The Keto Diet: Pros and Cons

Posted: Mar 12 in Nutrition, Weight loss by Dr. Lazarus

What is a keto diet?

People following keto weight loss diets eat high protein, high fat, and low carbohydrate. When the body is using fat as an energy source instead of carbohydrates the fats are broken down into ketone bodies, a process we call ketosis. Ketone bodies can be measured in the urine, blood or even with a breath test. The body is good at using these ketone bodies as an energy source until we resume a more normal level of carbohydrate intake.

People on keto generally eat a lot of protein and fat (meat, fish, eggs, cheese, fish, nuts, oils, non-starchy vegetables) and avoid all carbohydrates (breads, pasta, rice, sugar, fruit). To help our patients at CNC following a ketogenic diet, we recently started stocking a delicious peanut butter keto bar, now available at our clinic and through our online store. This is a significant departure from our USDA recommendations which call for 45-65% of our calories to come from carbohydrates.

Is keto safe?

Most individuals are able to safely follow a keto diet. When following keto, be sure to drink plenty of fluids and eat plenty of salt, including potassium. However, keto diets can cause some negative side effects including: bad breath, drop in blood pressure, lightheadedness, kidney stones, gallbladder attacks and electrolyte disturbances, particularly low potassium. Further, there can be some risk to patients with kidney disease, and keto diets can significantly increase cholesterol. For all of these reasons, we do recommend that people with obesity wanting to follow a keto diet for weight loss be supervised by a physician trained in the use of these sorts of food plans.

Is keto healthy?

Old studies suggested that keto diets were superior to more balanced diets for rapid weight loss. Newer studies cast doubt. Although initial weight loss is quicker, sustained weight loss is no better. Many people following a keto diet lose weight quickly and feel well while doing so. That is why at CNC we continue to offer the Protein Sparing Modified Fast. This plan is like a low-fat Keto approach, resulting in equivalent weight loss to our Optifast Full Meal Replacement Program, despite the use of mostly store-bought foods.

However, there is no long-term research on keto, and there are concerns that it can result in elevated cholesterol. Further, people become “keto-adapted” and it remains hard to follow long-term.

Keto summary:

There are many dietary strategies for weight loss. Keto is a tried-and-true way to get weight loss going, but it is not superior to other approaches for sustained weight loss. Talk to your obesity medicine physician to help pick an approach that makes the most sense for you as an individual, taking into account your medical history. If you want to pursue a keto weight loss plan, consider a comprehensive weight loss program supervised by a physician and registered dietitian like the Protein Sparing Modified Fast. That way, we can take off the most weight possible and do it in the safest way. Be sure to get proper monitoring of your labs during this weight loss program including your electrolytes, kidney function, liver function and cholesterol.

The best diet is one you can stick with long-term. And, we consider diet just one of several tools that we use in multi-component weight loss programs. The diet should be used in conjunction with behavior modification, physical activity, and for the right individuals, pharmacotherapy.