Is the Keto Diet Right for You?

You’ve probably heard of the latest diet craze that’s caught the attention of those seeking to lose significant weight and the curiosity of fitness and health enthusiasts, parents, dietitians, doctors and researchers.

Evidence seems to show that the ketogenic diet, or the keto diet, may help manage health issues including pediatric epilepsy, diabetes, obesity, hyperlipidemia, and cardiovascular risk factors. While some research studies point to positive responses to the keto diet, this highly restrictive way of eating comes with some warnings, like: it isn’t right for everyone.

What is the keto diet?

The ketogenic diet is a stricter version of the Atkins diet, which relies heavily on the consumption of fats and protein while limiting carbohydrates. The keto diet is more restrictive because it limits daily carbohydrates to 20 grams (less than the amount in an apple) while recommending no more than 60 grams of protein per day. The rest of the diet is based on fat consumption.

When deprived of carbohydrates for long enough, your body will start turning proteins into fuel. After three or four days on the keto diet, your body’s glucose reserves aren’t enough to support the central nervous system. This causes the body to produce an alternative source of energy called ketones. When your body enters this metabolic process, it’s called ketogenesis. This fat-burning state, often called ketosis, is the goal of the ketogenic diet.

The keto flu?

Many dieters find it hard to actually achieve or maintain ketosis because the first few days to weeks of eating only high fat, moderate protein and low carbohydrate foods can make you feel pretty awful. This common reaction is called the keto flu, because it makes dieters feel lethargic, moody, constipated and maybe even sick to their stomachs. But, if you stick with the diet long enough, it does pass. Once beyond that stage, keto devotees often report they feel healthy and experience far fewer cravings for sugar and carbohydrates.

The ketogenic diet began as a treatment for pediatric epilepsy.

While some of the physiology behind this is still being researched, doctors agree that the keto diet shows great promise for managing symptoms for young epileptics.

“Some adults choose to continue a similar diet (known as the Modified Atkins diet) into their adulthood to assist with controlling their epilepsy, in addition to epilepsy medications,” said Nicole Rittman, a registered dietitian with the University of Miami Health System.

Though the keto diet can be challenging for adults to maintain, there is strong supportive evidence that the use of ketogenic diets in weight loss therapy is effective. Recommended mostly for adults fighting obesity, the high-fat keto diet can provide more significant weight loss than low-fat diets that allow for more carbs.

“In the beginning days of the keto diet, initial weight loss is likely related in part to a loss in water weight, as opposed to fat mass,” says Rittman. “However, over the next several weeks, ongoing weight loss on this diet may be related to the dietary transition away from processed, refined products (like sodas, sweets, white breads, and pastas) and towards an increase in non-starchy vegetables (like salad greens, peppers, and broccoli) and healthier proteins and fats (like avocados, chicken, turkey, seafood, eggs, nuts, and seeds).

“Those on the keto diet may also consume fewer calories overall during the day, further contributing to the weight loss trend. The weight loss achieved from maintaining these dietary changes may also help prevent or manage type 2 diabetes and some cardiovascular diseases.”

There’s even evidence that ketogenic diets can improve the emotional mood of overweight dieters who follow the diet’s rules after the initial keto flu period.

Who should avoid the keto diet?

Rittman warns, “I would not recommend this diet for individuals with type 1 diabetes because of the keto diet’s restricted carbohydrate intake and increased production of ketone bodies.

“Additionally, it may not be appropriate for individuals with chronic kidney disease because of the emphasis on protein intake. I also do not recommend this diet for individuals with increased nutritional needs due to diseases such as cancer, Crohn’s Disease or ulcerative colitis. The keto diet may be too restrictive for these patients, resulting in unintended weight loss,” she says.

If you decide to start the keto diet…

If you’re considering the keto diet with the goal of managing your weight, cardiovascular issues or type 2 diabetes, first examine the type and amount of carbohydrates in your current diet. Getting on the keto diet would force you to avoid added sugars and processed foods, which are healthier practices for everyone. However, the diet would also reduce your intake of the fiber, vitamins and minerals found in whole grains, fruit, some vegetables, beans and legumes. Replacing these foods with those high in calories and saturated fats (which include red meats, whole-milk dairy products, and some vegetable oils) could increase your cholesterol levels and negatively affect the bacteria in your gut.

If you’re on the keto diet, Rittman recommends you drink adequate amounts of water because you’re missing out on the added hydration provided by fruits and veggies. Staying hydrated will help manage constipation caused by the lack of fiber in this diet and may help provide energy during the keto flu period.

To reduce your intake of saturated fats while on the keto diet, try eating more fish, chicken and turkey breast, eggs, soy, and nuts in place of red meat.

Rittman also recommends taking a daily multivitamin to supplement for the keto diet’s reduction in vitamins, minerals and antioxidants typically supplied by fruits, vegetables and whole grains.

“If you’re considering a restrictive diet like the ketogenic diet, I advise speaking with a medical professional or dietitian first to determine if it’s appropriate for you,” said Rittman. “The best diets for weight management, or overall health, aren’t necessarily diets at all. They’re lifestyle changes.”


Dana Kantrowitz is a contributing writer for UMiami Health News.