- Marie Belzile-Davidson, MS, RDN, LD
All About Diets Series: What is Keto?
Updated: Mar 3, 2021
"Diet" fundamentally describes typical food intake. That's it! Somewhere, somehow though, "diet" came to represent rules and restrictions and evolved into "dieting". Our society framed a healthy way of eating as something that excludes rather than includes certain foods.
"Diet" and "dieting" are truly not the same though. We need to talk about our diets but should be looking at them from a place of abundance, not scarcity. It's also important to note that specific diets can be beneficial short-term tools for long-term health (think gut healing)!
In this mini-series, we're going to break the tie between "dieting" and "diet." We'll take a look at the core concepts behind some popular diets (Keto, Paleo, Raw Food, and Whole30) and we'll go through the major pros and cons of each.
As always, it's important to remember that we all have different nutritional needs. These blog posts aren't intended to promote a certain way of eating but rather shed some light on often-talked about diets! If you're interested in taking things further and learning more about what your specific needs are, working with a Registered Dietitian might be the right next step for you! Complete our 1:1 Dietitian Nutrition Coaching Application today -Gretchen will reach out to schedule your complimentary call after you complete the coaching application.
The Keto Diet:
What is it?
The keto diet (short for ketogenic diet), is designed to shift the body into its secondary form of energy production. Carbohydrates are the body's primary fuel for making energy (specifically glucose). However, we have a secondary way of making energy using fat - this is known as ketosis.
While the keto diet has recently gained popularity, it is not new. It was originally developed in 1921 as a therapeutic diet to treat pediatric epilepsy (1). The keto diet has made a comeback but this time it's more commonly used for rapid weight loss and the treatment of some chronic diseases such as high blood pressure, pre-diabetes, and type 2 diabetes (1, 2, 3, 4).
There is scientific data to support some beneficial short-term effects of the keto diet. However, we don't have a clear picture of what the long-term health impacts of this diet are (1, 3).
Note: this nutritional state of ketosis is considered relatively safe (if properly monitored and managed) and differs from the life-threatening condition of ketoacidosis (1).
What is food intake like?
The modern ketogenic diet is a very-low-carbohydrate, moderate-protein, and high-fat diet. However, there is no one specific keto diet macronutrient breakdown. Ketogenic resources suggest intakes ranging anywhere from 70-80% fat, 10-20% protein, and 5-10% carbohydrate (1,5).
By minimizing carbs, this diet doesn't leave room for processed carbohydrates like refined sugar and flour, and also doesn't leave much room for whole-food sources of carbohydrates like fruits, vegetables, grains, etc.
When it comes to fat, it's still important to minimize saturated fat intake and focus on unsaturated fats from fatty fish and plant sources like nuts, seeds, and avocados.
A common misconception is that meat is essentially unlimited on this diet. That's not the case though - taking in more protein than you need while on the keto diet can actually lead to glucose production in your body (isn't the human body amazing?!) (1). It's also important to note that proper fluid and electrolyte intake is key with the keto diet (1).
What are the pros?
· There is evidence supporting that the keto diet may help improve blood triglycerides, blood pressure, blood glucose regulation, and may increase HDL cholesterol levels (this is the one cholesterol we want to increase) (1).
· You may feel more satiated. With other diets, it's common to feel hungry as you work to lose weight. However, hunger can be less intense, even while losing weight on the keto diet (1,2).
· It can be beneficial for weight loss, in the short-term. There is often an initial period of rapid weight loss (mostly water weight), which is then followed by fat loss (1).
· If done properly, lean muscle mass can be maintained/spared while losing weight on the keto diet (1).
What are the cons?
· This diet is quite limiting in terms of what you can and cannot eat to remain in ketosis. It is a big undertaking that requires a large lifestyle change. This can make it difficult to do otherwise simple things like eating out with friends or quickly throw together a meal for the family. Overall, this leads to low long-term compliance and means weight loss is not sustained long-term(1).
· There are some short-term side effects, sometimes referred to as the "keto flu". This can include nausea, headaches, dizziness, vomiting, insomnia, body aches, and more. (1,2).
· The low-carb nature of the ketogenic diet means it's hard to get enough fiber. Inadequate fiber intake can lead to constipation, issues with your gut bacteria balance, and is even associated with an increased risk of colon cancer (2).
· Your LDL cholesterol may increase on this diet (unlike HDL, we don't want LDL levels to go up) (1).
Wrapping it up:
The pros and cons mentioned above are by no means an exhaustive list - they're just some of the highlights. Overall, the ketogenic diet can provide some health benefits but does require a lot of work and can be quite limiting. There is data to support the previously mentioned benefits, from a short-term perspective, but we have yet to uncover what the impacts are of following a ketogenic diet long-term.
1. Masood W, Annamaraju P, Uppaluri KR. Ketogenic Diet. [Updated 2020 Dec 14]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK499830/
2. Stafford, R. (2019). A skeptical look at popular diets: How ketogenic should you go? Retrieved from https://scopeblog.stanford.edu/2019/02/14/a-skeptical-look-at-popular-diets-how-ketogenic-should-you-go/
3. Barry D, Ellul S, Watters L, Lee D, Haluska R Jr, White R. The ketogenic diet in disease and development. Int J Dev Neurosci. 2018 Aug;68:53-58. doi: 10.1016/j.ijdevneu.2018.04.005. Epub 2018 Apr 22. PMID: 29689338.
4. Kalra S, Singla R, Rosha R, Dhawan M. Ketogenic diet: situational analysis of current nutrition guidelines. J Pak Med Assoc. 2018 Dec;68(12):1836-1839. PMID: 30504952.
5. Health, H. S. o. P. Diet Review: Ketogenic Diet for Weight Loss. Diet Review. Retrieved from https://www.hsph.harvard.edu/