Alright, we may get some heat from this post… and that’s ok! We can take a little bit of heat. Today we tackle the Keto Diet for weight loss, another Fad Diet. As our tagline states, we encourage people to STOP dieting. This can feel a bit of an oxymoron given that we are dietitians, professionals who can give out diets. However, there is a difference between therapeutic diets (like low fiber for someone with diverticulitis, or thickened liquids for someone with dysphagia) and fad diets. We have to categorize the Keto diet for weight loss as what it is, a fad diet.
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A little background on the Keto (or Ketogenic) diet
This diet was developed by a physician who wanted to find a way to manage epilepsy, a neurological disorder that causes seizures. Despite the recent hype and popularity among celebrities and public figures, this diet has been around since the 1900’s. The Keto diet has had some wonderful results (and pretty solid evidence) in the management of epilepsy in children.
More recently, the Ketogenic diet has had some positive results in adults with Alzheimer’s disease and Parkinson’s disease. In a systematic review from 2021, researchers combed through studies that focused on the Ketogenic diet as a therapeutic diet for neurological disorders from 2004 to 2019. Researchers concluded that although there were significant limitations (like small or limited sample sizes, possible placebo effect, among others), evidence seems to demonstrate “cognitive benefits” with a ketogenic diet in this patient population.
All this to say, there is promising research coming out regarding the ketogenic diet and neurological disorders. It’s pretty fascinating if you dig into the literature. However (and this is a BIG however), the Ketogenic diet has also become popular for weight loss. In our perspective, this shifts a therapeutic diet to a fad diet. This my friends, can be a pretty slippery slope.
So, what exactly is the Keto diet?
Essentially the majority of your calories come from fat, with moderate protein and low to very-low carbohydrate intake. The Keto diet relies on the body’s adaptive process of converting fat and protein into an adapted form of energy when we are not consuming enough carbs. This adapted form of energy is called ketone bodies, hence the name Ketogenic diet.
When the body is not getting enough energy, including not enough carbohydrates, there is a process called gluconeogenesis that overrides the way our body metabolizes food. This process kicks in when you’re starving; the body is trying to prevent all your systems from shutting down. This is an important process because if we are stuck in a situation where we do not have access to food for a prolonged period of time, our body keeps our brains well fed and thereby alive.
Are there side effects to following the Keto fad diet?
If you’re thinking this process does not sound like something we should rely on long term, you’re onto something. There are worrisome long-term and short-term effects associated with this diet. Some short term side effects include bad smelling breath, bad smelling private parts coined “keto-crotch” (sexy!), insomnia, flu-like symptoms, constipation, vitamin deficiencies – to name a few. This diet is also not recommended for individuals that may have thyroid issues, liver conditions, kidney disease, pancreatic disease, gallbladder disease, or eating disorders. To be honest, those are TOO MANY ORGANS for this diet to be considered healthy in our book.
What about following the Keto fad diet for weight loss?
The research on this one is a little murky. On the one hand, it has shown to speed up the process of losing weight as compared to well-studied diets like the Mediterranean diet. On the other hand, some research indicates that lipid levels, like total cholesterol, can increase overtime on the Keto diet. There is also the concern of over-consumption of saturated fats on the Keto diet that may upregulate inflammatory markers and lead to a pro-inflammatory state. In addition, long-term effects of this diet (beyond 5-10 years) are unknown because we simply do not have research on this. We cannot say for certain that following this diet for a prolonged time is safe; we do not have the data to make that claim.
On a personal note (Cat here), I have close friends and family members who are on this diet. And yes, I am concerned for their health. However, I live by a motto when it comes to nutrition: giving unsolicited advice is the same as criticism. Therefore, I don’t talk about my personal view on this topic nor what the latest literature says because it’s simply not my place. We, as diet experts, have to acknowledge that some people feel great on the Keto diet- some have lost weight that they have struggled with for many moons. I won’t take that from them. Food is personal and I respect that above all.
I will end on this note. Those individuals who have been on this diet and have come to me for advice, now know that the evidence is murky. Some of these individuals have experienced negative health outcomes directly associated with following the Keto diet (ie: gallbladder removal, hospital admissions, hyperlipidemia). We can still have a conversation about how to improve our health, add healthy fats, lower our simple carb intake, and feel good about our food choices. If you ask me, however, I do not believe the Keto diet is the best choice for improving our health. It’s unfortunate but the bottom line is that the Keto diet is just another fad diet.