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What is the Keto Diet?


by Dr. Nancy Rahnama

Director of Health & Nurition

The keto (ketogenic) diet has become increasingly popular over the past decade or so, and you can now find hundreds if not thousands of success stories online about people who have finally been able to shift the weight for good. But is this extreme diet all it seems to be? We asked Dr Nancy about whether it’s effective, healthy, or just another trend.

 

What is the keto diet?

The keto (ketogenic) diet is a type of low-carb diet where you try to eat as few carbohydrates as possible so the body is forced to go through ketosis, which is where the body moves from using carbohydrates for energy, to using fat for energy. The theory behind this is that once the body can’t rely on the fast-acting carbs for energy, it has to start using the body’s fat stores.

The keto diet was first used to treat patients with seizure disorders, particularly children. It has now become popular for those not experiencing seizures and effectively suppresses insulin secretion and the rapid metabolism of fats.

 

What are the benefits of a keto diet?

  • Weight loss: Outside of being an effective management technique for seizure disorders, it has become popular because it can help dedicated followers lose a significant amount of weight. Many of the people who have found success with the keto diet did so because it was not as restrictive on their love of red meat and cheese, two things that many adults find difficult to give up.
  • Decreases inflammation: Inflammation is often caused by excess sugar and fat in the body, and when these drop, inflammation in the body drops. This is notable because studies now believe that long-term inflammation is now linked to all major causes of death worldwide – in fact, 3 in 5 people are believed to die due to a chronic inflammatory disease.
  • Increases insulin sensitivity: Keto is often used by those that are prediabetic to lose weight and increase their insulin sensitivity, something that is often dulled after years of eating a diet rich in sugar and carbohydrates. The keto diet is extremely effective and results in the reversal of Type 2 Diabetes in most individuals.
  • Reduced water retention: the reduced insulin levels help to reduce water retention in the body.
  • Improved blood pressure and cholesterol: because water retention drops and fat metabolism increases due to the drop in insulin, blood pressure and cholesterol levels improve.
  • Heart health: the improvement in inflammation, blood pressure, and cholesterol all result in drastically improved heart health in most individuals.
 

Why is the keto diet controversial? 

The keto diet has many fans, but many also discuss its downsides. The reason why it is controversial is because it is so extreme – dieters essentially cut out all sources of carbohydrate from the diet and rely solely on fat and protein.

  • Lack of balance: While the diet does recommend healthy sources of fat and protein, it lacks balanced nutrition. You cannot eat fruit, many vegetables that contain antioxidants and anti-cancerous properties, and similar. It’s important to remember that the reduced rate of fiber also means that many following the diet experience constipation. While keto diets usually do not count fiber in the macros (using a “net” carbs system instead), the overall reduced rate of carbs means that this lack of fiber is often unavoidable.
  • Keto flu: Another downside of the diet is the “keto flu.” The process of putting the body into ketosis is not a comfortable one, and most people experience some level of keto flu, which is a range of symptoms the dieter may experience. This is a result of the ketones that are being produced and then removed by the body through frequent and increased urination. This can lead to dehydration, fatigue, dizziness, irritability, nausea, and muscle soreness. The increased rate of urination also means that the body is losing electrolytes at an increased rate, which often makes these symptoms worse. That’s not to mention that cutting carbohydrates out of the diet almost completely results in increased sugar cravings, brain fog, difficulty concentrating, and other similar withdrawal symptoms. This makes it particularly difficult to follow initially for anyone working a difficult job, whether physical or mental.
  • Organ distress: the dehydration we touched on above can have much worse risks, including acute kidney injury. This increased urination often results in a loss of essential minerals, such as sodium, magnesium, and potassium, without which many people will experience heart arrhythmias.


Can anyone do the keto diet?

The extreme and constrictive nature of the keto diet means it is not right for everyone. While it is simply not possible for vegetarians and vegans, it is also not suitable for most people with chronic conditions, such as high blood pressure, diabetes, and other similar conditions that are often caused by someone’s chosen diet.


The keto diet must be started and followed under the close watchful eye of a doctor, as while it can offer significant benefits for those with diabetes, it may require a change in medication frequently.


The symptoms associated with ketosis can be uncomfortable and serious – even seemingly minor symptoms such as dizziness and brain fog could put the dieter and those around them at risk while driving a vehicle.

Can the keto diet be followed long-term?

Due to the lack of nutrients inherent in the unbalanced nature of a keto diet, it is not a good idea to follow it long-term. It can quickly result in micronutrient deficiencies, and well as other consequences. If it is going to be followed, whether for short-term weight loss or long-term weight loss, it needs to be done under medical supervision.

The ketogenic diet is extremely effective, but any patient starting the diet needs to be doing so with the supervision of a medical professional and must increase their fluid intake before and for the duration of the diet. Some patients may need to supplement with minerals such as sodium or potassium, though this will depend on the individual patient. While the keto diet has proved successful for many for rapid weight loss, it must be done safely with a medical professional’s guidance, or you may cause much larger problems while trying to solve a smaller one. Often, following a balanced diet with plenty of vegetables will be a safer choice. 

 


Dr. Nancy Rahnama, MD, ABOM, ABIM, is a medical doctor board certified by both the American Board of Obesity Medicine and the American Board of Internal Medicine. Her specialty is Clinical Nutrition, that is, the use of nutrition by a medical doctor to diagnose and treat disease. Dr. Rahnama has helped thousands of people achieve their goals of weight loss, gut health, improved mood and sleep, and managing chronic disease. In addition to her private practice in Beverly Hills, she is also the co-founder and Director of Nutrition for Dr Nancy MD.

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