What Experts Have to Say About the Keto Diet

You have probably heard of the keto diet if you have ever experimented with dieting.

According to data from the International Food Information Council, as many as 7% of Americans adopted this diet in 2022, and the global market for foods that support the ketogenic diet exploded to $8.8 billion in the same year.

The ketogenic diet is a high-fat, low-carbohydrate plan with a moderate protein intake. And although the short-term benefits of this restrictive eating habit can be remarkable, is it truly “good for you?”

Christopher Gardner is the Rehnborg Farquhar professor of medicine and director of nutrition studies at the Stanford Prevention Research Center at Stanford University. “The goal [of the keto diet] is an extreme restriction on carbohydrate to the extent that the body shifts from burning a combination of glucose and fat for fuel, to only burning fat for fuel—a condition referred to as ketosis,” Gardner told Newsweek.

However, how does this “extreme” restriction actually appear in daily life? “The amount of carbohydrate needs to be around 5 percent of calories,” Gardner stated. “Typical diets in the U.S. are around 50 percent calories from carbohydrate, so this is DRASTIC.”

It’s a popular misperception that meat and high-protein diets take the place of these carbohydrates. “Many people misunderstand the diet and assume it is high protein, and high meat,” Gardner stated. Nevertheless, the body lacks storage space for extra protein. Thus, after daily requirements are satisfied, the excess protein is transformed into carbohydrates, which are precisely what one must avoid in order to enter ketosis.

“In order to be in ketosis, the emphasis needs to be on fat. A ‘Well Formulated Ketogenic Diet’ is around 75 percent fat. The typical American diet is around 35 percent fat, so this means more than a doubling of fat intake.”

What foods are genuinely allowed on a ketogenic diet?

“Foods promoted to eat are butter, lard, poultry fat, plant fats (olive, palm, coconut oil), avocado, coconut, certain nuts (macadamia, walnuts, almonds, pecans), and seeds (sunflower, pumpkin, sesame, hemp, flax), non-starchy vegetables (leafy greens and kale, cauliflower/broccoli, onions, cucumber, lettuces), berries in small portions, 90 percent or higher dark chocolate, plain coffee and tea,” Nancy Oliveira, dietitian and manager of the nutrition and wellness service at Harvard Medical School’s Brigham and Women’s Hospital, told Newsweek.

“Protein content in beef, chicken, fish, hog, bacon, organ meats, eggs, tofu, and some nuts and seeds is moderate.

“[You’re] not allowed [to eat] bread, pasta, rice, any grains, flour, most fruits, potatoes, winter squashes, corn, peas, beans, regular milk and milk products.”

It is obvious that following this rigorous diet plan requires a lot of effort, but is it worth it?

According to Kristen Smith, a dietitian and national spokesman for the Academy of Nutrition and Dietetics, “the ketogenic diet has been shown to produce favorable weight loss results in the short term period,” Newsweek was informed.

“In addition to weight loss, the ketogenic diet has also shown positive short-term changes in insulin sensitivity, increased [‘good’] cholesterol and decreased triglycerides [the most common type of body fat.]”

Thus, certain people may benefit from a ketogenic diet. “For people with pre-diabetes or diabetes, the ketogenic diet can be very helpful in lowering blood glucose and blood insulin levels,” Gardner stated.

The ketogenic diet was first developed in the 1920s to help children with epilepsy reduce their seizures. It is also frequently used as a treatment for epilepsy sufferers.

But is everyone suited for this diet?

“For most people who try this diet, the success is short-term,” Gardner said. “It is so restrictive that most people can’t maintain it long-term. A 2019 meta-analysis looked at 6- and 12-month effects of the diet. There were several benefits at 6 months, but these were gone at 12 months. One reason for a lack of persistence of benefit is the inability to stick with the diet.”

The keto diet is not only difficult to follow, but it may also be harmful to our general health.

“I do not recommend this diet,” Gardner said. “It is a high saturated fat and low-fiber diet. It consistently raises [‘bad’] cholesterol. I study the microbiome, and in our studies we see benefits of dietary fiber for a healthy microbiome.”

Research has indicated that a robust microbiome, which consists of the trillions of bacteria and microbes living in our digestive tracts, could be crucial in safeguarding our health against various ailments such as obesity, depression, Alzheimer’s disease, and Parkinson’s disease. For this reason, feeding it properly is crucial to our general health.

Not getting enough fiber might starve your gut microbiota and have other unpleasant side effects. “Constipation is a common complaint for individuals following the ketogenic diet, especially during the initial phase of the diet,” Smith stated.

Furthermore, there are other waste pipes that may also be impacted. “Potential negative side effects of a longer-term ketogenic diet could be an increased risk of kidney stones (this has been seen in people following keto long-term as an epilepsy treatment) and increased blood levels of uric acid which is a risk factor for gout (as a gout-protective diet includes fruits, vegetables, whole grains, and low-fat dairy),” Oliveira stated.

The keto diet is low in fiber and extremely restrictive, making it difficult to obtain adequate amounts of important vitamins and minerals. “I wouldn’t recommend a person start out with a keto diet for weight loss or even diabetes control, because I don’t think you can create a balanced diet from it,” Oliveira explained. Yes, multivitamins are a good idea, but since they don’t contain fiber, you aren’t supporting the health of your gut microbiota. You also forfeit the hundreds of plant compounds in a full food that promote wellness.”

How therefore ought our eating habits to change? “The emphasis in my opinion is to eliminate as much of the simple sugars (i.e., added sugars and refined grains—the hallmark of junk foods) as possible,” Gardner stated. Based on national data, these poor-quality carbohydrates account for about 40% of the calories consumed in the United States diet. I believe that foods strong in unsaturated fat should replace half of that, and foods high in fiber should replace the other half.

“The Mediterranean diet is full of flavor, not restrictive, and allows for more people to follow this pattern for longer periods of time, even a lifetime.”