Why People Love Keto and Experts Hate It

The keto diet is everywhere. You can read endless articles about the diet online, while markets carry all sorts of keto-friendly products. People just love talking about the keto diet, and many dieters attribute their weight-loss success to the plan. On the other hand, many nutrition experts don't promote (and actually hate!) the keto diet. Why is this diet in a love-hate relationship with nutrition experts and dieters?

Dieters all over social media have been touting the benefits of keto, but it's rare to find a full explanation of the physiological response to the diet. This high-fat, moderate-protein and very-low-carb diet has dieters giving up grains, legumes, sugar, low- and non-fat dairy, some nuts and seeds, some vegetables and most fruit. The science behind the diet is that by cutting carbs this low, your body needs to use an alternative mechanism to provide the body energy. As such, your body turns fat into ketones, which are, ultimately, the body's backup mechanism for providing energy. But with so many success stories, why aren't nutrition experts hopping on the keto bandwagon?

What Nutrition Experts Say

Keith Ayoob, EdD, R.D.N., an associate clinical professor of pediatrics at Albert Einstein College of Medicine, says putting your body into a state of ketosis is never recommended, and could even be harmful. "It's certainly a sign of an unbalanced diet. You may lose weight on it, but a ketogenic diet is, by definition, unbalanced and should never be maintained—that's a red flag for a bad diet."

But long-term maintenance isn't the only reason nutrition experts aren't fans. "I hate the keto diet because it limits the amount of fiber you would receive from fruits and whole grains, which could lead to constipation," says Jonathan Valdez, owner of Genki Nutrition and a media spokesperson for New York State Academy of Nutrition and Dietetics "Stay constipated long enough, you will also feel bloated and very uncomfortable. Plus, long periods of time on the toilet due to constipation is not a cute look especially when you're on-the-go with family and kids."

Nutrition experts also don't like the fact that the keto diet omits entire food groups. Ayoob says that food decisions may be easier with limited choices, and might even explain why many people like the diet—until they get bored. "You still need the nutrients from those omitted food groups," Ayoob explains. "No dairy, no grains, no fruit, not even many veggies, and no scientific evidence behind it? No way this is a good diet. I can't get behind any diet that demonizes foods like apples, whole-grain breads, and yogurt."

The diet's rigidity is also a concern to Malina Malkani, M.S., R.D.N., C.D.N., media spokesperson for the Academy of Nutrition and Dietetics and creator of the Wholitarian Lifestyle.  "A lifestyle requiring so many restrictions—like counting grams of carbohydrates, eliminating major food groups, watching protein intake and restricting food choices within allowed food groups—is hard enough to maintain in the long-term as an individual. For parents, maintaining these restrictions over time is even more challenging in the context of feeding a family and socializing within a community, and it can be detrimental when trying to role model a healthy relationship with food for children," Malkani explains.

The Reality

As a registered dietitian, I have developed keto recipes and understand first-hand how difficult it is to stay within the carb limits of this diet. It took me, an expert, a while to compute every single carb in dishes, which means it would certainly be time-consuming for others to get all the numbers right.

Where do these hidden carbs come from? There are so many hidden sources. For example, the keto diet promotes consumption of avocados, but even moderate portions will add a few grams of carbs. The same is true with dried herbs—add one to two teaspoons to a dish and you've got some grams there, too. As such, it would seem that most people are unknowingly doing a modified version of the keto plan and eating more carbs than they think (which, again, isn't a bad thing!).

A modified keto diet tends to be followed by a dieter who is trying to ease off the plan. The diet consists of 55 percent fat, 30 percent protein and 15 percent carbs. It can also be used by those who don't like the strictness of the actual keto plan and need something more doable. It also allows for more fiber and nutrients from fruits, vegetables, nuts and seeds. You can even add a touch of whole grains, legumes, and other foods that are strictly forbidden on the traditional keto diet, all of which would add essential fiber, vitamins and minerals.

The bottom line is this: Although you may be in love with the keto diet now, there are good reasons for nutrition experts to dislike the diet plan. Very strict diets have a very high rate of failure, and the best diet is one that is sustainable for the long-term. Adding a few more carbs through various healthy foods in your diet isn't a bad thing, and that's most likely what's happening without you even realizing it.
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Member Comments

I start most of my weight-loss patients off on a low carb (less than 50g/day), low fat and high protein diet. I do blood tests before, during and after this phase and really enjoy seeing so many things improve, including kidney function and liver function and a reduction in cholesterol. It's also brilliant when a patient starts off having Type 2 Diabetes and no longer has it by the end of the programme. Most people don't want to stay in ketosis forever, so once the majority of their weight has been lost, we reintroduce carbs gradually and work towards a more balanced diet they can maintain longterm. Even then though, the emphasis is on lean meat or fish and vegetables, with only small amounts of high carb foods. It's strict, hardwork and can be dangerous if not done properly. But it also helps so many people with a whole range of health issues, it really annoys me when I see articles like this. Report
Like i said in another blog on Keto; it is too expensive for my budget. I cannot afford to buy steaks and other high priced meats and buy other sugar alternatives like Swerve. I will stick to our food plan of cutting out white sugar and flour. That is easier for me than counting carbs in food and limiting foods I like. Report
This article is completely one sided. You make it appear as if the only fans of a keto lifestyle (it IS a lifestyle - NOT a diet!) are the people living keto. That is so not true. There are so many physicians out there, MDs in varying specialties, who know the science behind keto, the benefits that result from eating keto, and prescribe it to their patients. I am lucky enough to have one of those physicians as my primary care doc. Just take a look on YouTube. You tout only what you think is wrong with keto. That is totally unfair. Report
I am not a fan of keto, mainly because it doesn't explain why all the long-lived cultures of the modern world are mainly starch eaters. I'm disappointed that this article didn't look at long term effects besides the problem that dieters don't want to adhere to it long term (studies show that low carb dieters eventually go back to moderate carb eating.) It's also disappointing that these experts seem unwilling to look at its benefits because there are definitely people with illnesses who have been helped by it. I think it's an appropriate diet for certain medical conditions; weight loss is a side effect! I would have to be very sick to consider keto just because I loves me carbs and have lost all my weight eating them. This article seems full just of personal opinions and not a real look at the facts, even if they are supposedly experts.

Any extreme plan should be a last resort, IMHO. Unfortunately, people want quick loss and when they don
t get it, abandon their attempts. Too bad, because they often abandon attempts after quick weight loss stops. Report
I have been in Nutritional Ketosis for most of the last 5 years. I shed a few unwanted pounds but more importantly, it has kept my chronic illness under control. I am so glad my Naturopath recommended that I try it way back in 2013 before anyone but body-builders knew what it was about.
However, I do not recommend it unless you have a serious illness that ketosis has been shown to have an impact on (seizures, some brain conditions, cancer, diabetes... new ones all the time).
For the better part of 3 years I weighed every gram of what I ate and carefully balanced my meals. (Thanks to SparkPeople for providing the tools to do this!) I emphasize non-saturated fats and every spare carb comes from a vegetable. I am also constantly finding ways to add fiber and minerals. I have blood work done at least 4 times a year to make sure all my numbers remain in line. That's way too much to do unless the stakes are life and death as they are for me.
When people ask what I am doing that keeps my energy so good and my body fit, I recommend this: Cut out all alcohol. Then stop eating sugar (including most fruit). If you can do that, then cut out grains. Most people cannot do all this but even if they make a good attempt they will be way healthier and probably leaner than before. No need to add in a bunch of beta hydroxybutyrate, butter and especially not bacon! Non-compliant or "dirty keto" looks like an excuse to eat a lot of fats, to me. Maintaining proper nutritional ketosis is a big commitment. Report
This article is really filled with keto myths. I would advice checking out dietdoctor.com a website written by doctors about the keto diet. Keto has been around since before the use of insulin for diabetics to keep sugar under control. It works. Report
I am usually STARVING on a diet that has the recommended number of carbs. The only way I have been able to lose weight is by doing a low carb/1200 calorie diet. I have tried every other diet out there including personal nutritionists and nothing ever worked for me. I am finally in a healthy weight range after years and years of paying for a nation wide group (WW) and others. I was never able to stick to any of them because I was always soooooo hungry. I started on a low carb diet limiting to below 50 with lots of vegetables and low cholesterol proteins. I'm never hungry and, in fact, it's hard to eat all 1200 calories. I often use Keto recipes which are satisfying and taste great! I started out at 186 pounds last summer. Now I am down to 156 pounds, lower blood pressure, my back and knees feel so much better, I have more energy, sleep better, etc. etc., etc. My husband convinced me to try this diet as he lost over 50 pounds on it and has maintained it. I'm so glad I tried it. There are many scientists now promoting the benefits of a low-carb diet. Just look at all the podcasts out there from researchers. I think eventually nutritionists will see the LIGHT! Report
I've lost 65lbs. on the keto diet--weight I needed to lose very badly after a back injury. I have eaten consistently from every food group. You can get everything you need nutritionally, you just need to plan and calculate a lot. I get wellness checks annually and I have no vitamin or nutritional deficiencies due to my dieting. In short--keto is AMAZINGLY effective for weight loss, but it's a lot of work to do right and yes, you will have to switch to a non-restrictive, weight-maintainin
g diet when you reach your goal, like with ANY other diet. Keto isn't a miracle or a magic wand OR dangerous and unhealthy--it's a crazy effective weight-loss strategy that takes a ton of calculating and dedication Report
Thanks! Report
Written without the proper knowledge to advise.... Sad ! Report
Poorly written, ridiculous, one-sided article. For those of you who are using this "information" to make up your mind about Keto please do some more research. Report
I don't fully understand Keto, but everyone I know who is on it seems to stuff themselves full of saturated fats and I think to myself,... that cannot be good for their heart! Report
I wish SP would provide more info about the health risks of ketosis! Yes, I've been told (not by medical doctors BTW) that ketosis is not the same as ketoacidosis, that happens to diabetics when blood sugar is too high for too long..... However, long ago a doctor explained to me that ketosis was when your body started "eating itself". The body doesn't have the carbs to feed on so it feeds on itself with detriment to organs, muscle and yes, what fat might be there. In this article, I did not read a compelling reason to refrain from a Keto Diet. If you read what others posted, it didn't do it for them either.... They found ways to defend it! Kidney failure is a good reason to avoid the keto Diet! Report


About The Author

Toby Amidor
Toby Amidor
Toby Amidor, M.S., R.D., is the founder of Toby Amidor Nutrition and the author of "The Greek Yogurt Kitchen" and "The Healthy Meal Prep Cookbook."