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Approach the Keto Diet with Caution

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Lose-weight-quick diets have been around for years. One of the most popular diets today is the keto diet, but dietitian and diabetes educator Theresa Anderson says the diet brings several health risks with it.

“The keto diet is mainly about eliminating most, if not all, carbohydrates,” said Anderson, who counsels diabetes patients at Good Samaritan Regional Medical Center. “With this diet, 80 percent of your calories come from fat, 15 percent from protein and the rest from carbohydrates. It’s appealing because you lose weight fast.”

Concerns About Keto

But that quick weight loss can carry several dangers, Anderson said. She pointed out that while a carb-heavy diet can lead to weight gain, carbs are important for glucose production and daily energy. While the diet is new enough that long-term studies aren’t available to verify the diet’s effect, Anderson bases her concerns on the most recent dietary research.

She explained that carbohydrates are stored with water, so cutting out most carbs can make it appear that weight loss is fast, but it can leave you dehydrated.

“There’s a huge nutrition imbalance with the keto diet: It leaves out a lot of vitamins and minerals,” she continued. “If there is inadequate carbohydrate intake, the body has to develop glucose from protein instead of carbs, so that can lead to decreased muscle mass, and it can affect your endurance.”

Keto diet supporters say the diet helps decrease blood pressure and increase your good (HDL) cholesterol. But according to the American Heart Association, blood pressure improves with weight loss in general, not due to any specific diet. And the cholesterol gain is risky for people with genetically high cholesterol.

She listed several other health risks and drawbacks:

  • Brain function is impacted without the quicker-released energy of glucose from carbs, as well as from potentially compromised hydration.
  • Bone mass can decline from an excess of protein, as well as potentially inadequate calcium and vitamin D consumption.
  • Intestinal function can be damaged, which can lead to cancer and other dangerous conditions. This is due to the proven cancer-causing properties of red meat and processed meat (according to a World Health Authority study in 2014), as well as increased saturated fat on the keto diet, and inadequate intake of calcium, fiber and vitamin D.
  • It can lead to kidney and liver diseases, as well as mid-life death. The kidneys are at risk due to the high protein content of the diet, and the dehydration that comes from high-protein diets. The liver is at risk also due to the high protein content, as well as the high fat content.
  • It can actually increase your waistline while you’re losing weight elsewhere.

“I’ve seen it my entire career: People are looking for a quick and easy way to lose weight,” Anderson said. “And with the keto diet, there’s an appeal that it tastes good, and glamorous people like Kim Kardashian promote it.”

Alternative Weight Loss Strategies

What should people do instead to lose weight? Anderson said the best general idea is to eat a healthy diet and take the weight off slowly. She also emphasized patience with the process.

“There’s truly no magic bullet for long-term success and prevention of related health issues that might be created by unhealthy, dangerous diet plans,” she said. “Do we want to increase stroke risk from heart rhythm problems, even though blood pressure is lower? Do we want to increase risk of kidney failure and dialysis, but with a thin body? Do we want to run faster with a thinner body but have much increased risk of bone fractures and osteoporosis?

“In health care, our primary focus with any medical treatment is ‘Do no harm,’” Anderson continued. “With that in mind, I could never recommend this diet.”

Anderson points to research that suggests:

  • Limiting high-calorie and non-nutritious foods
  • Getting into a routine with regular meals so your body can start recognizing “internal cues” of hunger and fullness
  • Choosing low-calorie snacks
  • Eating slowly and mindfully
  • Staying hydrated throughout the day
  • Staying full with lots of vegetables and other high fiber foods
  • Finding activities to prevent boredom eating
  • Setting realistic, measurable goals for weight loss
  • Finding motivation to commit long-term to your goals
  • Getting active

 Read more about other diets including the Mediterranean and DASH diets.