Most people don’t realize it, but the ketogenic diet has been around for nearly a century, having first gained popularity in the 1920s and 30s as a treatment for epilepsy and to provide an alternative to fasting, which was much less mainstream.
This low-carb and high-fat diet is appearing more and more in research and studies that suggest it to be a very legitimate and healthy eating plan that also comes with a trove of wealth benefits such as its association with improvements in cardiovascular risk factors like obesity, type 2 diabetes, and HDL cholesterol levels.
In this article, we’re going to take a closer look at what it means to have a ketogenic lifestyle, what research is saying about its health benefits, and how safe it can be in your everyday life.
The Keto Diet
The ketogenic diet is focused on a low-carb, high-fat intake with the goal of putting your body into a metabolic state called ketosis. During this state, the body is forced to rely on ketone bodies—molecules that are produced during the break-down of fat—as its source for fuel or energy.
When your body is severely lacking in carbohydrates, this compels your body to break down its fat and release fatty acids into the bloodstream where the liver then converts them into ketone bodies. This loss in fat mass leads to one of the biggest and most popular effects of the diet: weight loss.
A study on 17 obese men on the ketogenic diet revealed a reduction in hunger and satiety, which was attributed to the altering of the macronutrient composition of the diet.
But is it Safe?
The long-term effects of the high fat consumption of the ketogenic diet has long been a concern for many health professionals. So is it really safe?
Heart Disease Risks
Not only is the ketogenic diet safe, but is has been shown to be useful in helping people with a variety of health conditions.
One of the biggest concerns and rumors about a high-fat diet is that the saturated fat will lead to heart disease, which is simply untrue. Saturated fats have been blamed for heart disease because they raise cholesterol levels in some people, especially LDL cholesterol.
Research has found that heart disease is primarily due to triglyceride and inflammation levels. A 24-week study on the ketogenic diet in obese patients concluded with a decrease in triglyceride levels, LDL cholesterol (bad cholesterol) and blood glucose, and an increase in HDL cholesterol (good cholesterol).
Another big concern about the keto diet is something called ketoacidosis. When your body enters a state of ketosis, the liver helps produce more ketones to satisfy your body’s needs. When this increase in ketones gets too high, however, it can lead to ketoacidosis.
Ketoacidosis is a dangerous metabolic state caused by uncontrolled diabetes. In this case, there is an insulin deficiency which causes fat and liver cells to go into starvation mode even after consuming adequate calories.
In a nutshell, this condition causes blood sugar to rise to unhealthy levels, while the lack of insulin leads to a buildup of ketones in the blood.
Many people, doctors includes, confuse ketoacidosis (unsafe metabolic state) with ketosis (healthy metabolic state). Ketosis is a natural process whereas ketoacidosis is most common in people with diabetes who aren’t properly controlling their insulin levels and diet.
Note: They are not the same and the ketogenic diet does not lead to ketoacidosis.
The Keto Flu
Another worry for people considering the ketogenic diet is the keto flu. This is a fairly common and unpleasant side effect of the keto diet that typically occurs within the first few weeks of the diet. It’s called the keto flu because its symptoms are comparable to the flu or a cold:
- Poor sleep
- Decrease in physical performance
- Increased heart rate
This occurs in response to your body’s new carb restriction where glycogen and insulin levels drop, leading to the rapid loss of sodium and fluids.
While the keto flu is common and usually doesn’t last more than a few days or a week, there are ways to avoid it.
If you’re thinking about switching to the keto diet from a diet rich in carbs, it’s best to transition slowly rather then dive in head-first.
Give yourself a week or two of decreasing carbs in your diet before getting more strict on your carb intake. This will significantly decrease your chances of developing keto flu symptoms.
Other Ways to Stay Keto-Happy
Here are some other ways to minimize the more unpleasant side effects of the keto diet:
- Stay hydrated—Make sure you are drinking enough water each day (the amount varies depending on sex, weight, height, etc). This will help your body replenish lost fluids.
- Pinch of salt—Add a teaspoon of unrefined salt to your food or water each day to help replenish the sodium lost.
- Consume more minerals—One effect of the keto diet is that your body flushes out water which contains important minerals for your body. Increase your mineral intake by consuming foods high in potassium and magnesium, which will help your body avoid leg cramps and other symptoms. Some of these foods include pumpkin seeds, spinach, almonds, and avocado.
- Add a little exercise—Low-intensity exercises such as cycling or walking can help alleviate flu symptoms and increase fat burning. Be sure to increase your water intake if you are exercising and don’t push yourself too far in exercise while your body is adapting to ketosis.
The Verdict on the Keto Diet
While adapting to the ketogenic diet can be a challenge to many people and bring an onslaught of unpleasant symptoms due to the shifts in the body, these kinds of symptoms do not last. Give your body time to adjust and make sure to eat more fat and fiber, drink plenty of water, get the minerals your body needs, and maintain an active lifestyle.
While ketones and ketosis may have developed a bad rap over the years for people not managing their diabetes properly which can lead to ketoacidosis, this absolutely doesn’t mean ketones and ketosis are unsafe.
Any diet can be unsafe if not done correctly, which is why it’s incredibly important to ensure you are getting the minerals, fats, proteins, and overall nutrients you need rather than “winging it”.
Start testing your ketone levels buy purchasing a urine strip or blood sugar meter to ensure you’re on the right track and staying as healthy as possible.
 Kosinski C., Jornayvaz F.R. Effects of ketogenic diets on cardiovascular risk factors: Evidence from animal and human studies. Nutrients. 2017;9:517 doi: 10.3390/nu9050517. [PMC free article] [PubMed][Cross Ref]
 Johnstone AM, Horgan GW, Murison SD, Bremner DM, Lobley GE. Effects of a high-protein ketogenic diet on hunger, appetite, and weight loss in obese men feeding ad libitum. Am J Clin Nutr. 2008; 87(1):44-55. doi:10.1038/ejcn.2013.116. [PMC free article] [PubMed]