Keto Diet-Friend or Foe?

“Keto here, keto there, keto everywhere!” It is inevitable, whether attending social gatherings, visiting the grocery store or interacting on social media you have probably heard about the keto diet and been tempted by its promises. In fact, the keto diet was the most searched weight loss diet in 2018. But is this diet the weight loss solution we’ve all been waiting for?

The ketogenic diet (better known as ‘keto’) is a high fat (70-80% of total calories), low carbohydrate (less than 50 g of carbohydrates (5-10% of total calories), moderate protein (10-20% of total calories) diet that adjusts the way the body produces energy. On a normal healthy eating plan that typically has 25-35% of total calories from fat, 45-60% of total calories from carbohydrates and 20-35% of total calories from protein, the body relies on burning carbohydrates for energy. On the other hand, in the ketogenic approach the body becomes dependent on burning fat producing ketones bodies to fuel itself. This is where the theory of keto diet for weight loss came from. It is difficult to know when one enters ketosis, unless you check for ketones in the blood/urine. However, it is very easy to leave this state, since the slightest increases in carbohydrate intake may resume regular energy production, adding to the challenges faced on this restricted diet.

Like other weight loss diets with restricted intake, individuals may notice rapid weight loss in the first week (about 2-10 lbs), primarily related to water loss and glycogen stores depletion. Shortly afterwards, the rate of weight loss slows down, similar to other weight loss diets, to about 1-2 lbs/week. Whether this diet is sustainable and improves overall health outcomes is in doubt.

The ketogenic diet is not a new trend. In the 1800’s, scientists discovered its efficacy in treating epilepsy and other similar seizure disorders in kids. Therefore, most available research, especially long-term studies, is concentrated on that rather than weight loss. Long-term studies linked the keto diet with increased risk for kidney stones, osteoporosis, hyperlipidemia, possible nutrient deficiencies and risk for liver abnormalities. Short term effects recorded in adults include constipation, brain fog, irritability, increased levels of both good (HDL) and bad blood cholesterol (LDL), binge eating and relapse, adequate muscle maintenance and building and mild improvements in serum glucose levels.

Well, is it a friend or a foe? As a registered dietitian nutritionist, there is too much risk and not enough research to prove that following the keto diet will lead to greater weight loss and better health outcomes than other less restricted more realistically sustainable diets. Therefore, I would consider losing weight on the ketogenic diet as a foe for now. However, there are some positive sides of this diet that we can learn from to improve our health and wellness that include:

  • Being mindful with the quality and quantity of carbs we eat
  • Practice portion control
  • Overcome fear from fat and work in more healthy fats
  • Listen to hunger and fullness cues.

Please remember that there is no one size fits all when it comes to eating. We are all unique with different health issues, so it is important that we base our diets on what our individual body needs rather than following mainstream food trends.

Thanks to R. Farra, MDS, RD, LD for co-authoring this article with me.