The Keto Diet – Does It Work And Is It Safe?

What Is The Keto Diet?

The Keto diet is a very low Carbohydrate, moderate Protein and high Fat diet. It’s recommended for adults to get 45-60% of their overall energy from Carbohydrates (Dietary Reference Values | DRV Finder, 2017). In the Keto diet only 5-10% of your calories come from carbohydrates (Feinman et al., 2015).    So the aim of a Keto diet is to keep the body in a permanent state of ketosis.r opinion.

What Is Ketosis?

Ketosis is when the body changes its preferred energy source of glucose from broken down Carbohydrates, to Fat.  Fat is broken down and ketones are produced in the liver and used as energy.  It takes about 4-5 days for the body to adapt and for ketosis to kick in.  Until it kicks in you basically fell like sh*t.  It’s referred to as the ‘Keto flu’.  Because of this your body has no energy source because ketosis hasn’t kicked in yet.  Symptoms of ‘keto flu’ include.

• Headache
• Fatigue
• Brain fog
• Irritability
• Constipation and other gastro issues like nausea, stomach-ache, cramps
• Sleep disturbance
• Dizziness
• Sugar cravings
• Sore muscles
• Bad breath

What You Can And Cannot Eat On Keto

Not Allowed	Allowed
Grains – Oatmeal. Pumpernickel.  Flour and corn tortillas.  Rye bread.  Wheat bread, Oats.  Sourdough bread.  Buckwheat. Corn.  Crisps.  Cereals.  Pasta.  Rice.  Couscous	You aren’t allowed any grains at all….
Vegetables – All starchy vegetables, so anything that grows below the ground.  Sweet potatoes. Potatoes.  Yams.  Corn.  Parsnips.  Turnip.  Artichoke.  Pumpkin	Vegetables – Broccoli.  Bitter greens.  Bok choy.  Chard.  Collards.  Endive.  Kohlrabi.  Nori.  Summer squash.  Zucchini.  Aubergine.  Cabbage.  Asparagus.  Brussel sprouts.  Celery.  Cauliflower.  Green Beans.  Cucumber.  Spinach.  Green and red peppers.  Kale.  Lettuce.  Avocados.  Olives.  Tomatoes (In moderation).  Certain mushrooms
Legumes (peas, beans and lentils) – Chickpeas.  Baked beans.  Pinto beans.  Lima beans.  Black-eyed peas. Black beans.  Green peas.  Cannellini beans.  Kidney beans.  Lima beans.  Great Northern beans.  Navy beans.	No Legumes allowed…
Fruits– Oranges. Tangerines. Bananas.  Pineapples.  Grapes.  Pears.  Nectarines.  Mangos.  Peaches.  Fruit juices.  Fruit smoothies.  Dried fruits	Fruits–   Blueberries. Blackberries.  Strawberries.  Raspberries.  Lemons.    Limes.  Unsweetened cranberries.
Dairy – Condensed milk.  Most milks derived from animal sources.  Fat-free or low-fat yogurt.  Creamed cottage cheese	Dairy – Butter/ghee. Bleu cheese.  Cottage cheese.  Cheddar cheese.  Cream cheese.  Cream.  Feta.  Gouda.  Goat cheese.  Mozzarella.  Plain Greek yogurt.  Swiss cheese.  Parmesan cheese
Meat and meat alternatives – Breaded meats.  Bacon with added sugar.  Processed meat that could have hidden carbs.  Processed meats high in nitrates.  Plant-based proteins	Meat – Beef.  Chicken.  Bacon.  Ham.  Eggs.  Pork.  Lamb.  Poultry.  Pork.  Venison.  Veal.  Wild Game.  Organ meats Deli meats in moderation (Sliced chicken, corned beef, ham, pancetta, pastrami, prosciutto, roast beef, speck, and turkey, etc.) Cured meats in moderation (Sliced chorizo, pepperoni, salami, and soppressata) Seafood – Crabmeat.  Cod.  Clams & Oysters (In moderation).  Halibut.  Flounder.  Mackerel.  Lobster.  Herring.  Wild salmon.  Shrimp.  Sardines.  Squid.  Sole.  Trout.  Tuna
Oils – Corn oil.  Canola oil.  Grapeseed oil.  Peanut oil.  Rapeseed oil.  Safflower oil.  Soybean oil.  Sunflower oil.  Margarine.  Vegetable shortening.  Cottonseed oil.  Flaxseed oil.  Soy-based oils.  Commercial lard	Oils – Butter, preferably from grass-fed sources.  Coconut cream.  Avocado oil.  Coconut oil.  MCT oil.  Olive oil. Walnut oil.  Sesame oil. Cacao butter.  Ghee.  Lard from pasture-raised sources
Nuts – Cashews. Chestnuts.  Pistachios.  Soybeans.  Edamame.  Peanuts.  Flours or butters made from any of these sources	Nuts – Coconut.  Chia seeds.  Brazil nuts.  Hemp seeds.  Flaxseeds.  Macadamia nuts.  Hazelnuts.  Pumpkin seeds.  Pecans.  Sesame seeds.  Sunflower seeds.  Walnuts.  Almonds.  Pecans.  Flours or butters made from any of these sources
Drinks – All soda, including diet soda.  Tonic water and energy drinks (use caution with “sugar-free” varieties).  Sugary sports beverages.  Kombucha.  Kefir.  Lemonade.  Fruit juice.  Frappuccino, mocha, and other sweetened “coffee” drinks.  Sweetened iced tea.  Most beers.  Cocktails like screwdrivers, margaritas, and pina coladas.  Liqueurs and other sweetened liquors. Sweet wines	Drinks – Lemon water. Black coffee.  Unsweetened tea.  Bone broth.  Mineral water
Sweeteners – Sugar.  Honey.  Agave.  Maple syrup.  Fructose.  Saccharin.  Aspartame.  Sucralose	Sweeteners – Erythritol.  Monk fruit sweetener.  Stevia.  Xylitol.  Sorbitol. Maltitol.  Allulose.  Splenda

Pretty restrictive, huh?  Also, where is the Fibre??  The sweeteners allowed are used in Diabetic sweets and chocolate.  As a Type 1 Diabetic myself I would strongly recommend you stay away from them unless you fancy having explosive diarrhoea.  There’s’ also a LOT of animal Fat and Protein.  Cutting out all grains, beans, starchy vegetables like potatoes and a lot of fruits too.  It also looks like it would be expensive to follow.  ‘Organic’ and ‘grass fed’ dairy and meat are generally more expensive. .

What Health Benefits Does The Keto Diet Claim To Have?

• Most people are interested in Keto for weight loss.  It does usually cause fast weight loss.  Keto is high in Protein and Fat.  Both macronutrients keep you fuller for longer.  Remember the ‘hunger busting trio’, Protein, Fat and Fibre.  Unfortunately, Fibre has been left out this time.  However, the initial weight loss is mostly water weight.  This diet is not a sustainable way to lose weight.  Once you start introducing non-keto foods back into your diet you will likely gain all that weight back. 

• Some research shows the Keto diet to be beneficial for people with Type 2 Diabetes.  On the Keto diet you don’t consume enough carbohydrates to cause high blood sugar levels.  However, if you have Type 1 or Type 2 Diabetes and are on insulin you should not attempt a Keto diet as it could lead to hypoglycaemia (low blood sugar levels).  This can lead to coma or death (Leow et al., 2018). 

• The Keto diet is still being used as a treatment for epilepsy when other treatments are not effective.

What Are The Health Risks From Following A Keto Diet?

• Firstly, I want to look at how restrictive the Keto diet is.  Imagine you’re going out with friends and everyone decides to go for a pizza.  What will you do?  Sit and watch while they enjoy the pizza?  Try to find something that is Keto friendly?  Leave early?  Restrictive diets like this can lead to a person becoming obsessed over food, and not in a good way.  I have heard of people on low carb diets who literally dream about bread!  Does that not ring alarm bells that your body is obviously not having its needs met nutritionally?

• The Keto diet has also been linked to an increased risk of developing kidney stones.  Take it from someone who knows.  You don NOT want kidney stones.  The increased amount of Protein is very hard on your kidneys.

• Because of the increased amount of saturated fat in the Keto diet it has been linked to significantly higher risk of developing Coronary Heart Disease (CHD).  You’re also cutting out Fibre which helps reduce blood pressure and cholesterol. 

• Obviously due to its restrictive nature you are probably going to be at a higher risk of multiple Nutrient deficiencies.  Especially Fibre and the B vitamins (Thiamine, Riboflavin, Niacin, Folic acid & B6). 

• I always emphasise the importance of Fibre for good gut health.  So, if you cut out Fibre what happens to your gut?  About 30-50% of people who start the Keto diet experience gastro symptoms such as abdominal pain, nausea, vomiting and constipation.  These symptoms don’t give off ‘happy gut’ vibes.  Research has shown that the Keto diet is associated with large shifts in the diversity of the gut microbiota (Tuck and Staudacher, 2019).  That means there is an imbalance in good and bad gut microbe because there is not enough food (Fibre) for the good gut microbes, so they are dying off.  Watch my video on the gut to find out why this is not good for overall health, not just gut health.  There aren’t a lot of long-term studies done on the effects Keto has on gut health, but I wouldn’t say it benefits it in any way.  A low Fibre diet has been linked with increased risk of Colon cancer among other chronic illnesses.

• Extra fat in the liver can result in liver inflammation.  This can damage to your liver can create scarring. In serious cases causing in liver failure.

• A very large long term meta-analysis study over 30 years showed that adults who followed a very low Carbohydrate, high animal Protein and Fat diet (AKA Keto) actually had a lower life expectancy than someone who eats a diet containing the recommended amount of Carbohydrate, Protein and Fats.  Approximate less than four years to be exact (Seidelmann et al., 2018)!

• If you have an overactive thyroid, are type 1 Diabetic, a heavy drinker or are not consuming enough calories you are at risk of Ketoacidosis.  This is when Ketone build up in your blood stream and cause your blood to go acidic.  It can cause coma and death.  Watch out for symptoms like extreme thirst, frequent urination, extreme fatigue, confusion, and fruity smelling breath.

Types Of Keto Diets

There are three main types of Keto diets.

• The Standard Keto Diet (SKD) involves approximately 10% of your calories coming from carbs, 20% from protein and 70% from fat.
• The High protein Keto Diet (HPKD) is like the SKD but it includes a larger percentage of protein.  Typically, 5% carbs, 35% protein and 60% fat.
• The Targeted Keto Diet (TKD) includes carbs around workouts and
• The Cyclic Keto Diet (CKD) includes several low card ‘Keto’ days, and several high carb days.  Example 5 Keto days and 2 high carb days.

So that is everything I could find about the Keto diet.  Personally, it is 100% not for me.  I love my carbs too much and have no intention of ever giving them up! 

In conclusion, If you really want to lose weight, please try a good old fashioned balanced diet mixed in with some common sense!  Listen to your body and it will tell you what it needs.

If you don’t know where to start check out my Nutrition services and let me help you feel healthy and happy with NO RESTRICTIONS!

References

Dietary Reference Values | DRV Finder (2017) EFSA. Available at: https://www.efsa.europa.eu/en/interactive-pages/drvs (Accessed: 19 November 2020).

Feinman, R.D. et al. (2015) ‘Dietary carbohydrate restriction as the first approach in diabetes management: critical review and evidence base’, Nutrition (Burbank, Los Angeles County, Calif.), 31(1), pp. 1–13. doi:10.1016/j.nut.2014.06.011.

Leow, Z.Z.X. et al. (2018) ‘The glycaemic benefits of a very-low-carbohydrate ketogenic diet in adults with Type 1 diabetes mellitus may be opposed by increased hypoglycaemia risk and dyslipidaemia’, Diabetic Medicine: A Journal of the British Diabetic Association [Preprint]. doi:10.1111/dme.13663.

Seidelmann, S.B. et al. (2018) ‘Dietary carbohydrate intake and mortality: a prospective cohort study and meta-analysis’, The Lancet Public Health, 3(9), pp. e419–e428. doi:10.1016/S2468-2667(18)30135-X.

Tuck, Caroline.J. and Staudacher, H.M. (2019) ‘The keto diet and the gut: cause for concern?’, The Lancet, 4, pp. 908–909. Available at: https://www.sochob.cl/web1/wp-content/uploads/2019/12/The-keto-diet-and-the-gut-cause-for-concern.pdf (Accessed: 16 November 2021).