Keto: Is It Safe?
You may have heard it referred to as the low-carb diet, ketogenic diet or keto diet, but what exactly is this diet? The ketogenic diet is a very low-carbohydrate, high-fat diet. It has become very popular, but is it safe?
What Exactly Is Keto?
Keto involves reducing carbohydrate intake and replacing it with fat, which this is usually a drastic change for people. Some of the carbohydrate sources that you must cut out include:
- White bread
"For most people, this is a major change from what they were previously eating," said Kristal Twardy, registered dietitian and health coach at Franciscan WELLCARE. Twardy said that the keto diet differs from general healthful eating recommendations.
On the keto diet, the goal is eat so few carbohydrates that your body can't rely on glucose for energy. And since keto meals are loaded with fat, your body switches over to using fat for energy instead of carbohydrates. Once you begin reducing the carbs that you put into your body, you will enter a metabolic state called ketosis.
"A true 'keto diet' means you are in ketosis," said Amanda Crosby, registered dietitian and certified diabetes educator with the Franciscan Healthy Living Center in Lafayette.
How Does Ketosis Work?
Normally the body's cells use glucose as their primary form of energy. Glucose comes from dietary carbohydrates, and when you are on keto, you are not consuming enough carbs to meet your body's energy demands.
Once your body has limited access to glucose (blood sugar), you will enter a natural metabolic state called ketosis and begin to convert fat stores into energy, releasing ketones in the process. Ketones are acids that build up in the blood and serve to indicate that the body is breaking down fat.
According to Crosby, this is when weight loss is likely to occur, because your body is burning fat, but this all depends on the person.
To achieve ketosis, people generally need to eat fewer than 50 grams of carbs per day and sometimes as little as 20 grams per day. The process to go into ketosis typically takes 3 to 4 days.
Symptoms of Ketosis
- Bad breath
- Weight loss
- Increased ketones in the blood
- Increased ketones in the breath or urine
- Decreased hunger
- Increased focus and energy
- Short-term fatigue
- Digestive issues
Can The Keto Diet Help My Medical Condition?
The keto diet is used often by people who are trying to lose weight, but it has been proven to help people with certain medical conditions.
Epilepsy is a common neurological disorder that affects people of all ages. Anti-seizure medications can help control the seizures many, but around 30% of patients continue to have seizures despite using these medications. According to the Epilepsy Foundation, doctors usually recommend the keto diet for those who have not responded to several different seizure medicines. Higher ketone levels is often the reason of improved seizure control.
Other medical conditions that the keto diet may help benefit include:
- Heart disease: Reducing carbs to achieve ketosis may improve heart disease risk factors like blood triglycerides, total cholesterol and HDL cholesterol.
- Metabolic syndrome: Ketogenic diets can improve all major symptoms of metabolic syndrome, including high triglycerides, excess belly fat and elevated blood pressure.
- Alzheimer's disease: A ketogenic diet may have benefits for patients with Alzheimer's disease.
- Cancer: Some studies suggest that ketogenic diets may aid in cancer therapy, possibly by helping to "starve" cancer cells of glucose.
- Parkinson's disease: A small study found that symptoms of Parkinson's disease improved after 28 days on a ketogenic diet.
- Acne: There is some evidence that this diet may reduce the severity and progression of acne.
Talk to your doctor if you have any medical conditions before attempting a keto diet.
Are There Negative Side Effects Of Keto?
Like any diet, there are negative side effects to the keto diet. Some of the side effects are common and will most likely happen while on the keto diet, but other effects will only occur if keto is not done properly. Partnering with a registered dietitian and your healthcare provider can help you make the best dietary choices for your health.
- Constipation: Cutting out common sources of fiber from your daily diet can cause constipation.
- Muscle loss: The keto diet can lead to loss of lead body mass, which includes muscle protein.
- "Keto flu": This is when the time when your body is withdrawing from carbs and comes with many side effects like headaches and fatigue.
- Kidney damage: On the diet, people may eat too much meat and not drink enough water and this can cause an increase of uric acid and this acid is known to cause kidney stones.
The traditional ketogenic diet puts your body into ketosis, but there are modified keto diets. On a modified keto diet, your body will go in and out of ketosis and still shed weight and body fat.
Targeted keto diet
The targeted keto diet is popular among athletes and active individuals who want to live a keto lifestyle but need more carbs. It allots an additional 20 to 30 grams of carbs immediately before and after workouts to allow for higher-intensity exercise and enhanced recovery. (The total carb count comes to 70 to 80 grams per day.)
The best options include fruit, dairy or grain-based foods, or sports nutrition products. Because the additional carbs are readily burned off, they don't get stored as body fat.
Cyclical keto diet
Keto cycling is a way to cycle in and out of ketosis while enjoying a more balanced diet on your "days off." One keto cycling approach includes five days of traditional keto diet and two non-keto days per week. For best results, eat wholesome carbohydrate-rich foods on your off days, including fruits, starchy veggies, dairy products, and whole grains (rather than added sugars or highly-processed fare).
High-protein keto diet
This plan entails eating about 120 grams of protein per day and around 130 grams of fat per day. Carbs are still restricted to less than 10% of daily calories.
Many people find this modified keto diet easier to follow, because it allows you to eat more protein and less fat than the standard keto diet. This approach may not result in ketosis, because like carbs, protein can be converted into glucose for fuel. But the high-protein keto diet will generally result in weight loss.
Diabetes And Keto
In diabetic patients, ketosis can occur due to the body not having enough insulin to process the glucose in the body.
According to Crosby, ketones produced when you have diabetes is usually seen with patients who have type 1 diabetes, as the pancreas no longer produces any insulin.
"If you are sick, not taking insulin and need to be, or have, increased carbohydrate intake, then it can lead to the body's inability to get glucose to cells. The body is then forced to use fat as an energy source," said Crosby. Some dietitians may recommend a ketogenic diet for individuals with type 2 diabetes. With type 2 diabetes, the body still produces some insulin but is unable to properly use the insulin to transport glucose into cells for use as fuel.
"If a patient has type 2 diabetes and follows a keto diet, then they need to look for good glucose control and test positive for ketones," said Crosby.
Individuals with type 2 diabetes are recommended to reduce carbohydrate intake as carbohydrates are converted to glucose and increase blood sugar levels. Work with your healthcare provider and dietitian to help avoid developing diabetic ketoacidosis, a separate, serious, life-threatening, condition that can lead to diabetic coma or even death.
Is Keto Safe?
The verdict on if keto is a safe or healthy long-term diet is still out, but no matter how long you decide to do the diet, it will be a change for your body.
"If you do long term it is definitely a commitment, it's a lifestyle change if you want to do this," said Crosby.
Crosby said that supplements are suggested when on the keto diet because you are missing out on key minerals and vitamins. There are many supplements suggested, but some of the best ones to take according to research are:
Besides taking supplements, Crosby suggests meeting with a dietitian. "Also, talk with your doctor and be medically supervised," said Crosby.
By Ariel Anderson
Social Media Specialist