Keto Diet Made Simple: A Definitive Guide to The Pros and Cons

What’s with all the hype about the Ketogenic Diet? Why do a number of weight-conscious people and even some doctors and other health practitioners hail this diet as a new way of improving overall health while satisfying your cravings?

Ketogenic Diet or Keto Diet is sometimes referred to as “bacon and butter diet” because it calls for 75% of daily calories to come from fat. This perhaps caught your attention. How can someone lose weight when they’re actually adding more fat than the usual recommended intake of this macronutrient?

Are the claims real or just myths? Let’s examine the pros and cons so you can decide whether it’s right for you.

How does the Keto Diet work?

The 2010 Dietary Guidelines for Americans recommends eating within the following ranges:

• Carbohydrates: 45–65% of calories
• Fat: 20–35% of calories
• Protein: 10–35% of calories

But in the Ketogenic diet, it is made up of 75% fat, 20% protein, and 5% carbohydrates.

It works by enabling your body to enter a state of ketosis. Simply put, it is a natural state of the body wherein it is almost completely fueled by fat instead of glucose from carbs.

To help you understand:

Our brain typically uses glucose from carbs since the blood brain barrier is actually impenetrable by fatty acids (found in fats). 

However, what happens when the body doesn’t have enough carbohydrates to burn for energy? That’s when the liver steps in by turning fat into ketones/ketone bodies which can supply energy for the brain.

The production of ketone bodies requires high levels of acetyl CoA which is a product of beta-oxidation of fatty acids.That’s why during fasting or when one has a very low carb intake, the brain utilizes ketone bodies to reduce reliance on glucose.

PROS of Keto

• Support Weight Loss

KDs have undoubtedly been shown to be effective, at least in the short to medium term, as a tool to fight obesity, hyperlipidemia and some cardiovascular risk factors. ^[1]

TAKE NOTE: These advantages are only indicated for SHORT-TERM USE. Ketogenic diets also raise some concerns among physicians in this particular concern. The duration of ketogenic diet may range from a minimum (to induce the physiological ketosis) of 2–3 weeks to a maximum (following a general precautionary principle) of many months (6–12 months).

• Epilepsy

KD emerged as a medical tool in the early twentieth century, as a strategy to mimic fasting. It is not until 1920s and 1930s that there were initial reports released documenting its efficacy on epileptic seizures and attacks.

“The mental development has been normal in all patients, and exceptionally good in
seven of the twenty who are now free from attacks. In all the children treated with the
ketogenic diet there was a marked change in character, concomitant with the ketosis,
a decrease in irritability, and an increased interest and alertness; the children slept
better and were more easily disciplined. This action of the diet warrants further
study“ ^[2]

• Alzheimer’s Disease

KD might increase the achievable levels of ketone bodies which has the potential to improve brain metabolism, reduce accumulation of Aβ plaques, and reverse Aβ toxicity to support neurogenesis rather than neuronal cell death. ^[3]

Even though this has yet to be proven, studies has shown a correlation of ketogenic diet involving increased ketone levels and carbohydrate reduction as an effective treatment and prevention strategy for the disease.

• PCOS (Polycystic Ovary Syndrome)

KD led to significant improvement in weight, percent free testosterone, LH/FSH ratio, and fasting insulin in women with obesity and PCOS over a 24 week period. ^[4]

• For Diabetes/Prediabetes

KD helps you burn excess fat, which is a main factor closely linked to type 2 diabetes, prediabetes and metabolic syndrome. ^[5][6]

Another study compared a ketogenic group with a glycemic index diet group (typical low-carb diet for diabetics) and found that 95.2% of the ketogenic group were able to stop or reduce diabetes medication, compared to 62% in the GI diet group. ^[7]

This perhaps supports the study that found the ketogenic diet improved insulin sensitivity by 75%. ^[8]

Summary of the Pros:

A low-carb diet such as Keto  may help improve blood pressure, blood glucose regulation, triglycerides, and HDL cholesterol levels. However, LDL cholesterol may increase on this diet. Ketogenic diet has shown promising results in a variety of neurological disorders, like epilepsy, dementia, ALS, traumatic brain injury, acne, cancers, and metabolic disorders.

CONS of Keto

• Reversal on Weight Loss / Benefits decrease over time

Studies of greater than 6 months’ duration, however, have failed to show continued benefit of high-protein, low-carbohydrate diets on weight loss and cardiovascular risk factors compared with conventional diets. ^[9]

• Increase Arterial Stiffness and Risk of Cardiovascular Disease

High-protein, low-carbohydrate diets may add additional risk to individuals with cardiovascular disease due to their high fat and cholesterol content combined with decreased intake of fruits, vegetables, whole grains, and other nutrients related to cardiovascular risk. Deficiency in micronutrients, particularly selenium, causes prolonged QT intervals that may lead to cardiomyopathy. ^[10][11]

• Increased Risk of Bone Fracture

Overlooking the need of other minerals and micronutrients will lead to Vitamin D deficiency which affects bone mineral density and eventually lead to fractures. Another important factor that will decrease bone strength is ketoacidosis. ^[12]

• Not Beneficial to Bodybuilding

Low-carbohydrate dietary approaches, such as KD, would not be an optimum strategy for building muscle mass in trained men under the training conditions. ^[13]

• Increased Risk of Constipation, Hypoglycemia and Gastroesophageal Reflux

KD increases fat and decreases carbs and glucose. Restriction of glucose includes a limited consumption of fruits and other vegetables, thus decreasing fiber intake which will lead to constipation, decreasing glucose intake which will cause hypoglycemia and increasing production ketone bodies which is highly acidic to the body causing GERD. ^[14]

Summary of Cons:

The most common and relatively minor short-term side effects of ketogenic diet include a collection of symptoms like nausea, vomiting, headache, fatigue, dizziness, insomnia, difficulty in exercise tolerance, and constipation, sometimes referred to as keto flu. Long-term adverse effects include hepatic steatosis, hypoproteinemia, kidney stones, and vitamin and mineral deficiencies.

CONCLUSION

1. Get essential tests and consult your physician and dietician before going into it.

Ketogenic diet therapy is a unique therapy that requires the expertise of a mutltidisciplinary medical team. The expertise of the dietitian is an essential part of the ketogenic diet team. The dietitian writes diet prescriptions, calculates meal plans, determines nutritional supplementation, and provides the majority of education to the family during ketogenic diet therapy. The dietitian also tracks growth and laboratory data relevant to nutritional status and diet therapy. A successful ketogenic diet program allows for the allocation of time and resources to this endeavor.

2. Short-term effects shows significant results

It’s primary effects are undeniable in weight loss and in various treatments of certain conditions.

3. Long-term effects requires further assessment

Long-term health implications are not well known due to limited literature. More studies are therefore warranted to better assess the effects of long term use of KD on metabolic diseases and cardiovascular risk factors, but also to better define which dietary macronutrient composition is optimal.

4. Sustainability is low.

Long-term compliance is low and can be a big issue with a ketogenic diet, but this is the case with any lifestyle change.

Come to think of it. If lifestyle is a way of living intended to be implemented for a lifetime, why should you try a diet that poses a great number of risks and has still been a subject of debate? Choose a diet that will cause more benefits than harm in the long term. Be wise and you’ll live a healthy life.