Starting the Keto Diet means committing to a small but powerful set of new habits. Caution is a healthy mindset to be in when deciding to make big changes like this.
Many have heard of Keto's effectiveness, but still may have questions about its safety. Because the internet is awash in unfettered advertising, it can be difficult to distinguish a potentially dangerous fad diet from a legitimately safe weight loss tool.
Here is a short, emphatic message for the cautious: the Keto Diet is safe. Anecdotal evidence from happy Keto dieters, though, might not be enough to convince the skeptical initiate. A brief look into its history, and an exploration of some medical studies, can help us demonstrate its safety.
Despite only recently becoming a popular diet, Keto methodology in the West has been around for a hundred years. In the 1920s, a form of fasting was found to dramatically decrease seizures in people suffering from epilepsy, particularly children. The benefits of fasting were already well-known in many cultures around the world. It's been shown to help with a variety of health conditions, not just epilepsy.
But how are fasting and Keto related? Ketosis, the metabolic change that occurs when carbohydrates are scarce, evolved in response to food insecurity. Our ancestors often didn't fast by choice; in times of scarcity, human bodies had to adapt. Our bodies and brains are designed to be able to run on ketones, chemicals we naturally produce as an alternate form of energy when breaking down fats instead of carbs. Humans have been interacting and experimenting with this metabolic phenomenon since before ketones had a name.
The clinical studies that began in the 1920s now have much additional reserarch to back back them up. Another recent study from 2017 analyzed the effects of the Keto Diet on 19,000 participants over the course of one year. The most important takeaway from this study is that, across the board, there were "no adverse effects" reported. The study also showed "good one-year results for weight maintenance," a substantiated claim that can't apply to fads.
Maintaining Keto Safety
Since Keto has been thoroughly studied, we're familiar with what works. There are certain parameters that need to be observed in order to stay healthy while in ketosis. Simply eliminating carbs can cause some drastic weight loss, which might be what you're looking for. But, unless you're careful about diet choices, you won't feel your best -- and the weight could come back.
A couple of guidelines to keep in mind while following Keto are to avoid bad fats, and get enough fiber. In a BBC report on Keto, dietician Susan Medlin warns against saturated fats: "Eating an unhealthy diet containing lots of saturated fat may increase health risks such as heart disease and stroke."
The Keto Diet is often simplified as a low-carb, high-fat diet -- which is not inaccurate. It's important to remember, though, that there are different kinds of fats. Saturated fat, often labeled the "bad fat," is found in sugary and pre-packaged foods. As a general rule in any good diet, those should be consumed sparingly, if at all. Some common foods Keto practitioners recommend like cheese, fatty meats, and even plant-based oils, contain saturated fat. Check nutrition facts, and don't consume these foods with abandon, even if they're Keto-friendly.
Fiber is essential for digestive function. "Foods containing carbohydrates are often also high in fiber, which is important for a healthy gut microbiome and keeping you fuller for longer," Medlin advises, suggesting fiber-rich foods like "leafy greens, broccoli, cauliflower, flax seeds, nuts, coconut and avocado."
Special Medical Concerns
The Keto Diet is designed to provide weight loss for individuals who were previously eating a "normal" high-carb diet and not experiencing other serious medical issues. Ketosis causes physical and chemical changes that could harm people with preexisting metabolic disorders. Please check with a physician if you have a metabolic disorder and are considering Keto.
People with gallbladder diseases, diabetes, pancreatic insufficiency, or have recently undergone bariatric surgery are discouraged from Keto because these conditions interfere with the ability to process fat. People who are already very thin (at a BMI of 20 or below) don't need to lose weight. People who suffer from anorexia should seek eating disorder counseling instead of dieting. Young children and pregnant/breastfeeding women shouldn't attempt Keto due to special protein requirements. Finally, Keto might not be for people who tend to develop kidney stones, as it can cause fluctuations in salt and fluid balance.
More information on conditions that clash with Keto can be found here. It's also important to remember to consult with a doctor if you have any concerns about starting a Keto plan. Health, safety, and personal happiness should be at the forefront of any new dieter's goals, so if in doubt, ask.
Ketone Bodies as Anti-Seizure Agents. (2017, July). NCBI. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5505793/
Ketogenic enteral nutrition as a treatment for obesity: short term and long term results from 19,000 patients. (2012, October 30). NCBI. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3557201/
Is a keto diet the best way to lose weight? (2019, September 13). BBC Food. https://www.bbc.co.uk/food/articles/keto_diet_weight_loss
Ede, G. (2014). Is the Ketogenic Diet Safe for Everyone? Diagnosis Diet. https://www.diagnosisdiet.com/full-article/is-ketogenic-diet-safe