Why the Keto Diet may not be right for you
Though known and employed for nearly a century, the ketogenic diet enjoys an unprecedented status in popular opinion today. Scores of books, DVDs and phone applications are available for its proper execution among devotees. Thousands testify to this regimen’s efficacy regarding weight loss, immunity and other markers of good health. Clearly, the keto diet is onto something. At the same time, however, some have adhered to the diet with less than satisfactory–even negative–results. The delta between the happy dieters and the frustrated ones may mystify on the surface. Yet there are sound reasons why this plan should be avoided by certain people.
How the Ketogenic Diet Works
As early as 500 BCE, physicians manipulated diet to simulate a fasting state. This was a treatment for epilepsy and–in the 1920s–scientists introduced it as a formal option for those prone to seizures. Ensuing decades, however, saw the development of effective anti-epileptic medications and nutrition receded as the primary remedial therapy. What made ketogenic eating so powerful as an anti-paroxysm agent is the high-fat content combined with restricted calories from carbohydrate. It actually modifies genes responsible for metabolizing brain energy. In so doing the diet helps to secure the neurons involved in epileptic episodes.
Though no longer the go-to treatment for epilepsy, the keto diet turned out to be an effective fat-burning stimulant. Because it proscribes carbohydrates to a high degree, it depletes the body of its primary energy source–glucose (measured as blood sugar). Human physiology then resorts to other sources to access glucose. When they are exhausted, insulin levels drop and the body resorts to fat for energy. When this happens, the liver emits organic compounds known as ketones and the body assumes a state called ketosis. Simply stated, ketosis is the body’s signal that it burns fat for energy.
Keto Health Benefits Besides Fat Loss
This way of eating has found favor with Hollywood celebrities like Jenna Jameson, Halle Berry, the Kardashian sisters and others for whom an attractive physique is paramount. Still, keto effects are more than just skin deep. For example, many diabetics testify to this plan as a positive blood sugar corrective, citing improvements in fasting glucose readings and A1C indicators. In addition, several forms of cancer that feed on sugar show some inhibition when a ketogenic diet is adopted. Improvement among female depression patients is, in some cases, also credited to a ketogenic regime.
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Is There a Down Side?
For all of its assets–real and hyped–the keto diet comes with some baggage that people need to know about.
The Transition Can Be Rough
As noted above, the body’s physiology experiences a significant change when it realizes that there is no more available glucose with which to fuel. At times, this transition is manifest in feelings of fatigue and lassitude. In more pronounced cases, diarrhea and even vomiting can mark the internal bodily metamorphosis. This phenomenon is dubbed the “keto flu,” and can last from a few days to a number of weeks. Prospective dieters should stand prepared for a period of discomfort.
Ongoing Diarrhea
Even when keto flu passes, the havoc in your bowels may continue. Some doctors speculate that the increased fat intake burdens the gallbladder’s capacity to break down fat by means of bile production. Alternatively, the severe reduction in fiber consumption is also a suspect in instances of chronic diarrhea. Yet ketogenic dieting can also play a role in constipation, particularly if not enough salt is consumed. While there are supplements and behavior modifications (more exercise, e.g.) that can mitigate this condition, dieters should realize that diarrhea is a signal that things are out of balance.
Diminished Athletic Capacity
Despite personal reports of improved performance in running, cycling or swimming–for example–there is research indicating the opposite is true. For one thing, progress in sports and fitness achievement is easily attributed to weight loss (which is possible through several avenues, not just keto). In fact, research implies that performance in some endurance events declines because of the highly acidic condition that is ketosis. While more study is warranted, the information available points to a more alkaline nutritional intake is optimal for boosting athletic gains.
Decreased Lean Muscle Tissue
A typical ketogenic eating plan calls for 75 percent of calories to come from fat; 20 percent from protein; and five percent from carbohydrates. For a significant number of people, this amounts to much less protein than they need to continue to build muscle. Of course, other factors come into play, such as exercise frequency and intensity; present body weight; and overall health based on age. To maintain or create more muscle tissue, 35 percent of calories from protein is optimal, especially for those seeking weight loss, consistent exercisers, senior citizens and children. Without it, lean tissue gains are compromised, as is metabolism that depends on adequate muscle.
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One Step Forward, Two Steps Back
The impressive weight loss that people enjoy on a ketogenic diet can be deceiving. Keto eating requires a narrow choice of foods that can become monotonous and take the fun out of breaking bread (so to speak) with friends and family. A recurring pattern among dieters is to lose weight, go off the diet and gain the pounds back with interest. Other highly restrictive food programs yield similar results. Unfortunately, this occurrence can commence a long stretch of yo-yo dieting, or weight cycling, to use scientific jargon. Such repetitive behavior constitutes a full-fledged eating disorder in many instances.
Getting Diabetes When Avoiding Diabetes
As mentioned above, there are diabetic sufferers who report solid improvement in their blood sugar numbers while adhering to a ketogenic eating regime. Without contesting this anecdotal information, there is nonetheless data that hints at the onset of type-2 diabetes when indulging in the large quantities of saturated fat. A study out of Zurich, Switzerland observes a correlation between ketogenic eating and insulin resistance, the infamous culprit behing diabetes mellitus (or type-2 diabetes). While findings are only preliminary, those without the metabolic disease might consider another dietary regime to be on the safe side.
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The Specter of Heart Disease
Like diabetes, heart disease risk appears lessened according to many satisfied keto-dieters. What must be emphasized, though, is that long-term studies in humans have not been conducted regarding cardiovascular disorders relative to ketogenic diets. Reseach shared with the American College of Cardiology in 2019 pointed to keto eating as raising the risk of atrial fibrillation by 18 percent. This irregular rhythm can result in clotting and even stroke. While this information does not assert direct causation of AFib by ketogenic eating, it does raise a red flag over which to be concerned.
Ketoacidosis
Acknowledging some benefits of the ketosis state, taking care not to accumulate too many ketones is imperative. When this overabundance occurs, the pH level falls in the bloodstream, creating a highly acidic situation for your internal organs, including the brain. Ketoacidosis, as this condition is called, can be fatal, and diabetics are prone to it. Certain symptoms should motivate you to seek medical attention immediately:
- Extreme thirst
- Frequent urination
- Vomiting and nausea
- Pain in the abdomen
- Lethargy and fatifue
- Disorientation
People with type-1 or type-2 diabetes should only begin a ketogenic diet under a physician’s close oversight.
Kidney Stones and Osteoporosis
Some foods high in fat are associated with calcium and acidic disorders. These include kidney stones, osteoporosis and gout. For instance, kidney stones aggregate when uric acid and calcium are so highly concentrated that the fluids of the urine can not dilute them. Osteoporosis happens as bones get porous, brittle and thin. Some of this is due to aging. Still, deficiencies in calcium (e.g. from leafy green vegetables) consumption can also contribute to its acceleration. Gout attacks the joints through the accretion of uric acid crystals. It is often associated with eating large amounts of red meat (and drinking alcohol), and can be excruciatingly painful. A ketogenic diet too low in complex carbohydrates can serve as a catalyst to these agonizing maladies.
Summary: Be Careful
It bears repeating that while there is abundant information on keto results in the short term, consequences that crop up over the years have not yet been properly ascertained. Listed above are some of the dangers of entering into this celebrated eating plan without sufficient knowledge of its side effects…or of one’s own health and physiological responses. This is why consulting with a primary care physician–or even a specialist–is warranted.
Yes, even the professionals disagree about this controversial diet. Nevertheless, patients who educate themselves before a consultation are in a better position to ask the right questions and assess and risks…and there are risks. Severe obesity and its attendant health dangers may warrant ketogenic eating for a season. Going into the process fully informed helps you to understand when to start and, if necessary, to stop.