Should you try the keto diet? - Harvard Health (2024)

Should you try the keto diet? - Harvard Health (1)

In the world of weight-loss diets, low-carbohydrate, high-protein eating plans often grab attention. The Paleo, South Beach, and Atkins diets all fit into that category. They are sometimes referred to as ketogenic or "keto" diets. But a true ketogenic diet is different. Unlike other low-carb diets, which focus on protein, a keto plan centers on fat, which supplies as much as 90% of daily calories. And it's not the type of diet to try as an experiment.

The keto diet is used to help reduce the frequency of epileptic seizures in children. Whileit also has been tried for weight loss, it's best to make this only a short-term dietary change to help jump start weight reduction.

How does the keto diet work?

Here are the basics. The keto diet aims to force your body into using a different type of fuel. Instead of relying on sugar (glucose) that comes from carbohydrates (such as grains, legumes, vegetables, and fruits), the keto diet relies on ketone bodies, a type of fuel that the liver produces from stored fat.

Burning fat seems like an ideal way to lose pounds. But getting the liver to make ketone bodies is tricky:

  • It requires that you deprive yourself of carbohydrates, fewer than 20 to 50 grams of carbs per day (keep in mind that a medium-sized banana has about 27 grams of carbs).
  • It typically takes a few days to reach a state of ketosis.
  • Eating too much protein can interfere with ketosis.

What do you eat?

Because the keto diet has such a high fat requirement, followers must eat fat at each meal. In a daily 2,000-calorie diet, that might look like 165 grams of fat, 40 grams of carbs, and 75 grams of protein. However, the exact ratio depends on your particular needs.

Some healthy unsaturated fats are allowed on the keto diet — like nuts (almonds, walnuts), seeds, avocados, tofu, and olive oil. But saturated fats from oils (palm,coconut), lard, butter, and cocoa butter are encouraged in high amounts.

Protein is part of the keto diet, but it doesn't typically discriminate between lean protein foods and protein sources high in saturated fat such as beef, pork, and bacon.

What about fruits and vegetables? All fruits are rich in carbs, but you can have certain fruits (usually berries) in small portions. Vegetables (also rich in carbs) are restricted to leafy greens (such as kale, Swiss chard, spinach), cauliflower, broccoli, Brussels sprouts, asparagus, bell peppers, onions, garlic, mushrooms, cucumber, celery, and summer squashes. A cup of chopped broccoli has about six carbs.

Keto diet risks

A ketogenic diet has numerous risks. Top of the list: it's high in saturated fat. McManus recommends that you keep saturated fats to no more than 7% of your daily calories because of the link to heart disease. And indeed, the keto diet is associated with an increase in "bad" LDL cholesterol, which is also linked to heart disease.

Other potential keto risks include these:

Nutrient deficiency."If you're not eating a wide variety of vegetables, fruits, and grains, you may be at risk for deficiencies in micronutrients, including selenium, magnesium, phosphorus, and vitamins B and C," McManus says.

Liver problems.With so much fat to metabolize, the diet could make any existing liver conditions worse.

Kidney problems.The kidneys help metabolize protein, and McManus says the keto diet may overload them. (The current recommended intake for protein averages 46 grams per day for women, and 56 grams for men).

Constipation.The keto diet is low in fibrous foods like grains and legumes.

Fuzzy thinking and mood swings.The brain works best when the energy source is sugar from healthy carbohydrates to function. Low-carb diets may cause confusion and irritability.

Those risks add up — so make sure that you talk to a doctor and a registered dietitian before ever attempting a ketogenic diet.

What about the other diets?

The popular low-carb diets (such as Atkins or Paleo) modify a true keto diet. But they come with the same risks if you overdo it on fats and proteins and lay off the carbs.

So why do people follow the diets? They're everywhere, and people hear anecdotally that they work. Theories about short-term low-carb diet success include lower appetite because fat burns slower than carbs. But concerns remain about staying on a keto diet long term.And eating a restrictive diet, no matter what the plan, is difficult to sustain. Once you resume a normal diet, the weight will likely return.

Image: © valentinrussanov/Getty Images

Should you try the keto diet? - Harvard Health (2024)

FAQs

What do cardiologists think of the keto diet? ›

However, a new study presented at the American College of Cardiology's Annual Scientific Session Together With the World Congress of Cardiology suggests that a “keto-like” diet may be associated with higher blood levels of “bad” cholesterol and a twofold heightened risk of cardiovascular events such as chest pain ( ...

Is the keto diet recommended by doctors? ›

Is the keto diet bad for you? Both Condon and Kleinman say they wouldn't recommend the keto diet to their patients because it is ultimately not realistic or sustainable. The diet restricts fresh fruits and vegetables, whole grains and low fat dairy that can help with long term weight loss and overall health.

Are there any downsides to keto diet? ›

Common short-term side effects resulting from the initiation of KD have been referred to as “keto flu,” which encompasses symptoms including fatigue, headache, dizziness, nausea, vomiting, constipation, and low exercise tolerance [6].

What is the Harvard perfect diet? ›

You start by filling half your plate with fruits and vegetables, a quarter with whole grains like quinoa, oats, brown rice, and the last quarter with what they call "protein power" such as fish, poultry, beans, and nuts. Add healthy oils in moderation and choose water, coffee, or tea over juice or sugary drinks.

How is keto not bad for your heart? ›

Ketogenic diets can have a number of potential heart health benefits. There is often an initial drop in LDL (the “bad” cholesterol) but in two studies, this was not maintained over a 12-month period. The “good” cholesterol, or HDL, will often increase somewhat depending on the level of fat consumption.

Who is not a candidate for keto diet? ›

TABLE 2
Main contraindicationsMain arguments in support of contraindications
Recent stroke or myocardial infarctionIncreased risk of arrhythmia
Heart failureIncreased risk of arrhythmia, hydroelectrolitic alterations
Respiratory failureAcidosis
Active/severe infectionsImmunosuppression
11 more rows
Jul 10, 2020

Do nutritionists agree with keto? ›

From a nutritional perspective, as the keto diet is so low in gut-feeding fibre, pre- and probiotics and phytochemicals, this way of eating is low in many of the health-enhancing nutrients needed for the body to function optimally.

Does Dr now recommend keto? ›

Now suggests a high-protein, extremely low-carb diet, especially before surgery (remember that the goal is to lose a lot of weight quickly, which low carbs will help you do). Nonetheless, he doesn't want his patients to follow a strict ketogenic diet. A very high-fat, very low-carb diet is what the keto diet entails.

Do registered dietitians recommend the keto diet? ›

Before starting any type of dietary change, talk with your primary care doctor or dietitian about finding an option that's right for you. Coleman says that if weight loss is your primary goal, she doesn't recommend starting with a strict keto diet. Instead, try focusing on a low-carbohydrate diet.

What are big mistakes on keto? ›

Eating too much protein and not enough fats

Proteins as well can cause insulin spikes when over-consumed. The only macronutrient that doesn't spike insulin is pure fat. For this reason, you need to be adhering to very specific fat/carb/protein ratios when following a Keto Diet.

Is keto hard on the kidneys? ›

The ketogenic diet is becoming more popular as a weight loss regimen; however, the evidence has failed to show clinically significant benefits over comparator diets. Even worse, it may cause hyperlipidemia, vitamin and mineral deficiencies, fatigue, and kidney damage, among other complications (Figure ​1) [6].

What foods not to eat on keto? ›

10 Foods You Can't Eat on the Keto Diet & Their Substitutes
  • Grains and Starches. ...
  • Sugary Foods and Sweets. ...
  • High-Carb Fruits. ...
  • Starchy Vegetables. ...
  • Legumes and Beans. ...
  • Processed Foods with Hidden Carbs. ...
  • Alcohol and co*cktails. ...
  • High-Carb Sauces and Condiments.

What diet does Oprah use? ›

Her diet is balanced by whole grains, fruits, and vegetables. She consumes lots of calcium-enriched soymilk, and yogurt and eats about 1,100 mg of calcium daily. She also consumes an average of 34 grams of fiber a day.

What diet did Beyonce do? ›

For Coachella she did the 22 Days Nutrition plan by trainer and exercise physiologist (and friend of Queen Bey) Marco Borges. It saw her eating plant-based foods and limiting herself to "no bread, no carbs, no sugar, no dairy, no meat, no fish, no alcohol...". She also gave up coffee and fruit drinks.

What are the four diets of Harvard? ›

Hu's team analyzed four healthy eating styles — all of which emphasize whole grains, fruits, vegetables, nuts and legumes — seen frequently in the US: the Mediterranean diet, a balanced plant-based diet, a traditional healthy diet based on the the Dietary Guidelines for Americans and Harvard's own amalgamation of ...

What is the best diet for a heart patient? ›

The plan should include plenty of lean protein, vegetables, fruits and whole grains. Limit high-fat foods such as red meat, cheese and baked goods. Also limit foods that are high in sodium such as sandwiches, pizza, soup and processed foods.

What potential cardiovascular risk for some on keto style diet? ›

After an average of nearly 12 years of follow-up, individuals on a keto-like diet had more than double the risk of having several major cardiovascular events, such as blockages in the arteries that needed stents, heart attack, stroke, and peripheral arterial disease.

Is a low carb diet good for heart patients? ›

It is perfectly healthy to follow a low-carb diet, as long as it includes a variety of nutritious, whole, unprocessed foods. Low-carb diets can be good for heart health, since they may increase good cholesterol levels, and decrease blood pressure and triglyceride levels.

Does keto raise cholesterol levels? ›

Numerous studies evaluating the impact of the ketogenic diet on cholesterol and triglyceride levels have shown a relatively modest increase in cholesterol levels [2,5,12].

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