The keto diet: Good for your health?

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Speed Read

What: The ketogenic diet is a high-fat, low-carb food regimen that also includes protein. Designed in 1924 at the Mayo Clinic, the diet was created to help children with drug-resistant, epilepsy-related seizures. Today, it has become a weight-loss craze touted by celebrities and health gurus. Proponents say it’s a great way to lose weight quickly while gaining energy. Critics say it’s unhealthy and potentially dangerous, and that side effects of the so-called keto flu can include dehydration, constipation, brain fog and nutritional deficiencies.

How it works: The diet makes the body believe it’s fasting by switching the metabolism from burning glucose, which comes from carbohydrates, to burning ketones, which come from fat. The goal is for the body to reach ketosis, a state in which the body burns fat for energy.

Ketosis is actually a medical condition in people whose bodies are starving, such as those with anorexia. However, the diet can benefit people with particular health conditions, including Type 2 diabetes and morbid obesity. In those individuals, keto can reduce hunger, improve blood pressure, increase muscle mass and speed metabolism, according to the Mayo Clinic.

Followers get about 80 percent of their calories from fats and the rest from protein. They eat meat, dairy, nuts and oils, and avoid grains or fruits and vegetables that are high in carbs. The diet contradicts the U.S. Dietary Guidelines, which advise the average adult to get about 45 percent to 65 percent of their calories from carbohydrates.

Why now? The diet has become something of a pop culture craze over the last few years, spiking in January after a debate over its effectiveness erupted among celebrity fitness guru Jillian Michaels, Today anchor Al Roker, and Bravo host Andy Cohen.

Michaels slammed the diet, telling Women’s Health that the diet is “a bad plan, for a million reasons.” Al Roker, a fan of the diet who has publicly discussed his success with the regimen, responded via Twitter, calling Michaels a bully. Cohen, another proponent of the diet, also publicly slammed Michaels after she criticized its latest resurgence.


Keto, when used as a medical therapy, can do a lot of good.

“As a therapeutic, the ketogenic diet has been used as a standard of care therapy for epilepsy for almost a century. We are now exploring it as a therapy for a range of chronic diseases, including diabetes, cardiovascular disease, cancer and Alzheimer’s. As humans, we lived without significant carbohydrates in our diet for more than 95 percent of our existence. Ketogenic diets are not ‘the latest fad diet.’ If you have adopted a ketogenic diet, I can assure you that the evidence supports it.” – David Harper, Vancouver Sun

The current obsession with keto shows we mistake weight for the key measure of health.

“The real driving force behind keto’s popularity is our myopic focus on weight as the sole determinant of health, keeping us on the dieting merry-go-round as those diets become more extreme with each rotation. Yet dieting has been shown to increase body shame, anxiety, depression and disordered eating patterns, particularly binge eating and bulimia. It is also ineffective, being one of the strongest predictors for future weight gain.” – Laura Thomas, The Guardian

Keto is dangerous for women’s reproductive systems.

“If you do one extreme thing to your body, there’s likely other downstream effects on important hormones. … Losing weight fast creates a state of stress in your body, which can trigger your adrenal glands to fire out more cortisol, also known as the stress hormone. Extra cortisol coursing through your system can lead to libido and menstrual changes and potentially suppress ovarian function if levels get too high. The potential end result: a disappearing period.” – Dr. Rekha Kumar, Glamour

After decades of diet research, there are few firm conclusions on which are best.

“Most studies comparing diets have produced results like Dr. Gardner’s: no difference in weight loss between study groups as long as the calorie intake was kept equal. But within each group, there always have been a few individuals who lost a lot of weight, a few who did not lose any weight, and a few who actually gained. Dr. George Bray, an obesity researcher who is emeritus professor at the Pennington Biomedical Research Center in Baton Rouge, La., sums it up this way: ‘Eat the diet you like and stay with it.’” – Gina Kolata, New York Times

Long-term effects of the keto diet are relatively unknown and carbs are not the enemy.

The Mayo Clinic has the most aggressive stance against keto as simply a weight-loss tactic, calling the diet “more hype than help.” Mayo quotes its own expert, Dr. Donald Hensrud, author of “The Mayo Clinic Diet Book”. He described people who go on keto or any other restrictive diet: “They want an easy way out,” Hensrud said. “They want the magic panacea.”

And while decreasing carbohydrate intake dramatically will make a body burn fat and drop weight, problems arise after the initial weight loss, Hensrud said. “Long term, it’s hard. People miss some fruits, different vegetables, grains. … It becomes a very restrictive diet. So although people lose weight initially, maintaining it and keep it off long term is a real challenge on a keto diet.”

Hensrud recommended exercise, portion control and increasing fruits, vegetables and whole grains for long-term health.

Bonnie Taub-Dix, a registered dietitian and certified dietitian-nutritionist, told “Well and Good” that she’s against keto long term or even for a short while. “This is just another fad diet,” she said. “Carbs are not bad for you. … They’ve really gotten a bad rap over the years, but it’s more about choosing the right carbs.” – Rose Kennedy, Atlanta Journal-Constitution