Should you fall for the eternal allure of the keto diet?

I won’t argue if someone serves me a bunless burger or takes away the croutons on my salad (although I may be a little sad). But I certainly won’t give up my fresh, crisp, fruit, making me a terrible advocate for the keto diet. However, it’s one of the rare fad diets that has outlived the word “fad”. Much has been said and written about it over the years; it’s worth discovering if there is merit.

Like any diet, its success of it comes down to multiple factors—a consistently applied calorie deficit, the quality of the food you eat, and the person’s fitness goals and genetics. You can achieve this on the ketogenic diet, and for some people, the ketogenic diet has been a great experience. It helps them lose stubborn weight or feel less hungry while trying to diet. For others, it won’t be as pleasant. They find it challenging to adhere to and don’t feel their best.

Also read: Is intermittent fasting actually good for weight loss?

Personal experiences aside, little is actually known about its long-term effects and whether it stays effective. So what exactly is a ketogenic diet? A ketogenic diet is one that heavily favors the intake of fat over carbohydrates and protein. The general macronutrient breakdown is approximately 15-20% protein, 5% carbs (no more than 50g, which is less than a plain bagel), and 75-80% fat. Sometimes, people will even ingest up to 90% of their daily calories from fat alone.

The rationale behind switching our diet’s emphasis from carbohydrates to fat is that our body’s primary fuel source is glucose, derived from carbohydrate consumption. By minimising our carbohydrate intake to almost zilch, we force our bodies to rely on our survival backup fuel—ketones, which are made from fat. This fuel switch means that we can lose weight while still eating and feel satisfied, offering huge benefits for people who struggle with managing their hunger cues on diets.

However, don’t be fooled into thinking that skipping one day of carbohydrates will initiate this response. It takes a few days for the body to use up its stored glucose from the liver. During that time, people may experience “withdrawals” affectionately known as the “ketogenic flu.” These are the side effects that emerge from reducing your carbohydrate intake, according to the article Why the Keto Diet Cause Flu-Like Symptoms. The keto flu may last a few days and include nausea, fatigue, and headaches.

Now to stay in “ketosis” (the act of using ketones for fuel), your carbohydrate intake must stay chronically low. The maximum daily amount of carbohydrates on the ketogenic diet is 50g—some people eat as little as 20g (the equivalent of one piece of bread). Because of this restriction on a number of foods, ketogenic dieters find staying in ketosis very difficult since it often means heavy cutting down your fruit and vegetable intake, if not eliminating them. If you eat even an apple, you will have to restart the whole process. Ouch!

People who find eating so much fat difficult may try to increase their protein intake. However, Harvard Health tells us that if protein levels are too high, it’s unlikely someone has entered ketosis, as some amino acids can inhibit this.

The ketogenic diet is not without its challenges, but it wouldn’t have so many avid followers if it didn’t have some positive effects on people’s health. For example, ketones, made and used for fuel during ketosis, can decrease oxidative stress on the body, reduce free radicals, and boost antioxidants. And eating a ketogenic diet has been shown to help those with Type 2 diabetes.

According to Advantages and Disadvantages of the Ketogenic Diet: A Review Article, other disorders are linked to insulin resistance, such as polycystic ovarian syndrome (PCOS) in women. Also, the ketogenic diet can improve other health parameters such as “insulin resistance, high blood pressure, and elevated cholesterol and triglycerides,” according to the American College of Cardiology.

However, the effects seem to be short-lived. Weight loss diminishes post 12 months, according to an article in the New York Times, What is the Keto Diet and Does it Work. In addition, after 12 months, the ketogenic diet has no added benefit to the scales than another competing diet.

And yes, there is a dark side to eating so much fat. Circling back to the American College of Cardiologists, they caution that “an emphasis on foods high in saturated fat also counters recommendations from the Dietary Guidelines for Americans and the American Heart Association and may have adverse effects on blood LDL cholesterol.” It’s not just your cardiovascular health that may suffer; ketogenic dieters may suffer from kidney stones, constipation, and micronutrient deficiencies that may impact their overall health.

So what can we can gather from this information? The ketogenic diet may be a great way to kick-start your weight loss process. But you need to remember that it’s a short-term solution and your health needs to be monitored by a medical professional all throughout.

Also read: Why protein is so important for older adults

If you’re interested in trying the ketogenic diet, the overall recommendation is to do it for a minimum of 2-3 weeks, a maximum of approximately six months to a year. Starting a new diet such as this, have a conversation with your doctor to determine if it’s the right fit. And yes, people with medical conditions, such as an elevated risk for cardiovascular diseases and liver or pancreas issues, shouldn’t try the diet.

Seems too difficult to try? In that case, you may want to start by simply reducing the carbohydrates in your diet. The act of reducing your carbohydrates may not put you into ketosis the way that the ketogenic diet will, but it is a step in the right direction toward rebalancing your overall energy intake.

Jen Thomas is a Chennai-based weight-loss coach

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