What Are the Potential Health Risks and Benefits of the Keto Diet?
If you search online for the term “keto diet,” you will see that the health claims associated with the ketogenic diet are numerous. But before you give this diet program a try, it’s important to know what the science suggests about how it may affect your body.
Risk: You May Suffer Fatigue and Other Symptoms As a Result of the Keto Flu
One of the most common side effects of starting the ketogenic diet is the “keto flu.” This term describes the often unpleasant, fatigue-inducing symptoms that occur as the body adjusts from a high-carbohydrate to a low-carbohydrate diet. During the keto flu, the body’s stored glucose begins depleting, and the body starts adapting to producing and utilizing ketones as energy. (2)
Symptoms of the keto flu include headache, fatigue, dizziness, sleep problems, heart palpitations, cramps, and diarrhea. These side effects usually lessen and eventually resolve in about two weeks. (2) But to lessen the effects of any discomfort, simply consider slowly transitioning onto a ketogenic diet rather than rushing to change your eating habits. By slowly lowering your carbohydrate intake, while gradually increasing your intake of dietary fat over time, you can transition with less of a negative impact and potentially prevent the keto flu.
Risk: You May Experience Constipation If You Don’t Eat Enough Fruits and Veggies
The removal of many grains and fruits with such a large emphasis on fats can bring about its own set of side effects. “If not done properly — with most of your carbohydrates coming from fiber-rich vegetables — you may not be getting enough fiber, which can lead to constipation,” says
Chris Mohr, PhD, RD, a sports dietitian based in Louisville, Kentucky, and co-owner of
Risk: You Could Develop Potentially Dangerous Nutrient Deficiencies
Further, eliminating food groups can be problematic. “Ketogenic diets are often low in calcium, vitamin D, potassium, magnesium, and folic acid, which over time can lead to nutrient deficiencies if the diet is not planned carefully,” adds
, who is based in Atlanta
Risk: You May Harm Your Heart Due to the Diet’s Focus on Animal Fat and Protein
Reliance on a diet rich in animal fats and proteins may also have a negative impact on heart health, research shows. (
) “This diet is not for anyone who is at risk of developing cardiovascular disease or who has already been diagnosed with it,” Spano cautions.
This means that if you have risk factors for
— such as elevated cholesterol levels,
high blood pressure (hypertension)
, or a strong family history of the disease — you should use caution when following this diet. The diet’s heavy reliance on fat, especially saturated fat, can elevate cholesterol levels, further increasing your chances of developing heart disease in the future. (
Risk: You May Experience Potentially Dangerous Low Blood Sugar If You Have Diabetes
For any individual with diabetes, discussing dietary changes — especially those as dramatic as the ones the ketogenic diet requires — with your healthcare team is essential. Because carbohydrates are broken down into glucose in the blood, cutting carbohydrates from your diet could cause levels to crash rapidly depending on your current medication regimen. Such a change may require significant adjustments to medication and insulin to prevent dangerous side effects such as low blood sugar, called
Risk: You May Experience Weight Cycling, Negatively Affecting Your Metabolism
Outside of physical health changes, one of the biggest concerns of the ketogenic diet may be in long-term adherence. “It’s a very difficult diet to stick to and maintain. Compliance is a challenge because it is so restrictive,” explains Mohr.
Following a strict diet for weight loss and then quickly reverting to old habits when the dietary changes are too restrictive can lead to what is known as weight cycling, or yo-yo dieting. Gaining and losing the same weight over and over can start to have a negative impact on your self-image and motivation, and potentially your health. (
Benefit: You May See Improvements in Your Athletic Performance
For athletes, research on the keto diet highlights potential improvements in athletic performance, especially when it comes to endurance activities. An article suggests ketogenic-type diets may allow endurance athletes to rely mostly on stored fat for energy during exercise rather than having to refuel with simple carbohydrates during endurance training and competition while additionally improving recovery times. (
Benefit: You Could Lose Weight Fast — But Not Necessarily More Than You’d See From Other Diets
If you’re looking to lose weight, one benefit the ketogenic diet may offer is the ability to suppress appetite. A review of this form of eating suggests it may help decrease appetite, but how this actually happens needs to be studied further. (
When it comes to weight loss — a big possible draw of the plan for many individuals — the benefits of the ketogenic diet may not be much different from any other diet plan. “There is no magical weight loss benefit that can be achieved from this diet,” says Spano. “The ketogenic diet may help weight loss in the same way other diets help — by restricting food choices so you eat fewer calories.”
Mohr agrees. “Cutting so many carbohydrates is a big reduction in calories,” he says, adding that this effect will lead to a loss of water weight up front, “which is why people like the immediate response of weight loss that comes from this type of diet.”
Benefit: You May See Better Blood Glucose Control If You Have Type 2 Diabetes
For individuals with diabetes, adapting a very low-carbohydrate diet, such as the ketogenic diet, may offer some benefits when it comes to glucose management. For instance, a review found that dietary restriction of carbohydrate may reduce or eliminate the need for medication in individuals with type 2 diabetes. (
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