Keto Diet Pros and Cons

Chances are you have heard a lot about the Keto Diet ​​ from friends, coworkers, or family members. It is also all over the news and popping up in social media. The popularity of the Keto Diet has soared over the past few years because of marketing campaigns and by word-of-mouth. So what is the Keto Diet, and is it safe? Does it work? What foods do you eat, ​and what do you avoid? What are the ​Keto Diet pros and cons? What does the research show about it, and when should you consider using it?

History of the Keto Diet

​Versions of the ketogenic (Keto) diet have been around for over 100 years. It was used in the 1800s to help control blood sugar levels in patients with diabetes. Later, it was introduced as a treatment for epilepsy in children in the 1920s. It has since been used as a treatment for various conditions, including cancer, dementia, and other neurological disorders.

Over the past 30 to 40 years, its popularity as a weight loss diet has skyrocketed. It began with the Atkins Diet, which promoted a mostly protein (meat) based diet with moderate fat intake and low carbohydrates. Other diets, based on this concept, ​have since been developed such as the South Beach Diet, Whole 30, Paleo, and many others. The primary reason for the progression and differences of these diets has been in the percentage of fat that is recommended in each of them.

​What is the Keto Diet?

​While Atkins, South Beach and other diets ​have a high amount of protein, the Keto Diet gets the majority of its calories from fats. Protein levels are moderate, while carbs are extremely low (around 5% on the traditional Keto). The concept of the Keto Diet is to make your body burn fat for fuel instead of glucose. The preferred fuel for our cells is glucose (sugar). Glucose is derived from eating foods that contain sugar and carbohydrates. That glucose is either used immediately for fuel or stored in the liver or muscles as glycogen. With the Keto Diet, the body is deprived of sugar and carbs. After three or four days, all stores of glucose in the body are used up, and then the liver begins burning fat for fuel, producing ketones (thus the name ketosis).

Keto Diet vs Low Fat Diet

​Many of the major health organizations still agree that too much fat in the diet can be a major cause of serious health issues. In fact, most still recommend keeping fat intake to no more than 30% of total calories consumed. However, many studies over the past decade have called this recommendation into question. Many experts now recommend reducing the carbohydrate intake rather than fat.

So which is better a helping with weight loss: low carb or low fat?

One study showed no weight loss difference between a low fat and a low carb diet. Several other studies; however, show that low carb diets result in more weight loss than low fat diets, especially early on. Click here, here, here and here to see examples of the results that are possible with the Keto Diet. It’s important to note that big problem with most low fat diets is that participants tend to replace the fat content in the diet with simple or processed carbs, which is much worse than eating fat.

​Benefits of the Keto Diet

The Keto Diet has grown in popularity in the treatment of Type 2 diabetes.

When a person consumes very few carbohydrates, more calories are spent converting fat and protein into glucose, which increases the overall calorie expenditure of the body. A low carb diet has been shown to reduce hunger more than a low fat diet will. This is most likely due to reducing insulin and ghrelin levels. A reduction in insulin levels promotes a decrease in body fat and overall inflammation which could help other health issues, such as PCOS or autoimmune conditions. Here are other areas where the Keto Diet can provide relief: can help improve acne; can be helpful in treating certain cancers; can help raise HDL and lower LDL levels; it can reduce seizures in children; it may help with other neurological conditions; the keto diet may help with cognitive disorders such as dementia, ADHD and others.

Potential Negatives of the Keto Diet

The Keto Diet can be hard for some people to follow. The first 5-14 days on the Keto Diet may cause flu-like symptoms as your body adjusts to burning fat for fuel instead of sugar. This is sometimes called the "keto flu." The best way to manage this is to increase fluid intake. Keto may cause low blood sugar, especially at first. Be especially careful if you are diabetic and taking a medication that lower glucose levels (such as sulfonylureas). Keto diets may cause an increased risk for kidney stones, but this is typically more common in the high protein diets like Atkins. Staying on the Keto Diet for a prolonged period of time can possibly lower bone density. Another study, however, showed no significant change in bone density. This way of eating may increase uric acid which can trigger a gout attack; however, the highest risk of this is within the first few days of starting the diet. Reducing inflammation in the body will eventually lower the risk for gout.

The source of fat and protein in a Keto Diet is very important. One study showed an increased death risk from people eating a Keto Diet that relied upon animal sources for the fat and protein instead of plant-based fat and protein. The Keto Diet is not recommended during times of rapid growth, like during pregnancy or while breast-feeding. If children partake in this lifestyle, they need to be closely monitored.

Those eating keto may experience constipation, but they can alleviate that problem by eating enough vegetables.

After stopping the keto diet, ghrelin levels may rise. This can cause a temporary increase in appetite. A Keto Diet could potentially lower free thyroid hormone levels, so it’s important to monitor your thyroid levels regularly while on the diet, especially if you have thyroid issues.

​How Long Should You Stay on the Keto Diet?

​While some people feel great on the Keto Diet, other people can feel fatigued or moody. Some experts feel that the true benefit of the Keto Diet would be to go in and out of ketosis, not necessarily stay in ketosis indefinitely. I typically recommend giving the diet a good 4-6 weeks. At that time, assess how you feel and monitor your lab work (blood sugar, insulin, thyroid, kidney function, and liver function). If you feel good, you can continue on it for longer. If you feel bad, consider slowly adding back some good whole food carbs, like fruit, veggies, and legumes until you feel better. Another option to consider is eating a strict Keto Diet for about one month every 3-4 months, then going back to a whole food, organic diet with more carbs during the other months. Everybody and every system is unique, so you may have to practice trial and error until you find what eating plan best fits you.

​​How Do You Get Off of the Keto Diet?

Go slow - don't just go back to the way you used to eat. Slowly increase complex carbs (fruit, veggies, beans) at one meal per day. If you are tolerating it, you can gradually add them to other meals. If you experience bloating or gas, slow down the process of adding carbs back into your diet. Avoid simple carbs and sugars. Remember: eating too much sugar and processed carbs is probably what got you to the point of needing to start the Keto Diet in the first place! You might feel more hungry at first and might even have some blood sugar variations. Watch your blood sugar and try your best to avoid the munchies.

Will You Gain Weight After Stopping the Keto Diet?

You can gain the weight back after stopping the Keto Diet if you’re not careful. If you go right back to your previous poor eating habits, you will likely gain some of the weight back. That is why it is so important to transition off of the Keto Diet slowly and carefully, preferably to a primarily whole food, organic diet. Continue to avoid sugar and processed carbs (pasta, bread, doughnuts, etc). If you do this correctly, you will most likely maintain your goal weight you’ve reached while on the Keto Diet.

​My Guidelines for Using the Keto Diet

The Keto Diet is a great choice for patients with seizure disorder or other neurological or cognitive conditions. It's also a great choice for patients with insulin resistance/type 2 diabetes. If you’re on diabetes medication, closely monitor your glucose levels and consult with your medical provider before starting the diet. The medications may need to be reduced rapidly or even stopped. Choose healthier sources of fats and proteins. Plant sources are better than animal sources at providing nutrients to your body. Eat plenty of whole, green vegetables because they provide the needed fiber and are a healthier source of protein and fat. And hydrate, hydrate, hydrate! It is very important to drink plenty of water because most of us are dehydrated already. Dehydration will worsen potential side effects of the diet. Consider doing Keto for a limited time, several times per year. Eat a whole food, organic, primarily plant-based diet the other times.


​The Keto Diet is an extremely popular diet that works by reducing the amount of sugar and carbs consumed. The majority of calories come from healthy fats, while protein intake is moderate. After a few days, the lack of sugar in the diet forces the body to burn fat for fuel. This results in the production of ketones that can cause significant weight loss and help reduce appetite. This diet has been shown to help treat neurological and cognitive disorders, and it can also help reduce insulin resistance and lower cholesterol levels. The Keto Diet can cause significant side effects early on. It may also increase uric acid, worsen constipation, and may have an effect on thyroid levels. It is important to find good, healthy sources of fat and protein, especially plants.

The pros and cons of the Keto diet

​Now it's your turn...

Have you tried the Keto Diet?  What results did you have?

Di you have any side effects or other problems?

Leave any comments or questions in the comments section below.

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