Keto Diet: Friend or Foe?

We all know diet trends come and go. The current one gaining popularity lately is the ketogenic or “keto” diet – but is it really healthy for us?

The keto diet has been around for many years, as early as the 1920s and 1930s it has been used in the treatment of epilepsy, specifically in children. Ketogenic diets are hypothesized to aid in weight loss in the obese due to inducing a metabolic condition called “physiological ketosis”. This is what happens when the body does not have enough glucose to use for energy, so it breaks down fat for fuel. Glucose is also known as sugar- this is what all carbohydrates break down into for use by the brain and cells to give us energy. When you eat a diet that is very low in carbohydrate (less than 20 grams per day, equal to about 1 large apple per day), your body breaks down protein and fat to turn into glucose for energy. Hence why those following a “Keto diet” are often cited to feel exhausted and drained, because your brain isn’t getting it’s preferred fuel source. This fat breaks down into what’s called “ketone bodies”, which can be used as an alternative fuel source during starvation (or inadequate carb intake). This diet is still very much controversial in regards to evidence of its safety and efficacy, so let’s take a deeper look.

So what does the keto diet actually look like? This diet is extremely high in fat (65-75% of your diet is fat), very low in carbohydrate (<5% of your diet) and moderate in protein (15-20% of your diet). Looks quite different than the recommendation by the USDA that your diet should consist of 10-35% of protein, 45-65% of carbohydrate and 20-35% of fat. So with this diet, you are consuming things such as butter, bacon, cheese, meat, nuts. Sounds too good to be true right?

Here are our top reasons to not follow a keto diet:
1) The first risk: there’s no conclusive long term studies on this diet for weight loss and health. We don’t know how it may effect our bodies in the long run. Yes, it may produce some weight loss initially, but if there is the possibility of health problems down the road, is it really worth it? We don’t have all the answers yet.


2) We do have evidence that diets high in saturated fat increase the risk for heart disease. Excess consumption of bacon and other meats has also been linked to various cancers. To fulfill the high fat content of the diet, naturally you’re likely to consume high amounts of saturated fat and trans fats, the unhealthy types of fats.


3) Studies on the keto diet are often very conflicting, there is no conclusive evidence. Some studies show promise and positive findings (such as weight loss), whereas another study will come out a week later stating the opposite. Of the studies that do show promise for weight loss, the diets are used very short term, and patients are always monitored closely by physicians (checking labs & vitals), and always are transitioned back to a normal diet.


4) You’d be missing out on so many research-backed beneficial foods! This diet is so low in carbohydrates that you’re missing out on 2 HIGHLY important parts of our diet (that are actually evidence-based) such as a. Fruits/Veggies and other complex carbs, & b. FIBER! The keto diet is devoid of some of the healthiest foods known to man-kind: fiber, vitamin, & phytochemical-rich fruits, vegetables, low-fat dairy and whole grains. And without adequate fiber, you are promoting an unhealthy gut microbiome, which has been linked to inflammation, autoimmune diseases, long term weight gain, and poor digestion. Stick with your fruits and veggies, people.


5) Another recently published study showed that a long-term Keto Diet (22 weeks) caused dyslipidemia, a pro-inflammatory state, signs of hepatic steatosis, glucose intolerance and a reduction in beta and alpha cell mass, without weight loss in mice (not at all something you’d want).


6) The quick weight loss promised is often simply water loss. Carbs hold onto more water than protein or fats in the body, so when you drastically cut down on carbohydrate intake, you also lose water as a result. Drink more water and go back to a more normal way of eating, and you’re likely to gain it all back, since it wasn’t true weight loss. Remember – slow & steady weight loss is the way to go. Losing weight too quickly often means you are losing hard-earned muscle (which burns calories) or simply water weight. A healthy rate of sustainable weight loss is 1/2-1 lb per week (more or less depending on your body size).


7) Lastly, the keto diet may affect our hormones, which greatly affect our appetite, fat storage, metabolism, and so much more. One study done at Harvard demonstrated that the keto diet resulted in an increase in the stress hormone cortisol in those following a very low carb/keto diet. High levels of cortisol is associated with insulin resistance, heart disease and promotion of fat accumulation.

So what should we take away from the keto diet?

The first is to absolutely include healthy fats in your diet, as they do aid in satiety and feeling full! Moderation is key for all food groups-avoid any extremes or cutting out any entire food groups. Follow a healthy, balanced diet that includes fruits, vegetables, whole grains, lean protein (nuts, beans, fish, poultry, etc), low-fat dairy, and healthy fats (olive oil, avocado) while limiting your intake of saturated and trans fats, added sugar, excess sodium, and highly processed foods. The Mediterranean diet is one healthful eating pattern that has been studied extensively and is evidence-based. Trust the science.

Sources:

1) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3945587/#B13-ijerph-11-02092
2)https://www.nature.com/articles/ijo201766
3) https://www.physiology.org/doi/10.1152/ajpendo.00453.2013
4) https://www.ncbi.nlm.nih.gov/pubmed/22735432