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.
 
Pros:
  • 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.
Cons:
  • 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

I tried keto diet for 2 weeks, maybe I gave in too soon to see real results, but I didnt see any real different results. 3 lbs in 2 weeks. I was sick up to my eyeballs of eggs!! Never a real fan of eggs to begin with.
I am now doing low carb, but just not pushing myself to go the KETO low.
I have not minded giving up breads and pasta. But I strive every day to get enough fiber.
No amount of the veggies allowed on keto add up to the number of fiber grams SP recommends.
I like oranges too much to stay on that diet for very long.
Several friends have been successful on the Keto diet.
I wish everyone well in whatever plan they choose to follow.
Drink lots of water, try to exercise as much as you physically can. and dont forget to enjoy life once in awhile.
If you deprive yourself too much you will grow resentful and self sabotage.
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Some people use this nutritional plan successfully. I am not one of them. I tried for more than a month and my body just wouldn't respond to the regimen. If this works for you then more power to you. Just remember the key to any weight loss: No one can tell you for sure what "the best plan" is. Everyone's body is different and responds differently. You need to determine what works best for you. And then actually stick with it :) Report
great. Report
I have a friend who is doing the me to diet, and while it may be a good choice for her and many other, it's not the right choice for me. It sounds like it has many good benefits of you can follow it, stay in track with it and it's something you can do long term. Report
This article is incredibly biased & misinformed!! This is not a fad diet. It's been around for 100 years & has been used that long on children with seizures. No other eating plan shows the brain benefits (along with a plethora of other benefits) that Keto provides. My physician highly recommended this eating plan for myself & for my mother who has Alzheimer's. Be sure to do your own research & don't just buy into what "they" (pharmaceuticals, insurance & government) tell you is best. They have a vested interest in keeping us unhealthy!! You might want to go to YouTube & check out all that KenDBerryMD has to say about keto vs. other eating plans. This is the kind of regular misinformation that keeps our nation overweight & unhealthy!! Report
I've been Keto for almost 2 yrs. I gained some weight back when I stopped tracking and let carbs creep in. I was on insulin for 6 yrs. thanks to the USDA guidelines and big pharma pushing T2 diabetics into using insulin. I stopped processed foods, starches and sugary vegetables. I feel great and am no longer on diabetes meds. It's "professionals" such as the author who kept me UNhealthy. Six meals and whole grain is DEATH to a diabetic. Balanced nutrition where fruit and grains are push is a death knell. Look at the real science behind Keto. My endocrinologist is very knowledgeable and on board with what I'm doing. This is a horribly biased article, not based in real science. Talk to Dr. Westman and learn the truth about real nutrition, not what big pharma and big corporate Farms are pushing on the education system you got your degree from. Report
Thanks for the info on Keto. Basically the same as what my diabetes educator told me. I will not be doing KETO. Report
I'm glad to see so many "Recovering Carboholics" here! I, too, have the full support of my medical team (not just for me, but also my husband and teenage son). This "diet" has been around for 100 years and has been used to treat a plethora of conditions, successfully. I've met people who've been on a Keto way of eating/life (WOE/L) for over 20 years, one for 40 years. My doctor told me she wishes all her patients were as healthy as me. I did all sorts of programs, including FAITHFULLY following everything here and my body didn't respond. Sure, I lost a little, but it came back, even while still following the program to a T. My body just isn't "normal". My husband is now off his blood pressure meds, heartburn meds, his cholesterol normalized and his sleep apnea has improved. The PA at our office was astonished that his good cholesterol went up! My son's cholesterol has been coming down. Mine hasn't really changed, but I have more to loose than they do. I'm down 70# in less than a year and have about 60# to go. I literally needed to loose more than half my body weight. My next step was to suffer through looking into gastric surgery. I don't think I could have actually gone through with it. I was, physically, healthy except for slightly elevated cholesterol to begin with so I don't really have any other medical stuff to measure against like my husband did. #ketoon #ketoforlife #askmeifimissbrea
d Report
Good to consider. Report
EMAN08
Even the Medical Diet "Dash Diet" which was originally created for controlling blood pressure and losing weight updated their diet in their new edition including a low a carb life style. During the first 2 weeks of their diet no starchy carbs are allowed at all. Not even fruits are allowed. On week 3 you introduced them back but they now recommend only 2-4 servings of starch compared to their original diet which was 6-8 servings of starch. At the beginning of their book they explain that once you are over age 35 you are most like insulin resistant or will become insulin resistant and will not be able to handle starchy carbs as well the older you get.

Me personally, I was pre diabetic for 2 decade until I hit a 6.8 AIC and was put on Metformin. Even with medication my fasting blood sugar in the morning is 130. On a Keto Diet my fasting glucose is between 113 to 120 so under diabetic and I have a chance to improve it overtime and get off medication. Report
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.

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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


 

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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