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Low-carb diets are all the rage right now. There’s been Atkins, South Beach, Paleo, and more. Now keto seems to be the newest kid on the block. People have claimed to have great success on this diet, but does that mean you should try it? The thing about diets is, we need to consider the impact to our overall health. Weight loss isn’t worth much if you’re trashing your health to get there. So, in this post, we’re talking keto and what you need to know before considering this diet for yourself.



What Is a Ketogenic Diet?


A ketogenic diet is one that emphasizes a high fat intake with extremely low carb intake. About 75% of calories are consumed from fat, 20% from protein and 5% from carbohydrates. The goal is to force the body to use fat for fuel by starving it of carbohydrates. This process is called ketosis.


Keto was not originally designed for weight loss. It was initially used to help reduce seizures in children suffering from epilepsy. However, its purpose evolved, and we all know the diet industry loves a new product to sell.



What Is Ketosis?


Under normal circumstances, your body derives fuel from glucose. It obtains glucose by breaking down carbohydrates. The glucose is then used immediately for fuel, or stored in the liver and muscle tissue as glycogen.


When there isn’t enough glucose available, your body enters starvation mode. It will try to keep you alive as long as possible to find your next meal. To do this, it begins burning stored body fat. This is a metabolic process called ketosis.


However, it’s important to note that ketosis is not a condition under which your body thrives. Therefore, it is not ideal to be in this state for long periods of time due to some side effects that occur. More on that later.



Carbs vs Fat as Fuel


Carbohydrates are your body’s preferred source of fuel. This is because they are clean burning and easy to break down into glucose. They are also prevalent in natural foods. Meaning it’s rather easy to find carbohydrates in your diet and much harder to avoid them.


When there aren’t sufficient carbs to burn for fuel, your body tries to burn fat instead. But not all parts of your body can use fatty acids for energy. To remedy this, your liver works hard to convert fatty acids into ketone bodies, or ketones. As ketone levels rise, your blood becomes more acidic. Normally, your body has methods to correct this (more on that later), but diabetics tend to create more ketones than most. The result can lead to ketoacidosis, which is a serious condition that can prove fatal. Type 1 diabetics are at higher risk for ketoacidosis. In their case, this requires serious medical intervention to avoid diabetic coma.


As far as energy sources go, carbohydrates are like solar power. Easy to generate, and non-polluting. Fat is more like burning coal for energy. It can do the job but in a very messy way. This results in unnecessary ‘pollutants’ in your body.




Hand with measuring tape interlaced with fingers with text overlay - what you need to know about keto.




Side Effects of Ketosis


Now, you may be thinking of ketosis as the holy grail of weight loss. After all, most people would be happy to burn through some of their body’s fat stores. However, it’s important to note that there are many side effects that come with prolonged ketosis. Let’s go over some of these now.



Keto Flu


When beginning a ketogenic diet, most people experience flu-like symptoms within the first 1-4 weeks. Symptoms include:


  • Headache
  • Dizziness
  • Fatigue
  • Nausea
  • Stomach pain
  • Confusion
  • Irritability
  • Poor quality sleep
  • Constipation
  • Trouble concentrating


If you can tough it out through those symptoms, most will resolve within a few days to a week. Although, it typically returns again when people discontinue the diet.



Bad Breath


This is due to acetone, one of the ketones your body starts creating. Those of you who have ever removed nail polish will know how foul acetone can smell.  In an effort to reduce the acetone levels in your blood, the body will try to get rid of some in the breath. Other ways your body can try to rid itself of acetone is via sweat and urine.



Digestive Trouble


Constipation is a common side effect of ketosis. Some also report diarrhea. This is due to the lack of fibre present in the ketogenic diet. A low-carb diet is typically also a low fibre diet, which has its own host of side effects. But more on that later.



Muscle Cramps


Many people report muscle cramps after starting a ketogenic diet. This is mainly experienced in the leg muscles. The main source of weight loss early on in the diet is water weight. This can lead to mild dehydration, causing cramping in the major muscle groups.



Keto Rash


While uncommon, some people report a rash or itching while on the keto diet. This is caused by acetone, one of the ketones produced in ketosis. The same one that can contribute to bad breath and smelly sweat and urine. It can be very irritating in higher concentrations.


Still with me? Ok, let’s keep going. More side effects to get through.



Heart Palpitations


Some people experience an increase in heart rate when beginning a ketogenic diet. This can be due to an electrolyte imbalance or potassium deficiency, which are common with this diet. It can also be attributed to the initial water and sodium loss people experience on keto.


An increase in resting heart rate means that your heart has to work harder than usual to pump blood. This is not something you want to see, as it is a sign of stress on the body.



Kidney Stones


Remember when I mentioned that ketones cause the acidity of your blood to increase? Well, it also increases uric acid levels, which can lead to kidney stones. Increased acidity also causes bones to demineralize, releasing calcium to try and correct the blood ph. This increase in calcium in the bloodstream can also lead to the formation of kidney stones.



Increased Risk of Bone Fractures


This is also caused by the increased acidity of the blood. As I mentioned above, your body will work to counteract this acidity by leaching calcium from your bones. This leaves your bones weaker, and more prone to fractures. Over the long-term, this may also contribute to osteoporosis



Nutrient Deficiency


The restrictive nature of this diet means that lots of foods are no longer on the menu for keto followers. Carbohydrates are found in a wide array of healthy food sources. Fruit, whole grains, legumes and even some vegetables contain carbohydrates. Which means they are either strictly controlled or not allowed at all on a ketogenic diet. These are not foods one should avoid when aiming for good health. The end result is a real risk of nutrient deficiency. Particularly in nutrients like fibre, folate, thiamine, potassium, magnesium, calcium and vitamins A, E and B6.



Change in Blood Composition


A common side effect of a high-fat diet is increased lipid and cholesterol levels in the blood. This is due to the high consumption of meat, dairy and associated saturated fats. A diet higher in fat, especially saturated fat, can put you at an increased risk for high cholesterol and ultimately heart disease.


I could go on (seriously, there are more) but we have some other points to cover, so let’s leave it at that. The takeaway here is that there are side effects to ketosis. Lots of them. As I mentioned above, burning fat for energy is not unlike burning coal. That messy fuel comes with side effects.




Brunette woman on scale with overlay text - what you need to know about keto




Implications of High Fat Diet for Type 2 Diabetes


It may appear that a low-carb diet helps to control blood sugar. Well, that’s easy to do when you’re consuming very little sugar. However, we know now that the underlying cause of insulin resistance is not sugar, but fat. I explained this in The Truth About Carbs. A buildup of fat in the bloodstream and muscle cells makes insulin less effective at moving glucose from the blood into the cells for use.


Difficulty with blood sugar control is also seen when coming off the diet. Even non-diabetics may see huge blood sugar swings and signs of insulin resistance when discontinuing the diet. This is likely due to the high amounts of fat consumed on a ketogenic diet. That excess fat directly contributes to increased insulin resistance.



Health Effects of a Low Fibre Diet


Do you know what you miss out on when you aren’t eating carbs? Fibre. Yep, natures scrub brush for keeping those intestines moving as they should. In fact, most of the population, low-carb or not, is not consuming even close to the recommended amount of fibre on a daily basis. As a result, we see increased complaints of digestive upset. A diet low in fibre is associated with constipation, irritable bowel syndrome, weight gain, elevated cholesterol and an increased risk of colon cancer.



What Available Studies Show


Multiple studies have been done over the years to look at the long-term effects of a low-carb diet plan. They’ve found an increased risk in mortality of anywhere from 21% to 53%. A recent meta-analysis looked at the available data to pull some conclusions. They found an average increase in all-cause mortality of 31% across all of those studies. This means that while following a low-carb diet, participants had, on average, a 31% increased risk for death by any cause.

It begs the question, is a diet worth dying over?



Difficulty With Keto


We all know the problem with diets is that they only work when you’re on them. Once you stop, the weight usually creeps back on, and then some. This is absolutely the case with keto. Once you start eating carbs again, you start to experience the rebound weight gain.


Keto is incredibly restrictive. The carbohydrates are cut to almost nothing, so fruit, bread, rice, grains, legumes and even some vegetables are off the table. As well as any sweet treats.


It’s also really difficult to follow. You have to be rather vigilant with your intake to be sure you remain in ketosis. Often time people need to purchase test kits to check for ketones in the urine. You need to be 100% on plan in order to experience weight loss. These factors make it a diet that is unsustainable over the long-term.



Fad Diets


It’s important to take a minute here to talk about fad diets and why they become so popular. The thing about fad diets is that people tend to get caught up in results. So, there must be some results to be had if people are jumping on the weight loss train, right? Why is this?


Well, what do most fad diets have in common?

First, you have to give up processed junk food.

Second, you prepare meals yourself rather than hitting up the fast-food drive-thru.

Third, you tend to be on your best behaviour when trying out a diet, eating only as directed.


The irony here is that doing any of these things will usually net you some weight loss. Cutting out processed junk and fast-food will undoubtedly have a positive impact on your waistline and your health. So, take these fad diets with a grain of salt. It’s important to look at the long-term effects on your body, and whether these diets have a positive or negative impact on your overall health.



The Bottom Line


You don’t need to eradicate carbs from your diet, it’s not a healthy choice. Instead, choose good quality carbs. A doughnut is not the same as an apple, or beans, or whole grain toast. Don’t fall for the oversimplified diet that counts them all the same. If you’re confused about good carbs vs bad carbs, check out this post where I help you discern the difference.


The fact is, there are no shortcuts to healthy, sustained weight loss. Many will spend lots of money and put their health on the line trying to find them, but they don’t exist. The best approach is to eat healthfully on a consistent basis. This will help with weight loss as well as improving your overall health.


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The Truth About Carbs

How to Choose Good Carbs

The Truth About Protein



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Feature Image credit: Photo by Thought Catalog on Unsplash

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