The keto diet may cause low blood pressure, kidney stones, constipation, nutrient deficiencies and an increased risk of heart disease. Strict diets such as keto may also cause social isolation or eating disorders. The ketogenic diet is not safe for people with pancreas, liver, thyroid or gallbladder disease. The ketogenic diet, also known as the keto diet or simply keto, has become the latest craze in weight loss plans, recently promoted by celebrities such as Jenna Jameson, Mama June and Halle Berry.
The diet involves greatly reducing carbohydrates, to 50 grams a day or less, to help the body reach a state of ketosis, where it has to burn fat (rather than sugar) for energy. Josh Axe, a doctor of natural medicine and clinical nutritionist, estimates that about 25 per cent of people who try a keto diet experience these symptoms, with fatigue being the most common. If you find yourself running to the bathroom more often while on a ketogenic diet, a quick internet search will show you that you're not alone. Yes, people are tweeting about ketogenic diarrhoea.
Diarrhoea can also be due to a lack of fibre on the ketogenic diet, says Kizer, which can occur when someone cuts down too much on carbohydrates (such as whole-grain bread and pasta) and doesn't supplement with other fibre-rich foods, such as vegetables. It can also be caused by an intolerance to dairy products or artificial sweeteners - things you might be eating more of since switching to a high-fat, low-carb lifestyle. If you have type 1 or type 2 diabetes, you shouldn't follow the keto diet unless you have your doctor's permission and close supervision, says Kizer. That's because, for people with diabetes, ketosis can trigger a dangerous condition called ketoacidosis.
This occurs when the body stores too many ketone acids produced as a by-product of fat burning and the blood becomes too acidic, which can damage the liver, kidneys and brain. If left untreated, it can be fatal. Ketoacidosis has also been reported in people without diabetes who were on low-carbohydrate diets, although this complication is quite rare. Symptoms of ketoacidosis include dry mouth, frequent urination, nausea, bad breath and difficulty breathing; if you experience these while on the ketogenic diet, consult a doctor immediately.
Because the keto diet is so restrictive, health experts say it is not an appropriate plan to follow long-term. Even Axe says it is best done for 30 to 90 days, followed by a more sustainable diet plan. Just this week, a study of 25,000 people presented at the European Society of Cardiology Congress in Munich suggested that people on the lowest carbohydrate diets had the highest risk of dying from cancer, cardiovascular conditions and all other causes. Another study, published this month in the Lancet, also found that people on low-carbohydrate diets high in animal protein (typical of the keto diet) had a higher risk of premature death compared with those who ate carbohydrates in moderation.
However, the opposite was true for those on a low-carbohydrate diet who opted for plant-based proteins over meat and dairy. Neal Barnard, MD, FACC, associate professor of medicine at George Washington University School of Medicine and co-author of the study, tells Verywell that keto diets contain the types of foods that are associated with cancer risks. For example, a patient with obesity might need knee surgery, but the surgeon will refuse to treat her until she loses weight, in which case a keto diet might make sense, Apovian says. In particular, guidelines for doctors monitoring people on a very low-calorie keto diet for weight loss recommend supplementation with potassium, sodium, magnesium, calcium, omega-3 fatty acids, psyllium fibre and vitamins B, C and E.
(1 In recent years, the keto diet has become a fad diet for weight loss and management of some other health conditions. Keto diets have been promoted for weight loss and, less commonly, for other health reasons seizure disorders, obesity and weight control, type 1 and type 2 diabetes, fatty liver disease, cancer, Alzheimer's disease, heart disease, kidney health, and pre-pregnancy and pregnancy, all of which were considered in this review. Doctors say that the ketogenic diet may be helpful in the treatment of epilepsy; it is not known exactly why, but something about the ketogenic state seems to reduce the frequency of seizures. And in fact, the ketogenic diet is associated with an increase in bad LDL cholesterol, which is also linked to heart disease.
High-protein ketogenic diets may also cause kidney stones, as well as accelerating kidney disease in those with kidney disease, according to the review. Another study of 30 elite walkers found that those who followed the keto diet for 3.5 weeks had significantly higher levels of blood markers of bone breakdown compared to those who followed a higher carbohydrate diet (1).Some evidence suggests that high-fat, low-carbohydrate diets that focus on animal foods may lead to poor health outcomes, while diets that emphasise plant sources of fat and protein provide benefits (20, 2.Some studies also suggest that the keto diet reduces the amount of citrate released into the urine. Although the keto diet is associated with weight loss and other short-term health benefits, it can lead to nutrient deficiencies, digestive problems, poor bone health and other problems over time. Another study of more than 15,000 adults found similar results, but linked both low-carbohydrate and high-carbohydrate diets to a higher rate of all-cause mortality compared to moderate-carbohydrate diets in which carbohydrates comprised 50-55 of total daily calories (2).WASHINGTON In the most comprehensive analysis yet of ketogenic (keto) diets, a review in Frontiers in Nutrition finds that keto diets put pregnant women and patients with kidney disease at risk for adverse health effects.
