I review the pros and cons of the Keto Diet and what I actually think about people using the ketogenic diet for weight loss.
I wasn’t planning on writing about the ketogenic diet but that all changed with my recent YouTube video. If you guys caught this video on my channel, my girl Abby Langer and I found a hilarious Reddit thread that shared some keto-followers favourite “strange but delicious” keto-friendly meals and snacks. Let’s just say, it was extreme. I was by no means under the impression that everyone (or even a large number of people) on the Keto diet ate that shit. But, I get why some viewers on youtube maybe thought that and they got PISSED. Like, viciously pissed.
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So, jokes aside, I decided to share what I ACTUALLY think on all things keto and give you guys a comprehensive review of the diet so there’s no confusion. At the end of the day, ‘haters gon hate’ but at least I can sleep at night knowing I’ve done my due diligence in whole heartedly giving you all the necessary information around this diet.
Let’s dive in.
What Is the Keto Diet?
If you haven’t already jumped on the keto diet bandwagon, I’ll give you a brief introduction. Basically, the ketogenic diet is a super high in fat (80% of your diet is fat), a super low carbohydrate (<5% of your diet) and moderate in protein (15-20% of your diet). Surely, not the most balanced of diets considering Health Canada your diet should contain 20-35% of protein, 45-65% of carbohydrate and 10-35% of fat. So how to you meet that skewed macronutrient distribution? Well, you load up on keto diet staples like meat, fish, butter eggs, cheese, heavy cream, oils, nuts, avocados, seeds and low carb green vegetables. And you cut out all your go-to carb sources like grains, rice, beans, potatoes, sweets, milk, cereals, and fruits. These kinds of restrictive diets tend to make nutrition professionals like dietitians run for the hills but I’m going to give it my honest unbiased account.
Dos and Don’ts of a Keto Diet
PROTEIN
Dos: Most proteins are fair game with a keto diet, however it is encouraged to enjoy organic, grass-fed or pasture-raised meats. On a keto diet you can enjoy a variety of protein sources such as whole eggs, fatty fish like salmon, seafood, organ meats, steaks, pork, poultry and more.
Don’ts: While the majority of proteins are okay in a keto diet, any meats or protein sources with added sugars is a no no.
OILS AND ADDED FATS
Dos: Fat makes up a huge part of the keto diet because it’s basically your main fuel, which is why it is encouraged to choose organic and grass-fed whenever possible. Excellent fat sources include olive oil, mayonnaise, coconut oil, butter, lard and other non-hydrogenated or unprocessed oils.
Don’ts: As long as there are no added sugars to the fat source, most fats are fair game.
NUTS AND SEEDS
Dos: Nuts and seeds are the best snack to fuel your day on a keto diet. Excellent sources include almond butter, flax seeds, macadamia nuts, brazil nuts and pecans.
Don’ts: Nuts covered in sugar are a no no.
DAIRY
Dos: Enjoy all of the cheese you would like on a keto diet. On top of that other great dairy sources include whole milk, full fat Greek yogurt and cream.
Don’ts: Avoid yogurts and creamers that are sweetened because they can quickly add to your overall carb count for the day.
FRUITS AND VEGGIES
Dos: To avoid constipation, load up on low carb veggies like kale, spinach, cabbage, mushrooms, green beans and green bell peppers. Some lower sugar fruit options include blueberries, blackberries and raspberries, but eat them sparingly.
Don’ts: Since fruits are high in sugar and carbs, they are usually a no go except for the few mentioned above. Fruits that are usually avoided on a keto diet include oranges, grapes, mangos, apples, papaya, pineapple, bananas, dried fruit and fruit concentrates. Avoid highly starchy vegetables like potatoes, corn, parsnips and yams.
GRAINS
Don’ts: All grains, even whole grains, should be avoided on a keto diet. A high intake of carbs will interfere with ketosis.
BEANS AND LEGUMES
Don’ts: Due to their high starch content, beans and legumes should be avoided.
What is Ketosis?
Ketosis is natural and normal, though arguably not optimal.
Our bodies run well on glucose (carbs)–they give us the necessary energy we need to function on a daily basis. When our body doesn’t get enough glucose (either because we’re cutting carbs too low, OR we haven’t eaten in too long), our body kind of freaks out and looks for other forms of energy to satisfy that role. That’s where the fat comes in. Without carbs, our insulin levels drop and fat is released from our cells. The fat overwhelms the liver which turns it into ketones, our body’s second choice to carbs for energy.
So, to confirm. Yes, your brain CAN function without carbs, but carbs are still your brains favourite good and some brain cells can only use glucose for fuel.
Ketoacidosis in Diabetes
It’s important we distinguish between the process of ketoacidosis seen in type 1 diabetes and this ketosis that so many people on the keto diet are striving for. If someone with diabetes lacks enough insulin and/or does not eat enough carbohydrates, they risk entering a state known as ketoacidosis. For those with uncontrolled diabetes, this can increase the levels of ketones in the blood, increasing the acidity of the blood, and potentially leading to a coma or even death. In ketosis for a healthy individual, the level of ketones in the blood never reaches these crazy high levels so it’s generally safe for the average healthy individual.
Bottom line: Ketosis is not ketoacidosis and is generally safe for most healthy people.
Keto Diet History
So where did the ketogenic diet come from? Interestingly enough, this fad diet didn’t spark from a celebrity endorsement or some guy missing a medical license. There’s evidence of the keto diet being used back in the early 1920s to treat severe childhood epilepsy and it’s still being used today for that purpose. Research suggests that the production of ketones may influence neurotransmitter activity in neurons allowing for a reduction in seizure attacks. A recent Cochrane Review demonstrated a 30-40% reduction in seizures compared with non-keto diet controls. One thing to keep in mind, however (which is a theme when discussing the keto diet) is that it’s generally difficult to adhere to and difficult to tolerate for a lot of people. In other words, people go on it and then come off it pretty damn quick.
Neurological Diseases
Once the medical community acknowledged the keto diet’s effectiveness in reducing seizure episodes, they decided to look further and study its impact on neurological diseases in general. Neurological diseases share a common problem – a deficiency in energy production. Ketones provide that energy for normal brain cell metabolism, and may even be a more efficient when the body is in starvation mode. When patients were put on the keto diet, the number of mitochondria (energy powerhouse) in brain cells increased. Ketones may also act as an antioxidant by inhibiting the formation of reactive oxidant species, which is why they may have promising effects in the treatment of certain cancers in conjunction with chemotherapy.
A 2017 mice study from the University of California found that a ketogenic diet (90% of calories from fat) lead to an increased life span, memory and motor function. Researchers observed a 13% increase in median life span when compared to a high carb diet.
Really exciting stuff, actually. Let’s look at a few other specific neurological diseases and the impact of the keto diet there.
Alzheimer’s Disease
In a study, Alzheimer’s patients fed with a ketogenic diet experienced improvements in their symptoms, which again may be due to the improved mitochondrial function. In another study, patients with Alzheimer’s were given a drug with ketones and after 90 days, they experienced improvements in cognitive function.
Parkinson’s Disease
In a pilot study, five out of seven patients trialed a keto diet for 28 days and showed marked reduction in physical symptoms. Parkinson’s attacks our human nervous system, partially as a result of an abnormal accumulation of a protein called alpha-synuclein. Research suggests that a ketogenic diet may reduce the associated cognitive and motor symptoms.Obviously, we need more research here but its an exciting finding.
Multiple Sclerosis
This also may be too premature, but an animal study found that the keto diet delayed motor neuron death and showed MS improvements, however it did not increase the life span of the subjects. In an exciting 2016 study, the ketogenic diet improved the quality of life, physical health and mental health of patients living with MS.
Ketosis and Cardiovascular Health
What about heart health and the keto diet? Previous older schools of nutrition would purport that a diet rich in fats (specifically saturated fats) would be detrimental for heart health, but more recent research suggests that saturated fat is not as bad as previously believed. There is actually a tiny little bit of evidence that a keto diet may improve triglyceride, HDL and LDL levels. Like here and here. An even more recent study found that a keto diet improved triglyceride, HDL and LDL levels. We’ll definitely have to wait to see how that research unfolds because there is definitely a lot of competing elements at play.
Keto Diet and Type 2 Diabetes
There have been many attempts at studying the link between type 2 diabetes and the keto diet. In one study, a strict low-carbohydrate diet was administered in obese patients with type 2 diabetes. After 14 days of being on the diet, the glucose levels of participants normalized, their hemoglobin A1C decreased from 7.3% to 6.8% and insulin sensitivity improved by 75%. Some of this study’s limitations include the short duration, the small sample size and the weak control group. In another study, 84 obese patients with type 2 diabetes were randomized to either a low-carbohydrate keto diet or a low-glycemic reduced calorie diet. At the end of the study, both groups experienced improvements in glycemic control however the low carb keto group had greater improvements in hemoglobin A1c and higher HDL levels compared to the low-glycemic group. A more recent 2017 study in the journal of Nutrition and Diabetes found that a low carbohydrate ketogenic diet for 12 months led to greater reductions in HbA1c and body weight. These results suggest that low carbohydrate interventions may be effective at improving glucose control.
Keto Diet and Cancer
There is exciting research on the role of a keto diet as a form of treatment for cancer. In one study, the use of a keto diet on patients with advanced cancer was deemed safe, and some evidence suggested it played a role in stabilizing the disease or resulting partial remission. In another study, the keto diet was used as a form of therapy for patients with malignant brain cancer. The study found that the keto diet may carry anti-tumor effects when administered in experimental animal and human brain tumors. The researchers believe this may be due to the reduction in calories, which reduces the circulating glucose needed for tumor growth. It is still unsure whether a keto diet per se plays a role in this or simply calorie restriction. All of this is to say that the research is preliminary, however still promising.
Keto Diet and Sports Performance
Traditionally, in the sports nutrition field, we talk about the importance of timing carbohydrate and fluid intake on improving sports performance. For some time now, research has been looking at the role of very low carbohydrate diets on sports performance. Trailblazers in keto and sports performance research like Dr. Stephen Phinney have been conducting studies in this area since the 80s. In one of his studies, the glycogen stores of cyclists on a keto diet were not completely depleted and lipid oxidation was increased. Researchers concluded that the body was able to adapt to the lack of carbohydrates and preserve what was needed to use the fat as fuel. However, based on the VO2 max breath test, since the body was attempting to preserve the carbohydrate during the exercise, it appears that the intensity of the exercise was limited. In a more recent study, off-road cyclists following a keto diet experienced small improvements, but still not significant enough to make strong conclusions.
The only difficulty with some of these studies is that they tend to have small sample sizes, like this one that only has five cyclist participants and the data was largely skewed by the fact that only ONE cyclist experienced a large enhancement of exercise capacity after the keto diet. Their studies also tend to be short term. Back in 2014, Phinney and scientist Tim Noakes wrote an editorial that stated that in the past 31 years, there have only been a handful of studies measuring sports performance and low carb diets. Out of a total of 11, only 3 found exercise improvements.
Recently a large study was released which contains a collection of 200+ keto and carbohydrate studies. Pretty big deal. Part 1 of the series looked at the ketogenic diet’s impact on body fat, muscle mass, strength and endurance. Let’s look at what the recent research says.
MUSCLE MASS
Studies found greater lean body mass loss in individuals following a ketogenic diet. However, since lean body mass contains water, glycogen and muscle protein, it was hard to determine whether lean body mass in the studies meant a loss in muscle protein or water and glycogen.
ENDURANCE PERFORMANCE
Studies found that endurance performance, whether it was anaerobic or aerobic was impaired or maintained with a ketogenic diet. This is still a complicated area to study, since majority of studies used in this review had small sample sizes, no control group or were very short in duration (no more than six weeks). Because of this, it is still unclear whether endurance performance is enhanced or impaired with a ketogenic diet.
STRENGTH PERFORMANCE
The majority of the studies found that there was no statistically significant difference between the groups when it came to strength performance. Having said that, researchers had a tough time comparing the diets since protein and total energy were not matched.
So far, no studies have evaluated the long term effects of the keto diet on sports performance (more than 6-12 months). That does not mean that the keto diet won’t be effective, but for now we don’t yet have the evidence to draw strong enough conclusions to call it standard best practice.
Keto Diet and Weight Loss
Aside from the therapeutic uses of a keto diet, most people are using this diet for rapid weight loss (surprise, surprise). Let’s take a look at what the literature says.
First of all, I can’t deny the fact that people will lose weight on a keto diet. Here’s why. First of all, you’re eliminating a major food group. When you do that, you limit your food options and most likely your food intake, so it’s not rocket science that you’ll likely lose weight. Second, most people on a low carb diet tend to increase their protein intake in the absence of carbs and there is some evidence that consuming higher amounts of protein may have some weight loss benefits. The large recent study mentioned above also looked at fat loss and found that individuals following a keto diet lost about the same weight as individuals following a different diet when they ate the SAME amount of calories. However, the studies found that individuals on the keto diet tended to lose body weight quicker.
Here’s why. All of these effects take time, but a reasonable explanation as to why the keto diet leads to rapid weight loss is due to the loss of water weight. One of the concerns with the keto diet is the loss of muscle mass and the depletion of glycogen stores. Glycogen, which stores our glucose, also stores water, so when stores are depleted, we flush out excess water. In other words, that rapid weight loss isn’t fat, it’s just water.
The keto diet also has an impact on our hormonal levels. Many studies have looked at whether the state of ketosis suppresses our appetite through the actions of leptin and ghrelin. A 2013 study found that after patients lost weight on a keto diet, our hunger hormone (ghrelin) was altered and suppressed. A systematic review also concluded that the state of ketosis appears to be a plausible explanation for the suppression of appetite. So this the keto diet may be good for dieters who can’t stand the discomfort of hunger. Finally, the keto diet also may have an impact on our stress hormone, cortisol. This was demonstrated in a Harvard study where the keto diet resulted in an increase in cortisol in individuals following a very low carb keto diet. High levels of cortisol is associated with insulin resistance, cardiovascular disease and may promote fat accumulation.
So we got the short term effects, but what about long term impacts of the Keto Diet?
So one study looked at the long-term effects of a keto diet in obese patients and after 24 weeks, patients lost weight, reduced their total cholesterol, LDL, triglycerides and increased their HDL. Another study conducted on 132 obese patients found that the low carb (keto) group lost more weight than the low fat group while improving biomarkers like decreased triglycerides, improved insulin sensitivity, and decreased fasting glucose. This all was confirmed in a 2013 meta-analysis, 13 RCTs (1,569 participants) found that patients assigned to a very low carbohydrate diet resulted in greater weight loss compared to those assigned to a low-fat diet.
Having said that, there are also studies suggesting that long term carbohydrate restriction diets (aka. the keto diet) may result in fast short term weight loss but people gain it all back in the long term. An RCT put 63 individuals on a low-fat diet or a low carb diet, and the study found the low carb dieters lost more weight compared to the low fat group by month 3 and 6, but that the weight loss evened out by month 12. This was confirmed by a Meta-analysis which found that while low-carbers lost more weight than low-fat dieters but the differences disappeared by the one year mark.
Another thing we know about diets and weight loss is that the results are not easily maintained. I’ve written about this in depth with regards to the participants on the Biggest Loser. This was evident in a study analyzing 31 long term studies on dieting, which found 2/3 of dieters put back the weight they lost. Other research has reported the failure rate may be as high as 95%. This isn’t specific to the keto diet but rather, any diet that is restrictive and unrealistic may be nearly impossible to sustain.
So while the keto diet, like any diet, may result in weight loss, is it sustainable and what are the dangers of doing this long term?
Potential Dangers of the Keto Diet
Loss of Muscle Mass
A huge concern with the keto diet is the maintenance and potential loss of muscle mass. Many people will just think: hey, dummy, then just eat more protein. However, some research has shown that even if your protein intake remains constant, a low carb diet may promote muscle loss. A study from the Netherlands confirmed these findings. In the study, participants were given three diets (high carb, moderate carb, low carb) and moderate protein. The study found that those following a low carb diet experienced increased muscle breakdown. This is because when we eat carbohydrates, we produce insulin which promotes muscle growth. This is why athletes depend on carbohydrates (along with protein) to fuel their performance. When we eat carbs, the insulin release “unlocks” our muscles to let the protein in so it can do its job at building our muscles. So, when we skip the carbs all together, muscle glycogen stores get depleted, we lose out on those muscle building opportunities. Forget about high intensity training. A depleted glycogen store also means our workouts will suffer because we just don’t have enough oil left in the tank. This was a again suggested in the recent review looking at many ketogenic studies. The studies found that there was greater lean body mass loss in the ketogenic groups compared to the other diets being studied.
Keto “Flu” and Bad Breath
Since our body isn’t used to using ketones, we tend to feel flu-like when in ketosis. Lots of brain fog, fatigue, headaches, nausea and poor endurance. You also get bad smelling breath, sweat and pee from the acetone (a byproduct of fat metabolism). Sexy? Not so much. Thankfully, if you are in ketosis long enough, a lot of people report that most of these side effects start to go away.
Constipation
Constipation is one of the most common onset side effects of following a keto diet. A ten-year study looking at the effects of a keto diet on 48 children found that 65% of the children experienced constipation. This is all due to the fact that a low carb diet means you’re missing out on fibre-rich grains, fruits and certain vegetables.
High Cholesterol
With the high intake of fat, are we concerned about the high intake of cholesterol? YEP. A study using the keto diet as a form of treatment for epileptic seizures in children found that after 6 months of administering the diet, triglyceride levels increased, total cholesterol levels increased, and HDL and LDL increased. These results suggest that over time, a keto diet may lead to an increased risk of hypercholesterolemia and hypertriglyceridemia. In the same ten-year study, 40% of patients developed hypertriglyceridemia and 29% of patients experienced hypercholesterolemia. So, if heart disease runs in your family, you may want to bow out now.
Mineral deficiencies
Strict dietary restriction means we may be missing out on crucial vitamins and minerals. With the keto diet, major minerals that are missed include sodium, potassium and chloride which is why they are typically supplemented with a table salt tablet. Other vitamins that might be missed out on include vitamin D, calcium, magnesium, selenium and zinc. The lack of vitamin D and calcium puts keto dieters at risk for reduced bone health and increased risk for fractures and long term bone diseases.
The Verdict on the Keto Diet
Cutting out a whole food group (or in this case, more than one) is a dietitian’s worse nightmare. It not only makes it a really hard diet to follow, but also stresses the hell out of your body and makes it work a lot harder to keep up. In a US News & World Report’s review of 2018 diet, the ketogenic diet came in last place as a sustainable means to weight loss because of its restrictive nature.
Carbohydrates make up the life blood of our body’s ability to function. Our body’s need it to run efficiently, promotes muscle growth and endurance in athletes and gives us the energy to get through the day.
We’ve seen the role of a keto diet in neurological diseases and as a form of treatment. The keto diet may also act as a quick fix rapid weight loss tool just like any other restrictive diet. While the risks are likely low if you’re an otherwise healthy individual, I still wouldn’t brush them off as NBD.
More problematic for me is the fact that ANY diet, especially one that is as devastatingly restrictive as the keto diet, is likely to encourages disordered eating behaviours. I’ve written about my own experience with , and this is a pretty scary reminder of how UNHEALTHY that world can be.
My biggest beef with this diet is that it focuses on how much and what you can eat and less about the quality of the food you eat. A recent 2018 study found that people who focused on eating plenty of vegetables and whole foods and less on counting calories and limiting food groups, lost a significant amount of weight over the course of a year. This continues to echo the notion that the key to successful weight loss is diet QUALITY and not QUANTITY. And now, there’s research that actually supports that!
I’m a big believer that everything – especially carbs – can be enjoyed in moderation and the best diet is just whatever eating pattern you find most pleasurable that also meets your body’s unique needs. I don’t know about you, but I need a summer peach, or a pillowy slice of focaccia, or a mindful bowl of pasta.
What does your body need?
Leave me a comment below. Have you tried the keto diet for weight loss?
Have you been successful?
Would you ever attempt a NO CARB diet?
I love the combo of watermelon and feta! So refreshing!
yes! so perfect!
I had no idea what banofee was until now. Looks like a dessert I would love.
Soooo delicious
Another fad diet to confuse the Dietitians as if we did t have enough on our plate! Thanks for sharing Abbey. Great breakdown.
haha yep exactly! Thank you 🙂
I actually have been keto 20 months, lost 94 pounds and got off blood pressure, potassium, acid reflux, and anxiety meds.
Keto is a life saver and I’m just 6 pounds from my goal weight.
Have you read Grain Brain, Wheat Belly, Obesity Code, or Keto Clarity?
I’m part of a FB group called Ketogenic Success and I’d encourage you to join.
I’ve helped 25 others start their keto journey and together we’ve lost almost 800 pounds in 20 months. I’d say…
That’s better than Weight Watchers!
Please do more research.
I’d love to share my journey any time!
Hi Diana, so glad that the keto diet worked for you. Based on the research, I’ve found that the keto diet doesn’t seem to work for the majority of people, but for those that it does, I am glad. Thanks for reading and for sharing your experience 🙂
I do not think you are glad this diet was effective for this person. Your video recipe reviews are juvenile at best, and your overall review is extremely negative. My personal experience is wt loss of 60 lbs in 11 mos; three migraines in 11 mos vs minimum of three per month for over 53 years, and all I was trying to do by starting keto was delay type 2 genetic diabetes onset . I am no longer prediabetic and I have taken less sumatriptan in one year than I have historically taken in one month. I sincerely hope your review has not prevented one person from enjoying their life to the degree I have in the past 11 months as a direct result of the keto diet. Shame on you!
Hey, my reviews are not put out to stop people from doing whatever they want. I am merely here to inform and let people decide what is right for them. I’m glad you were able to find a solution that works for you. Thank you for your comment!
Hi. I have been on the keto diet for 6 weeks and have not lost any weight but even more concerning, my gerd is much worse. I’m taking ppi’s just to stay on the diet. Constipation which has always been an issue for me is now much worse, hello laxatives! For these reasons, I have decided to go back to a more balanced diet leaning towards vegetarian. Keto works for some, I’m not one of them. I appreciate your info.
totally agree Maggie. i’m glad you’ve found what works for you!
I have found several Ketogenic Success groups…exact name…but one was 2.0 …so which one are you refering to.
Thanx
can you find me on facebook and tell me more about keto diet please? Elizabeth Stallings !
It might be “working for you” at the moment but in the long run, you’re going to have major health problems.
Keto/LCHF was named one of the worst fad diets ever and it is the worst for diabetes. Here a little excerpt from Exercise Physiology:
The body responds by letting the liver convert the Acetyl CoA to an acid called a ketone. Ketones slow the metabolic rate, reduce appetite and build up levels of acid in the blood (and your body does not like acid). Left unchecked ketosis can lead a person who has diabetes, into a coma.
Protein can be used for ATP production within the Krebs Cycle, and the liver has to turn protein into glucose! If you deprive your body of glucose, it responds by depriving you of your muscle mass, a situation that slows metabolic rate even more and makes it hard to lose body fat.”
Basically, you’re burning muscle tissue to make glucose (that you should be getting from carbohydrates) to survive.
Here is another one from Endocrinology:
“Glucose is the favorite fuel of your trillions of cells, and some really important cells — your brain cells — can’t get their energy from anything else. Glucose in your bloodstream is all about energy — it’s delivered right to the doorstep of every cell that needs it.”
I would seek a professional RDN who specializes in diabetes (CDE). You’re headed for trouble if you stay on this diet.
All the people I know that did high protein/low carb or keto back a number of years ago are now having major health problems.
I reversed my T2 eating about 300 grams of healthy carbs a day. I have helped a lot of clients do the same.
Well said! Totally agree with you
Mark What serious health problems do your friends that used keno diet have?be specific please
Disagree. I’ve been eating like this for ten months. I still enjoy carbs on the rare occasion but stick to a ketogenic diet most of the time. Ive lost 94lbs. I understand people lose weight in other ways but for me this worked. I eat 10x as many green vegetables as I ever have (at least 2 meals a day). My blood pressure dropped drastically in the first month. My cholesterol, triglycerides and blood sugar all normalized within the first 90 days. I don’t see any reason not to continue. I find this way of eating empowering and not restrictive. Before you call something a fad, because you obviously don’t fully understand this, you ought to read something from people other than the people you agree with. This is the problem I have with dieticians and most doctors. You don’t think for yourselves. You follow whatever the accepted guidelines are and spout them off without ever asking if they are right. It’s easier to stand with the crowd. I get that. But do not use your expertise as a means to criticize real progress. I would think as an expert your would be a proponent of what works! Have you ever been morbidly obese? Do you know what it is like to think your going to die from a heart attack at a young age? Do you know what it’s like to know your going to get type 2 if you can’t overcome your weight? Eating this way got me out of all of that and gave me my life back. Come down from the Ivory tower… Just maybe a little less judgement, a little more open minded
You hit the nail on the head
Amen to you well said
I won’t comment on the diet itself but dietitians do not simply rely on guidelines handed to them, nor on anecdotal cases. This article refers to specific studies all throughout, some that support the diet and others that don’t. The goal of a dietitian is to help clients reach their optimal health while still enjoying a high quality of life. I’m sure Abbey is genuinely happy for those it has helped. That does not mean this diet is best for everyone regardless of their unique circumstances, goals and medical history. Sadly there is not enough high quality research that Keto promotes sustained weight loss in the general population. Maybe there will be in the near future, but right now it would be unethical to recommend such a restrictive diet to the broad audience of a blog. I am truly happy it has worked for some people and I wish them luck on their journey. Thank you Abbey for a great article!
Like any researcher, one could pick and choose which research aligns with their argument. I could find ten research studies to argue all of her points.
I wonder what she thinks about a child with autism that removes an entire food group (glutens, sugars, etc) in order to see positive behavioral and cognitive change. I am going to go with my experiences and those of my clients’ and less from someone with a blog.
What I suggest… read ALL of the research and not just what suits your point.
why don’t you do the same? You dismissed the points that disagreed with you while pointing fingers at the dietician when she included studies from both sides. Stop the hypocrisy
I think you should take some of your own advice…you are being judgmental and thinking your diet will work for everyone. Look at the scientific facts; your body’s life blood is carbohydrates, the bread of life. Simple carbohydrates are what is killer to American society. Any diet that cuts out junk food like greasy potato chips and ice cream and cake will make you lose weight, not rocket science. Where do you think your body is getting fuel from? Muscle mass! It has to use that because you are depriving it of fuel! Why go on extreme diets when all you need to do is practice portion control and get up off the couch and walk around?
The walking around part is not true in my experience, exercise alone will not help an obese person. I’ve been doing Keto and most things I’ve read have come true, I found this article to be unbiased. I will say this however, I agree I too have been eating many green veggies and the bad stuff I do use I use very little for flavor (like bacon) what I found that is utterly ridiculous on the part of the folks that did the diet rankings was saying Keto was unsustainable. The way I feel from being on Keto is insanely well. I want to keep eating this way! Unsustainable its the only diet I can do intermittent fasting on. I was type 2….
Watermelon is really refreshing. i am waiting for some free time so i can make it.
Yes totally worth it!
I personally don’t think this type of diet makes any sense and can’t see how eating so much fat could possibly be good for you. Just my 2 cents
Inuit people of the South Pole eat only protein and fat as their frozen ground can grow no fruits and veggies.
The typical American diet is rife with SUGAR.
Maybe Keto is not an end-all beat-all, but its a start to reduce one’s refined sugar intake and allow some quick weight loss results to get a person “jump started” to a healthier lifestyle.
I am staying on Keto to lose one more pound, which is 10% of my body weight, then adding back in enough carbs to break even or maybe reduce more slowly. I do feel like crap all the time, but part of that is menopause, so which came first, the chicken (meno) or the egg (Keto)?
I have been the same over-weight for 12 years since my last baby, and this was a good starting point to lose some weight, get in touch with my body like never before, and learn more about SUGAR than I ever thought possible. It has opened my eyes to how much SUGAR controls our American diet, and to the reality that “low fat” diets DO NOT WORK.
Wendy, I am not sure about the Inuit people of the South Pole or whether the North Pole has ‘frozen ground’.
Abby says
“I’m a big believer that everything – especially carbs – can be enjoyed in moderation and the best diet is just whatever eating pattern you find most pleasurable that also meets your body’s unique needs.”
Sounds good sense to me.
Great post! Thanks for sharing!
Delicious! My kids will love these!
Looks so yummy and so pretty!
Looks amazing!
Great post, Abbey!! Thank you for taking the time to write this and share it with us! This diet may work in some cases as you pointed out but i find it very dangerous, eventhouh i’m not a dietician. I tried it and i felt horrible. I felt depressed, constipated, pain in my right side which i think was my gallbladder. Couldn’t sleep, terrible breath. AWFUL!!
Excellent article. DKA is caused by too little insulin. As a result, cells don’t get sugar from the blood, so the body breaks down fat to get energy. The byproducts of this process are ketones.
Thanks!
I love how you explained everything in a simple yet informative way!
This whole post must have taken so much effort and I think it’s incredible that you do this. The issue with these diets is that people hear about it, think it sounds good and do it. No questions! We are so lucky to have dietitians like you actually laying out all the research, the good, the bad, and everything in between about these diets, so THANK YOU!
Second point, I have never tried ketogenic dieting and also I did my calculations based on a 4:1 ratio and I was amazed at how much fat I would need to consume even at my size and the foods I would have to 1. Get rid of to achieve that and 2. Add in my diet to get there and , no thank you. My heart goes out to the families with children who do have to be on this diet.
The closest I came to low carb was when I followed a paleo diet (yup, been there , done that). I lost weight for sure down to 107 pounds because I was I lunch eating 800-900 kcals. You bet for SURE I gained all of that back and then some.
Finally at a stable point where I include all foods, in the right portions for me and I hope everyone can do that same!
Hey Monica! Thanks so much for sharing! These diets are so unsustainable and in the long term, just not worth it!
“These diets are so unsustainable and in the long term, just not worth it!” Most definitely in your opinion. I did a LOT of research on Keto before I started it in 2009. I lost 130lbs. It’s not a diet, it’s changing the way you think about food and fuel for your body. And once you do that you understand food freedom. I eat mostly Keto but if I want a beer and a piece of Watermelon I will let myself have one. True it’s not for everyone, not everyone has the willpower to control what they put in their mouth. We tend to reward ourselves with food instead of using it what its for, nourishment and fuel. It’s why our country is dying of obesity. Awesome that a size 10 women can put what she wants in her mouth everyday, exercise, and it not affect her weight but guess what, you are becoming the minority.
It’s not a fad diet. People who are really interested in changing their lifestyle or want to know more about Keto from a licensed professional should review articles by Shawn Mynar, Leanne Vogel, Jimmy Moore, Gary Taubes…to name a few.
Glad it worked for you. Thanks for sharing your view with us!
Celebrity endorsements is the WORST reason to start a diet. And yes, it is a diet. Why? Because it’s not long term sustainable. Anyone can lose weight; ask an overweight person. They’ve lost weight hundreds of times. Keeping it off is a whole other ballgame and depriving yourself of carbs can lead to kidney damage. Educate yourself on the dangers of high protein diets that were largely debunked in the 70’s. Get with the program, girl!
Amen! So agree with you.
YES! Same here! That’s why I am here reading this article 🙂
I don’t even see carbs as food anymore unless its green.
As someone who is prediabetic, Keto has been a godsend! I thought I was just a glutton, but now I’m certain I am actually insulin resistant. I am on Keto and can manage half a cup of blackberries without coming out of ketosis, but almost any other carb/sugar and I become a mindless food consuming zombie. I literally feel like I have zero control over my ability to stop eating. Also before trying Keto, if I was not able to eat constantly throughout the day I became grumpy and tired. Like none tired where it felt like I had lead running through my veins. On Keto, I can go a good 5-7 hours without eating and I don’t feel off at all. I am hoping to lose weight, but mostly I do not want to become diabetic and my problem is that I am insulin resistant. I do plan eventually to eat more black beans, vegetables and fruits again. Maybe a little chocolate on holidays and cake and ice cream on my
Birthday, but I need to live a mostly carb-free life. I was raised under the misconception that pasta and grain and cereal was fine and all you had to do was limit fat. I can’t help but wonder if following those eating restrictions as a developing child/teenager made me become insulin resistant in the first place
Celebrity endorsements is the WORST reason to start a diet. And yes, it is a diet. Why? Because it’s not long term sustainable. Anyone can lose weight; ask an overweight person. They’ve lost weight hundreds of times. Keeping it off is a whole other ballgame and depriving yourself of carbs can lead to kidney damage. Educate yourself on the dangers of high protein diets that were largely debunked in the 70’s. Get with the program, girl!
Sounds amazing 🙂
Love all the recipes! Thanks for putting these together!
Everything looks delicious. Now I’m off to check out Vegan Huggs. Thanks.
As a vegetarian, potatoes have always been a big part of my diet. I still believe that anything that grows naturally in the ground is good for you.
absolutely amazing article!!! I love that you went deep and not just on the surface, plus showed all sides of things. I know it’s not something that feels right for me, but this is great info that I can share with friends who are wanting to try it.
Gorgeous!! Total show-stopper.
Wow! What a great line up up veggie burgers!! Sooo loving this! Going to pin now for yummy meals later!
BRUSSELS SPROUTS TACOS! Say what now?! Ummmmmmm THIS is brilliant!!
Yessss thanks girl!
This looks so delicious and complex with flavors and textures!
I will certainly check out those bowls for the meat eating half of the family. Great combo
Delicious! I love a good taco and I love Mann’s!
These sound awesome – I can’t wait to try them! My go-to taco filling is usually the standard ground beef or ground turkey, so I definitely need to think outside the box a bit more like you have with these ones.
Ground chicken makes for great taco meat too! 🙂
Yum, for sure
What a great idea for tacos! So creative!
This looks delicious !! I love the blueberries !! I can’t wait to try to make !!
My oldest daughter would love these, she loves Brussels sprouts, sausage, apples, craisins, so many of the ingredients!
So creative! I love everything with Brussels sprouts but tacos just take them to a whole ‘nother level! ????
I love how perfectly maple flavors make everything even more delish! Yum!
My dad got a farm here in newfoundland we grows potatoes and turnip and carrot and greens and khorbi zuchinni and pumpkins and corn cabbage lettuce tomatoes and strawberries
Please educate yourself about ketosis & a ketogenic way of eating. This post is uninformed & closed minded. So sad that a nutritionist isn’t willing to be open minded.
Thank you for this well written & researched post. I’ve been obsessed with proving this diet to be ridiculous for months and you did the legwork.
I am in many groups on Facebook for keto and I can’t say this on Facebook, but I’ll speak freely here. There is not one woman who has a body I would want in any of these groups. They constantly speak of falling on & off the diet.
Every single food post is healthy foods smothered in cheese and/or bacon. Literally!!
They think this is so great and yes they’ve lost weight but they have no muscle tone and nobody works out. I’m so glad you have shown my gut was right about this ridiculous diet.
I’ve just spent two weeks on keto, joined a very popular Facebook group in the process and thought I’d finally found the answer! I feel like crap! I’ve lost 8 lbs. but am so bloated and constipated as well. The more I read the postings in the group, the more freaked out I became, guzzling pickle juice and drinking salt water to balance electrolytes, everything slathered in cheese and fat and heavy cream. The baking recipes are garbage! These people must be terrible cooks to begin with because the waffles and pancakes they are raving over taste like garbage, a waste of time and ingredients. They dole out advice on vitamin and mineral supplementation as if they are doctors. Very scary. My jaw dropped open at the posting about hair loss, and everyone saying oh don’t worry, it eventually goes away. So here I am, Monday morning of a brand new week trying to formulate a plan that will work for me. I think for many of us, we are so desperate to lose weight that it’s easy to get caught up into these diet plans.
Hey Darl, I hear ya. I’m sorry you had to go through all of that. Sounds like a nightmare! It can be very scary, and is definitely not a diet for everyone! Thanks for reading and sharing your experience!
I appreciate your approach to the keto diet it is the most unbiased I’ve seen. I decided to take a more mindful approach to the keto diet. I took the allotted carbohydrates and decided to count the net carbohydrates. I researched the most healthy vegetables highest in nutrition value and antioxidants and use those for my net carbohydrate allowance. Then using my lean muscle mass calculated the necessary amount of protein using the healthiest options like lean chicken breast fish with no bacon and no fatty Meats. I decided to get my fat grams from avocado olive oil and coconut oil. Monitored my micronutrients and supplemented them as necessary to reach the daily requirement. Using a vegetables I attempt to get the highest fiber possible and supplement the rest. I’ve changed my concept of what is cheating on a diet to indulging in fresh pineapple and watermelon raspberries blueberries and blackberries. Grains have always caused problems with feeling bad gastric bloating and water gain for me. So it was not difficult to decide to leave those off research the nutrition and a tip to substitute. as far as gaining all the weight back if you return to the diet that got you overweight you can only expect to get it back. A calorie Surplus will put on weight. As I near my goal I will increase the carbohydrates using the healthy foods I have grown accustomed to to achieve the highest level of carbohydrates that does not have me regain the fat. Because remember my protein intake was based on my muscle mass. As I follow the diet I am mindful of the behavior changes choices that caused me to gain weight and there is no getting off the diet there is only bringing balance to the macronutrients. If dietitians everywhere find my Approach unhealthy that is their opinion they have a right to. I’m using this strict limited diet initially for the weight loss success as a positive reinforcer while modifying my behavior using the healthiest food choices. Which does not include heavy cream butter and fatty Meats.
Hey Jade, sounds like you’ve done a lot of research and are mindfully monitoring the diet every step of the way. Thank you for sharing your journey with us!
Jade, congratulations for your keto approach! I’ve had lots of sugar cravings & binging and keto was my solution for “cooling down” and getting back on track. I am also very careful with animal fat and I tend to get the fats from other sources – at least until further notice. I have also made a list of super-foods as I like to call them, vegetables high in micronutrients and low in carbs and also others high in fiber. I actually managed to search these foods in the USDA database and rank them from top to bottom, depending on the micronutrient. This way I know how to get the richest foods that are less calorie dense. I could say I’ve had some revelations along the way.
I would love to keep in touch on this journey, I think it would be a great benefit to have someone to share your findings, progress and experiences with. Hit me up on bogdanmsg@yahoo.com and let me know we’ve met up here.
Thank you Abbey for your article, good day!
I wasn’t going to comment. But then, I decided I wanted to give my 2 cents on this particular post.
1. Why are you in multiple FB Keto groups if the diet is so “ridiculous?”
2. I have T1 Diabetes (29 years). Keto has made me much healthier.
3. Fine that it doesn’t work for you. It does for MANY of us. There is a LOT of legitimate research to support its legitimacy.
4. I am in good shape, I work out, and I LOVE my body now.
5. There are many, many athletes who follow a ketogenic way of life and are very successful. Saying that the women “have no muscle tone” is a very generalized statement. Maybe the women who went from 300 lbs. to 150 lbs. don’t, but that’s not everyone who is on the keto diet.
Hi Leigh, I like to inform myself before I make my arguments, so I try to do as much research as possible. Same goes for when I was looking into the keto diet. I’m so glad you’ve seen improvements with the keto diet. I still believe that for the majority of people, the keto diet has its side effects and may not be successful. If it helps some people, then I’m glad!
Hey Abby,
Regardless of the position of your article, I want to thank you for your professionalism, your research, and your citing of sources. Too many people are getting defensive instead of being objective. You have giving things to think about to those that are still open minded.
I have the ability to sift through data, and I think that most people have either lost, or never developed that skill, as many of these comments prove. They have sat down on the little piece of land that they call truth and will never move again… until something more charismatic comes along to lure them away.
I have been on and off diets for years and the one and ONLY true statement that I have experienced is that not all thing work for all people. You stated positives. You stated POTENTIAL negatives and outcomes. You did a great job.
Keep up the good, open-minded, fact-based work.
Hey Colin, I really appreciate your message and I totally agree.
The keto diet is amazing! I’ve been on it for 15 months now. I maintain 20 grams or less carbs a day. I lost 60 pounds in less than 3 months and have maintained that loss. My triglycerides and cholesterol numbers are far better than average. My blood pressure normalized within a month and I no longer take mesds. I have a heart condition called PVC and am off all meds for that as the symptoms are no longer a bother. Those symptoms, as well as blood glucose numbers, decreased considerably within 2 weeks. It is the most beneficial “diet” I’ve ever used. It is a lifestyle that I 100% support. It is sustainable long term. I go to the gym daily. I am now 50 and have better energy than ever and feel far better than I did in my 30s and 40s.
So glad you commented! I am a Type 1 Diabetic (29 years) and I also follow keto. The misinformation out there is astounding. Good for everyone else that they don’t follow it. Fine! Works for some of us, and I hate that people say it’s “ridiculous” and doesn’t work. Clearly it does for some of us 🙂
I wonder why dietitians and nutritionists are so much against the ketogenic diet when so many people are singing the benefits they had with keto.
It is because WE, Dietitians studied everything about how to lose weight IN A SAFE AND HEALTHY WAY… people are so impatient in losing weight… They didn’t realized that they gained they’re weight a lifetime and wanted to lose in a glimpse of a eye….
yes you will lose weight FAST like you wanted to… BUT you will gain it back faster than you think… and probably those people whose singing the benefits they had with keto are still on the early stage…
we only wanted to help people lose weight in a HEALTHY AND LONG TERM WAY….
MS ABBEY, thank you for your post….
Thank you for sharing Macrene 🙂
So if the diet you dietitian maintain so much is so amazing where are the studies about the SAD diet and why are there so many overweight people if everyone is following the SAD diet and overweight. Honestly keto is the most amazing thing that ever happened to me after trying the SAD diet for 15 years and constantly gaining weight with no weight loss at all. I find the review you did full of guess work and no actual research.
Hey Amy, sorry you feel that way. We did do our diligent research and even more research is coming out to support this. I’m glad that the diet worked for you. Thanks for your comment 🙂
I am now part of the Abbey’s Kitcheb Family and I can’t wait to get the rest of these recipes!
That smoothie looks fantastic!! YUM!!
I would have never thought to add meta to a smoothie! Great idea!
Thank you SO much for your blog post. My niece went into Ketoacidosis recently and I compared it to what a former RN in my neighborhood has been doing & recommending to everyone (& they believe her because she used to be a nurse, but definitely NOT a Dietitian). Anyway, after reading, I learned they are completely different, however if a healthy person does test for ketones in their blood, what are acceptable levels? (This same nurse tests for ketone levels). I appreciate how much work you put into this write-up and honest feedback! (I work with 2 RDs who agree with you!)
Very clever play on a classic. Such pretty color to!
Yes!! Love this and will be recommending – tried the “ice cream” and it’s delicious!
Sounds like you have a lot of good things happening right now 🙂 It’s been a crazy summer so far at my house too-busy, but good! I don’t know which one of these recipes to start with-they all looks delicious!
Okay – A – I love that you put sausage in a taco and B – the Mann’s bowls look awesome. What an easy way to create a beautiful meal!
AGREED — PERFECT for Pride month!
Yes!! Thanks Danielle 🙂
I still have not tried Kombucha! This looks like a fun summer treat for sure
I highly recommend it! So delicious 🙂
What a delicious float recipe Abbey! I pinned it to my favorite drinks board – looking forward to trying it! Happy Summer!
yay! Thanks Ilka!
From one dietitian to another…Thank you for this!!!
Aw thanks Jenn!
I tried the ketogenic diet and it really helped me even out my energy levels and I don’t grave sugar anymore. I had issues absorbing my B vitamins. I had high candida and l-acidophylis levels. I was also addicted to sugar. I started this 3 years ago, and since about a year ago, I’ve added fruit. Now I enjoy a little rice and potatoes as well. I even had a bite of chocolate cake and didn’t die. I started out at 112, lost 10 pounds within a month and have slowly gained most of it back. I am happy I did it, but I will be more confident to add more carbs, although it will mostly be in the form of more fruit and starchy veggies. Thanks for your article.
Hey Rashelle, I’m glad you found it helped you! Thanks for sharing 🙂
I asked my neurologist what she thought about me going keto to help with a seizure disorder (just RD2B things…), but she said it wasn’t worth the difficulty trying to adhere to the diet. Especially with my mild situation and age, she didn’t think it would make a difference at all! So glad I read this 🙂
Hey Anna, it’s great you got a second opinion! Thanks for reading 🙂
So for all the dangers you listed on this, my dietician prescribes this diet to everyone who comes into his office looking for weightloss, he has a stack of packets with standardized information regarding the specific diet. For what it’s worth, most of the side effects you listed, I did go through, although the sugar withdrawal was the worst, but after a couple weeks, that passed too. Now I’m on the same 1200 calorie, <20g carb, 0 sugar diet, and it feels VERY sustainable. The only thing I really miss is pizza, and even then, there are keto friendly chicken based crusts that really hit the spot. I guess one thing that sticks out to me is my doctor told me that the human body doesn't need any sugar to survive, and while he makes the distinction between simple and complex carbs, still cuts them out in a normal keto diet style (no potatoes, corn, most beans in larger quantities, etc). Should I be concerned about my doctor? He came as a referral and has a large track record of long term success with his patients.
Hey Josh, I can’t really tell you what to do about your doctor, but it doesn’t hurt to get a second opinion! Knowledge is power so hearing a different perspective can be beneficial. Thanks for sharing your experience.
I tried it and it is a complete rubish and unrealistic.
First of all I was miserable, hungry most of the time, felt guilty if I accidentally ate even a small amount of anything with mid-high carb.
What really killed it for me was the unrealistic restrictions of the entire day carbs count you should end up with – there is no f***ing way I can get by one full day with 20 grams of carbs and under. Just one of my meals ended up with at least 15 grams of carbs (half small onion-small red bell pepper-half cup chopped mushrooms-cup green beans), sometimes 20-25, times 4-5 meals (amature bodybuilder) and I end up with ~100 grams of carbs per day, at least.
How the hell these “gurus” decided 20 grams of carbs for all? that is total rubish.
One additional concern is what happens on social gatherings, such as a birthday party, are you going to be the only a-hole who will hold up on eating a cake while everyone else enjoy it?
Hey Sal, sounds really awful. I know I could never last having only 20 grams of carbs a day. And interesting point you made about social gatherings. Definitely puts a damper on everybody’s party. Thanks so much for sharing your experience 🙂
A vegan not approving of keto. What a huge surprise. I think you may be biased.
I’m not vegan.
Done Keto diet for over a year now. I started it due to increased liver enzymes showing a start on a path towards low-level diabetes due to being about 30 lbs overweight (229 lbs, 5’10” endomorphic, muscular build). After a year, my Cholesterol is excellent, I dropped to 192 lbs (37 lbs lost), maintained muscle mass through maintenance workouts and cardio, resting heart rate is 50bpm, EKG shows perfect results, blood pressure is excellent, and full panel of bloodwork shows zero abnormal liver enzymes.
Here’s what you got wrong…Keto is about a balanced fat and protein diet with very low carbs and high nutritional content. No one on keto shoots for an 80% fat intake, that’s just impossible to achieve and isn’t what keto is about. I targeted 110g of protein and 90g of fat in a day … and under 20g of carbs. I ate a lot of leafy/dark green vegetables and got most of my carbs from other veggies and fruits like tomatoes, onions, and berries (with a high GI). This is what most people target, a 40/40/10 ratio of protein, fat, carbs … but the common misconception is that the fat amount is a goal, whereas it’s a limit. The protein is more important to a healthy body, but the fat teaches the body to release/produce the ketones in the bloodstream.
The biggest win for your body is the loss of all sugars, both natural and artificial. Sugar is sugar is sugar…honey, raw, brown, etc. And artificial sugars, as you well know, trick your body into both a physiological and psychological reaction to it as if it was real sugar (kicking off addiction and liver/insulin responses).
I achieved my goals without fasting, but fasting is growing to be one of the most healthy ways of eating that are available to a human. The fasting process initiates a lot of systems in the body that remain dormant in a regularly fed human. That, in conjunction with the presence of ketones (which encourage fat consumption for energy), make fasting during ketosis massively effective for both weightloss and a healthy body.
I like the list of health benefits you talk about here. But I seriously reject most of the side effects you claim without any basis. The only real risk that all keto dieters face, is constipation. I never encountered it, as I drink ample water and ate ample vegetables until I got sick with the flu and dehydrated. But that’s easily manageable. As with any diet, you should have your doctor regularly monitor your blood pressure, cholesterol, and other blood panel stats.
I also hardly can see how you can call it a fad diet when it’s been around, in science studies, for almost 100 years.
Hey Rob, so glad it worked for you. I call it a fad diet because it’s only recently been used as a diet for “rapid weight loss”. Before that it was used as a therapy for seizures. Thank you for your comment!
Thanks for an in depth analysis! I’ve been researching this diet, and good to hear how it may be harmful. Learning to cook more, eat balanced and healthy.
For sure. Keep it simple, I always say 🙂
I recently went to a walk in lab and found that I have high cholesterol and I am pre-diabetic. However, I am well on my way to healing my body with nutrition and supplements. I was able to reverse all my pre-diabetic symptoms in a few days (brain fog, blurry vision, thirst, frequent urination) and I have amazing energy and mental clarity now. I’m losing weight without hunger or counting calories. I eat low carb produce, poultry, fish, nuts and dairy. I believe that the key to avoid diabetes is to drastically reduce or eliminate grains, sugar and any type of processed food or cured meat from your diet. For cholesterol, I take plant sterols/stanols before meals and tumeric & black pepper, fish and flax oil. I believe that everyone who eats meat should take plant sterols (Try Minute Maid Heart Smart OJ!). It is the ultimate preventative, because it is not usually not possible to reduce your cholesterol enough with diet and exercise alone.
Thanks for sharing your view, and glad you found something that worked for you.
My friend suggested this diet for weight loss, but I have never been comfortable with elimination diets. Thank you for your research.
I hear ya! Thanks Claudia
Abbey, I appreciate the article, it’s helped me come to a decision on KETO. I’ve been on KETO for over 3 months, I’m a woman of 55 and post menopausal with a good 40 lbs of fat to lose. I work out 3-5 per week at an intense level doing cardio, HIIT and weight training and I have NOT lost any weight (ok, a single pound). I am in Ketosis most of the time (testing often) and I’ve been eating 1,200 to 1,300 cals per day. My carb intake around 15-20 grams per day, Fat around 90 grams and protein was about 45 grams until I increased it after learning I had lost muscle mass confirmed on a SECA scale.
I’m throwing in the towel but will continue working out as I LOVE it. I am going to eat sensible, keep up the weight training and see how it goes. I feel like I gave it a good run but if I haven’t seen results in 90 days I don’t feel this is the best way to eat for my body. I’m curious if anyone else has had lack luster results like mine while being diligent with a strick KETO diet.
Hey Lynn, thanks for sharing your story with us. I’m glad you were able to listen to your body and so what worked for you! Good luck 😉
I had high blood pressure, was going into atrial flutter, obese, tired, moody and hurting and miserable, I kept having allergic reactions to the medication for my blood pressure which enhanced the atrial flutter, my doctor and cardiologist suggested that I go off all medication and approach this by getting rid of the problem, being obese. I started with a lower fat version of a Keto diet (I needed the fat on my body to be used before the fat in my diet). I eat small amounts of fruit and about 2 lbs a day of veggies and I manage to stay under 30 g of carbs a day, which works for me. I lost 40 lbs in 10 weeks. Here is the clincher, every 2 weeks by blood work was done by my doctors and everything is improving drastically, also I was getting the bod pod completed every 2 months to check my body weight / fat percentage, and I am not losing muscle, I am losing fat. I noticed that it was mentioned that it is too hard to sustain this way of eating, but there is really only one choice for me..putting that crap in my mouth is just putting poison in my system and I don’t want that ever again. I eat better now that I have ever ate as I am eating real food. I know dietitians were taught and trained to help people lose weight, but like any industry things evolve and change and things progress, and one must be open minded that there are different approaches that work for different people, and that as a professional dietician, I would expect them to see that there is more than one option to help people. Some people do just fine on 100 g carbs a day and I don’t, as I was addicted to carbs / sugar and now I am free of those drugs and I am healthy and happy. Everyone keep an open mind and try adaptations that work for your body and situation.
Cheers
“the fat overwhems the liver” What evidence do you have that the liver finds this overwhelming? The liver is designed to do all sorts of things. Wouldn’t breaking down fat be a good thing if you’re trying to lose weight?
Just because glucose is burned first, doesn’t mean that it’s preferred. High glucose levels in the blood can damage tissues and organs, so the body has to manage it. Ketones are “cleaner burning” in that they produce less free radicals
Insulin is not the only hormone that helps build muscle. When insulin and glucose are low, the body produces more human growth hormone. And other studies have found the low-carb, high-fat diets did a better job of preserving muscle mass.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5384055/
I have found eating low-carb, high-fat to be easier than other diets because I feel satiated, and I have good energy and feel warm (I usually feel cold in the winter). I can also skip snacking because I don’t get “hangry”. I totally understand if it’s not for everyone; people are different with different genetic expressions, and their bodies will respond in different ways. But if you’re going to give it a try, it make take a couple of weeks before your body is adapted to burning fat instead of glucose. Make sure to get enough salt, and eat lots of vegetables (if you don’t like spinach salad, roasted cauliflower or fired mushrooms, this diet may not be for you).
The devil is in the details. And, in few parts of the post, details were missing. Specifically, weight gain in post-Keto stages are due to?… getting back to SAD, perhaps? Indulging on ice cream and filtered fruit juices?
Ketogenic state can be achieved and maintained with low-carb food balance. Looks like very few people make he distinction between “therapeutic Keto” and “nutritional Keto” and there IS difference! For nutritional Keto, the food intake balance need not to be extremely restrictive, and I submit that every individual needs to find the dietician balance suitable for one’s own body.
This said, I do prefer low-carb balance compared to SAD. I can speculate a lot about SAD and about the non-discrimination of different carbs – like, lactose vs. fructose. It is only my opinion, that fructose has its value in the nutrition (black bears get body fat for hibernation eating fruits) yet somehow we miss to notice that naturally fructose had been available in humans’ diet only seasonally, while nowadays juices of all kinds are available year-round; not to mention fructose additives to sugar-rich products. And yes, fructose is addictive, and yes, this is part of the evolution for 200 thousand years of humans.
I am Keto proponent. I have been through muscle cramps when missing greens while riding my bike for 100 km in 5.5 hours (and I am going on 64!) Getting kale and spinach and parsley is a must, getting the fruit whole is a must. Consumption of “good” fats like coco, olive, avocado oils definitely does not hurt. Consumption of meat – and of organs, yes, organs – is very important. And finally, monitoring the body reaction and measuring ketones and glucose helps; I am doing observations regularly. What about G=4.2 and K=.3 in the morning? It is not ketogenic state per se, but in the morning my muscles do not need much fuel, and my frontal cortex and red blood cells need only minimum glucose. What about G=5.4 and K=3.6 in the third hour of bike ride, with acetone in the breath high and ketone disposal in urine very low? What about post-exercise levels of G=4.4 and K=1.2, with almost no acetone in breath and urine levels going sky-high because the body needs not ketones any more?
My submission is, that a healthy body – liver, pancreas, kidneys – know how to maintain the right balance and produce or dispose of fuel, either glycogen or ketones as needed. I disagree that glucose is the favorite fuel, it is only the easy fast fuel for the body, which has one great advantage – PERFORMANCE! Both muscle and brain, fast performance is fueled by carbs. But, for ENDURANCE, it is ketones which are the best fuel, and moreover, burning ketones leaves less waste to be disposed off. I think that for athletes, the challenge is how to find the right performance-endurance balance.
High-carb diet – like SAD – is outright harmful and statistically it is proven, since the overall health of North American population deteriorates steadily since the 70s. Low-carb, high-fat diet is definitely less harmful; in my opinion it could be beneficial for the vast majority of humans. Whether one can plough through the addiction of sweets, that is totally different story.
I have to thank you for presenting a more rational view of keto than I have seen presented by other dietitians. However I am a Type 1 diabetic, and ahem, also a registered dietitian and since finding keto a year ago would not have any reservation in guiding a pt, especially a diabetic, to eat keto. I find the diet far less restrictive than a vegetarian or vegan diet, and food cravings have completely been eliminated. I’m far more satiated when I eat and I have no problem adhering to this way of eating. The fact that dietitians advise eating 45-60 g CHO per meal to a diabetic (someone who essentially has a carb intolerance) is absolutely ludicrous to me. As a T1D I’m off the blood sugar roller coaster, no longer have dangerous lows and have achieved an A1c of 5.1, which means no long-term complications. I think the main fear in the mainstream media comes from that F word–fat. With the dawn of the low-fat era in the 1960s, sugar and carb consumption skyrocketed, fat consumption plummeted and what happened as a result? Yes, that’s right, rates of overweight and obesity skyrocketed. Insulin is the body’s primary fat storage hormone and carb consumption triggers insulin. The reason a keto diet works for weight loss (more than just water weight from loss of glycogen stores) is because insulin levels stay low, which allows for the mobilization of fat.
I understand your reservations on this diet (I was once the same way), however I encourage you to take a deep look into the mechanisms of the diet, and maybe give it a try for yourself. Give it 90 days. Read any number of books on it with an open mind (Keto Clarity is a great one and is a quick read) and perhaps you may find it challenges you to second guess the dietitian dogma that is pushed by the AND.
While I do appreciate the amount of research that went into this article, I need to weigh in here— no pun intended. I am a 44 year old woman who suddenly and inexplicably gained a lot of weight at about age 20 and pretty much (albeit a few bouts of massive dieting and exercising) have remained fat until the age of 42. I had always been thin without having to give my lifestyle much thought before my sudden weight gain — so I have spent the last 20+ years becoming pretty proficient on learning how the body uses fuel. I have had success losing great amounts of weight a few times in my life — twice reducing my calories the “nutritional counseling” way — using the old school and outdated food pyramid and tons of exercise. It took literally having to spend hours and hours at the gym — being miserably hungry all the time — only to achieve slow progress at the scale. Months and months I would spent this way only to gain the weight right back the minute that I let go of the reins. I’m always hearing about “sustainable lifestyle changes” from you nutritionists— an I believe in daily exercise — but that lifestyle was completely unsustainable in the long term which is why so many people are unsuccessful.
Even at what I now refer to my ignorant age of 20 years old — before Atkins became a household word— I remember a nutritionist telling me how the body works, and then telling me I needed to eat carbs and I recall thinking “wait a minute — if my body needs to use the carbs I consume before it begins to dip into my stored fat— why on earth is she TELLING me to eat so many carbs?”
In 2014 — for the first time — I discovered a low carb diet called Ideal Protein. It’s different from Keto in that you also keep a low fat intake as well. I can’t speak for Keto as I’ve not done it personally, but I lost 80 pounds on Ideal Protein in 5 months. It fit into my life as a busy mom and returning college student because I didn’t have to spend hours at the gym. I just ate low carb and moderate protein.
While I admittedly struggled after going off the diet (they have some high protein, low carb,good tasting premade foods that I no longer had access to) with what to eat, I at least had better knowledges of HOW to eat and have been able to maintain my weight loss since. For the first time ever, I realized that I couldn’t eat the “food pyramid” suggested amount of carbs if I wanted to maintain a healthy weight. I even began running because I was thin enough to do so. What people who have never been fat before don’t understand is how much being fat holds us back from trying new things. If only there was a way to get people to quickly and easily lose the weight so they could be successful at dieting and discover such things (tongue in cheek).
I went back to school for Medical Laboratory Science which involved a lot of chemistry and physiology. I pieced together what I had learned through dieting over the years and how the body works — and I have to say that I am really waiting for the medical community — doctors and nutritionists to finally get on board with lower carb diets. If dropping 80-100 pounds isn’t successful then I don’t know what is. I don’t really care how “unhealthy” you call it because of how rapid the weight loss is. How unhealthy is being obese in the first place?
Dieting itself is notorious for setting us up for failure — mostly because the lifestyle changes are unsustainable and people become frustrated with having to work that hard to lose that slowly. If people can lose weight rapidly — it causes a snowball effect more often than not. Maybe someone should conduct a study on that aspect of things.
The medical community is failing their patients by continuing to shove the food pyramid in their faces. Let them lose weight in a manner that works best for them — and let them lose it fast so they see results. Im sick of hearing “it’s a lifestyle change” because diets themselves are not meant to be lifestyle changes — they are meant to be a period of weight loss. Show them the lifestyle changes AFTER they lose the weight necessary to become healthy again. How I see it — where people fail and where you are failing them — is not helping them to realistically lose the weight in the first place and then in not teaching them how to maintain their lifestyle using realistic macros guidelines to do so.
I won’t hold my breath to watch the medical community get on board to this platform. Instead you will just keep shoving the high carb food pyramid at people and then complain that people don’t really “want” to lose weight. And stop calling diets that cut carbs as “extreme”. Working out for 2-3 hours a day to lose 1 pound a week is extreme.
I say thank you, Abby, for the time you spent on your research of the KETO diet. I have been wondering what all that fat intake of the KETO diet would do to your liver. It can’t be healthy! But hey, it’s a matter of preference I guess. I prefer to be healthy. Okay, I’m not obese, I’m 5’1″ with 38 lbs. According to what I’ve read online and what my health insurance says, I need to lose about 15 lbs. I’m 60 years old — so, nah– probably not happening. I may be old, but active (walking 5 miles each day, doing one workout video on Grokker daily, gardening, hiking, kayaking). I want to lose enough weight to feel better (less arthritic) when I roll my butt out of bed in the morning, but I don’t want to deprive myself from the fun of eating. I don’t do fast or fat foods. I love cooking and eating healthy (like greens and everything veggie and beans and healthy grains like quinoa, freekeh, farro, black rice) and I like my beer of and on. I can do without sweets, but I do crave cheese. Take the “likes” away, and I get grouchy. I was trying to go with a low carb diet years ago, but the brain farts that came with it where just too pronounced. My body needs carbs! As long as they’re healthy carbs, I’ll be ok. I stay away from white bread and packaged, processed foods. I cook mostly low sodium and going out to eat is a special occasion. But I do count calories overall. I started logging my food intake on http://www.cronometer.com and that has helped a lot. I can create my own recipes, incorporate them into other recipes, and it gives me an overview of all the nutrients I consumed – both for the whole day or by each food item. I can tell how many calories or sodium is in each of my recipes. When I first started logging stuff on their website, I ran across the setting for “KETO diet”, but after I saw that it required to only eat 100 mg of carbs, I clicked off that one really fast. You get more than that from 1 glass of Porter! I love dark beer and good food. Real food, not pre-packaged powders or bla-tasting boxed food. I want fresh garlic, sumac, harissa. I want spice and texture. And low fat in most foods. If I want fat, I eat real cheese like goat cheddar. But that’s a treat. As long as I stick to my rule of eating at least 500 cal less than I burn, I’m ok with losing weight slowly. I want to be healthy first. So yeah, it’s a matter of preference. And patience. 🙂 To those of you who love Keto, cause it’s fast and it works for you, by all means: stay on it! It’s your body. My body runs better with a balanced diet. And that’s my 5 cents worth. 🙂
Hey Sabine. Thanks for your comment. I especially love the way you described a lack of carbs as brain farts. I know exactly what you mean. Like I always say, find what works for you and find that balance within yourself. Sounds like you’re doing what works for you!
Thanks for the great and helpful information about the Ketogenic diet .Since the last 4 years I’m on a keto diet I’m very happy,feeling a lot more healthy and I have lost a lot of weight.During that time I did quite few mistakes mainly due to misinformation so I highly recommend everyone who is really interested in keto diet to read this first https://tinyurl.com/y7xp7c6u
Glad it worked for you Stan. Thanks for sharing 🙂
I did the Keto diet for 26 days. I’m not really what anyone would consider overweight but did lose 11 pounds. My heart rate is out of control. My resting heart rate is 98 and my blood pressure is above high. I’m actually a little scared. I loved the diet and being on it, but as someone who always had optimal blood pressure and pulse before and great endurance for intense workouts, I’d say the diet has destroyed that. I wish I’d have known before. I didn’t take magnesium, potassium or salt drops like so many told me I should have been doing. (Didn’t realize this before) In my opinion, if you need to do that to stay alive on a diet it isn’t safe! I have lost weight in much healthier ways before without needing to supplement to stay alive. I am now working on getting my heart rate down at the age of 33 and 145 pounds. Such a ridiculous outcome. Diet fail!
Thanks so much for sharing Cheryl. I think if you need to take all of these supplements while on the diet, it’s probably not the best diet.
Exactly. I was eating all the foods recommended to keep the levels of these nutrients high, but apparently you can’t get the amount needed while on the diet from food alone. That definitely made the decision for me. Thanks for your article.
Thanks so much Cheryl.
Amazing review of this diet – thanks for your great information in an easy-to-understand explanation! Totally agree with your assessment. I am a nutrition consultant studying some of the research/reviews on several different plans. Great job.
Thanks so much!
This article just goes to show that NOBODY knows wtf they are talking about… For example first saturated fat is bad… years later they “find out” it is healthy… but maybe not? How can there be 2 opposing sides (with intelligent minds on each), about something as simple as what a human should eat?! My doctor told me to try the keto diet to help weight loss and improve my blood lab results. I’m only 2 weeks in but this is the easiest diet ive ever had in my life! I love everything I eat! I doubt our ancestors thrived off pasta, soda, candy, and all the processed boxed garbage the American diet consists of today. Their bread was nothing like the crap bread in stores now either. Fruit and starchy veggies are ok to eat however only in moderation. I’m just fed up with how nutritionist and scientists cant make up their mind about what a healthy diet is.
Hey Josh, nutrition research is a really complicated area and that’s why it’s always changing. The important thing is that we keep doing research to educate ourselves better. Also what works for you, may not work for other people which is another reason why research is hard to interpret as well. Thanks for your comment 🙂
I think every body responds to diets differently. What works for one person doesn’t work for another. There is not true, standard diet that’s one-size-fits-all. My sister eats a diet of mostly carbs and very little protein – and she functions just fine on this. Personally, even a moderate amount of carbs gives me brain fog, fatigue, irritability, and bloat.
While fat isn’t forbidden on keto – I also don’t think that it makes up 80% of my diet. I wouldn’t know because exact % because I don’t count fat – but I do know that I eat too much chicken, turkey, fish, and vegetables for that to be true. Contrary to the belief of some, not every person on keto is scarfing down a pound of bacon and slathering butter on everything.
And people can talk about how people who eat keto gain the weight back – show me a diet where that doesn’t happen. There isn’t a lot of reputable research about long-term weight loss, but the little that does exist isn’t great. Most people who lose a significant amount of weight will gain at least some of the weight back – if not all of it. It’s just about finding what works best for your balance and life style.
Yup totally agree. Thanks for your comment Morgan. It’s a very individual experience.
The Keto craze has not worked for me. My favorite websites unfortunately are full of blogs and recipes that keep reminding me to eat more fat. Unfortunately I still eat carbs. This has led to weight gain. For example, I love avocados and bacon, but being encouraged to eat more avocados and bacon while I’m still giving in to a quick sandwitch for lunch several times a week means my calorie intake is too high.
Definitely doesn’t work for everyone. I always encourage finding a balance that works for you.
I think you are being kind Abbey in your responses. No, nutrition is not confusing – it is very simple. Physiology/ Anatomy/ evolution says Starches and plants along with grains, and we evolved eating some meat as hominids. However, this doesn’t mean that it was ever good for us, but merely survival.
We are closest and related to primates. Primates are primarily fruit eaters and plants. Our systems are best as Frugivores mainly as we don’t digest cellulose quite as well.
Who are the healthiest people on the planet? Not those on Atkins diets, Keto diets, Paleo diets, Weight watcher diets or soup diets. As mentioned above, plants rule, and this is evident with communities who eat ‘carb dense’ foods, 90 -95% plants. They are often disease free, disability free and drug free. This is basedvon living an entire life this way – never dieting like we do.
This way of eating is a lifestyle and it has never failed, because we are all the same. The only variations are peoples environments/ temperature and food availability. Of course if someone lives in Siberia they will not eat the same as someone who lives in Phillipines; and not everyone has access to the healthiest environment and the healthiest cleanest food.
Thank you for comment!
Im a huge fan of the KETO DIET but of course, I know a lot of people “can’t do it”… Which I will “sympathize” with to an extent. If you can put your mind to it you can do it, but if they “can’t” I say, fine, add sweet potatoes! haha!
For sure! Not for everybody!
Hey Abbey. Another great post. I’m not a big fan of Keto, but I know for some people it works.. as for long term, I don’t know.
We are all created differently and I know we can’t say YOU CAN’T DO THAT, but I hope in the long run, people stay on top of their health and get off this train if it’s not helping them.
Yes totally agree! Thanks Mikki
Awesome post on the keto diet! I’ll definitely be revisiting this article when I get questions. Thanks for your thorough breakdown!!
Amazing, thanks so much love
Such an in-depth post (and I applaud you for remaining so professional throughout some of these comments)! I’ve heard a lot about the keto diet and am glad that it does seem to work for some, but am definitely more on board with a more balanced diet. Kudos to the people it does work for though (I’ve had several patients with epilepsy who follow a ketogenic diet and it does seem to be helpful for them)!
Yes, there are many benefits of the keto diet for neurological purposes. Thanks for reading love