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Is the Ketogenic Diet a Good Idea?

By: 
Alyssa Principe

If you have been on the internet over the past year chances are you’ve heard something about the Keto Diet. Whether it be success stories, celebrity endorsements, Keto supplements or recipes, it is near impossible to ignore. So what is it exactly? Does it work? And should you try it?

The Ketogenic (Keto) Diet is a very low carbohydrate, high fat diet that has actually been used in the medical community since the 1920’s to help treat epilepsy. More recently it’s being touted as the newest way to drop the weight.

What does it involve?

People who follow the Keto Diet eat almost no carbohydrates - that means no potatoes, beans and certainly no pasta or sweets. They eat as much as 80% fat with 15-20% protein and 5% carbohydrates.

So, what can you eat?

Foods NOT Allowed:

* Rice, Cereals, Pastas, Breads

* Potatoes, Corn, Winter Squash

* Legumes (beans, lentils)

* Sweets (pastries, cakes and candies)

* Most fruits, fruit juices

* Most wines and beers

Allowed on the diet:

* Meats, Fish, Poultry, Eggs

* Butter, Cheese, Cream

* Oils (olive, palm, coconut)

* Nuts (Walnuts, Almonds & Pecans)

* Avocados, Coconut

* Most non-starchy vegetables

How does it work?

The goal of this diet is to put your body into a state of ketosis. Naturally, our bodies prefer to burn carbohydrates for energy. When we deplete our carbohydrate stores we switch to breaking down fat to produce ketones for fuel.

When first starting this diet people often lose weight quickly, which is always exciting. Unfortunately this is mostly water weight. Carbohydrates are stored with water, when we use up these stored carbohydrates we lose the water with it. After this, actual weight loss slows down. People also develop symptoms of the “Keto Flu”, which includes brain fog, fatigue, headaches, bad breath and foul smelling urine which last a few days to a week.

Should you try it? Does it work?

Studies show this diet is effective for weight loss in the short term. With this weight loss we have also seen improvements in cholesterol levels and blood sugar control. All sounds promising!

What about the first few weeks of weight loss? Do you keep losing weight?

Research say no, not really. After the initial loss of water weight the Keto Diet is no better at enabling weight loss than the less restrictive gold standard Mediterranean Diet. Most worrisome for nutritionists like me is that Keto is yet another restrictive diet lacking a long term plan. This puts people in the typical diet cycle consisting of restriction, deprivation, cravings then binge eating.

Sound familiar? This diet cycle may create unhealthy food guilt and disordered eating patterns. The concern that Keto contributes to this cycle is a common reason many health professionals don’t recommend this diet plan to their patients.

Other health criticisms of the Keto Diet include potential deficiencies of specific nutrients like sodium, potassium, chloride, magnesium and zinc, which are vital to having a healthy, functioning body. It also lacks fiber which often leads to constipation. In addition there is concern about the actual content of each person’s diet when they aren’t being followed by a nutritionist and are creating their own Keto Diet plan. When people in research studies follow the Keto Diet they are encouraged to get calories from healthy fats and oils. In practice many people decide to use this as an opportunity to indulge on bacon and butter as fat sources. This important different may not produce the same cholesterol improvements that people who get fat from healthy sources experience.

I do like that the Keto Diet instructs elimination of processed foods and sugar. But, despite this the long term effects of the Keto Diet on heart disease and sustained weight loss make it difficult to recommend this diet for the general public. If you still think you want to try it I’d recommend consulting with your PCP first, and working with a dietitian to ensure safety and a plan to maintain weight loss. Above all I stand by the tried and true recommendation: make small, reasonable lifestyle changes over time to truly achieve your long-term results. Eat more fruits, vegetables, whole grains, lean proteins and healthy fats while reducing processed fats and added sugars.

Interested in learning more about healthy eating? Check out our healthy habit support group. Every other Wednesday from 5:30-6:30pm. Free and open to the community. Or if you are a patient at SBCHC ask to make an appointment with Alyssa!

Alyssa Principe

Alyssa Principe, MS, RD, LDN is a Registered Dietician at South Boston Community Health Center. She runs the free Healthy Habits Support Group and sees patients of all ages at the Health Center. She works with patients of all ages on a variety of goals, from healthy and weight issues, to picky eating. If you're interested in learning more stay tuned for her recipes and helpful tips or make an appointment to see her in clinic today!