During the year I spent in medical nutrition therapy classes in college, the ketogenic (or keto) diet was less than a footnote.
I’m going to date myself by admitting this was around 2009, but back then, the keto diet was maybe the subject of one multiple choice question on one midterm exam. A blip.
That’s because, back then, the keto diet was really only used by dietitians and neurologists whose work focused on treating children with severe epilepsy—a complex nutrition therapy effective in controlling a specific medical condition.
It wasn’t until 2012 that an Italian professor of surgery published the results of an adult weight-loss study involving the keto diet. Fast forward to 2016, when it first appeared as one of the top ten diet-related searches according to Google’s annual Year in Search report, and the trend continues.
Just consider that for a moment. You likely lived your whole life happily unaware this highly restrictive diet existed, until sometime within the past three years, diet culture tried convincing you it was a weight-loss magic bullet.
So, what is the keto diet? It’s an eating pattern high in fat, low in carbs, with moderate amounts of protein recommended.
This goes against general, healthy eating recommendations by including foods high in saturated fats (not heart-healthy) and severely restricting nutrient-rich foods because of their carb content, including fruits, vegetables, whole grains, milk and yogurt.
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With carbs being our main source of energy, severely restricting these foods forces the body into ketosis. This is an alternate state of metabolism where, rather than carbs, fats are broken down into ketones. These ketones are then used to fuel the body, and even the brain—which normally relies on glucose as its energy source.
Because the body is able to use ketones for energy, lean muscle mass is not broken down like it would be during true starvation. However, this eating pattern still brings with it plenty of unpleasant short- and long-term health risks.
In the short term, people who try to achieve ketosis often find themselves suffering from an upset stomach, fatigue, headaches and dizziness—often referred to as the “keto flu." When you consider the body and brain prefer carbs to ketones, these symptoms make sense.
In addition, cutting back on carb-containing foods means fiber intake is likely to suffer, and we all know a lack of fiber leads to some pretty unfun bathroom complications.
Because enthusiasm for the keto diet has outpaced evidence-based research, the jury is still out on some of its long-term health implications. However, that doesn’t mean there aren’t some well-known risks.
Deficiencies in nutrients, like vitamins A, C, K and folate have been well-researched in other areas of science, leading to consensus on their overall importance. These same nutrients are often lacking in the keto diet.
And all I can say about relying on fat as fuel is that high saturated fat intake has a long track record of being linked to high blood cholesterol, heart disease and stroke. So, those following the keto diet will want to be careful about choosing healthy fats most often.
While I applaud anyone making strides toward better health, this dietitian wishes for a world where no one feels their best option is a diet with its very own “flu."
The content of this article is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.