Diets Explained: Keto

In the last 2 years I've heard the word “keto“ coming from more peoples mouths than I ever heard in my 4.5 years of undergrad in dietetics. Now as an aspiring dietitian it's kind of on brand to look down upon or strongly disapprove of the keto diet. But, my attitude is this: I’m presenting the facts and information, and you can make your own educated decision for what is right for you! Of course there's science and evidence which tends to push people in one direction or another on their opinion on the infamous keto diet but every body is different.

The history

The ketogenic (keto for short) diet was introduced by physicians back in the 1920’s as an effort to help childhood epilepsy. Studies showed that when the body was in a state of ketosis (the process when the body is using fat for energy rather than carbs/sugar) there was a reduced number of seizures. It’s pretty crazy to learn that changing how a person eats can affect whether they have seizures or not. Anyways, the diet is still used today for this treatment and can be prescribed for children with close watch of medical professionals, meaning lots of checkups and lab reports.

What exactly is the diet

The main gist of the diet is it’s a diet very high in fat and very low in carbs. When the diet was developed originally for epilepsy treatment, it was prescribed to be about 90% fat! With a diet this high in fat, lots of butter, oils, heavy cream, and avocados needed to be added into every meal and snack to achieve this goal. The medical version of this mainstream diet is very different than what you’ve heard on TikTok. Now the diet has been morphed into one that is high in both protein and fat, and very low in carbs. There are a few versions of this plan but the standard calls for 65-70% of calories coming from fat, 20-25% protein, 5-10% carbs. This is different than what is recommended by health professionals and what I’ve been taught in school which is 20-35% of calories coming from fat, 10-35% from protein and then 45-65% from carbs. As you can see calories are distributed very differently.

Why do people follow this diet?

The attraction of this diet is that it puts the body in a state of ketosis, the process when the body uses fat for fuel rather than carbs. This is a great thing for weight loss cause you’re trying to shed fat! Carbs are the bodies preferred fuel source because they can be broken down quickly and easily to make energy. All 3 macronutrients (fat, carbs and protein) can be used for energy because our body has mechanisms to get energy wherever it can.

Pros Vs. Cons

Pros:

Great for weight loss: Its very easy to get a lot of calories from carbs but harder from fat and protein. Think about it, how many pieces of chicken breast are you going to eat? Now think about how many slices of pizza you might eat? Carbs are in a lot of foods people tend to overeat so cutting out carbs will cut out calories. Also when your body is using fat for energy, this will cause weight loss.

Helpful for diabetes and pre-diabetes: Diabetes is a disease in which your body either does not produce insulin or only produces a small amount. Insulin is important for regulating you blood glucose levels and without management of this, it can cause serious long term health effects. So with a diet low in carbs, it would be most beneficial for people who need to be cautious of their carb intake. Less carbs/sugar in the body means less worrying about out of whack blood sugar levels. Also the overall weight loss that comes with cutting out carbs also helps to improve your risk of diabetes.

May improve polycystic ovarian syndrome: It is thought that the reduced insulin levels caused by this diet may help in the reduction of ovarian cysts.

Cons:

GI upset: Since sugar and carbs are not allowed on this diet, lots of artificial sweeteners are used in recipes and products on the shelves. It is known that for some people with IBS (irritable bowel syndrome) these sweeteners can cause more problems and bowel upset. Also, it’s not fully known yet the effects fake sugar can have on the body, more research is coming out but some scientists believe people should stay away.

Missing out on vitamins and minerals: There are some vitamin and minerals that are only found in grain products such as niacin, thiamin, riboflavin and folate. As I mentioned in my last post, every vitamin and mineral play an important role in your overall health. If you choose to avoid grains and grain products, make sure you supplement for your B-vitamins regularly.

Lack of fiber: I have talked about how important fiber is in the past, and how it’s a crucial part of a healthy diet. When on a diet like keto, you’re not consuming grains and grain products meaning you are not eating a lot of fiber. Yes there is fiber in fruits and vegetables but not as much as whole grains. Also, this diet limits the amount of fruits and vegetables you can eat because these things are full of carbs and sugar.

Limited fruit intake: Fruit is full of sugar, and yes fruit is healthy but there’s still sugar. Following this diet means you are restricting how much fruit you can eat. Fruit contains sooo many important vitamins, minerals and fiber.

Might not be sustainable: Everyone loves carbs and sugar and cutting them out of your diet completely, forever is a hard thing to do! Being so restrictive and not consuming these things may lead to unhealthy habits of binging on sweets and carbs in moments of falling off the diet. Depending on your commitment to the diet, it might be hard to stay with it for long.

My opinion

So like I said earlier in the post, I’m here to present the facts and information about the subject and then you can go forward making your own educated decision. That all still remains true buttt in this section I’m going to give my opinion so do with that what you will. Personally, I think this is an extremely hard diet to follow, like you’re cutting out all the joys of food! Carbs are amazing! They might be a reason why you gain weight and of course we know sugar is not good for us but damn they taste good. I know that for myself, cutting down on the amount of sugar and carbs I eat wouldn’t be a bad thing that's for sure. But I also know I wouldn't be able to cut them out completely and definitely not for a prolonged period of time. My recommendation would be cut down how much sugar you are eating, switch to whole grains and eat more protein and vegetables in meals/ snacks than you do carbs. I personally think following a healthy diet full of diverse fruits, vegetables, whole grain carbs, lean proteins and good quality fats in the best to follow. Carbs are important for the body and they’re why we have energy to do anything so we shouldn’t villainize them! I think there are some good things and bad things about the diet, and overall I think it‘s got the right idea but a little too restrictive for my liking.

Sources: https://www.gosh.nhs.uk/conditions-and-treatments/procedures-and-treatments/ketogenic-diet/ ; https://www.healthline.com/nutrition/ketogenic-diet-101#other-benefits ; https://pubmed.ncbi.nlm.nih.gov/16004827/ ; https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4899993/