Ketosis - What is it and is it safe?

This article describes the benefits and risks of a keto diet. While it can be helpful in treating high blood pressure, epilepsy, and other health issues, it is not for everyone and is not without risks.

The standard keto diet, or ketogenic diet, is a high-fat, low-carbohydrate diet that provides the body with fats instead of carbohydrates for energy. It has become very popular in recent years as a means of weight loss. Other low-carb diets include the protein keto plan which centres around getting 20% of daily calories from protein and about 80% from fat.

The keto diet has gained lots of attention for its weight loss benefits and its ability to help individuals quickly shed pounds.

The goal of this ketogenic diet is to drastically reduce your daily carbohydrate goal to around 70 – 80% of your total daily calories. To do this, individuals should focus on eating natural fats like olive oil, avocados, and oily fish such as salmon, pilchards, sardines, and mackerel. They should also consume a moderate amount of carbohydrates like vegetables and some fruit - but focus more on the low carb items like cauliflower, green beans, mange tout, kale, broccoli, asparagus, mushrooms, and squashes.

When it comes to protein, you want to aim for the middle ground as consuming too much can kick you out of ketosis.  Bulk up your meals with healthy fats as they will help keep you full while helping you reach your daily calorie goal with ease.  Nuts, seeds, and avocado are good for this.

People who use this diet will experience a big reduction in water weight and overall body fat for weight loss purposes. The idea behind this nutrition therapy is to adapt the body to using primarily fats for energy, instead of so many carbohydrates.

The excess fats that are consumed during this diet get stored in the liver and are then broken down into ketones which are used as an alternative fuel source for the body’s cells. While some may find it intimidating to switch to such an extreme eating plan, people who have stuck with it have seen great results with regard to weight loss and improved overall health.

When you eat carbohydrates, they are broken down into glucose which is then used as energy. When your glucose levels drop, your body produces compounds called ketone bodies in a process known as ketosis. These ketones are produced by the liver, as mentioned above. When glycogen stores are depleted and become an alternative source of energy. This process shifts our body into a state of nutritional ketosis, where it utilises fat as fuel instead of glucose. This effectively reduces the amount of stored body fat since the fats are now being used as fuel instead of being stored away in the form of triglycerides.

In order to maximise the potential benefits of ketosis, involving weight training is recommended as it can help minimise muscle loss while eating. On average, the recommended macronutrient breakdown for individuals on a keto diet is 165 grams of fat, 75 grams of protein, and 25 – 50 grams of carbohydrates per day depending on one’s lb body weight. For example, if you weigh 150 – 180 lbs, you should aim for about 40 grams of carbs per day.

It can also raise cholesterol levels, especially if you have a heavy reliance on saturated fats. While it’s not recommended for people with diabetes, it may be beneficial for those who are at risk of developing heart disease.

It can help you lose weight, reduce the frequency of migraines and even improve acne. It has been used to treat epilepsy in children since the 1920s, and studies show that using a ketogenic diet is an effective way to control seizures in people with epilepsy who do not respond well to epileptic drugs. In fact, it has been found to be more effective than drugs in some cases. A ketogenic state also helps treat high blood pressure and type 2 diabetes by stabilising blood sugar levels. Many studies have shown that when people follow the Keto Diet, they experience improvements in overall health.

"The keto diet is one way to help achieve this goal. The keto diet is a low-carb, high-fat diet that puts your system into a metabolic crisis, forcing it to burn fat for fuel. It can result in rapid weight loss of one to two pounds per week,’" according to Scott Keatley, RD, of Keatley Medical Nutrition Therapy.

Side effects of keto diet

Keto flu

Some individuals report nausea, fatigue, gastric upset, and fever which can last up to three days.  As the body used up its resources for energy, it has to adapt and start using fats and proteins.  This switchover can cause keto flu. Remember this could affect your ability to work or drive, so plan your change of eating style well.

Loose bowels

The gallbladder produces bile which helps break down fats.  Again, the adaptation can cause the gallbladder to be overactive initially.  The gallbladder activity can cause loose bowels and bloating. The bowel movement can be urgent which could cause embarrassment, so again plan your change.

Ketoacidosis

Check with your health professional if you are diabetic, both type 1 and type 2. Blood sugar levels will fluctuate and could cause other health concerns and even be dangerous if a Keto diet is introduced. Always seek supervision and advice before embarking on this regimen. It is prudent to self-check blood sugar levels.

Weight bounce back

It is not advisable to follow the keto diet long term as it is so nutritionally deficient. Long-term use could lead to osteoporosis, for example. Some individuals regain weight they lost when they reintroduce carbohydrates. The reintroduction phase should be carefully monitored and managed to prevent this and undo all the good the regimen had created.

Loss of muscle mass 

This will particularly affect individuals who do not weight train. As the body loses weight it can lose muscle mass which in turn can affect the ability to lose weight as muscle burns more calories than fat. A simple exercise programme can really help maintain long-term weight loss.

As a Nutritionist, I sit on the cautious side with this eating style. The fact it should be used temporarily and some people are marketing that they have used it for years worries me, as it is giving the wrong impression to the public.  

It must be used with caution and as a temporary diet. I advise that individuals seek professional support whilst they use this style of eating, so they protect themselves against malnutrition.

References

Should you try the keto diet? - Harvard Health, available here. 

7 Side Effects of the Keto Diet (health.com), available here.