Do Dietitians Recommend the Keto Diet?
By Kayley George, RDN, LD
Every couple of years there is a new “it” diet that the wellness community loves to buzz about. In the 80s and 90s we were sipping weight loss shakes, in the late 90s low-fat/high-carb diets were all the rage, and then in the 2000s we completely flipped and traded low-fat diets for low-carb diets, prioritizing the fats that we banished merely years before.
Today’s new diet craze is the Ketogenic diet, known in shorthand as “Keto.” Everywhere you look, you see keto products, keto recipes, keto menu items, and keto devotees.
Interestingly, this diet was actually introduced during the 1920s to reduce seizures in pediatric patients with epilepsy. It claims to be an easy solution for rapid weight loss, with this diet mainly including fat and protein. All carb-rich foods are excluded from the diet.
The theory is that when there are less carbs the body alternatively uses fatty acids or ketones to produce energy. This process is known as ketosis.
Your best friend might swear by the keto diet, but what about dietitians? Do they recommend the Keto diet? That is exactly what we will be reviewing in this post.
What Is Keto?
First, let’s dive into the main principles of the Keto diet. The Keto diet is a version of a low-carb diet with more specific numbers and science as guidelines. The standard ketogenic diet focuses on macronutrient management, containing 70% fat, 20% protein, and 10% carbs.
The proponent of keeping a diet so low-carb is to put the body in a state of ketosis, a metabolic state in which your body redirects its fuel source from carbs to its own body fat. Since carbohydrates converted to glucose are your body’s main energy source, the body instead turns to body and dietary fat and converts that into ketones for an alternative source of fuel.
Let’s now turn to what the Keto Diet looks like in real time. Keeping carbs at 10% of your daily intake comes out to roughly 20g to 50g of carbs per day. For reference, one banana alone is around 30g of carbs, meaning that eating one banana could fulfill a Keto dieter’s carb consumption for the entire day.
Protein consumption is also monitored, as the body can sometimes convert protein into glucose and the Keto Diet is trying to steer the body away from glucose and towards ketones for energy. The Keto Diet places emphasis on high fat food items, like eggs, cheeses, meats, oils, and nuts, and suggests cutting out grains, starches, fruits, beans and legumes, and low-fat diet products.
Do Dietitians Think the Ketogenic Diet Is Safe & Healthy?
Let’s get to the root of this post. Do dietitians think the Ketogenic Diet is safe and healthy? The answer is a resounding NO.
In general, any diet that completely cuts out a food group or purports an imbalanced macronutrient scale is not healthy. Carbohydrates are your body’s main fuel source for a reason, and completely cutting carbohydrates as a food source goes against our body’s biological needs and wants.
While there are proponents of the Keto Diet that are healthy, namely the emphasis on healthy fats and choosing natural foods over processed items, in general the Keto Diet is another quick fix solution that can have long-term health hazards.
Will I Lose Weight on a Ketogenic Diet?
The answer is yes. Some studies show people have lost weight while following a ketogenic diet. Like any diet that cuts out major food groups, there will be a major loss at the very start of the diet as your body adjusts to the massive change in nutrition. That loss always comes from a big drop in water weight.
However, the current high fat principles of the Keto Diet can sometimes result in weight gain down the line. While cutting carbs can result in weight loss, leaning into such high fat food items, especially those high in saturated fat like butter, high fat cheeses and creams, bacon, and fatty cuts of meat as the backbone of a diet is not a recipe for a calorie deficit.
Furthermore, replacing fruits and vegetables with these high fat items, that tend to be low in nutrition but high in saturated fat, can have an adverse effect on one’s health. In the end, that big drop of water weight at the start of the diet will be returned in the future and will be harder to work off.
Reasons Dietitian’s Don’t Like Keto
Let’s look in to more detail on the specific reasons dietitians are not fans of the Keto Diet. We have touched on these above, but there is a lot more to losing out on nutrients than meets the eye.
So, let’s take a deep dive into the negatives surrounding keto according to a dietitian.
Keto Flu
There is no better evidence of the negative effects of the Keto Diet than the “keto flu.” The keto flu is a phenomenon that happens to every keto follower in the first week or two of beginning the diet.
While not medically recognized as a true ailment, the “keto flu” has such symptoms as brain fog, sleeplessness, headaches, poor digestion, and general irritability. While keto devotees paint the keto flu as your body’s natural detox as it gets into a state of ketosis, in reality the keto flu is a cry for help from your body.
Poor sleep, terrible headaches, and exhaustion are not signs that your body is in a happy place. Rather than seeing the keto flu as a necessary step in a weight loss journey, let’s instead call the keto flu what is really is: your body signaling that this new way of eating is not preferred.
Ignoring those signals is basically ignoring your body’s biological needs and is its own form of restriction.
Nutrient Deficiency
While the Keto Diet can result in weight loss, is it actually a healthy diet? The answer, like every answer in reference to a diet that completely cuts of a major macronutrient group, is no.
Carbohydrates are not only your body’s preferred energy source, they are also the backbone of fruits and vegetables, the main suppliers of vitamins, phytochemical, and nutrients for our bodies. Keeping carbohydrates so low means cutting out fruit almost entirely and cutting way back on vegetables.
That leads to huge nutrient gaps in our diets and can result in major health issues down the line, such as poor eyesight, weak and brittle bones, frail nails and hair, bad skin, and more. No amount of weight loss is worth the negative long-term effects of depriving our body of vitamins, phytochemical, and nutrients.
Not Sustainable
Another major downside of the Ketogenic Diet is that it’s not sustainable and is incredibly limiting to one’s lifestyle. Like it or not, our society has a culture built around food.
We celebrate with food, we mourn with food, we drink with friends, we cook with our family. The principles of the Keto Diet cut out all parts of that.
Celebrating a birthday? You have to skip the cake and likely most of the other food served at the party (except the vegetables and meat). Out to dinner with friends? You’ll have to get your own meal while everyone else splits the amazing delicacies that the restaurant has to offer.
Most American holidays have food built into them, meaning you’ll have to be the lone person in the corner munching on green beans while everyone else at the dinner table is sharing an awesome meal. And that’s just food; alcohol is mostly carbohydrates, meaning that drinking is completely off the table.
Is weight loss really worth it if you can’t be social and share experiences with friends and family? The Keto Diet is definitely sustainable in a bubble, but in the real world it is simply not a long-term solution.
Mental Health
Cutting out major food groups can have a huge impact on one’s mental health. The principles of the Keto Diet preach that carbs are the enemy to weight loss.
Not only is this patently untrue but these claims are incredibly damaging to one’s long-term associations around food. Many people who have done the Keto Diet have reported a growing fear of carbs and have developed some damaging disordered eating habits around this major macronutrient group.
Carbohydrates are essential to your body, your energy, and a major part of the American lifestyle. Making them off-limits and having a fear of consuming them can lead to some incredible black and white thinking, the foundation of disordered eating.
Also, depriving our bodies of their preferred energy source has major negative side effects. Being in ketosis 24/7 is akin to walking around with a constant brain fog. Having such a low carb intake can result in crazy mood swings, sleeplessness, and irritability, all of which have horrendous effects on our day to day operations.
No weight loss is worth such low feelings day in and day out.
Physical Impact
Some of the negative physical impacts from the Keto Diet include:
High blood sugar
Dehydration
Kidney stress
Tummy problems
Brain fog
Funky breath
Weight regain
Metabolic rate
Athletic performance
Let’s review what this list means. The number of ketones increase in the body when the primary fuel source is converted from carbs to fat resulting in high blood sugar levels. Too many ketones and high blood sugar levels result in diabetic ketoacidosis (DKA). DKA is more prevalent in type 1 diabetes but can occur in type 2 diabetes if ketones are too high, which is possible while being on the keto diet.
As far as dehydration goes, glycogen is a complex carbohydrate that holds water. As carbs are restricted glycogen is not present to hold water leading to dehydration
Extra stress is placed on the kidneys as there are additional ketones for the kidney to process. A patient who already has kidney problems might run into a bigger problem and need dialysis. Kidney stones can develop as well.
Due to the limited intake of fiber, you might experience constipation. On the other hand, some might experience diarrhea as the gallbladder is producing extra bile to break down the ‘extra’ fat.
Decreasing carbs from the diet can cause brain fog which includes headaches, confusion, slower processing of information, and even memory loss. As far as your breath is concerned when the body is in ketosis, your breath can start to smell like nail polish remover (aka Acetone).
FAD diets are diets that are popular for a while and promise unreasonably fast weight loss. The Keto diet is a FAD diet. These restrictive diets make people give up on them and some end up gaining more weight than what they started with.
Your resting metabolic rate could be negatively impacted. Although the body is aiming for ketosis, many times the weight loss is more from the muscle than the fat, as muscle burns more calories than fat. If you regain weight, more fat is gained rather than lean muscle, which can affect your resting metabolic rate.
Lastly, in ketosis, the body is in an acidic state. This may limit the ability of the body to perform at peak levels, compromising your athletic performance ability.
Are There Situations Where Someone Should Try the Keto Diet?
While Keto is not recommended for the general weight loss goals or nutrition overhauls there are certain populations that can benefit from a Ketogenic diet. The Ketogenic Diet is beneficial to any person that is insulin resistant and/or trying to watch their blood sugar.
These populations include those with Type II Diabetes, those that are diagnosed as pre-diabetic, people that are post-menopausal, and those with epilepsy. All of these groups have medical conditions that require them to watch their carbohydrate intake and the Ketogenic Diet’s low-carb mentality fits with the general recommendations for those trying to regulate their blood sugar.
However, for those that aren’t insulin resistant or have not been told by a doctor to watch their carbohydrate intake, the Ketogenic Diet is not recommended.
You will find that dietitians generally do not recommend a keto diet, especially since it’s not a sustainable, long term solution for your health.
It is not the recommendation of this dietitian to pursue the Keto Diet. A diet that promotes bacon, cheese, burgers, and heavy cream sounds too good to be true and that’s because it is. The Keto Diet has horrible ramifications for one’s health because it leaves huge nutrient gaps and room for serious health risks to rise.
The long-term mental effects of cutting out carbohydrates can result in wild energy swings and disordered eating patterns. On top of that, there is not a lot of research to predict the long-term effects of a ketogenic diet.
The Keto Diet is today's trend, Atkins was yesterdays, and the future will have another one. There are other ways to create a calorie deficit than this diet.
The bottom line is to modify your lifestyle by making healthy choices that are long lasting. Instead of omitting carbs or increasing fats, the goal should be centered on how to customize the plate with the right types of food from each group and keep a healthy proportion of all macro and micronutrients while controlling portion sizes. Our team of registered dietitians and health coaches can provide more information and guidance on how to build a sustainable diet to implement into your life - give us a call today for a FREE consult!
Published on Aug 19, 2020 at 7:42 am