Is the Keto Diet Healthy and Safe?

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What is the ketogenic diet?

When you think of eating “keto”— short for ketogenic — you should first think of eating a LOT of fat, plus MORE fat, a pinch of carb (roughly 20-50 gm/day), and some protein. What sets this diet apart from others is the effect it has on our metabolism (the way our bodies burn and/or store calories for fuel).

The ketogenic diet forces the body’s metabolism to use fat (ketones) for fuel rather than carbohydrate (glucose). When the body is adequately nourished while in ketosis, we call this “nutritional ketosis”. After approximately 2-4 weeks, the body will become “fat adapted”, meaning it prefers ketones as the primary source of fuel rather than glucose. This is where the many health benefits begin.  I like to think of ketones as “high octane fuel” for our bodies, which can reap many health benefits when the diet is followed correctly.

With the ketogenic diet’s rise in popularity, especially as a weight management tool, its touted health benefits have become a highly debatable topic in media and healthcare professionals. This brings about the commonly asked question, “Is the ketogenic diet really healthy?” Let’s let the research do the talking…

ask-keto-nutritionist breath stalls best apps — doctor's scale

The ketogenic diet helps with weight management.

Multiple studies have shown that people on a ketogenic diet tend to lose more weight and keep it off longer than people on low-fat diets. Why is this? Simply put, when excess carbohydrate is ingested, it is turned into fat and stored. However, on a keto diet, not only is this process halted, but the ingested and stored fat is used for fuel!

Also, the keto diet actually revs up our metabolism rather than slowing it down, as shown with other diets focused solely on calorie restriction. Because most of us have plenty of stored fat to burn, plus the fat from our diet, we are able to feel more satiated (full) longer, maintain constant energy, and burn more calories, which in turn may lead to decreased caloric intake and weight loss.  Win-win.

woman eating next to hangry sign

Keto eating reduces hunger and/or being hangry.

Is “hangry” (bad temper and irritability in response to hunger) part of your daily vocabulary? If so, you can surely blame the carbs. On a typical diet, your body uses the limited supply of glucose for energy. So, after a few hours of not eating, our blood sugar level begins to drop. This triggers a hormone called insulin to alert our brain to eat again resulting in hunger. If ignored too long, hungry may turn to hangry.

On a fat-fueled diet, there are no significant changes in blood sugar and insulin levels, so hangry doesn’t typically exist. In ketosis, our bodies have a constant supply of fat to burn as fuel, resulting in steadier moods and an increased time one can go between meals. In fact, many people report for the first time, they are more in tune with their true appetite and feel less moody when a meal is delayed or even missed.  Often times, people who are fat adapted can go longer between meals, rather than the standard 3-4 hours, which is dictated by a carbohydrate fueled diet.

Keto improves metabolism.

Contrary to many beliefs, weight is NOT just about “calories in and calories out” or “move more, eat less”. Our bodies are much too complex for this simplistic idea. The ratio of macronutrients (fat, carb, protein) that we consume impacts our appetite and our weight. Additionally, many other factors contribute to our ability to burn calories such as hormone imbalance, stress, and insulin resistance.

Did you know that many people on the keto diet do not even count calories? In fact, they may be able to eat significantly more calories while still losing weight effortlessly. In a fat-fueled state, our bodies are able to handle more calories than it can when fueled by carbs.

On a low-fat, calorie-restricted diet, our metabolic rate (how much fuel our bodies need to function) actually drops! Initial weight loss may be seen, but only until the body re-adjusts to functioning at a lower metabolic rate. And unfortunately, studies show that even when calories are no longer restricted, the lower functioning metabolism doesn’t spring back to normal. This means weight loss by restricting calories is regained plus more, because your body figured out how to adapt without having to work as hard—in other words, it got lazy.

The good news? The ketogenic diet has shown no slowing effect on metabolism and actually may increase the rate at which we burn calories, playing a crucial role in improving the success of maintaining weight loss in the long-term. 

woman reading book

Keto dieting helps with mental clarity.

Once fat adapted, the previously carbohydrate spoiled brain discovers that fat is awesome! Remember when I said that ketones are like high octane fuel? Ketones are very efficient and highly available as fuel for the brain. Many people have reported increased mental clarity and focus, ability to better stay on task, ample amounts of sustained energy, and decreased “brain fog”.

Ketogenic eating helps fight heart disease.

The ketogenic diet has also shown to significantly improve blood cholesterol and triglyceride levels. HDL cholesterol (known as the “good” cholesterol) is increased, and previously elevated triglycerides usually take a nosedive into healthy levels. There’s a lot of confusion and debate among low carb critics surrounding high-fat diets and its perceived increased effect on LDL – the “bad” cholesterol. LDL cholesterol is not just about the number but the size of the particle (four LDL sizes: large bubbly ones and three smaller ones).

To put it simply, the larger bubbly particles are more protective and the smaller ones, well…less. In a standard cholesterol test, total LDL may appear to increase and misinterpreted as “danger”, but a closer look will often show an increase in the number of large bubbly LDL and less of the smaller ones. In addition, despite what we were once told, intake of foods high in saturated fat and cholesterol are NOT associated with elevated serum cholesterol levels. Saturated fat is not only a healthy fat, it is one of the best sources of fuel for your brain! 

Hands holding a glucose test device

Keto helps with Type 2 diabetes and insulin resistance.

This is a big one! There is increasing evidence in the use of the ketogenic diet for the management of Type 2 diabetes and insulin resistance. As an example, think of your insulin as a doorman to deliver the blood sugar out of the bloodstream and into the cell. With insulin resistance, the doorman (insulin) knocks on the cell door, but the cell will not open. The end result? Chronic elevation of blood sugar, which eventually leads to inflammation, diabetes, and metabolic syndrome.

Not surprisingly, on the ketogenic diet, there is almost no sugar to be delivered. As a result, decreased risk of Type 2 diabetes, improved insulin sensitivity, and those with Type 2 diabetes may be able to completely come off of medication, managing by diet alone. Note: anyone on medication for management of diabetes should NOT begin the ketogenic diet until they have spoken first with their doctor so as to safely taper medications and avoid the risk of severe, life-threatening hypoglycemia.

But what about Type 1 diabetes?

According to the most current research, the ketogenic diet may help reduce need for insulin and slow down disease progression, however, it is unlikely to ever completely come off of insulin entirely as the body is unable to produce enough to manage even the small amount of carbohydrate from dietary intake as well as what is produced by the body.

woman jumping on trampoline

What are other benefits of keto diets?

Below are other areas of research the diet has shown to benefit:

  • Brain tumor/cancer
  • Chronic inflammation
  • Neurological disorders: epilepsy, Parkinson’s, Alzheimer’s, traumatic brain injuries, ALS…
  • Mitochondrial disease
  • Autism
  • Exercise performance
  • Mental health

pregnancy test in hand

Who’s at high risk for starting the ketogenic diet?

The ketogenic diet may offer many health benefits as mentioned above…however, dieting is NOT a one-size-fits-all. And although it may be a complete game changer for some, it may not be for others. Below is a list of conditions which may present a higher medical risk. People with these conditions should absolutely talk with their doctor BEFORE starting the ketogenic diet:

  • Anyone on medication that would be affected by nutritional ketosis
  • Diabetes (Type 1 and Type 2)
  • Kidney disorders
  • Heart disease
  • Any type of metabolic syndrome
  • Pregnant or nursing mothers
  • Infants and children
  • Anyone who has a concern about their health and ability to go on the ketogenic diet

doctor holding patient chart

So, is the ketogenic diet healthy and safe?

In general, the answer is yes. However, a healthy ketogenic diet is a well-formulated one. If you think it’s just as simple as not eating carbs…you’ll end up finding yourself in trouble and back on the chronic diet train. Those willing to put in the work, learn, and seek out professional guidance will find keto to be a healthy sustainable lifestyle and not just another failed attempt at dieting.

In a nutshell: The keto diet has been criticized as “unsustainable” and “impractical”; however when done with the right guidance to create a well-formulated, and personalized diet plan, the keto diet becomes a healthy lifestyle rather than just another diet.

Join The Discussion

Comments 16

  1. Leslee Miller

    Amazing article! I have been doing keto since the New Year and have lost 52 pounds. This answered so many questions and filled in the blanks for me…

  2. Jill B.

    Tara, I was trying to observe the Keto diet but then when I went to give blood, my cholesterol was 257 so I stopped. Is that too high to do this diet?

    • HipHolly1

      Hi Jill! You should consult your physician in this case as everyone should do so before starting a new diet such as keto! Hope that helps! 🙂

    • Marie

      Jill B – the Keto diet is actually deadly!! There is so much information online about the dangers of it. Cholesterol should never be that high. Please be careful!!

  3. Kelli

    I really want to start a low carb/Keto diet. My problem is that I have an 8 year old and a snackaholic hubby so my will power goes away when I’m home with them. Any thoughts on how to fight this battle(with myself).

  4. Lori

    I have been on this diet for 2 weeks now. I feel like crap, no energy, muscle fatigue, brain fog. Can anyone tell me when this ends? As I’m ready to give up.

    • Agata

      Lori, it’s called a keto flu. You lose a lot of water on keto diet and also electrolytes. You need to make sure to include extra sodium potassium and magnesium. The easiest way is to drink a cup or 2 of salty broth per day and you will see improvement quickly. Keep doing keto, its worth it!

    • Marie

      Lori, please be careful!! No healthy diet should EVER make you feel like that – ever!!! A real healthy diet should make you feel amazing from day 1. There are so many other, non-dangerous diets out there! I wish you the best!

  5. Catherine

    The Keto Flu lasts about 10 days. Are you getting enough salt? That caused me issues in the past.

  6. Rebecca Delmonte

    Hi- you mention caution with “Anyone on medication that would be affected by nutritional ketosis”- but when I look online I really cannot find anything about that- could you tell us what medications you’re referring to?

    • Amber (Hip2Keto Sidekick)

      Great question! Thanks for asking! We will forward this over to our nutritionist for a possible upcoming Q&A, so stay tuned!

  7. Judy Fields

    I love the keto lifestyle and have lost 37 pound but I have reached a major stall for about 3 months. Suggestions please.

    • Amber (Hip2Keto Sidekick)

      Hey, Judy! This is a great question! We’ll have our nutritionist address that in an upcoming article! Stay tuned!

  8. Anerol

    I have hashimotos disease (underactive thyroid) which makes it super hard to drop any weight at all. Is Keto OK to do myself?

  9. Mary Angela

    I am a carboholic and never in my wildest dreams did I think I could survive without bread and pasta! Well 7 weeks and -12 pounds later I crave NOTHING! The first week I couldn’t believe my mind clarity. The sugar was obviously FOGGING my brain!! I have more energy, am NEVER hungry and sometimes have to force myself to eat!

    I have Crohn’s Disease and an Ileostomy, an 61 years old, and start running for my health 3 years ago! So anyone who thinks this won’t work for them don’t write Keto off, but do check with your doctor. #KetoOn!!

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