A Closer Look at the Keto Diet: Is It Really All It’s Cracked Up to Be?

Monica Salafia
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Eating butter, bacon, and heavy cream might sound like a dream diet to some. And that’s exactly what’s promised with the Ketogenic Diet (Keto). Followers of a Ketogenic Diet seek out high-fat, low-carb food choices to sustain their energy. But is this diet really all it’s cracked up to be?

Let’s take a closer look at the origins and manifestations of the Ketogenic Diet to determine if it’s actually safe for us to participate in.

Origins of the Ketogenic Diet

The Ketogenic Diet was originally developed to treat patients with seizures who do not respond to medicine. It’s designed to be prescribed to patients by physicians, and monitored by registered dietitians (RD).
The classical ketogenic diet provides 3-4 grams of fat for every 1 gram of carbohydrate and protein. That is about 90% of calories from fat. Patients follow this diet to get into ketosis under direct supervision of a clinician’s care.

What is Ketosis?

Ketosis is reached when circulating ketone bodies: beta-hydroxybutyrate, acetate, and acetoacetate are built up due to lack of glucose in the body. These chemicals are created when the body breaks down fat. Ketoacidosis can occur when ketone bodies rise too high as a result of excess blood sugar.
Diabetic Ketoacidosis (DKA) can happen in patients with Type 1 Diabetes if they do not take enough insulin or become sick, and may be life threatening – leading to coma or death.
The Ketogenic Diet is currently being studied as a possible treatment for already established chronic diseases like Alzheimer’s, Brain Cancer, Epilepsy, and uncontrolled Type 2 Diabetes, but it is by no means a diet meant to prevent disease.

The Fad Keto Diet for Weight Loss

We have known since the early 1900s that food deprivation has long-term effects on people’s relationship with food and eating behavior. Despite this, the dieting and weight loss industry encourages people to keep trying the latest fad diet without regard to your physical and emotional health. And in this case, it’s the Keto Diet.
The Keto Diet as a weight loss trend is a uniquely low carb diet. So low, in fact, that in order for our bodies to adapt to the starvation mode it thinks it’s in, our body cells use ketones as fuel instead of glucose, its preferred source.
It’s very difficult to maintain good nutrition on the Keto Diet because it’s so restrictive and it’s complicated to manage, which is why a dietitian typically oversees the nutritional planning.
Just like other diets out there, the Keto Diet is restrictive, unsustainable, and effective only because it lowers total caloric intake. It also comes with a slew of negative side effects, including gaining all the weight back (and more) once you stop the diet.
Some side effects of the keto diet include:

  • growth retardation
  • bone mineral loss
  • hyperlipidemia (high blood triglycerides, LDLs)
  • kidney stones
  • irritability
  • birth defects
  • dehydration
  • constipation
  • bad breath
  • poor sleep

Long term, the Ketogenic Diet can damage to the heart (because it’s a muscle), the kidneys, and, in extreme cases, the liver. It’s also likely to come with the emotional exhaustion of dieting.


Pitfalls of the Ketogenic Diet

There are so many pitfalls to this style of eating in terms of health, sustainability for self, and sustainability for the planet.
Foods that are not allowed on this diet include whole grains, legumes, pulses, fruits, some vegetables, plant-based protein foods like soy, and others. All of these foods are so rich in nutrients, fiber, and antioxidants – things we know we need in order to live healthfully and prevent disease.
Ultimately, the goal of nutrition is to fuel your energy needs. This is difficult enough, and becomes more so when you eliminate whole food groups and/or entire macronutrient groups. People who adopt any restrictive diet are at risk for not meeting energy needs, and this is especially true with the Ketogenic Diet. This diet makes it nearly impossible to meet all nutrient requirements.

So Why is the Ketogenic Diet So Popular?

With all the pitfalls and side effects of this diet, you’d think people would avoid it with a 100-foot pole. So why is it so popular? I have some theories:

  1. People aren’t actually doing the real Ketogenic Diet. Instead, they’re doing some version of low-carb dieting. If they do reach ketosis and lose weight, it may be due to the fact that ketones and dietary fat intake can suppress appetite. That leads to eating fewer calories overall, which is why people lose weight. While this works for weight loss it also leads to nutrient deficiencies.
  2. Social inclusivity. Being part of the “in-crowd” becomes more desirable, and for some that outweighs the cons.
  3. People only talk about the highlight reels. As in, we can see changes in the scale and in appearance, but blood work and other health markers may tell a different story.


The Ketogenic Diet Takeaway

There are much better eating styles to adopt to improve health and prevent disease than the Ketogenic Diet. Plant-based eating styles, Mediterranean Diet, MIND, and other eating styles that support gut health and are rich in fermented foods and probiotics are far more condusive to life-long health.
When choosing a lifestyle diet, focus on sustainable, more realistic eating and activity patterns instead of fixating on macronutrient manipulation diets . . . especially ones as severe as the Ketogenic Diet. This way, you’ll develop a positive relationship with food and exercise, avoid the emotional roller coaster associated with a diet mindset, and improve your overall mental and physical health and wellness.

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Monica Salafia

Monica is a Registered Dietitian passionate about helping people reach their full nutrition, fitness, and wellness potential. Find her working at a coffee shop reading the latest nutrition research, weightlifting in the gym, or hiking in the Rockies.


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