The Ketogenic Diet and Health Risks

As we begin the second month of the new decade, it’s likely a good time to re-evaluate your weight loss diet.  If you have tried or are considering the Ketogenic diet, this is essential reading.  Celebrity tales of quick dramatic weight loss, along with a menu of tempting, otherwise diet-forbidden foods like bacon, butter and (bunless) cheeseburgers has made the ketogenic diet the new buzzword in weight loss. Be warned, however:  the probable long-term health consequences along with the low likelihood you can maintain this strict diet should make you think twice.  If you are an athlete, don’t even think about it.  The inefficient reaction of your body burning fatty acids from ketones and stealing from muscle to produce energy is harmful to your athletic performance and health. 

The latest in low-carb diets, the ketogenic diet is mostly fat;  from 75-85% with very little protein, around 15%, and  the daily carbohydrate equivalent of a small bagel.  This contrasts to the original low-carb Atkins diet of low fat, high protein and the Paleo and South Beach diets which are high protein moderate fat. A mostly fat diet claims to keep you feeling full and reduce cravings.

The basics behind the “keto” diet is that it switches your body into starvation mode, feeding off fat cells.  Without glucose, the main fuel used for muscles, organs and the brain, your body has to use fatty acids in the form of ketones.  Glucose is a simple breakdown product of carbs and is also released in the liver from protein and fat breakdown. Without glucose, water and muscle is lost along with fat as the body searches for alternative sources of fuel.   

The time during which the body changes from using glucose to ketones is physically exhausting and marked by nausea, fatigue, constipation, muscle cramps and dehydration, called the “keto flu.”  GI upset, bad breath, low energy, cramping and nutritional deficiencies continue while on the ketogenic diet.  Other researched medical body stressors of the ketogenic diet include higher rates of heart disease, atrial fibrillation, raised risks of both stroke and heart failure, and increased risk of dying from cancer and other causes. 

Besides short-term weight loss, there have been no proven long-term medical benefits to a ketogenic diet.  This highly restrictive diet also changes the blood environment for medications and must be cleared with a physician and or registered dietician before trying. Another limitation and notable downside is that within a day of going off the eating plan, the weight begins to return.  The weight quickly is regained differently than where it was lost from, both due to fuel source adjustment and also because the diet slows metabolism due to loss of muscle.  Alcohol is forbidden on the ketogenic diet as it increases risk of keto acidosis, a state of acidic blood that can be deadly.

The best diet for long term health, weight management, longevity and cancer prevention is consistently medically proven to be the Mediterranean diet- 40-50% carbohydrates, 30% fats and 20-30% protein.   This diet emphasizes vegetables, fruits , olive oil, nuts, and whole grains with moderate amounts of meat, dairy, and red wine with very sparing sugars. 

Healthy eating, healthy weight maintenance, healthy disease prevention and longevity are positively affected by portion control and living an active lifestyle.  “Dieting” is a term of extremes, which is stressful to the body and mind.  Maintaining long term weight loss requires a sustainable healthy pattern of eating and activity behaviors.  Finding a nutrition plan that is balanced, satisfying and feasible for you will lead to successful weight and health maintenance.  Remember, HEALTHY>>>> SKINNY. 

The opinions in this article are supported and inspired by The Journal of the American Medical Association’s patient page  published in January 31 2020 explaining the pitfalls of the ketogenic diet, along with  a study published February 2018 which found no relation to amount of carbs as a predictor of weight loss. 


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