Are Keto Diets Safe?

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.[1]

This very-low-carb, high-fat diet is appearing more and more in modern research, with clinical studies that suggest it to be a beneficial and healthy eating plan, particularly for protecting the brain and helping people lose weight.[2]

In fact, the keto diet is associated with improvements in cardiovascular risk factors like insulin resistance, high blood lipids, and high blood pressure.[3]

It almost seems counterintuitive, right? Eat more fat to lose weight, reduce LDL cholesterol levels, and decrease blood pressure?

That’s exactly what the research and anecdotal evidence suggest the keto diet does!

In this article, we’re going to take a closer look at what it means to “go keto”, what research is saying about its health benefits, and how to safely follow the keto diet.

The Keto Diet

The ketogenic diet entails eating very-low-carb, high-fat foods and a moderate amount of protein, with the goal of putting your body into a metabolic state called ketosis. During this state, the body is forced to rely on fat and ketone bodies—molecules that are produced during the breakdown of fat—as its main sources of energy.

When your body is severely lacking in carbohydrates, this compels your body to break down fat instead and release fatty acids into the bloodstream where the liver then converts them into ketone bodies. Your body will use both the fat that you eat and body fat (if necessary) to produce ketones, which can lead to weight loss benefits.

For example, a study on 17 obese men found that those on the keto diet ate less (due to feeling more satiated), which was attributed to the altering of the macronutrient composition of the diet.[4]

But is the Keto Diet Safe?

The long-term effects of the keto diet have long been a concern for many health professionals due to the high-fat intake. This makes many wonder, “Is the keto diet 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 clog the arteries and lead to heart disease, which is simply untrue. Saturated fats have been blamed for heart disease for decades because some studies suggested that they raise LDL (“bad”) cholesterol levels.[5]

However, that data is misleading with regards to keto since the studies were observational (meaning macronutrient and calorie intake were controlled) and because the keto diet doesn’t encourage exorbitant amounts of saturated long-chain triglycerides (e.g. the fat found in grain-fed animal meats, grain-fed dairy products, shortening, lard, etc.).

In fact, a 24-week study on the effects of the ketogenic diet in obese patients concluded that it helped decrease total triglyceride levels, LDL cholesterol, and blood glucose, while increasing HDL (“good”) cholesterol.[6]

Ketoacidosis

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 (making the blood highly acidic).

Many people, doctors included, confuse ketoacidosis (unsafe metabolic state) with ketosis (healthy metabolic state). Ketosis is a natural process whereas ketoacidosis is most common in people with type-1 diabetes who aren’t properly controlling their insulin levels and diet.

In other words, ketosis and ketoacidosis are not the same; the ketogenic diet does not lead to ketoacidosis in non-diabetics.

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:

  • Nausea
  • Headache
  • Fatigue
  • Poor sleep
  • Decrease in physical performance
  • Cramps
  • 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.[7] 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 metabolic changes, 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.

When done properly, the keto diet is undoubtedly safe.

In reality, 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”.

For maximal safety on keto, you can test your ketone levels by purchasing a urine strip or blood ketone meter to ensure you’re on the right track and staying as healthy as possible. Of course, getting routine blood work done through your doctor is also prudent.

More Readings:

Keto-Friendly Foods: The Ultimate List

The Potential Dangers Of Fasting On Keto

5 Common Reasons Your Keto Diet Is Not Working

How The Keto Diet Can Reduce Inflammation

Keto for Women: Top Health Benefits and 6 Tips for Success

References:

[1] Barañano KW, Hartman AL. The ketogenic diet: Uses in epilepsy and other neurologic illnesses. Curr Treat Options Neurol. 2008;10:410–9.

[2] Paoli, A., Rubini, A., Volek, J. S., & Grimaldi, K. A. (2013). Beyond weight loss: a review of the therapeutic uses of very-low-carbohydrate (ketogenic) diets. European journal of clinical nutrition67(8), 789.

[3] Kosinski C., Jornayvaz F.R. Effects of ketogenic diets on cardiovascular risk factors: Evidence from animal and human studies. Nutrients. 2017;9:517

[4] Johnstone, A. M., Horgan, G. W., Murison, S. D., Bremner, D. M., & Lobley, G. E. (2008). Effects of a high-protein ketogenic diet on hunger, appetite, and weight loss in obese men feeding ad libitum. The American journal of clinical nutrition87(1), 44-55.

[5] Artaud-Wild, S. M., Connor, S. L., Sexton, G., & Connor, W. E. (1993). Differences in coronary mortality can be explained by differences in cholesterol and saturated fat intakes in 40 countries but not in France and Finland. A paradox. Circulation88(6), 2771-2779.

[6] 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.

[7] Fletcher, G. F., Blair, S. N., Blumenthal, J., Caspersen, C., Chaitman, B., Epstein, S., … & Pina, I. L. (1992). Statement on exercise. Benefits and recommendations for physical activity programs for all Americans. A statement for health professionals by the Committee on Exercise and Cardiac Rehabilitation of the Council on Clinical Cardiology, American Heart association. Circulation86(1), 340-344.

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Jessica Cotzin is a freelance writer, web developer, and avid traveler. Born and raised in South Florida, she graduated with a Bachelor’s Degree in Multi-Media Journalism from Florida Atlantic University and currently resides in Miami Beach. Her passions lie in reading great literature and traveling the world, bumping blindly into new adventures.

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