As a registered dietitian, I’m sure you can imagine all the questions I get about the keto diet. A lot of people come to me after trying it, so that alone is telling me it’s not accomplishing what they had hoped.
Where did it come from?
The ketogenic diet was developed in the 1920s and became a common treatment for children with epilepsy. The original diet only allowed 10-15 grams of carbs/day, 1g of protein/kg of body weight, and the rest of the calories were from fat. 1938 brought the rise of the discovery of newer epileptic drugs, and the popularity of the keto diet faded. In the early 2000s, a program on the keto diet was aired and received national attention. Since then, the keto diet has gained significant popularity, even though it’s potentially one of the last interventions for epilepsy.
Who should not do keto?
Before we go into pros and cons, it’s important to make sure that keto might even be reasonably safe for you to try. People who should definitely NOT try keto are those who have fat metabolism disorders, liver failure, pancreatitis, and certain genetic mutations.
Pros
A recently published research article study looked at several studies on variations of the keto diet. What has been found is that a low carb diet (ketogenic variation) had positive effects on blood pressure, HDL-C (helpful cholesterol), triglycerides, glycemia, hemoglobin A1c, insulin, and C-reactive protein. Well sign me up! Sounds great.
Cons
Most of us are familiar with what can happen with keto initiation- the "keto flu". Fatigue, headache, dizziness, nausea, vomiting, constipation, and low exercise tolerance. (Um, maybe this doesn't sound great...) If you make it through the keto flu, you might be waiting on long term side effects, such as fatty liver disease, low blood protein, kidney stones, and vitamin deficiencies. Let’s also not forget the antioxidants you might be missing out on as well! Looking back at the pros: these truly do sound like great benefits, but we’re not seeing them long term. One study indicated that the “statistically significant results” were in the first 6 months. After that, significance decreased. Another noteworthy con is that people who were doing a more true style of ketogenic (very low carbohydrate) had higher harmful cholesterol.
Sustainability
This is a big problem with variations of the keto diet. Most if not all sources I’ve seen indicate that it’s not sustainable long term. What would be the point of subjecting yourself to a highly restricted diet that we don’t know much about to only have benefits as long as you’re participating? It’s just not realistic to expect people to give up almost all carbs for the rest of their lives.
In the end, it’s each person’s decision. Some people just want to experiment with it and see what the hype is about. If it is something you decide to do long term, I highly recommend working with a registered dietitian to make sure you’re getting vitamins and minerals you need!
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