By now, you’ve probably heard of the keto diet trend that seems to be taking over the diet and fitness industry.
Want to lose fat? KETO.
Want to have more focus? KETO.
Want to cure your cancer? KETO.
While that might sound a bit extreme, those are just a few of the claims I’ve heard made about the keto diet. As someone who’s trained to translate nutrition science into every day advice, I thought I’d break down the keto diet for you to learn and make an informed decision.
What is the keto diet?
Keto is short for ketogenic, or a metabolic state of nutritional ketosis. Normally (in the presence of carbohydrate), the body burns sugar (glucose) for energy. However, our body has the ability to create its own energy in times of starvation or food availability. When carbs are extremely low (less than 50g per day), the body shifts to burn (metabolize) fat as an alternate source of energy. This produces ketone bodies, which the brain and body can use for fuel.
Why the keto diet?
The appeal to reducing carbs is the claim of “fat burning,” since carbohydrates break down into glucose. Simply put, when the body is burning sugar for energy, if extra calories are available fat will be stored due to the hormone insulin. However, when carbs are low, glucose in the body is reduced, insulin levels are lowered, and the body burns both stored and dietary fat.
The keto diet functions on this by cutting out carbs and increasing fat. Essentially, keto is a low-carb, high-fat diet, moderate protein diet.
You might have heard of Atkins, Whole 30, Paleo, and South Beach Diet (just to name a few) before. Each of these are similar eating patterns that emphasise eating meat, fat, and non-starchy vegetables.
What are the keto guidelines?
Potatoes and high-starch vegetables
Grains: rice, wheat, corn, buckwheat, oats
Pasta, bread, pizza, cookies, crackers
Beans, legumes, soy
Sugar, soda, juice
Lean meat (protein must not be too high)
Large portions of vegetables
Meat, poultry, fish
Vegetables (non-starchy: broccoli, mushrooms, zucchini, etc)
Cheese, heavy cream, full-fat yogurt
Low sugar fruit (berries) in small amounts
Nuts and seeds
It’s also important to separate the keto diet from a low carb diet. There is no official definition of a low-carb diet, but generally in research studies, a low-carb diet might be anywhere from 30% of calories or have up to 120g of carbohydrates daily. A keto diet is a type of low-carb diet that restricts carbs enough to put the body into a state of ketosis.
What are the benefits of the keto diet?
The ketogenic diet was designed as a strict diet to treat seizures in children with epilepsy. It is prescribed by a doctor and carefully designed and monitored by a dietitian. However, after a few doctors found that decreasing carbohydrates significantly aided weight loss, it has gained popularity and been tested to manage different diseases and medical conditions.
Most studies on it are small and short term, so it’s difficult to make any health claims about what the diet actually does. For a more thorough review, I’d recommend reading this post.
When exploring the health effects of a keto diet, it’s hard to separate the benefits from cutting out sugar and refined carbs from the results of ketosis and fat metabolism. However, studies have shown that a low-carbohydrate diet has beneficial effects for:
Abdominal (belly) fat and total fat loss
Glucose (blood sugar) control
Blood cholesterol levels
Again, it must be considered that almost any diet changes will lead to better health, and when compared to other diets, keto doesn’t score much differently. Keto is one of the hardest diets to stick with as well, making long-term evidence difficult to find.
What are the risks of keto?
There are few risks for a healthy person to follow a ketogenic diet. When planned with proper calories, protein, and micronutrients (vitamins and minerals), there is no evidence of any dangerous effects.
The risk and dangers come when people with medical conditions follow the diet without medical guidance and when keto is not properly planned or customised. I’ve seen some alarming impacts that could have easily been prevented with professional guidance.
For your average healthy person, the main concerns are nutrient deficiencies, low fibre, athletic performance, and long-term sustainability. On the keto diet, multiple food groups are restricted (grains, fruits, vegetables, etc) and fibre, B vitamins, iron, magnesium, and zinc can become too low and create negative side effects. Especially with low fibre, digestion becomes a prime concern and constipation is likely to be an uncomfortable symptom.
Can you exercise while on keto?
Exercise and sports performance decline because glucose (from carbohydrate) is the primary source of fuel for the muscles. During activity the body needs more energy. So, those on a keto diet are at risk for an energy drop and poor performance. Without carbs in the diet, glycogen, the muscle’s stored energy is low, making it near impossible for them to work effectively.
Imagine trying to drive across the country in a vehicle without any petrol; you wouldn’t get very far. This is exactly what it’s like for our muscles when they’re not fuelled right.
However, sticking to a low carb diet can train the muscles to run on other energy (ketones). It takes at least 12 weeks to become “keto-adapted,” when the body is efficient and effective in running on ketones for fuel. So, it can be done with commitment and diligence to preserve muscle mass and exercise performance.
Is keto a long term solution?
Lastly, my main concern with a keto diet (and other restrictive plans) is the difficulty sticking to them in the long-term. Almost all research studies come to the conclusion that the best diet is the one that you can stick with. Food is not just fuel for our body, it’s a part of culture, social lives, and fun.
When you’re not able to enjoy a slice of cake on your birthday or have a bite of home-cooked food, the diet can quickly become a drag for you and those around you. Quick weight loss might look and feel good (keeping in mind that the first 5kg weight loss on a low carb diet are always from fluid), but sticking with it for weeks, months, and years is where the long-term health benefits come from.
A final note.
There are proven benefits to following a ketogenic diet. It can be great for weight loss, decreasing blood sugar, and possibly other medical conditions. To be successful, the diet must be individually-tailored and provide the tools and support to be able to stick with it for more than two weeks. Macronutrients and electrolytes need to be watched close to prevent muscle loss and other undesirable side effects.
Remember that eating is an important part of our life, and to successfully maintain new eating habits, the meals and foods must match your favourites and lifestyle. Eating should be delicious, enjoyable, and fun. While we all can benefit from reducing sugar and processed foods, it most likely doesn’t need to be taken to the extreme to cut out numerous healthy food groups.
Is keto right for you?
If you find rich, filling meals appealing and you’re interested in trying the keto diet, I’d strongly recommend first consulting with a doctor and/or a dietitian. They can help to rule (or monitor) out any possible medical conditions to be sure that it’s a safe choice for you. Keto works best with a tailored approach and by watching blood lab values, so their support is an important part of your decision.