diet that causes weight loss and provides numerous health benefits. It is also referred to as the keto diet.
The keto diet is associated with an increase in "bad" LDL cholesterol, which is linked to heart disease. It can also be hard to maintain because it limits what foods you can eat, and it may not provide all the necessary nutrients. There is also a risk of dehydration and kidney stress due to the elimination of glycogen from the bloodstream.
The keto diet is unsafe for most children, pregnant or breastfeeding women, people with kidney disease, those at risk of an eating disorder, and people taking certain diabetes medications.
The main foods you can eat on the keto diet include meat, fish, eggs, cheese, oils, cream, avocado, and nuts. You can also have some low-carb vegetables, such as leafy greens, cauliflower, broccoli, and cucumbers.











































