It’s a hot topic and one that continues to grow in popularity in the wellness space, but the question remains: should you try keto? Here are my thoughts as a holistic health coach and culinary nutrition expert, plus a few key things to be aware of if you’re considering trying keto yourself.
One of the most common themes that’s been coming up in the reader questions I receive has been the ketogenic diet, and if you’ve been reading this blog for a while, you may recall that I wrote a post, Ketogenic Diet Basics, a while back. If you haven’t yet read that one, I’d definitely suggest taking a moment to check it out, then come back here.
Lately the keto questions have been related to:
- Whether or not keto works for weight loss
- Some of its drawbacks/things to be aware of before starting
- Overall, my stance on whether or not I’d recommend it as a holistic health coach.
Disclaimer: As a reminder, I’m not a doctor and none of the material in this post is intended to be interpreted as medical advice. I would recommend checking with your doc before choosing to adopt a new dietary protocol or make other significant changes that affect your health.
Let’s start with a quick refresher…
The basics: What is ketosis?
In a nutshell, a ketogenic diet is a high fat, low carb, moderate protein approach to nutrition. Most of us break down carbohydrates from food into glucose, and our cells use that as energy. However, when a person restricts carbohydrates to a certain point, their body shifts into a state called ketosis. In this state, ketones produced from stored fat are used as the primary energy source instead of the glucose from carbohydrates. More about how this happens here.
Now into the questions…
Does keto work for weight loss?
I think the ketogenic diet can be a great tool for some people, especially those who are using it therapeutically to treat conditions like epilepsy, which is how it gained so much popularity in medical literature. I also believe it has potential to be effective for people who have tried other approaches to tackle weight loss goals without results.
To understand why, let’s quickly break down what happens when you eat carbohydrates.
- As we know, the keto diet is lower in carbs, and all carbs whether they’re plain white sugar, Skittles, oatmeal, a sweet potato or a bowl of rice, eventually break down into glucose. How fast this happens depends on how much fat, fiber and protein those foods (or what you eat them with) contain.
- The glucose is shuttled throughout the body in our blood to provide energy for our cells.
- The pancreas releases insulin to absorb the excess, returning the balance of sugar in the bloodstream to normal.
For people who eat a lot of carbohydrates, their blood sugar curve is one that’s constantly rising and falling dramatically – like a rollercoaster. This would be the case for someone who eats lots of refined, packaged non-whole foods. It would also be the case for someone who eats meals and snacks that have a lot of carbohydrates, but very little fats, protein or fibre. These 3 things slow the rate of sugar absorption, so their blood sugar peaks and valleys aren’t as steep. (Much more about sugar, blood sugar balance, cravings and reducing sugar intake here.)
When blood sugar spikes happen repeatedly over time, the likelihood of weight gain increases, plus the risk of diseases like diabetes. If your body is constantly in this cycle of high-low-high-low, the removal of carbs completely (the high and low quality ones) would greatly reduce all that up and down. So with that logic, I’d say that sure, ketosis has potential to be an effective approach for weight loss. But carbs have their place, and there’s a few more things you should know which I’ll get to next.
What are some potential advantages and disadvantages of ketosis?
It’s important to consider both sides of the story, so first, let’s talk advantages. You may have already read testimonials from pro-keto eaters who love it for reasons including:
- Clearer thinking and ability to focus
- Weight loss (albeit only temporary – the weight comes back once they reintroduce carbs, but if a short term fix is what you need, it can happen)
- Less having to think about food because 1) there are fewer foods to choose from, and 2) most report reduced appetite/hunger, thanks to fat being very satiating
- More even-keeled energy, thanks to no rollercoaster-style spikes in blood sugar and insulin
Research on ketosis (and low-carb diets in general) also suggests that it may be helpful for reducing triglycerides, reducing risk of heart disease and metabolic syndrome, improving HDL cholesterol (that’s the good kind), and treating brain-related disorders like epilepsy, as I mentioned earlier.
Then on the other side of the argument, let’s chat about some of the drawbacks. I briefly touched on some of these in my last keto post, but wanted to elaborate a bit more. These aren’t the only areas to be cautious about, but for the sake of not turning this into a novel, I’ll cover three:
1. Keto flu
As I described here, ‘keto flu’ is very common amongst people first getting started with ketosis as their bodies adapt to burning fat as fuel. Just these symptoms alone can be enough to put people off, making keto an unsustainable approach.
2. Nutrient deficiencies
This is the thing that concerns me most as a holistic wellness coach. Again, we know keto is high in fat, moderate in protein, and low in carbohydrates. Therefore with that in mind, for followers of keto, I see being the biggest potential areas of nutrient deficit:
- Vitamins, minerals, antioxidants and anti-inflammatory compounds from fruits + vegetables – Yes, there are lower-carbohydrate keto-friendly vegetables. However, since fruit and veggies contain carbohydrates (some of which is fiber – more on fiber in a sec) they often get reduced on a ketogenic diet. The problem is that these are also some of the most nutrient-dense foods we have, and the vitamins + minerals they contain are typically far more bioavailable (aka absorbable by our bodies) than supplements.
- Starchy foods + quality carbohydrates – I believe the amount of these that we thrive on depends on factors including athletic goals, sleep quality, mood and stress levels. Quality carbohydrates such as whole grains and some fruits + veggies provide things like B vitamins which are essential for helping us deal with stress and regulating mood. These foods also help to promote sleep, and one of the common side-effects of a very low carb diet is difficulty sleeping. If that already sounds like you when you’re not on keto, if you struggle at all with depression, or if you have athletic goals that require larger amounts of glucose for quick or sustained energy, I probably wouldn’t suggest ketosis.
- Fiber – If the protein in your keto diet is coming from meat (which it may be, since many plant-based proteins are higher in carbs), know that meat has no dietary fiber. That can be a problem (hello constipation) because there’s nothing to “be the broom” that sweeps food along the intestines. Fiber also helps us feel full, and keeps the digestive tract healthy. If you already experience poor digestion, I’d prefer to sort that out first before suggesting keto. (More about the potential implications on digestion here.)
I’m not saying that nutrient deficiencies are inevitable on keto, but preventing them would likely require supplementation, which might be more effort than a person trying keto is willing to put in.
3. Social situations
Depending on how committed you are and the level of support from people around you, this may or may not be an obstacle but I’ll mention it anyway.
We as a society have made many cultural links between food and social gatherings. Celebrations, holidays, and other socializing is often done with food involved. The keto diet may not be as easy as others (eg vegan, vegetarian, gluten-free, paleo) to follow if your social life involves regularly eating in restaurants, or regularly eating meals with others who are not on keto. While there are some generally keto-friendly foods, it’s not always as simple as just leaving out the meat (for vegans/vegetarians), using gluten-free pasta, or swapping grains for greens (for paleo/GF folks).
If you visit restaurants that are cool with making larger modifications and/or preparing dishes that aren’t on the menu, or eat at more progressive ones that have keto-friendly dishes, then that’s awesome. Or, if you do very little eating out and prepare the majority of your own food, you probably won’t have to worry about this. However, just be aware that most of the benefits of ketosis (including weight loss) aren’t achieved by following the diet in an on-and-off way due to the body’s requirement to change energy systems. If you’re hoping for a “cheat day” on the weekends, sadly it’s not part of the plan.
My stance on keto as a holistic health coach
To sum up what I’m about to say in one sentence, diets of any kind are only as good as our ability to sustain them long-term.
I think it’s fair to say we all want what’s best for ourselves, including our health. You probably have a good idea of your own strengths and weaknesses, and how much you’re willing to sacrifice for what you want. From what I’ve seen, we tend to to gravitate towards diets that allow us to maintain the habits we don’t want to break. For example, when the paleo diet started growing in popularity, plenty decided they’d go paleo because they figured it was a green light to eat unlimited amounts of bacon. Similarly, someone might look at the keto diet and think “Great! I can eat as much butter and sausage and bacon as my heart desires!” But as we discussed above, there’s always a catch.
Keto is a lifestyle that requires more precision than other eating styles because it’s not just a matter of having an eat and don’t eat list. One cup of a food that keeps me in ketosis might cause a greater insulin response in you, which would take you out of ketosis, or vice versa. As a result, your body wouldn’t be using fat for fuel (the whole point) and would remain burning carbs as its primary energy source. You wouldn’t know that for certain unless you were measuring blood ketones, which is a big ask for some people that have never done any sort of food tracking before.
While they may seem very different in some of their principles, veganism, the paleo diet, keto etc all have one thing in common: They encourage us to get processed food off our plates in exchange for real, unprocessed foods. I believe that a lot of us assume there’s a need for a restrictive or limited diet such as keto in order to achieve results, when really, simply exchanging processed and high-sugar foods for whole foods (ie plants, quality carbs, high quality proteins and healthy fats) would be easier to manage and sustain long-term.
To finish up, my intention here is not to discourage you from trying the ketogenic diet because I think we all owe it to ourselves to learn what works best in our bodies. Rather, what I’d like to emphasize is that while keto may bring about the health benefits we discussed earlier, what I’d suggest thinking about before diving in is whether there might be easier wins to be had first.
Is not being on keto really what’s causing you to feel crappy, struggle with weight loss, and experience brain fog? Or, could simply swapping some high-sugar foods for more nutrient-dense choices help resolve the problem? Or getting just one more serving of plants on your plate each day? Or perhaps going to bed a little earlier, or moving your body a little more frequently? These are all pretty easy adjustments that don’t require you to drastically change the way you eat. I know extreme approaches can have their appeal, but in the spirit of not adding more drama to life, why not take the easy wins where you can get them?
Alright, that’s more than enough from me. Now I’d love to turn it over to all of you!
Have you experimented with keto? What were your learnings/experiences? Do you disagree with any of what I said above? (Let’s talk about it!) Or, is it something you still have questions about? If so, post them below and I’ll either answer myself, or if it’s beyond the scope of my knowledge, will find someone who is qualified to do so.