Ketogenic diet: What are the risks?
Fad diets often come with big promises of weight loss and optimum health, but at what risks? University of Chicago Medicine Ingalls Memorial dietitians say the ketogenic or keto diet, which has gained popularity in the last several years, is extremely strict and difficult to maintain.
Rachel Kleinman, RDN, LDN, clinical dietitian at Ingalls, said the keto diet is primarily used to manage seizures in children with epilepsy. Research on the diet’s effectiveness in treating obesity or diabetes is limited.
Ketosis is a metabolic adaptation to allow the body to survive in a period of famine. Your body will break down ketone bodies, a type of fuel the liver produces from fat, instead of sugar or glucose from carbohydrates.
To achieve ketosis, the diet requires you eat 75 percent of your calories from fat, compared to 20-35 percent normally. It also requires 5 percent of calories from carbohydrates, about 20-50 grams per day, and 15 percent of calories from protein. Kleinman said it takes about 72 hours for ketosis to kick in. “It’s really an all or nothing diet,” Kleinman said.
People following the keto diet should be eating foods like fatty fish, eggs, dairy, meat, butter, oils, nuts, seeds and low-carb vegetables. “Fat bombs” like unsweetened chocolate or coconut oil can help people reach their daily goals for fat intake. Keto-compliant foods like red meats and nuts can be costly, Kleinman said. Keto-branded products like keto coffee and other supplemental products are also both costly and unnecessary.
Wellness Dietitian Mary Condon, RN, LDN, said the keto diet may result in weight loss and lower blood sugars, but it’s a quick fix. “More often than not, it’s not sustainable. Oftentimes weight gain may come back, and you’ll gain more than what you lost,” Condon said.
Condon said you should always consult your primary care doctor before starting any new diet.
“If you are on diabetic medication that causes low blood sugar, those meds may need to be adjusted within a few days,” Condon said. “There are heart-healthy sources of fat, however if that person is not educated on heart-healthy sources of fat, they may consume excessive amounts of saturated fats that can increase your risk of heart disease,” Condon said.
The keto diet could cause low blood pressure, kidney stones, constipation, nutrient deficiencies and an increased risk of heart disease. Strict diets like keto could also cause social isolation or disordered eating. Keto is not safe for those with any conditions involving their pancreas, liver, thyroid or gallbladder.
Kleinman said someone new to the keto diet can also experience what’s called the “keto flu” with symptoms like upset stomach, dizziness, decreased energy, and mood swings caused by your body adapting to ketosis.
Both Condon and Kleinman said they wouldn’t recommend the keto diet to their patients because it is ultimately not realistic or sustainable. The diet restricts fresh fruits and vegetables, whole grains and low fat dairy that can help with long term weight loss and overall health.
“There’s not one diet that’s good for everyone,” Kleinman said. “Do your research, consult a dietitian, discuss with your doctor, and make sure you’re being safe.”
Call the Health and Nutrition Experts at UChicago Medicine Ingalls Memorial at 708-915-8850 to discuss nutrition counseling programs offered to meet your personalized needs.
The Keto Diet Is Gaining Popularity, But Is It Safe?
A new twist on extreme weight loss is catching on in some parts of the United States. It’s called the “keto diet.”
People promoting the diet say it uses the body’s own fat burning system to help people lose significant weight in as little as 10 days.
It has also been known to help moderate the symptoms of children with epilepsy, although experts are not quite sure why it works.
Proponents say the diet can produce quick weight loss and provide a person with more energy.
However, critics say the diet is an unhealthy way to lose weight and in some instances it can be downright dangerous.
When it’s unhealthy
Critics say the keto-type diets usually work only in the short term and can be unhealthy.
For starters, most of the lost weight is water weight, according to Lisa Cimperman, R.D.N., a clinical dietitian at University Hospitals Case Medical Center in Cleveland, Ohio, and a spokesperson for the Academy of Nutrition and Dietetics.
“Once your body enters ketosis, you also begin to lose muscle, become extremely fatigued, and eventually enter starvation mode. Then it actually becomes even harder to lose weight,” Cimperman told Healthline.
Mawer said he doesn’t believe the keto diet causes muscle loss. He did caution it’s not optimal for someone trying to gain muscle.
Other experts interviewed by Healthline had stronger words of caution.
“Keto diets should only be used under clinical supervision and only for brief periods,” Francine Blinten, R.D., a certified clinical nutritionist and public health consultant in Old Greenwich, Connecticut, told Healthline. “They have worked successfully on some cancer patients in conjunction with chemotherapy to shrink tumors and to reduce seizures among people suffering from epilepsy.”
In the general population, Blinten said a keto diet should only be considered in extreme cases.
“It can do more harm than good. It can damage the heart, which is also a muscle,” she explained.
Anyone with type 2 diabetes can benefit from weight loss and a reduced-carb diet because it will improve insulin sensitivity, Cimperman explained.
“But there are many other ways to do it besides a fad diet that won’t keep weight off long-term,” she said.
Blinten, who has used a keto diet for some cancer patients in specific circumstances, cautioned, “people will do anything to get the weight off.” However, a keto diet will do more harm than good for the majority of patients, especially if they have any underlying kidney or liver issues.
“People are using this for cosmetic reasons, but it’s so extreme that it’s dangerous,” she said.
Read More: Why Severe Anorexia is So Difficult to Treat »
The feeding tube approach
Some have taken the keto diet a step further, using a feeding tube inserted into the esophagus through the nose.
Dieters adhere to a strict 800-calorie high-protein, no-carb diet administered through the tube by a slow-drip pump mechanism. Only black coffee, tea, or water is allowed in addition to the liquid diet.
A Florida doctor, Oliver Di Pietro, has been offering this tube diet to anyone who can pay the $1,500 cost. According to a 2012 local news report, Di Pietro learned of the diet while on a trip to Italy. He insists the keto diet is safe and effective, even for those wanting to shed just a few pounds.
“This is a ridiculous approach to weight loss,” said Cimperman.
With an 800-calorie-a-day diet, “you’re essentially starving yourself,” Cimperman said. “Of course you will drop weight.”
Anything under a 1,200-calorie daily diet is considered a starvation diet and is not meant for long-term weight loss.
Tube feeding is a legitimate tool in a hospital setting, she explained.
“Someone who is on a ventilator, or can’t swallow because of a stroke or cancer, might have to eat this way. But it’s usually used as a last resort,” she said.
“In an otherwise healthy individual it can create serious complications, including infections if the tube gets contaminated, increased sodium levels, and it can cause dehydration and constipation,” Cimperman added. “What would even possess people to want to walk around with a tube up their nose?”
Melinda Hemmelgarn, a registered dietitian in Columbia, Missouri, and host of the Food Sleuth radio show, told Healthline, “It’s crazy to consider sticking a tube down your nose to lose weight. It sounds to me like somebody is making a lot of money on someone else’s vulnerabilities. Just say no to this idea.”
Read More: Doctors Finally Begin to Treat Obesity »
Don’t become weight obsessed
Hemmelgarn advised anyone thinking of going on a fad diet to “keep food in perspective. It’s a gift. It’s how we nourish ourselves and stay well.”
Marketing this diet to brides just plays into our weight-obsessed society, according to Hemmelgarn.
Instead, anyone preparing for marriage should nourish herself well, engage in plenty of physical activity like walking, jogging, or bike riding, and be good to herself by eating fresh, whole, minimally processed organic foods.
There is no magic bullet for long-term weight loss, said Blinten. For long-term weight control, a Mediterranean style diet focused on fruit, vegetables, whole grains, beans, fish, and olive oil, is one that can be healthy for life.
“We fall prey to wacko diets, but the truth is there’s no quick fix,” Blinten said. “Cutting refined carbs and replacing them with fresh fruits, vegetables, and lean protein, cutting processed foods, and avoiding too many additives will keep you healthy in the long term.”
Cimperman said the healthiest approach to weight loss is to set realistic goals and ask yourself if your diet plan is:
- good for the long term
- includes exercise
- meets your long-term health goals.