If I had a dollar for every time someone asked, “What do you think about the keto diet?” I would be a wealthy woman-or at least I would be able to comfortably pay for childcare (amiright?). I have been wanting to do a deep-dive blog post on the ketogenic diet for awhile now. When my amazing dietetic intern Katelan volunteered to write this, I was so excited! There is a LOT of confusion out there about keto. It’s certainly a trendy diet right now. You guys know me, I am NOT a fan of diets that aren’t sustainable, more importantly I believe there are some important things to consider when “going keto.” Check out what Katelan has to say about keto and if you want to talk more about it, hit me up!


Image result for keto diet

Image from Kemin Industries


The Ketogenic Diet

Katelan Head, Dietetic Intern

In one setting or another, you have probably heard or read about the ketogenic diet. This particular diet seems to be gaining a lot of popularity yet continues to be one of the most controversial approaches to eating. Some studies have shown that going keto may be beneficial for weight loss and lowering blood sugars. The ketogenic diet has even been used since the 1920’s to treat patients with epilepsy by helping reduce the need for medication. But can eating extremely low carbohydrates and a high fat diet have any negative health risks? Let’s first start with the basics.


What is Keto?


The ketogenic diet essentially lacks sources of carbohydrates and is focused primarily on a high amount of fat and moderate protein. Typically when you eat a high carbohydrate meal, your body will produce glucose which can be converted and used as energy. When an individual is lacking carbohydrates through the diet, your body will start to produce ketone bodies to use as an alternate energy source putting the body in a state of ketosis. In should be noted that the only way to determine if you are in a true state of ketosis by testing your blood or urine and any small stray away from the diet will take you out of ketosis.

In healthy individuals, a small amount of ketones are continuously being produced to use as a source of energy. The production of ketone bodies will increase during times of fasting or when carbohydrate stores are decreased causing the body to burn fat instead of carbs. The liver begins to process fat in order to provide energy to the brain in the form of ketone bodies. This entire process is known as ketogenesis is the end of goal of following a ketogenic diet.



What does a typical Ketogenic diet look like?


On a 2000 calorie diet, 165 grams would come from sources of fat, 40 grams from carbohydrates and 75 grams from protein sources. Most ketogenic diets focus on having less than 45 grams of total carbohydrates. To put this in perspective, the American Dietary Guidelines recommend that individuals get 45-65 percent of food from carbohydrates on the same 2000 calorie diet which is between 225-325 grams per day.  It typically includes sources such as meat, fish, eggs, cheese and dairy, nuts and seeds, avocado oils and fibrous vegetables. This diet avoids and can be low in fruits and starchy vegetables, beans, and whole grains.

Image result for steak with blue cheese

Image from Certified Angus Beef


What are proven benefits?


The ketogenic diet has been seen to promote weight loss in some individuals and has been shown to provide faster weight loss than more traditional low-fat diets. In short term efforts, some studies have found that the ketogenic diet improves blood sugar for individuals with Type 2 diabetes.

In a study conducted on the effects of the ketogenic diet on children with epilepsy, results showed that following a ketogenic diet could be an alternative mechanism to seizure medication. However, it was noted that the effects of the keto diet on epileptic patients long term cannot be reported and that each patient has to be assessed individually and should be less restrictive.  Due to the evidence supporting the ketogenic diet in epileptic patients, studies are being conducted looking into the possible benefits of keto on other brain disorders including Parkinson’s, multiple sclerosis and Alzheimer’s. Currently, there are no studies conducted on humans that support using keto to treat these conditions.


Any negative effects?


The ketogenic diet was initially used to treat epileptic patients and was not intended for healthy individuals to follow. While studies are still being conducted to research overall health risks, the ketogenic diet may not be the best diet to try without consulting a medical professional.  There can be both short term and long-term negative effects from following a ketogenic diet that should be noted.

Short term, many individuals experience what is sometimes referred to as the keto flu. Symptoms include nausea, vomiting, headache and fatigue and usually occur as the body enters a state of ketosis and adapts to having lower carbohydrates. Other observed effects include hypoglycemia accompanied by chills, excessive thirst and anxiety or irritability. Changes in blood composition have been noted including higher than normal lipid levels in more than 60% of individuals and cholesterol levels in more than 30%. Eating foods with high amounts of fat, especially saturated fat can increase LDL cholesterol and increase risk for heart disease.

Long term, kidney stones have been seen in 5% of individuals following the ketogenic diet possibly due to bone demineralization from acidosis. Additionally, patients have also been seen to have an increased risk of bone fractures. A study also noted that the ketogenic diet can cause stunted growth in children due to reduced levels of insulin-like growth factor 1 which can be reduced as a result of diet. The keto diet has also been seen to affect hormonal signaling which can cause women to lose their periods.


Should I go Keto?


The ketogenic diet as proven to be effective as an alternative for seizure medication in epileptic patients. Keto has also helped reduce blood sugar levels in diabetic patients and helped aid in weight loss for obese patients. There are some positive correlations with the ketogenic diet and certain medical conditions. However for overall health and implementation, this diet is extremely restrictive and can be difficult to sustain. This is not a diet that has any room for flexibility and must be followed 7 days a week in order to remain in a true state of ketosis. There is no room for eating non-ketogenic foods in moderation or only following the diet during the work week.

If losing or maintaining weight is your goal, limiting carbohydrates long term may result in low energy levels, irritability and changes in blood composition. Restricting any food group may also increase the chances of binge eating or developing an unhealthy relationship with food. Food is meant to nourish our bodies and to help us thrive as we move through the day. Choosing a balanced meal complete with protein, healthy fats and complex carbohydrates is a wonderful way to provide your body with the nutrients it needs.

Finding an approach that is enjoyable, healthy and sustainable should be the main focus for any eating plan. If you are planning to begin any diet plan, please consult a dietitian or medical professional before starting.

Are you interested in transitioning off of the ketogenic diet and need support or have your own thoughts on keto that you would like to discuss? Contact Monika at Eat Move Thrive Spokane to connect today.