Is the Very Low-Carb Keto Diet Right for Me?

Diets come and go, and often they come back again with just a slightly different twist and name. Such is the case with the Ketogenic diet or "Keto" for short, the newest in a line of low-carb approaches to weight loss.
A ketogenic diet is considered a very low-carbohydrate eating plan because only about five to 10 percent of your calories are coming from carbohydrates, with less than 50 grams a day being about average. The remainder of your calories come from protein, which makes up about 10 to 25 percent, and fat makes up the other 70 to 80 percent. The chart below offers a comparison of the ketogenic diet percentages to the Institute of Medicine's dietary recommendations, which are the foundation of the SparkPeople plan.
Eating Plan Carb % Protein % Fat %
Institute of Medicine
(SparkPeople Plan)
45-65% 10-35% 20-35%
Ketogenic Diet 5-10% 10-25% 70-80%

The diet's foundation lies in the fact that when carbohydrates are lacking in a person's diet, the body cannot burn fat in the correct way. Normally, carbs combine with fat fragments to be used as energy. When carbs are not available, though, there is an incomplete breakdown of fat that produces a by-product called ketone bodies. These ketones accumulate in the blood and in the urine causing ketosis. A medically managed ketogenic diet has been used for years for the treatment of epilepsy, but is today's weight-loss version a safe and appropriate eating plan?
On a ketogenic diet, you avoid all refined carbohydrates, pasta, rice, snack crackers, chips, sugary beverages, candy, cake, cookies and pastries. But in order to maintain the very low carbohydrate intake, many nutrient-rich foods are extremely limited, too, including whole grains, milk, yogurt, fruit, starchy vegetables and legumes such as beans, peas and lentils. What's left to eat? Meals and snacks are composed of meat, fish, poultry, cheese, eggs, nuts, leafy greens, some non-starchy vegetables and lots of oils and fats.
During the first week or so, a ketogenic diet brings about a rapid five- to eight-pound weight loss. But before you jump on the bandwagon, realize that the scale isn't giving you the whole story. Carbohydrate is stored in your body as a substance called glycogen. The glycogen is stored in your muscles and liver and is used for energy when needed by the body. Each gram of glycogen has two grams of water stored along with it. When you greatly restrict your carb intake, the body turns to the glycogen. With each gram of glycogen that is used, the two grams of water is also excreted from the body in your urine. Basically, your body becomes somewhat dehydrated and much of the weight change shown on your bathroom scales is water weight loss, not body fat.
In the weeks to come, the body may lose body fat slightly faster than a traditional eating plan, but the difference is minimal. Studies have shown that by a year, the weight loss is the same on a ketogenic diet compared to a more balanced eating plan. Short-term studies on a ketogenic diet have shown improvements in risk factors such as total cholesterol, HDL-cholesterol, LDL-cholesterol, triglycerides, blood sugar, inflammatory markers and waist circumference. However, it is important to note that any eating plan that leads to weight loss will tend to show these same types of improvements.

The Body's Immediate Reaction to the Ketogenic Diet

When there is a severe deficit of carbohydrates, the body has several immediate reactions, some favorable and some not.
  • Ketosis causes a decrease in appetite because it's one of the body's protection mechanisms, so your body will experience hunger control. It's an advantage for someone experiencing a famine (which the body thinks it's experiencing during ketosis) to have a loss of appetite because the search for food would be a waste of time and additional energy.
  • No calorie counting. Your focus on keto is solely on counting the carbs, which is only in a few remaining foods in your diet.
  • A possible increase in motivation and momentum due to the more rapid weight loss.
  • Nausea, headaches, dizziness, fatigue, bad breath and sleep issues due to the accumulation of ketones and the lack of energy are common in the first few weeks. Many people experience a "ketosis flu" after beginning the diet.
  • Possible constipation due to the lower fiber intake can also occur.
  • Difficulty in completing your normal workout routine due to the decrease in energy.
  • You may also become bored with the limited food choices.

The Long-Term Effects of Keto

Evidence is not available regarding the long-term usage (more than two years) of the ketogenic diet on the overall health and wellness for humans. Therefore, there are numerous concerns to keep in mind before starting keto or any other very low-carb diet:
  • Restricting nutrient-rich carbohydrate foods also restricts essential vitamins, minerals, fiber, and antioxidants found in fruits, vegetables, legumes, milk and whole grains. Key nutrients that may be lacking include calcium, fiber, folic acid, magnesium, potassium, selenium, thiamin, vitamin A, vitamin C and vitamin D.
  • The risk of developing high blood pressure, heart disease, diabetes, osteoporosis and certain types of cancer increases when these healthy carbs are eliminated.
  • Depending on food selection, the risk of developing gout may increase. Protein-rich foods contain purines, which are broken down into uric acid. High uric acid levels in the blood may cause uric acid crystals to build up in joints, leading to gouty arthritis.
  • The risk of heart disease is increased on a long-term, very low-carb diet that is extremely high in fat, especially saturated fat.
  • Beneficial gut bacteria (probiotics) feed off of certain types of fiber. A very low-carb diet, lacking in fiber, could decrease the good bacteria in your gut.

Safety Guidelines

A ketogenic diet for weight loss could be completely safe and appropriate for some adults while being disastrous and dangerous for others. As stated in the 2013 Guideline for the Management of Overweight and Obesity in Adults, numerous dietary approaches that restrict calorie intake can produce weight loss, and carbohydrate restriction is listed among these approaches.
To determine if a very low-carb diet is safe, appropriate and sustainable for you, talk first with your health care provider or registered dietitian nutritionist and obtain a personalized eating plan. Be prepared to discuss these topics in detail:
  • Based on my medical conditions, what should the percentages be for carbohydrate, protein and fat? Ask for a handout of a sample meal plan, recipe ideas and reliable books or websites which incorporate these percentages. It is still important to favor lean meats and protein sources while limiting processed meats and highly saturated fat sources, such as fatty meats and cheeses, bacon, sausage, hot dogs, pepperoni, salami, deli meats, pork rinds, jerky, sour cream, cream, butter, lard, coconut oil, palm oil, chicken fat and duck fat. Use healthy fat sources such as nuts, peanuts, avocados and oils that are liquid at room temperature. For example, olive oil, canola oil, soybean oil, corn oil, safflower oil and sunflower oil are all great options.
  • How long am I able to safely use the diet?
  • When and how do I transition my diet to include more carb-containing foods?
  • Does the eating plan fit with my cultural, food preference and food budget needs?
  • Can I follow this eating plan for the rest of my life?
The bottom line: When it comes to the latest, greatest diet, who doesn't love sensationalism? It used to be "fats bad, carbs good," now it's "fats good, carbs bad." Come on, folks, let's get serious. "All or nothing" eating plans are silly, unrealistic and bring about feelings of guilt, frustration and failure.
While research has given us many answers regarding the role of carbohydrate, fat and protein on health and body weight, there are still unanswered areas to address. As we wait for well-designed randomized control trials to bring more clarity regarding this debate, it's best to stick with a calorie-controlled eating plan based on research evidence, such as the: DASH Diet, Mediterranean Diet, Choose My Plate or the Smart Carb-Shoddy Carb Plan.
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Member Comments

There is a ton of misinformation and even scare tactics in this article.
I have been Keto for rounding 2 years-- my weight is stable (I'm on maintenance), my lab work has never been better in my entire life! BP excellent, Cholesterol (though never too high) has greatly improved, A1C perfect 5, Glucose great. I am being monitored very closely by my Dr--all of my organs are in top condition. My doctor is thrilled with my health--she says I am healthier than most 25 yr olds. I have a team of Drs (6) and everyone of them looked the the specifics of my diet and told me to continue on.

As for nutrition--I eat more vegetables than ever before. Beans, peas, lentils are not taboo--they just need to be measured. Full fat dairy like cheese and yogurt (without sugar) are fine.

sounds like the "party line" Report
This is inaccurate. I have increased energy since starting keto, and I eat more fiber than I did before. Of course, if you do keto all meat then youíll get constipated, but I eat avocado, asparagus, spinach, Brussels sprouts.... the list goes on. Yeah, the first few weeks is rough, but usually upping sodium, magnesium or potassium intake helps a great deal. Also, you need to be careful not to eat too few carbs, which I made the mistake of doing. Just donít knock it till you try it. Report
I'm new to the Keto Diet. Does this group have meal plans for Keto? Report
I also read the article and the comments. Thank you for the information Becky but, I don't think I will be trying this diet anytime soon. My sister in-law once told me that her and my brother in-law followed a low carb diet (50) carbs two days a week. It worked for them they are able to maintain their weight. I tried it for a couple of weeks just two days a week and I could hardly remember my name. Anyway I do very well just tracking nutrition, exercise and using portion control. To all of you Keto dieters, I wish you success. Whatever works!! Report
Well! I guess the Keto lovers have been heard from. I found the article very interesting! The comments were very interesting as well! I will not be trying Keto anytime soon but more power to you "Ketonians"! Report
I started using Keto recipes to help my husband control his diebetis, I actually started the diet for me 2 weeks ago. I have started planning my meals in advance so I stay within my macros or correct proportions of carbs, fats and ptoteins. I never got the Keto flu, I drink 2 liters of water with lemon every day plus coffee and tea. I am enjoying the foods I eat, lots of salads with kale and spinach, avocado, tomatoes, cucumber. This has taught me discipline in my eating and meal planning. I cook most meals with whole foods. I made lasagne noodles out of eggs, nut flour and cream cheese and we had lasagne for dinner with a salad. Lots of good recipes available. The best part of this diet is that I don't feel deprived, I am eating tasty foods and I seldom feel hungry or have food cravings. I have lost 6 pounds in my first 2 weeks. Report
I agree that this bias is just that - bias. I have been on keto for 6 weeks. I quit smoking two years ago and gained 20+ lbs. I tried everything I had done in the past when I first started on SparkPeople in 2009 and at that time dropped 25 lbs in 3 months. This did NOT work this time around, no matter how much I watched what I ate and how much cardio and strength training I did (6 days a week - 45 - 60 minutes a day). NOTHING WORKED this time until I tried Keto. I have way more energy. I have much less arthritis pain. My persistent nasal congestion cleared up. I am NOT dehydrated because I drink at LEAST 10-12 glasses of water a day. Now, that being said, I do take a probiotic every day as well as a multivitamin, Vit C, Vit D, Calcium and magnesium. I also take at least a tablespoon of pure psyllium powder every single day. I resent people who do not do keto who assume we eat NOTHING but gobs of bad fats and tons of protein. I eat many veggies, tho they may not be the ones loaded with starches and sugar. I eat nuts, and avocados and salmon and I make my own bread with nut flours. I no longer have digestive issues that I would get from eating wheat bread and rice, etc. And I did NOT give up cookies or candies. I just choose to do a hell of a lot more cooking to make these items sugar free and healthier. So I have my Christmas cookies and my raspberry chocolate candies and I am not missing much right now (except maybe french fries :) After only 3 weeks on keto I was told my a friend that even my skin looked better. I won't deny that more long term research may need to be done, but look where the government's "guidelines" have gotten us. People are dropping dead of heart disease, developing diabetes at younger and younger ages and the number of people who are morbidly obese goes up every year. Why else would some local governments mandate that restaurants now to have post nutritional info in their stores and on their websites? So, ok, to each his own. But for me, right now keto is the lifestyle I choose. Report
A ketogenic diet is low carb, high fats and medium protein. This is NOT the Atkins diet because it did not limit proteins. High proteins are bag for the kidneys.
Why is it when the government pushed so hard for their diet recommendations that obesity INCREASED instead of going down? People followed the guidelines and failed because the recommendations were flawed. Your body adjusts its metabolism if calories are decreased, even if exercising.
Please, do your own research because the studies HAVE been done, and eating low carb IS safe. This attitude of Spark People is the reason I don't come here much any more, and am considering dropping them altogether. They can only parrot what government says, even when the dietary guidelines were implemented by someone who WASN'T in the medical field but was a politician. Report
If I had kidney's I would go on a Keto diet. I am using some of the recipes and the intermittent fasting. Cutting back on carbs won't hurt me. Ketosis would in my case possibly be deadly.
There isn't a one size fits all diet. But I believe the benefit of a Keto diet in certain adults outweighs the risks because most ppl that consider going on it are obese and that is more dangerous on your health then cutting out carbs and sugar. Just don't stay on it permanently. Reintroduce certain foods like fruit after a while etc. Report
Biased much? Report
I am on a keto diet and have never felt better, more energy, less aches and pains and my blood sugar is controlled without insulin! When I ate what my diabetes nutritionist recommended, my blood sugars were out of control and I had to go on insulin. Report
I'm on the Keto and Intermittent fast diet and lost 73 pounds in 6 months. There is a Doctor on YouTube that has helped thousands of people for free, His name is Eric Berg and worth a listen.
There are many health benefits doing the Keto diet. Report
Sparkpeople's outright bias against any low-carb diet is disgusting.

y living is NOT just 1200 calories/walking 5 miles a day/eating high carb & low fat. That is outdated and bad advice, and it's about time you caught up to the current science. Report
Intereed reading. Report

About The Author

Becky Hand
Becky Hand
Becky is a registered and licensed dietitian with almost 20 years of experience. A certified health coach through the Cooper Institute with a master's degree in health education, she makes nutrition principles practical, easy-to-apply and fun. See all of Becky's articles.
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