keto diet side effects

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—Adela D., sophomore, San Bernardino Valley College, California

Great question! The ketogenic (keto) diet has been a major topic of conversation and controversy among dieters and health practitioners, especially in the last few years.

The keto diet is essentially a very low-carb, high-fat diet that deprives the body of its primary energy and fuel source, glucose. The ultimate outcome promoted is a shift into ketosis (fat-burning mode), which often leads to rapid weight loss.

Although the keto diet may sound appealing, I would encourage you to think twice and proceed with caution before going down that path.

Keto diet risks and benefits

Glucose—which comes from carbohydrates—is the preferred source of energy for most of our vital organs (and the primary fuel that is used by our brain). Because we rely on glucose for energy, our bodies have built-in compensatory mechanisms that are triggered when we deprive ourselves of this primary fuel source. These mechanisms signal the breakdown of fat and protein from body tissue to create glucose. This process produces byproducts known as ketones, acidic substances that circulate throughout the blood until they are excreted through the urine as metabolic waste. We all produce small amounts of ketone bodies regularly; however, this state (known as “ketosis”) is not an ideal state to be in indefinitely, as we don’t know the long-term effects.

The most common side effects of a keto diet include:

  • Low energy
  • Irritability/mood swings
  • Constipation
  • Increased cholesterol levels
  • Kidney damage
  • Increased risk of nutrient deficiencies

The only clinically proven group of people known to benefit from ketosis are children with epilepsy. When it comes to type 2 diabetes, the evidence is mixed, which reinforces my conviction that there is no one “right” way to eat.

Why diets don’t work in the long term and what to eat instead

From a behavioral standpoint, a major catch with extreme diets is that they are not realistic or sustainable. I often see people go through a “honeymoon phase” initially; however, as time passes, life happens. We realize we cannot live in a bubble. We decide, “This isn’t fun anymore!” and fall back into less healthy eating habits. This reinforces a behavioral cycle commonly referred to as “yo-yo dieting.”

dog with baguette saying "carbohydrates are not the enemy."In the US, we have a very dysfunctional relationship with carbohydrates and the food system.  Carbohydrates are not the enemy. We need them to live. But, of course, like everything else, excessive amounts are not healthy either.

All of that said, I would not advise people to go on a keto diet for weight loss or general health purposes. I’m an advocate of the Health at Every Size® movement, so while I don’t advise people on weight loss, I believe that balanced, nutrient-dense food choices go a long way when it comes to our health. My recommendation is to include plenty of whole, nutrient-dense foods, such as fruits and/or vegetables, at most meals. We also want to make sure we’re regularly eating a variety of nourishing carbohydrates, fats, and proteins from whole, minimally processed foods. The MyPlate model is a great example that I use often for myself and others.

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Jenna Volpe is a registered and licensed dietitian, nutritionist, herbalist, and self-proclaimed foodie based out of Austin, Texas and Woburn, Massachusetts. She has been studying and working in the field of nutrition and health for over twelve years. Jenna runs a private outpatient nutrition practice where she helps people reverse chronic illness and heal their relationship with food. Her clinical specialties include digestive health, depression, diabetes, thyroid disorders, heart disease, eating disorders, and polycystic ovarian syndrome. Her philosophy is that we should all be able to have our cake and eat it too!