Posted on by Joy Y. Erdile, MSc, RD

The Keto Diet — a potentially dangerous and an unhealthy diet

Introduction

I’ve heard other Dietitians say that the keto diet is potentially dangerous because it focuses on ‘high intakes of processed meat, butter and cream’. Some have said harmful effects were seen years later, including newly diagnosed diabetes and non-alcoholic fatty liver disease (NAFLD). However, clinical evidence suggests these conditions often develop years before a diagnosis [1,3]. This article addresses the misconception that there is only one way to follow a ketogenic diet.

The belief that “the keto diet” (singular) must be high in processed meat, butter, and cream is common, but incorrect. What makes any diet ketogenic is not how much fat it contains, but the low amount of carbohydrate.

What is a Ketogenic Diet?

A ketogenic diet induces ketosis, where the body burns fat as fuel. These are often referred to in literature as very low carbohydrate diets (VLCD), limiting carbs to 20-50 g per day [4]. It is this restriction—not the fat intake—that results in the body using fat as its primary fuel.

Therapeutic Ketogenic Diets

Something is therapeutic when used to treat a medical condition. When implemented by a Dietitian, this is Medical Nutrition Therapy (MNT). Examples used for epilepsy, seizure disorders, or glioblastoma include:

  • Classic Ketogenic Diet (KD): A 4:1 fat-to-protein/carb ratio.
  • Modified Ketogenic Diet (MKD): A 3:1 ratio.
  • Modified Atkins Diet (MAD): A 2:1 ratio.

Weight-Loss Ketogenic Diets

There is a range of weight-loss approaches that use nutritional ketosis. Protein Power [14] is a low carb, high protein, moderate fat diet. The New Atkins [15] is only ketogenic for a limited induction phase. Newer approaches like the P:E Diet [22] promote high protein and low fat. The Stereotypical high-fat “Internet Keto” is just one type and often requires intermittent fasting to be effective for weight loss.

Failed Weight Loss and Lifestyle Change

Failure rates for traditional weight-loss diets are high, with many regaining more weight than they lost [8]. “Dieting” is rarely the answer for sustained success. A lifestyle change is preferred, acknowledging that there is no one-sized-fits-all approach. For many, a higher protein, lower added fat version of keto works best to preserve muscle while losing body fat.

Final Thoughts

The idea that “THE keto diet” must be high in fat, butter, and cream is a fallacy. A diet rich in nutrient-dense lean protein and vegetables can be ketogenic if it is sufficiently low in carbohydrate—and it can achieve successful weight loss without requiring extended fasting.

More Info?

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To your good health!

Joy

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References

  1. Sagasaka H, Sato Y, Someya Y, et al. Type 2 Diabetes: When Does It Start? J Endocr Soc. 2018 Mar 28;2(5):476-484. [https://doi.org/10.1210/js.2018-00071]
  2. AACE. American Association of Clinical Endocrinologists Framework for Dysglycemia-Based Chronic Disease Care Model. 2018. [https://pro.aace.com/disease-state-resources/diabetes/clinical-practice-guidelines-and-algorithms]
  3. Luukkonen PK, Dufour S, Lyu K, et al. Effect of a ketogenic diet on hepatic steatosis and hepatic mitochondrial metabolism in nonalcoholic fatty liver disease. PNAS. 2020 Mar 31;117(13):7347-7354. [https://doi.org/10.1073/pnas.1922344117]
  4. Feinman RD, Pogozelski WK, Astrup A, et al. Dietary Carbohydrate Restriction as the First Approach in Diabetes Management: critical review and evidence base. Nutrition. 2015. [https://pubmed.ncbi.nlm.nih.gov/25287761/]
  5. Bhanpuri NH, Hallberg SJ, Williams PT, et al. Cardiovascular disease risk factor responses to nutritional ketosis at 1 year. Cardiovasc Diabetol. 2018. [https://doi.org/10.1186/s12933-018-0698-8]
  6. Eades M, Eades MD. Protein Power. Bantam. 1997.
  7. Volek JS, Phinney SD. The Art and Science of Low Carbohydrate Living. Beyond Obesity LLC. 2011.
  8. Mann T, Tomiyama AJ, Westling E, et al. Medicare’s search for effective obesity treatments: diets are not the answer. Am Psychol. 2007 Apr;62(3):220-33. [https://pubmed.ncbi.nlm.nih.gov/17469900/]
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