I think every profession has this hazard to some degree. Tell people you are a lawyer, and you may find yourself getting invited for a social event more often to “pick your brain.” Tell people you are a “doctor” and watch out – you may be looking at a suspicious mole that hasn’t seen the sun in a decade before you can even tell the person you are, in fact, a dentist.
Tell people you are a nutrition coach, and watch as the people in your life explain why they have Doritos in their grocery cart and that they “don’t always eat like this” – or, after listening to a Joe Rogan podcast, that they decided that plants are dangerous to eat and eating only animal organs will sustain them while they are on the carnivore diet. Does organ meat contain a hell of a lot of nutrition? Yes. Can organ meat promote non-alcoholic fatty liver disease and bladder cancer? Also yes.
Nutrition misnomers, fad diets and uneducated podcasters have many people believing that this “all or nothing” approach to eating is the only way to lose weight. Since 90% of Americans pick diets for the goal of weight loss, I am going to stick with that desired outcome as an example. My least favorite and most asked about diet is the keto diet .
The ketogenic diet (KD) was introduced by modern physicians as a treatment for epilepsy in the 1920s. For two decades this therapy was widely used, but with the modern era of anti-epileptic drug treatment, its use declined dramatically. However, it remains one of the most popular fad diets. With “health” magazines, celebrity endorsements and KD food brands, the keto diet is a $9.7 billion dollar business – a business that preys on people looking to lose weight to hopefully become healthier.
The truth about keto
Beneath the surface lies a plethora of health risks that often go unnoticed or unaddressed. While proponents tout its effectiveness for weight loss, the keto diet’s extreme restriction of carbohydrates and high intake of fats can have detrimental effects on long-term health.
Nutritional deficiencies: By severely limiting carbohydrates, the keto diet restricts intake of many nutrient-rich foods such as fruits, vegetables and whole grains. These foods are essential sources of vitamins, minerals and fiber, which are necessary for overall health and disease prevention. Prolonged adherence to the keto diet can lead to deficiencies in key nutrients like vitamin C, potassium and magnesium, increasing the risk of health problems such as weakened immune function, muscle cramps and electrolyte imbalances.
Increased risk of heart disease: Despite claims that the keto diet can improve heart health by promoting weight loss and reducing blood sugar levels, research suggests that the high intake of saturated fats commonly associated with the diet may actually raise cholesterol levels and increase the risk of heart disease. A study published in the Journal of Nutrition and Metabolism found that long-term adherence to a ketogenic diet significantly increased levels of LDL cholesterol, the type of cholesterol linked to cardiovascular disease.
Kidney stones and impaired kidney function: The keto diet’s emphasis on high-fat foods can put stress on the kidneys, potentially leading to kidney stones and impaired kidney function. Ketones, byproducts of fat metabolism, can also acidify the urine, increasing the risk of kidney stone formation. A study published in the Journal of Child Neurology reported cases of kidney stones in children following a ketogenic diet for epilepsy treatment, highlighting the potential renal complications associated with this dietary approach.
Disordered eating patterns: The restrictive nature of the keto diet, with its strict limitations on carbohydrate intake, can contribute to disordered eating patterns and unhealthy relationships with food. Individuals may develop feelings of guilt or anxiety surrounding food choices, leading to a cycle of restriction and binge eating. Moreover, the elimination of entire food groups can perpetuate a black-and-white mentality toward eating, making it difficult to maintain a balanced and sustainable approach to nutrition.
Increased risk of nutritional ketosis: While the goal of the keto diet is to achieve a state of ketosis, where the body burns fat for fuel instead of carbohydrates, prolonged or excessive ketosis can lead to a dangerous condition known as nutritional ketosis. This occurs when ketone levels in the blood become dangerously high, resulting in symptoms such as nausea, fatigue and confusion. In severe cases, nutritional ketosis can progress to ketoacidosis, a life-threatening complication characterized by extremely high blood acidity levels.
In 2023, there were some 2,500 hospital stays in the United States directly related to complications from the keto diet, according to data from the National Institutes of Health. These hospitalizations underscore the importance of understanding the potential risks associated with this dietary approach.
So, while the keto diet may offer short-term weight loss benefits for some individuals, it’s essential to weigh these potential benefits against the considerable risks to long-term health. Instead of resorting to extreme dietary measures, focusing on balanced nutrition and lifestyle habits remains the most effective and sustainable approach to promoting overall health and well-being.
References:
Gibson AA, et al. Do ketogenic diets really suppress appetite? A systematic review and meta-analysis. Obes Rev. 2015;16(1):64-76.
Bueno NB, et al. Very-low-carbohydrate ketogenic diet v. low-fat diet for long-term weight loss: a meta-analysis of randomised controlled trials. Br J Nutr. 2013;110(7):1178-87.
Dashti HM, et al. Long-term effects of a ketogenic diet in obese patients. Exp Clin Cardiol. 2004;9(3):200-5.
Kosinski C, et al. Ketogenic diets: an update for child neurologists. J Child Neurol. 2013;28(8):1015-26.
Hussain TA, et al. Effect of low-calorie versus low-carbohydrate ketogenic diet in type 2 diabetes. Nutrition. 2012;28(10):1016-21.
