Keto diets! They are all the rage these days. But are they actually good for you? And what even is ‘keto’? Today, we are going to be chatting about keto diets, the modern, mainstream trendy keto diet, and what ketosis means for your body and health.
*Disclaimer: As always, this is general information intended for healthy adults. Your needs may vary based on medical status, lifestyle, or life-stage. Please never replace generalized health information you’ve read online with individualized clinical care.
What is the “keto diet?”
It is also recommended that no more than 75 grams of protein are consumed per day, as too much protein interferes with ketosis.
PS: Don’t feel like reading? Check out my keto chat here.
What actually is ketosis?
As chronicled in this post all about metabolism in starvation, ketosis is a metabolic state that your body enters when the body has been depleted of glucose to burn for fuel, and starts to process fat into energy in the form of ketone bodies to provide energy to the brain and body.
Ketosis occurs after a prolonged period of starvation or carb restriction; it can take anywhere from a couple days to a few weeks depending on the individual.
When the body is in a state of ketosis, ketone bodies (‘ketones’) are formed from the incomplete breakdown of fat when carbohydrate is not available.
Ketone bodies act a source of fuel for the brain, heart and muscles. Ketone bodies also travel to the liver to be reconverted to another form of energy for other cells.
In ketosis, ketones act as a major energy source for the brain to maintain function. You may have heard keto-fans say that going keto is “good” for “brain power.’ It is true that the brain is very efficient at using ketone bodies; perhaps even more efficient that it is glucose.
Keep in mind, however, that this is a survival tactic; your body is way of clinging to available fuel and trying to make as efficient use of it as possible, reserving anything else for future survival.
Ketone bodies are acidic. While your body is equipped with buffering systems to maintain a viable blood pH, prolonged elevated levels of ketones in the blood may overwhelm the body’s buffering system, leading to blood acidosis.
Clinical Applications of the ketogenic diet:
Carefully monitored ketogenic diets have some useful clinical applications, particularly to treat symptoms of pediatric epilepsy. Patients on the diet typically stay on it for several months to a couple years. Many slowly wean off the diet after achieving seizure freedom, and are able to be seizure-free for a couple years. If seizures resume they make re-start the keto diet or use anticonvulsant drugs, or both.
For these patients, the ketogenic diet is a form of medical nutrition therapy, and often a team of doctors, registered dietitians, nurses, and other clinicians work with the family to help plan and implement the diet.
Because of the great neuroprotective effects of the keto diet in this application, keto has been suggested as a potential treatment for other brain disorders such as MS, autism, and Alzheimer’s. While the idea is compelling, there are presently no human studies to support the use of the keto diet to treat these conditions.
The keto diet has been used as a weight loss tool in clinical studies, with some success. However, most of these studies only follow participants in the short term and compare them to other diets, such as low-fat diets, and as with all human nutrition studies, it is difficult to know how closely participants adhered to their diet protocols.
A recent systematic review of randomized control trials of keto diets versus low-fat diets concluded that while keto helped dieters lose weight in the short term, the loss was often not maintained. In fact, the authors of the review concluded that weight loss peaked at around 5 months, then weight was slowly regained.
Some also believe that the ketogenic diet may be useful as a therapeutic tool against hyperlipidemia and diabetes, but others raise concern over other possible risks of the keto diet, and using keto diets to treat metabolic issues is still controversial.
Main stream ‘Keto’:
In my eyes, the mainstream interpretation of the keto diet is essentially a rebranding of Atkins. Many people who follow a keto diet unsupervised simply consume large amounts of fat and protein (probably too much to achieve ketosis) and often do not always focus on consuming healthful fats.
I often see people eating loads of bacon, cheese, and steak cooked in butter or coconut oil claiming they are on a healthy keto diet, while conveniently ignoring that processed and red meats and saturated fats are notoriously unhealthful in large quantities.
Additionally, it does not seem unfeasible to me that many people unknowingly consume too many grams of carbohydrates to achieve ketosis. While failing to achieve ketosis is actually probably a good thing for most healthy individuals, I just simply don’t know what people think they are accomplishing.
Carbohydrates are an important source of fuel for most healthy people, and many sources of carbohydrates, such as fruits, vegetables, whole grains, and legumes, are healthful.
Dangers of Following a Ketogenic Diet:
As mentioned above, achieving ketosis can lead to blood acidosis. Blood acidosis can lead to symptoms such as confusion, fatigue, headache, lack of appetite, increased heart rate, drops in blood pressure, and rapid shallow breathing.
In addition to blood ketosis mentioned above, following a keto diet without clinical direction for medical treatment carries risk.
First and most obviously, consuming such a high level of fat, if done improperly, can be damaging. While fats are important, if a keto diet is made up of high levels of trans or saturated fatty acids, there is an increased risk of cardiovascular diseases and metabolic diseases.
Trials have shown increased risk of elevated blood lipids, as well.
Furthermore, following a keto diet requires a supremely low consumption of carbohydrates, which leaves little room for most fruits, vegetables, grains, and legumes, as most contain carbohydrates. While there are a few vegetables that are very low in carbohydrates, restricting the diet to only low-carb produce puts individuals at risk of micronutrient deficiencies.
Keto diets are also often low in fiber; fiber is important for satiety and is protective against metabolic and cardiovascular diseases.
Additionally, as ketosis places additional strain on the kidneys to metabolize protein, kidneys may become overloaded in prolonged ketosis, and long-term keto diets increase risk of hepatic steatosis and kidney stones. The liver may also have a difficult time metabolizing such a great volume of fat, and keto diets risk exacerbating any existing liver issues.
Furthermore, the urine can accumulate an excess amount of calcium due to bone demineralization.
Oh, and then there’s your brain. Glucose (from carbs) is your brain’s preferred source of energy. Low-carb diets may make you cranky and irritable.
The ketogenic diet, when followed under careful clinical guidance, is a supremely effective treatment for children with epilepsy.
However, for healthy individuals, I see no real reason to suggest a keto diet as a means to improve well-being. Not only is actual ketosis very difficult to achieve and requires a very strict diet pattern, it is very hard to maintain long-term.
If you are looking to improve health, rather than doing the keto-thing, I suggest enjoying healthful fats as part of macronutrient-balanced diet, along with healthful sources of protein, as well as carbohydrates from plant-foods, including micronutrient and antioxidant-rich fruits, vegetables, whole grains, and legumes.
Thanks for reading!
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