Should You Go Keto?

I get asked about the Ketogenic (or “keto”) diet ALL the time, so I wanted to share my opinion and educate anyone that is considering and/or following the keto diet.  As you know, I am not about the fad diets, but I can see why the keto diet is gaining traction. According to keto enthusiasts, the diet may have numerous benefits including protection from cognitive impairment, improved glycemic control for diabetics, reduced risk of developing cancer, improved cholesterol and blood triglycerides, and weight loss. After hearing this, you may be thinking, “Why am I not doing this?!”.

I’ll tell you why, but first let’s review the diet:

The ketogenic diet isn’t new. It’s been around since the 1920’s and has been historically used to treat epilepsy in children who didn’t respond to drug therapy. It is very high fat diet, very low carbohydrate diet that results in the production of ketones (byproducts of fat oxidation). This forces you to enter “ketosis”, a state in which the body uses ketones (or fat) for fuel instead of glucose (AKA carbohydrates). Despite being used for nearly a century, the mechanisms underlying its efficacy in epilepsy remain unknown. It is thought that ketones have a neuroprotective effect and play a role in modulating major excitatory and inhibitory neurotransmitters (which are involved in seizure control).

So, what does a ketogenic diet look like?

Typically, the goal is to consume 75% of daily calories from fat, 5% daily calories from carbohydrate and 20% daily calories from protein. So, let’s say your calorie needs are 2000 (for easy math). This would look something like 167 grams fat, 30 grams carbohydrates and 100 grams of protein. Food Translation: 3.5 tablespoons oil, ½ cup half and half, 2 eggs, 6 ounces sirloin, 5 ounces chicken thighs, 2 ounces cheddar cheese, 2 cups broccoli, 1 cup romaine lettuce and 1 avocado.

There are obvious drawbacks

First off, we’re not really into guzzling down tons of oil and half and half (and we love our veggies too much to be that restricted!). Second, this way of eating predisposes you to many nutritional deficits in energy (if you can’t get enough fat down), vitamins and minerals (lack of vegetables).

We are learning more and more about the gut microbiome and its impact on aging, digestion, the immune system, and cognitive function. Following a very low carbohydrate diet for a long period of can lead to gut dysbiosis and a reduction in the diversity of the gut flora. This may be due to the restriction of fibrous vegetables (to keep carbs down) which provide prebiotics (i.e. food for your “good bacteria”).

Another important fact: Carbohydrates play a very important role in regulating thyroid function (you know, that thing that basically controls your metabolism?). They are needed to convert the inactive T4 hormone into the active T3 hormone to ensure proper function of the thyroid.

Finally, you have to consider the effect any type of super restrictive diet will have on your life. It can be difficult to go out to eat, spontaneously meet a friend for drinks, or meet your grandma for tea and cookies. It also may require more time in the kitchen, food tracking, and lots of recipe research. You’ll also need to test your body with ketone strips to ensure you are in ketosis.

There are so many things to consider before embarking on any new diet. What works for someone, won’t always work for you. Tuning into your body is key.

Tired of the diets in general? Want to kick diet-culture in the you-know-what? Let’s work together!

Adapted from the original publication for Brown and Medina Nutrition