Nutrition Weight Management

Considering the Keto diet? What our health experts want you to know about the latest diet trend

July 2, 2018

Considering the Keto diet? What our health experts want you to know about the latest diet trend

Updated on 7/13/2018

So you want to lose weight fast. Is the ketogenic diet a valid approach, or just another fad?

This strict very low carb diet caught on because it sounds simple and can produce results.

But it can also be hard to maintain and should be undertaken with close monitoring by a health care professional with experience supervising the ketogenic diet.

The science behind this weight-loss diet is still being understood. In fact, more is being learned about its long-term effects.

A little history: The ketogenic diet was created by Gianfranco Cappello, a surgery professor in Italy. His study included 19,000 dieters who experienced significant, rapid weight loss and few side effects.  The diet was also found to help control seizures in children with epilepsy, though it’s not yet understood why. This and other low-carb diets have shown promise for those with obesity, type 2 diabetes and cardiovascular risk factors.
The trick with keto is that it’s strict. You have to adhere closely to the diet or it won’t work.

How it works: Put simply, a “keto” diet is composed of an extremely low-carbohydrate, adequate protein and high-fat diet which forces the body into a state of ketosis. This occurs when a lack of carbohydrates lowers a body’s blood sugar levels, which causes the body to break down fat instead of carbohydrates to use as energy.

That breakdown of fat is where the weight loss occurs.

Diet Composition:  The keto diet is typically planned to provide 80 to 90% of the energy from fat in a ratio of grams of (fat) to grams of (protein plus carbohydrate) as “4:1”.1  The total amount of calories to be consumed should be based on an individual’s body mass index, prior dietary intake and physical activity.  Getting the 80 to 90% of calories from fat required to achieve ketosis can be difficult. It’s also very easy to go over on your carbohydrate limit. Others struggle getting enough, but not too much, protein. Without getting the right balance, you can be ingesting a lot of fat without achieving the weight loss.

Precautions: The ketogenic diet relies on ketosis, which generates a higher than usual level of ketones in your body.  This can be very dangerous for individuals with certain inborn errors of metabolism.  This is why health care providers urge keto dieters to be under the supervision of medical professionals including a dietitian or nutritionist.

Since the keto diet can be heavy on red meat and fatty foods, it’s not considered good for your overall, long-term health. Side effects which can occur over time include kidney stones, high cholesterol levels, constipation, muscle loss, slowed growth and bone fractures.

My advice: If you want to go the keto route, work closely with your health care provider. If not, skip the keto route and stick with the basics. A healthy diet and regular exercise will achieve the weight loss you want.

Reference:

1. Gupta L, Khandelwal D, Kalra S, et al.  Ketogenic diet in endocrine disorders: Current perspectives.  J Postgrad Med. 2017 Oct-Dec; 63(4): 242-251

This post was updated to provide a more balanced review of keto diet and to include references. We also removed the reference to eating an apple, as that is typically not within the keto diet.

Learn more about Dr. Wang or request an appointment.

 

12 Comments
  1. EJ Newell

    Thanks for this piece. I now request an informed, counterpoint article posted in this newsletter that provides commentary from a medical doctor who supports a ketogenic diet /lifestyle.

  2. Stephen L Gillespie B.S. M.S. D.D.S.

    Very poor article. We may be comparing apples and oranges here, but the Atkins diet has been around since the early 70's and has been well documented. I used it to lose over 100 pounds in about nine months in 1972-73. I used it off and on for twenty-five plus years to maintain a healthy weight. Very little of the 100 pounds was " water weight." My blood sugar was well regulated, cholesterol and triglycerides good, and kidneys healthy. It has been less effective as I have gotten older, but lost 43 pounds in 8 months last year. I have a master's degree in biology with concentration on mammalian physiology. I know how and why this diet works for many people when others don't. It's very discouraging to see doctors in this day and age continue to spew old school platitudes that are not supported by data.

  3. Ketovore

    "Since the keto diet is heavy on red meat and fatty, processed foods..." Processed foods are NOT keto. Keto is all about fresh meats and veg, along with healthy fats. Please know what you are talking about before publishing an article.

  4. Tanya

    I feel that you have not researched this way of eating thoroughly.. as someone that’s eaten keto for over a year, one.. you can’t eat an apple on this diet.. two.. you fail to mention the energy gains and mind clarity. My blood levels are now perfect as well. I would encourage you to do more research before speaking on it. Processed foods are not typically eaten. I’m not sure where you got your research.. but most of it is incorrect.

  5. Craig Lacy

    I have to disagree. The Keto diet is not a fad or a scheme. Keto-bashing reports are everywhere, describing low carb ketogenic eating as the latest ridiculous diet fad that its followers like us are too dim-witted or gullible to recognize as 1) harming us; 2) ineffective or unrealistic; 3) setting us up (or our children) for future health problems; 4) unsustainable for regular folk; or 5) bad for the planet. It has evolved well beyond the original premise established to treat epileptic children. The "basics" you recommend are what have made a large portion of Americans sick. Most people, unfortunately, only eat processed and fast food in their diets, which is are what manufacturers promote. You and most dieticians, nutritionists, and anyone who recommends the Diabetic or Heart Association guidelines have not really done deep research on the Keto diet. Here is some information to provide more substantial evidence, and this is only one brief example. : "Early results of a current trial reported that Type 2 diabetes symptoms can be reversed in just 10 weeks on such a diet. Subjects suffering from diabetes were educated about carbohydrates and coached over the study period. They effectively cured themselves of their disease, something that mainstream medicine does not even believe possible. These are preliminary results, but many other studies on low-carb diets contain positive results that are similarly encouraging for people with nutrition-related diseases. Low-carbohydrate diets have now been tested in at least 70 clinical trials on nearly 7,000 people, including a wide variety of sick and well populations, mainly in the U.S. Thirty-two of these studies have lasted at least six months and six trials went on for two years, enough time to demonstrate the lack of any negative side effects. In virtually every case, the lower-carb, higher-fat diets did as well or better than competing regimens. The cumulative evidence shows that low-carb diets are safe and effective for combating obesity, highly promising for the treatment of Type 2 diabetes, and they improve most cardiovascular risk factors." ( GARY TAUBES AND NINA TEICHOLZ, JAN 28, 2018)

  6. KATE GIBBONS

    SO much misinformation in this article! ☹ People who are doing Keto do not aim for 80 to 90% of their calories from fat. That would not provide sufficient protein. Most people eat 70 to 75% fat. It is not hard to maintain once you learn how. I know people who have been doing keto successfully for 10 years or more. And there is nothing dangerous about it if it is done properly. In fact it is very healthy for most people and improves myriad health problems. Big Pharma does not like it because those who follow it nearly always end up no longer needing their medications for diabetes, triglycerides, cholesterol, high blood pressure, etc. It absolutely does NOT call for processed foods. Quite the opposite. Real, whole, paleo-type foods are stressed, and processed foods are avoided.

  7. Patrick

    Hi...I read your post and am curious as to what the “processed foods” are to which you refer above? I’ve always understood keto as encouraging nonor minimal processed foods.

  8. DW

    Are you being paid by the sugar/carb industry? This article is utter nonsense. I've been in ketosis for 4 months now and have zero issues and losing weight easily without HUNGER. Do you know how much people spend every year on a Magic Diet Pill? This diet is the safest and most effective and yet free. Oh wait you're probably being paid nicely by big pharma, makes sense now. Nevermind.

  9. Lisa

    I’m not sure where you got your information from but the idea that a ketogenic diet is heavy on fatty, highly processed foods is absolutely incorrect. The idea is to remove the processed foods from your diet altogether - I follow a ketogenic diet and eat very clean. Also, this idea that an apple would put you over your carbohydrate limit is also a fallacy. Unless you have a medical condition that requires very low carb intake, you can be in ketosis and still consume quite a generous amount of carbohydrates - again, we’re talking green leafy veggies, limited fruit, etc. there are so many ways of doing a ketogenic diet and to dismiss it all because there are some who comply with the macros but still eat processed food or who consume little to no carbs, which is hard to maintain is irresponsible to those who could really benefit from this way of eating.

  10. Marty Shumway

    This post is ridiculous and completely misrepresents a healthy nutritional ketogenic diet. Heavy on processed foods? This makes zero sense. A nutritional ketogenic diet should include NO processed foods. If it does, you are doing it wrong. What is your definition of a healthy diet? Since you don't say, I assume it's high carb low fat? This way of eating is responsible for the epidemic of obesity and metabolic diseases we have in the United States today, ever since the FDA began promoting a high carb low fat diet.

  11. RK

    Well, a few things. 1. The keto diet 'relies' on neither red meat nor processed foods. I get most of my protein from pasture-raised chickens and free-range eggs. There are vegetarian, and even vegan, people who do keto. 2.The only thing keto dieters don't take in that the nay-sayers keep coming back to is grains. The human race has existed for 200,000 years. Agriculture has existed less than 20,000. 180,000 years of eating meat, field greens, eggs, and berries was the norm, before cultured grains. 180,000 years is a long 'fad'. 3.It's not 90% of calories from fat. The number is 70%. If you make a big plate of fresh salad and drizzle a little olive oil over it, or add in an avocado... guess what? that's keto fat to carb proportions! And if you didn't mention the word 'keto' to anyone, but just let them watch what you're eating, they'd remark on your healthy eating habits. 5. The keto diet actually gets people cooking at home, watching their limits and being mindful of what they're eating. These are huge improvements over the standard habits that brought so many to obesity.

  12. GARETH LUTTON

    How is it heavy on red meat and processed foods. You literally said not too much protein. And there is no necessity to eat red meat or processed foods

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