Keto Diet: Is It Really Bad For Your Health?

The keto diet is a high-fat, low-carbohydrate eating plan designed to force the body into a state of ketosis, where it burns fat for energy instead of glucose. While it is advertised as a weight-loss solution, it is actually a medical diet that comes with serious risks and is not intended to be followed long-term. The diet is associated with an increased risk of heart disease, nutrient deficiencies, constipation, liver and kidney problems, and can lead to an unhealthy relationship with food.

High saturated fat content

The ketogenic diet is a high-fat, moderate-protein, and low-carbohydrate eating pattern. It involves deriving approximately 70-80% of calories from fat, 10-20% from protein, and 5-10% from carbohydrates. While the keto diet allows some healthy unsaturated fats, such as nuts, seeds, avocados, tofu, and olive oil, it encourages the high consumption of saturated fats. These include oils (palm and coconut), lard, butter, and cocoa butter.

The high saturated fat content of the keto diet is often cited as a concern due to its association with an increased risk of heart disease. Here are some reasons why people believe the high saturated fat content of the keto diet is harmful:

Increased Risk of Heart Disease

The link between saturated fat and heart disease has been a subject of debate. While early research suggested a connection between saturated fat intake and elevated low-density lipoprotein (LDL) cholesterol, which is associated with heart disease, more recent studies have presented a more nuanced picture. The effect of saturated fat on heart health depends on various factors, including individual responses, food sources, and overall diet composition.

High Consumption of Red Meat and Processed Meats

The keto diet's emphasis on high-fat foods can result in increased consumption of red meat and processed meat products, which are significant sources of saturated fat. However, these types of meat have been linked to an increased risk of cancers of the digestive tract. Therefore, while the keto diet may not directly cause these issues due to saturated fat, the overall dietary patterns it encourages could contribute to these health concerns.

Nutrient Deficiencies

The keto diet's restriction of carbohydrates and encouragement of high saturated fat intake can lead to nutrient deficiencies. This is because a focus on fatty foods may result in a reduced intake of fresh fruits, legumes, vegetables, and whole grains, which are rich sources of essential vitamins, minerals, and fiber. As a result, individuals following the keto diet may experience deficiencies in micronutrients such as selenium, magnesium, phosphorus, and vitamins B and C.

Difficulty in Sustaining the Diet

The keto diet's stringent food restrictions, particularly the high consumption of saturated fats, can make it challenging to adhere to long-term. This difficulty in sustainability may contribute to a cycle of yo-yo dieting, which is associated with increased health risks and mortality.

Cardiovascular Risks

The high-fat nature of the keto diet, especially the high saturated fat content, has been associated with an increased risk of cardiovascular disease. Studies have shown that the keto diet can lead to elevated levels of "bad" LDL cholesterol, which is a known risk factor for heart disease. Additionally, the diet's restriction of carbohydrate-rich foods, such as whole grains and legumes, can result in fiber deficiencies, further contributing to cardiovascular concerns.

Nutrient deficiencies

The keto diet is a high-fat, low-carbohydrate eating plan that can lead to nutrient deficiencies. While it may be effective for weight loss in the short term, it is not a balanced diet and can lead to health issues. Here are some of the potential nutrient deficiencies associated with the keto diet:

• Vitamins B1, B6, B7, and B12: These vitamins are essential for turning food into energy, and a keto diet may not provide enough of them.
• Calcium, magnesium, and phosphorus: These minerals are crucial for strong bones, and a keto diet may be deficient in these nutrients.
• Iron: Iron is necessary for carrying oxygen and supporting proper growth and development. A keto diet may not provide enough iron.
• Vitamin A, vitamin E, vitamin K, and linolenic acid: These vitamins and fatty acids are important for various bodily functions, but a keto diet may not provide adequate amounts.
• Fiber: The keto diet may be low in fiber, which is necessary for healthy intestinal function and nutrient absorption.
• Potassium and magnesium: Deficiencies in these minerals can lead to constipation, heart palpitations, fatigue, muscle twitches, and high blood pressure.
• Folate: Folate is important for pregnant women to prevent neural tube defects in their babies. A keto diet may not provide enough folate.

To avoid nutrient deficiencies, it is important to include a variety of nutrient-dense foods in your diet, such as grass-fed meat, poultry, wild-caught fish, leafy greens, nuts, and seeds. Additionally, supplementation may be necessary to ensure adequate intake of certain nutrients.

Kidney problems

The keto diet may stress your kidneys and increase your risk of kidney stones. This is because the keto diet typically includes a lot of high-fat animal foods, such as eggs, meat, and cheese, which do not contain carbs. Eating a lot of animal products can cause your blood and urine to become more acidic, leading to increased excretion of calcium in your urine. Some studies also suggest that the keto diet reduces the amount of citrate that’s released in your urine. Given that citrate can bind to calcium and prevent the formation of kidney stones, reduced levels of it may also raise your risk of developing them.

Additionally, people with chronic kidney disease (CKD) should avoid keto, as weakened kidneys may be unable to remove the acid buildup in your blood that results from these animal foods. This can lead to a state of acidosis, which can worsen the progression of CKD. Lower-protein diets are often recommended for individuals with CKD, while the keto diet is moderate to high in protein.

Kidney stones are a well-noted potential side effect of the ketogenic diet. Past research observed that among children following the keto diet as a treatment for epilepsy, 13 out of 195 subjects developed kidney stones. However, children supplementing with potassium citrate in the study noticed a decreased likelihood of kidney stones. Speak with your healthcare practitioner about supplementing if kidney stones are a concern.

A 2016 meta-analysis of nine RCTs in overweight and obese individuals with healthy kidneys showed a greater improvement in kidney function in those who ate a low-carbohydrate diet compared to those who consumed a control diet, though the improvement was likely too small to be clinically meaningful. A more recent meta-analysis of 12 RCTs found no evidence that low-carbohydrate diets are harmful to kidney health, even in people with type 2 diabetes.

However, a 2016 randomized cross-over study followed 14 male bodybuilders for a year. The men ate their normal diet for a total of six months and a high-protein diet for a total of six months. The study found no harmful effects on kidney function on the high-protein diet. Another study looked at five healthy bodybuilders who continued to consume a high-protein diet for a total of two years without any change in their normal kidney function measurements or other negative effects.

Nevertheless, if you want to minimize any risk of kidney stones, there are several things you can do. Firstly, ensure you are drinking enough water. Secondly, reduce your consumption of high-oxalate foods such as spinach, avocados, raspberries, turnips, tomatoes, Brussels sprouts, celery, almonds, Brazil nuts, pine nuts, and cashews. Thirdly, consume adequate dietary calcium. Fourthly, avoid supplementing with high doses of vitamin C. Fifthly, pay attention to adequate mineral supplementation, especially magnesium. Finally, if you have a history of kidney stones, your physician can measure your urinary concentrations of oxalate, phosphate, uric acid, and calcium prior to beginning a low-carb or ketogenic diet.

In summary, while the keto diet may increase your risk of kidney stones, the evidence suggests that it is unlikely to damage the kidneys of otherwise healthy individuals. However, for those with chronic kidney disease, the keto diet may worsen the progression of the disease.

Constipation and other gastrointestinal issues

The keto diet can also lead to other gastrointestinal symptoms, such as nausea and bloating. In addition, some people may experience diarrhea, abdominal cramps, and pain. These issues can be short-term while the body adjusts to the new diet, or they may last longer.

To relieve constipation and other gastrointestinal issues caused by the keto diet, it is recommended to:

• Eat more fiber-rich foods, such as greens, cucumbers, broccoli, and cabbage.
• Drink more water, especially mineral water, as fluids can be just as important as fiber in preventing constipation.
• Take probiotic supplements or eat more probiotic-rich foods, such as sauerkraut and kimchi, to support gut bacteria.
• Ease into the diet by slowly reducing carbs and increasing fats, giving the body more time to adjust.
• Reduce the intake of dairy products, as they are high in fat and can cause diarrhea, bloating, and gas.
• Drink sugar-free electrolyte beverages to replace lost fluids and electrolytes.

Cardiovascular issues

The ketogenic diet is associated with an increased risk of cardiovascular issues.

The keto diet is a high-fat, low-carbohydrate, and moderate-protein eating pattern. It involves reducing total carbohydrate intake to less than 50 grams a day, with some people adhering to less than 20 grams a day. The diet is designed to burn fat by cutting carbs and switching to burning fatty acids or ketones.

The keto diet is associated with an increase in "bad" LDL cholesterol, which is linked to heart disease. It is also associated with a higher risk of heart disease or other negative cardiac events.

The high-fat nature of the diet could have negative impacts on heart health. The American Heart Association recommends limiting saturated fat intake to 5 to 6 percent, but many people on the keto diet eat high amounts of saturated fats, which could increase the risk of cardiovascular disease.

People on the keto diet may experience dehydration because they are eradicating glycogen, which holds water, from their bloodstream.

The keto diet may also lead to a deficiency in potassium, which can cause constipation, heart palpitations, and extreme fatigue.

The keto diet is difficult to sustain because of the stringent food restrictions. It lends itself to yo-yo dieting, which increases mortality.

The keto diet is not intended to be adhered to long-term. It is recommended that people consult a health care provider before starting the keto diet.

Frequently asked questions