This story has been updated since it was originally posted on 7/24/2021 to include new research.
The keto diet has rapidly grown in popularity over the last several years as a method for weight loss which calls for prioritizing healthy fat and protein while keeping carb consumption to a minimum. Carbohydrates are traditionally more calorically dense foods, so the idea is that the keto diet will send your body into ketosis without these carbs, expediting fat burn and improving your metabolism for faster weight loss.
This diet has quickly picked up speed as a fad diet which can carry some health benefits if you struggle with certain food intolerances, but many people don’t know the details of the ketogenic diet before implementing it into their own lives. Before you turn to this eating plan for weight loss, we asked the experts all the questions you didn’t know you needed to be asking about this diet. They concluded that while it may help you lose weight, there are many health risks at hand. In fact, new research suggests that it can even increase your risk of heart disease over time. Learn more about all of this below.
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What is the keto diet?
As mentioned above, the keto diet is a low carb, medium protein, and high fat diet which is intended to send your body into ketosis. This is a state of fat burning which makes it easier for your body to lose weight quickly and is set into action when your body does not have carbs to use as fuel. “The ketogenic diet can be a safe method for weight loss for a short period of time,” says registered dietitian Trista Best. Followers of the keto diet note that alongside weight loss, the diet also provides them with stronger mental clarity, lower blood sugar, and lower insulin levels. However, carbs are a valuable energy source for the body, and cutting them out of your diet can have implications on your health when followed for a longer period of time.
Is it effective for long term weight loss?
While in the short term you can see some significant changes in your body from following the keto diet, research has shown that sticking to this diet for an extended period of time can prove to be detrimental to your overall health. Dieting is a difficult concept because it requires you to deprive your body, and the keto mindset is no different. Carbs are a positive energy source for your body, and when you deprive yourself it can be incredibly difficult to stick to over long periods of time, making for short lived results.
“As for effectiveness, studies show that it promotes weight loss in the first 6 months and some positive changes, including a reduction in serum hemoglobin A1c, in patients with diabetes mellitus type 2. Therefore it may be helpful for diabetics and others with abnormal glucose tolerance because it means that there is little insulin release making weight loss somewhat easier in these groups,” notes Julie Miller Jones, PhD, LN, CNS.
That being said, if you aren’t diabetic or do not struggle with a glucose intolerance, keto may not actually be a great fit for you. “A recent study showed that those getting 50% of their calories from carbohydrates lived an average of 4 years longer than those eating a higher or lower percentage. Some doctors are even trying it for various cognitive disorders such as Alzheimer’s, but there is no clear-cut evidence of its effectiveness,” notes Jones.
What are the downsides of keto?
Ketosis is achieved by eliminating the majority of carbs from your diet, making it necessary to commit entirely to this eating plan rather than easing in to see actual results. However, since it is such a restrictive diet, it can be difficult to stick to completely, and you may be depriving yourself most of the time while still not seeing positive results if you aren’t going all in. “It can be difficult to stick to the ketogenic diet when eating outside of the home. This is primarily due to not knowing the exact carbohydrate content in certain recipes. Some may seem to be low carb and high fat, but with added ingredients it can be hard to know for sure. This could potentially lead to the person being knocked out of ketosis,” explains Best.
In addition, carbs are genuinely important to your overall health and energy levels, and removing them from your diet is not a sustainable change to make for the rest of your life. Therefore, if you remove them in the short term, you will likely gain the weight you lost back when you re-add carbs to your diet. Lack of carbs isn’t the only possible issue with the keto diet, and this eating plan can come with a slew of other health issues. “Some of the negative aspects of the ketogenic diet include skin rash, dangerous ketoacidosis, brain fog, severe diet restriction, and potential for increased cholesterol,” warns nutritionist Lisa Richards.
Research suggests higher risk of heart disease
A recent study conducted by the Healthy Heart Program Prevention Clinic, St. Paul's Hospital and University of British Columbia's Centre for Heart Lung Innovation in Vancouver, Canada suggests that a low-carb, high-fat diet could increase your levels of bad cholesterol. That means that participating in a keto diet may lead to a higher risk of heart issues such as blocked arteries, heart attacks, and strokes.
Dr. Iulia Iatan, a lead study author, explained the study in a news release: "Our study found that regular consumption of a self-reported diet low in carbohydrates and high in fat was associated with increased levels of LDL cholesterol—or 'bad' cholesterol—and a higher risk of heart disease,” she said.
This study compared people who consumed a "keto-like" diet (45% of their total daily calories came from fat, with 25% from carbs) with those eating a standard diet. Research showed that those participating in the low-carb, high-fat diet had higher LDL (bad cholesterol) levels. While the study has not yet been peer-reviewed, it does suggest that a keto diet may be detrimental to heart health over time.
Overall, Richards says that while keto may help you lose weight, there are also significant risks at hand. "The weight loss claims are true, but without addressing the reality of rapid weight gain post-diet. Keto may be helpful for a short period of time, but it is best to follow a balanced diet for weight loss and health," she concludes.
