*This is a guest post
With over a million monthly Google searches for the Ketogenic (keto) diet, it’s safe to say that Keto has become one of the more popular ones in recent years. This ultra-low-carbohydrate and high-fat diet is touted as superior to most other diets for weight loss, diabetes control, and overall health. Some of these health claims are supported by scientific evidence, while others are still open to debate. So the question everyone is asking is – is the Keto diet healthy?
The Keto diet obviously flies in the face of conventional wisdom about healthy eating. Making fat the primary source of your daily calories is something most would consider unhealthy, if not downright dangerous. So, is this highly popular eating plan as healthy as its proponents would have one believe, or is this yet another passing fad? In this post we try to get to answer the much asked question: is the Keto diet healthy.
Defining the Keto Diet
The Ketogenic diet is, by definition, a very-low-carbohydrate diet (VLCD). The goal of this diet is nutritional ketosis, an altered metabolic state in which most of the body’s energy is supplied by ketones rather than glucose. But then again, what are ketones?
Also called ketone bodies, ketones are three acidic molecules made in liver mitochondria from fatty acids. They include acetoacetate, beta-hydroxybutyrate, and acetone, which serve as energy substrates for the brain when glucose is not available.
The Ketogenic diet was first developed back in the 1920s as a treatment for childhood epilepsy after researchers discovered that the diet mimics the metabolic effects of fasting, and wasting was already considered an epilepsy cure. However, its use has since expanded to include weight loss, diabetes control, and is now widely studied for many other benefits such as treating and preventing Alzheimer’s, acne, and even cancer.
What the Keto Diet Looks Like
The Ketogenic diet is usually broken down as follows:
- 5% daily calories from carbohydrates
- 20% daily calories from protein
- 70% daily calories from fat
Besides the above macronutrient ratio, Stephen Phinney, MD, Ph.D. and Jeff Volek, Ph.D., RD, experts in the Ketogenic diet recommend a “total daily carb intake can range from nearly 0 to 100 g/d,” depending on individual tolerance. But usually, most people will limit their daily carbohydrate intake to fewer than 50g per day to play it safe.
To achieve such a drastic carb limit and macronutrient ratio, keto dieters are advised to consume a wide range of low-carb and high-fat foods while limiting those predominantly composed of carbohydrates. Examples of foods to base a keto eating plan on are:
- Butter and vegetable oils
- Nuts and seeds
- Fatty cuts of meat
- High-fat dairy
- Almond milk
- Nut flours
- Leafy greens
- Fibrous vegetables
On the other hand, Keto dieters need to exclude all grains, legumes, starchy vegetables, high-carb fruit, sugar, honey, and most highly processed foods. Following such dietary guidelines helps dieters eat within their “Keto macros” while also increasing their chances of getting adequate nutrition.
Proven Health Benefits of the Keto Diet
So far, the strongest evidence for the Ketogenic diet is for seizure control in childhood epilepsy. A meta-analysis published in The Cochrane Database of Systematic Reviews (CDSR) found that rates of seizure freedom were as high as 85% after only three months on the Keto diet. Furthermore, the Epilepsy Foundation states that up to 15% of children on this diet become seizure-free.
The Ketogenic diet is also quite promising as a treatment for type II diabetes. According to a 2018 review from Expert Review of Endocrinology & Metabolism, “the Ketogenic diet is an effective alternative that relies less on medication, and may even be a preferable option when medications are not available.” Keto namely helps stabilize blood glucose levels mostly because it is a low-carbohydrate diet, but also because it helps lower insulin levels.
And when it comes to the most sought-after benefit of the Keto diet – weight loss – the evidence is also quite promising. Compared to low-fat diets, low-carbohydrate and Ketogenic diets produced greater weight loss according to one meta-analysis of randomized control trials.
This diet is now being considered as a possible treatment for obesity, with studies showing that it did not cause any major side effects in obese patients and was even effective in reducing triglycerides, LDL cholesterol, and blood glucose while increasing HDL cholesterol.
Possible Risks and Side Effects
And while the Keto diet provided therapeutic benefits for specific groups (children with epilepsy and obese patients), dietitians and doctors are not likely to recommend this diet to the general population. The diet goes against the grain of most government dietary guidelines and the initial stages of ketosis are also known to cause side effects.
Besides that, the keto diet, being notoriously high in fat, is known to raise both LDL and HDL cholesterol, even in athletes. On the bright side, the LDL particles raised in the keto diet are the larger, buoyant ones, which are considered less detrimental for cardiovascular health.
Another risk of the ketogenic diet is micronutrient deficiencies.
According to a study done by Beth Zupec-Kania, a world-renowned ketogenic expert, the Ketogenic diet is often deficient in many micronutrients, most notably thiamin, folate, vitamin B5, calcium, copper, iron, magnesium, selenium, and zinc, among others. And this was despite using only nutrient-dense keto foods to optimize results. That’s why she recommends supplementing the diet with low carbohydrate vitamins but also including more sources of omega-3 and omega-6 fatty acids.
All in all, the Ketogenic diet has its place in medicine as a treatment for childhood epilepsy and potentially diabetes and obesity. There’s also compelling evidence that the diet may work for other neurological conditions and even cancer. However, more research is warranted to know this for sure.
Using the Keto diet is best done short-term to minimize risks like nutrient deficiencies and hyperlipidemia. Once a person reaches their goals on Keto diet, they may consider reverting to a more conventional, way of eating as recommended in nutritional guidelines. The keto diet is definitely a healthy diet when you look at it as a therapeutic approach for certain medical conditions, but it may not be the best option if you’re relatively healthy and just want to boost your health outcomes.
Masood W, Uppaluri KR. Ketogenic Diet. Treasure Island (FL): StatPearls Publishing; 2018 Jan- https://www.ncbi.nlm.nih.gov/books/NBK499830/
Phinney S, Bailey B, Volek J. The Ten Defining Characteristics of a Well-Formulated Ketogenic Diet [Blog post]. Retrieved from https://blog.virtahealth.com/well-formulated-ketogenic-diet/
Martin K, Jackson CF, Levy RG. Ketogenic diet and other dietary treatments for epilepsy. The Cochrane Database of Systematic Reviews (CDSR). 2016 Feb 9;2:CD001903.- https://www.ncbi.nlm.nih.gov/pubmed/26859528
Westman EC, Tondt J, Maguire E. Implementing a low-carbohydrate, ketogenic diet to manage type 2 diabetes mellitus. Expert Review of Endocrinology & Metabolism. 2018 Sep;13(5):263-272. – https://www.ncbi.nlm.nih.gov/pubmed/30289048
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Zupec-Kania B. MICRONUTRIENT CONTENT OF AN OPTIMALLY SELECTED KETOGENIC DIET. Journal of the American Dietetic Association. 103:8–9 · September 2003 with 880 Reads –https://www.researchgate.net/publication/256648326_MICRONUTRIENT_CONTENT_OF_AN_OPTIMALLY_SELECTED_KETOGENIC_DIET
About the author:
Sophia Norton is has more than 6 years of experience providing wellness and nutritional support in various capacities. After Sofia learned about “food deserts” as a kid, she became determined to devote her life to like to making healthy foods accessible to everyone, regardless of income or location. Sofia has traveled around the world, teaching nutrition to communities in extreme poverty. In her spare time, Sofia loves long bike rides and exploring local farmer’s markets.