Risks Of The Keto Diet

Dangerously Low Blood Sugar Levels For Diabetic Populations

Are there health risks with the keto diet?

The keto diet restricts carbs so much that anyone who is on blood sugar lower medication or who has type 1 or type 2 diabetes must consult his or her doctor before making such a severe dietary change. As the body adapts to low-carb dieting, medication dosages and treatment plans will have to be revised, and blood sugar levels must be carefully monitored.

If you dont work closely with your doctor as you are changing your diet, you will run the risk of hypoglycemia .

For more information on how keto affects diabetic populations:

The Keto Diets Possible Role In Disease Prevention And Treatment

Besides weight loss, the keto diet may play a role in treatment or prevention of diseases other than epilepsy, including:

  • Metabolic Syndrome Limited research, including a study published in November 2017 in the journal Diabetes & Metabolic Syndrome: Clinical Research & Reviews, has suggested that adults with metabolic disease following keto shed more weight and body fat compared with those on a standard American diet, which is heavy in processed food and added sugars.
  • Type 2 Diabetes Research published in September 2016 in the Journal of Obesity & Eating Disorders suggested the diet could help people with type 2 diabetes and can lead to improvements in HbA1c levels .

What Are The Potential Health Risks Associated With The Keto Diet

The possible benefits of the diet are impressive, but there are a few potential downsides to note. One is its tough to stick to. In fact, in a review of 11 studies involving adults on the keto diet, which was published in January 2015 in the Journal of Clinical Neurology, researchers calculated a 45 percent compliance rate among participants following the approach with the aim of controlling epilepsy. The diet is pretty hard to follow because its a complete shift from what youre used to, Nisevich Bede says. Slashing your intake of carbs can also make you feel hungrier than usual a feeling that can last until youre three weeks in.

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Increased Hunger And Cravings

When you first start restricting carbs, you may experience intense hunger and cravings that may conjure up fantasies of eating french fries and ice cream.

To help you resist the temptation of indulging in unhealthy foods, try using these strategies:

  • Make sure you are drinking plenty of water throughout the day.
  • Have a high protein, high-fat meal to start your day .
  • Add MCTs to your morning beverage.
  • Have keto snacks on hand to prevent a spontaneous purchase of unhealthy convenience foods.
  • Try some keto-friendly versions of your favorite high-carb foods like ice cream, pizza, and pasta.
  • Make sure you are meeting your daily protein and calorie needs. Eating the right amount of protein and calories plays a crucial role in keeping you full and energized throughout the day. If you need help figuring out how much fat and protein you should be eating, try using our keto calculator.

Concerns Raised Over Long

Keto Diet Benefits and Risks

A new research review published in the journal Frontiers in Nutrition argues popular low-carbohydrate ketogenic diets are unhealthy for most people. The review rekindles a long-standing debate over the dangers of high-fat/low-carb dietary strategies.

Ketogenic diets can take a number of different forms. The general idea is to induce a metabolic state called ketosis by strictly eating foods high in fat but low in carbohydrates and sugars. This forces the body to turn to burning stored fats for energy instead of carbohydrates, leading to swift reductions in body weight.

Originally developed a century ago as a treatment for pediatric epilepsy, the dieting strategy has become popular in recent years. And thats because it does rapidly reduce body weight while allowing the dieter to eat an often meat-heavy diet.

But the long-term health effects of ketogenic dieting are controversial. Many nutritionists argue ketogenic diets are fundamentally unhealthy and Lee Crosby, lead author of this newly published review, goes so far as calling the typical keto diet a disease-promoting disaster.

“Loading up on red meat, processed meat, and saturated fat and restricting carbohydrate-rich vegetables, fruits, legumes, and whole grains is a recipe for bad health, says Crosby.

Lee Crosby, lead author of this newly published review, goes so far as calling the typical keto diet ‘a disease-promoting disaster’

The new study was published in the journal Frontiers in Nutrition.

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What Is A Ketogenic Diet

A ketogenic diet primarily consists of 80-90% fat, 10-20% carbohydrate, and 2-5% protein, and is practiced by many for weight loss, type 2 diabetes, epilepsy, and seizures.Weight loss can be a goal of people on a ketogenic diet, but the diet’s popularity has led to an ethical debate over who should be encouraged to eat the diet.Some say that, while a diet should help the overweight and obese lose weight, a ketogenic diet may be dangerous to the health of those without serious medical conditions, since it contains such low levels of carbohydrates.

  • Acid Reflux

Can Cause Excess Kidney Stress For Those With Chronic Kidney Disease

Though keto diets are safe for healthy kidneys, those with chronic kidney disease may not be able to handle the dietary change and should consult their physician before adjusting their meal plan.

This is because keto dieters tend to increase their intake of protein and processed meats, which compromised kidneys can struggle with.

That said, those who have fully functioning kidneys have no reason to worry. In fact, a well-formulated keto diet may help prevent chronic kidney disease by addressing two of its driving factors: chronically high blood sugar levels and hypertension.

Furthermore, the research literature on other health conditions has not found an increased incidence of kidney stones or any other kidney issues among those who followed a low-carb or ketogenic diet. This is likely because these diets emphasize daily low-carb vegetable intake, which has been found to reduce our risk of kidney stones and chronic kidney disease.

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What You Should Know About Diabetes And Ketosis

If you have type 2 diabetes and need to control your symptoms, following the ketogenic diet and reaching ketosis may be useful. Limiting carbohydrate consumption is critical for people with type 2 diabetes since eating too many carbohydrates raises blood glucose levels, which may damage blood vessels and lead to eye, kidney, and nerve issues.

Because you may achieve ketosis by limiting your carb consumption, this diet may naturally reduce your blood glucose levels. Furthermore, if you are overweight and have diabetes, consuming fewer carbohydrates may help you shed extra pounds, which is another strategy to get control of your blood glucose.

Many individuals with type 2 diabetes may go into ketosis because they still make insulin, which helps their bodies maintain a healthy amount of ketones in their blood. If you have type 2 diabetes and want to try ketosis or the ketogenic diet, talk to your doctor first to be sure its healthy for you. This meal plan may conflict with certain diabetic medications or be incorrect if you have diabetes complications such as renal damage.

In addition, attaining ketosis with type 1 diabetes may result in dangerously high levels of ketones in the bloodstream, which can lead to diabetic ketoacidosis. As a result, if you have type 1 diabetes, you should avoid sending your body into ketosis to avert this possibly fatal health catastrophe.

Your Period On Keto Might Undergo Some Changes

Dangerous Health Risks of Keto Diet You Should Know About

Periods may become irregular or completely stop on the keto diet, says Yawitz. This is more due to rapid weight loss than the diet itself and happens because of drops in gonadotropin-releasing hormone, follicle-stimulating hormone, luteinizing hormone, estrogen, and progesterone.

Long-term disruption of menstruation can bring on serious side effects, including low bone density. This is because estrogen is very important to bone health, says Yawitz. Studies have also found prolonged menstrual irregularity to increase risk for cardiovascular disease, depression, anxiety, and sexual dysfunction. Its important to contact your ob-gyn if your cycles become irregular or if you stop having periods.

But wait, theres one loophole. Have polycystic ovary syndrome ? Then the keto diet may help regulate your periods. Women with PCOS have high insulin levels, which cause sex hormone imbalances, notes Yawitz. In a small study published in the journal Nutrition & Metabolism, subjects with PCOS following a ketogenic diet for six months noted improvements in their menstrual cycles and a small number of women became pregnant, overcoming previous infertility obstacles. This study was very small, so we cant make recommendations for all women with PCOS based on its findings, says Yawitz. And really, any diet that leads to weight loss should help in PCOS.

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What This Means For You

Ultimately, you can decide what diet works best for your health goals. If you want to start a keto diet, consider its risks and whether it’s sustainable for you. Discuss with your doctor or nutritionist about how the dietary plan could affect your health. While keto works for some people to control seizures or lose weight, there are long-term risks that may outweigh any short-term benefits.

Ketogenic Diets And Chronic Disease: Weighing The Benefits Against The Risks

  • 1Physicians Committee for Responsible Medicine, Washington, DC, United States
  • 2Brenda Davis Nutrition Consulting, Kelowna, BC, Canada
  • 3Department of Medicine, New York University Grossman School of Medicine, New York, NY, United States
  • 4Department of Medicine, New York City Health + Hospitals/Bellevue, New York, NY, United States
  • 5College of Liberal and Professional Studies, University of Pennsylvania, Philadelphia, PA, United States
  • 6School of Public Health, Loma Linda University, Loma Linda, CA, United States
  • 7Adjunct Faculty, Department of Medicine, George Washington University School of Medicine and Health Sciences, Washington, DC, United States

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Ketosis And The Keto Diet

What makes the the ketogenic diet unique among low-carb diets is that its characterized by a drastic reduction in carbohydrates and also a significant increase in fats, as opposed to protein. The goal of the KD is to enter the metabolic state of ketosis, which happens after a few days of strict carbohydrate restriction.

Eating very-low carb depletes glucose reserves , which means that glucose is no longer sufficient to provide the body with enough energy and another fuel source must be used instead.

This is where dietary fats come into play: depleted glucose reserves leads to the production of ketone bodies that are used as an alternative energy source, especially by the central nervous system, including the brain which has high energy demands. In order to get enough fat and limit carbs, the keto diet includes plenty of foods like meats, eggs, oils, cheeses, fish, nuts, butter, seeds and fibrous vegetables.

Does the keto diet really work when it comes to improving health?

Is The Keto Diet Healthy

Dangers of a Ketogenic Diet (Who Should Not Go Keto)

Wellness Dietitian Mary Condon, RN, LDN, said the keto diet may result in weight loss and lower blood sugars, but its a quick fix. More often than not, its not sustainable. Oftentimes weight gain may come back, and youll gain more than what you lost, Condon said.

Condon said you should always consult your primary care doctor before starting any new diet.

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Vitamin And Mineral Deficiencies

The keto diet cuts out many common foods that serve as good sources of vitamins and minerals, so you may be at risk for some micronutrient deficiencies if you arent careful.

The most common micronutrient deficiencies on keto are:

  • Biotin
  • Vitamin E
  • Vitamin D

To prevent these deficiencies from happening, make sure you are eating a diverse array of keto-friendly meats, poultry, seafood, dairy, eggs, and veggies. Some of the most micronutrient-dense keto foods are eggs, low-carb vegetables, seafood, and organ meats like beef liver.

For more specific information on how to meet your vitamin and mineral needs while you are on the keto diet, check out our comprehensive guide to micronutrients. In this guide, you will find out how to meet your micronutrient needs with keto foods and how to track your intake.

Changes In Bowel Movements: Diarrhea And Constipation

With a dramatic increase in fat and reduction in carbs, many people can experience loose bowels, diarrhea, or constipation. This is a relatively common occurrence during the first week of keto dieting and will typically pass on its own.

However, if your digestive issues show no signs of improving after a week, then try one or more of the strategies below that apply to your situation:

If youre interested to read more about the potential short and long-term effects of a ketogenic diet, .

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How The Keto Diet May Help With Weight Loss

But the No. 1 reason people adopt the keto diet nowadays? Weight loss.

Initially, the weight loss comes from loss of water because you cut down on carbs in your diet and your body uses up the carbohydrates stored in the liver, which hold onto water. The diet results in further weight loss because it encourages you to load up on whole, high-fat foods, Nisevich Bede says.

By cutting carbs, youll also cut sugar and simple, refined carbohydrates, which means a steadier supply of energy. Once their bodies are used to the diet, The first thing people report is, Oh my gosh, I have this steady energy and I dont have the need to snack at 3 p.m. because my energy is waning, Nisevich Bede says. Research published in January 2015 in the journal Obesity Review showed that the keto diet may lead to fewer hunger pangs and a lower desire to eat.

It’s A Temporary Solution

Keto Diet Benefits and Risks

Ehsani explained: “The keto diet is a fad diet, meaning it works until it doesn’t. You may experience rapid weight loss, but it’s not a healthy solution towards attaining weight loss.

“If you’re looking for a healthy way to lose weight, instead work with a registered dietitian nutritionist ,” who can create a personalized plan based on your unique health and nutrition needs and goals, she added.

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How To Approach The Keto Diet Safely

In recent years, keto has become a trendy diet for losing weight and managing some other health conditions. However, Barnard suggests that theres usually a better dietary approach than keto.

Carbohydrates arent bad. Grains and beans and fruits and vegetables should be the staples of our diets, he says, adding that plant-based diets can predictably lower cholesterol, blood pressure, and blood sugar.

Some followers of the keto diet have broken away from the traditionally limiting format in favor of a plant-based or vegan keto diet.

Liz MacDowell, a certified holistic nutrition consultant and author of Vegan Keto,runs the food blog Meat Free Keto. She practices what she calls a quasi-keto diet. Liz adds fruits, vegetables, and beans into her diet, which can be controversial in the keto world. Shes even received backlash for sharing a post on her Instagram about strawberries.

Consuming those micronutrients far outweighs whatever challenge your body now faces to maintain ketosis with those minimal extra grams of carbohydrates, MacDowell tells Verywell. Fruit is not the worst thing. It has sugar but it has so many other positive things in it, so many good phytochemicals and micronutrients.

For anyone looking to add morefreshproduce into their keto routine, Liz emphasizes one important thing: Dont stress.

We have enough stress so we dont need to be stressing about eating one carrot too many or one cherry tomato too many, she says.

May Stress Your Kidneys

High fat animal foods, such as eggs, meat, and cheese, are staples of the keto diet because they dont contain carbs. If you eat a lot of these foods, you may have a higher risk of kidney stones.

Thats because a high intake of animal foods can cause your blood and urine to become more acidic, leading to increased excretion of calcium in your urine .

Some studies also suggest that the keto diet reduces the amount of citrate thats released in your urine. Given that citrate can bind to calcium and prevent the formation of kidney stones, reduced levels of it may also raise your risk of developing them .

Additionally, people with chronic kidney disease should avoid keto, as weakened kidneys may be unable to remove the acid buildup in your blood that results from these animal foods. This can lead to a state of acidosis, which can worsen the progression of CKD.

Whats more, lower protein diets are often recommended for individuals with CKD, while the keto diet is moderate to high in protein .


Eating a lot of animal foods on the keto diet can lead to more acidic urine and a higher risk of kidney stones. This acidic state can also worsen the progression of chronic kidney disease.

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Keto Diet And Life Expectancy

There is not now, nor do we have a record of there ever having been, a human population anywhere in the world eating a keto diet and experiencing long lifespans. To the contrary, in a 2018 study published in The Lancet, researchers concluded that people who eat low-carb diets have shorter lifespans . The authors write:

Low carbohydrate dietary patterns favouring animal-derived protein and fat sources, from sources such as lamb, beef, pork, and chicken, were associated with higher mortality, whereas those that favoured plant-derived protein and fat intake, from sources such as vegetables, nuts, peanut butter, and whole-grain breads, were associated with lower mortality

And in another 2018 study published by the European Society of Cardiology , researchers found that people who ate low-carb diets had a 32% increased risk of death from all causes when compared to those eating the highest amount of carbs. The researchers also learned that low-carb eaters suffered from a 51% higher risk of dying from heart disease and a 35% higher risk of dying from cancer.

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