The Ketogenic Diet

You’ve probably heard of the keto diet, but do you really know what it is? And is it appropriate for you?

By Susan B. Sloane, BS, RPh, CDE

The keto diet is a diet plan that is high in fat and protein and very low in carbohydrates. The key here is to stimulate the body to burn fat as fuel (since no or little carbohydrate is available). The reason the diet plan is called ketogenic is that this type of diet promotes the formation of ketones which the liver produces when the body burns fat.

On this type of diet plan, you avoid eating grains, sugar, and most fruits (those with high sugar) and potatoes. You can eat leafy greens, high-fat dairy, nuts, berries, above ground veggies, and other fats such as coconut oil. The percentage of nutrient intake in the ketogenic diet is about 70 percent fat, 25 percent protein, and 5 percent carbs. At the beginning of this diet, carbs are generally restricted to about 20g per day only.

This does cause noticeable weight loss for most because of the very low carbohydrate content of the diet. The question becomes: is this a sustainable diet plan and are there any health risks?

To the first question, I would answer that it is hard to maintain and sustain a meal plan that is not palatable to the end user. If you don’t truly enjoy eating foods that are part of your meal plan, you may be unhappy and unable to stick with the plan. Any good solid plan for a healthy diet should include food that you enjoy eating and preparing and that your family and loved ones can also potentially enjoy.

Many nutrition experts do not see the keto diet as a good option because it eliminates many vegetables and fruits, and will possibly cause nutritional deficiencies over time. Some people on this diet experience bowel changes that include constipation, for example. You will also have electrolyte changes as you convert fats to energy and start moving into a state of ketosis.

This change in electrolytes can cause other body systems to get out of rhythm and anyone starting on this diet, especially those with heart arrhythmias and other cardiac issues should probably be under medical supervision.

People with type 1 diabetes should not attempt this type of restrictive diet (unless strictly medically supervised), as there would be a high risk of hypoglycemia. In the early stages of this diet plan, you will urinate a lot more as the body composition starts to change. This leads to an increased risk of dehydration. Dehydration can be damaging to the kidneys and can also put patients at an increased risk of kidney stones.

Any diet plan that restricts eating will essentially be effective for weight loss and help control blood sugars. Studies have found the keto is diet effective for patients with type 2 diabetes, and can even potentially help with those with pre-diabetes.[1] These diet plans should be medically supervised (such as weight loss counseling) so that they are done safely, and are not the right choice for everyone, depending on other underlying health issues.

When you go off of the diet, the benefits appear to be lost, and you also should go off the diet gradually to avoid any health issues (strain on organs, etc).[2] There is a place for different diets of all types for the appropriate patients. The best advice is to see a dietician to address your own individual health care needs.

About Susan Sloane
Susan B. Sloane, BS, RPh, CDE, has been a registered pharmacist for more than 29 years and a Certified Diabetes Educator for most of her career. Her two sons were diagnosed with diabetes, and since then, she has been dedicated to promoting wellness and optimal outcomes as a patient advocate, information expert, educator, and corporate partner.

Susan has published numerous articles on the topic of diabetes for patients and health care professionals. She has committed her career goals to helping patients with diabetes stay well through education.

Medical Disclaimer
The articles provided on this website are for informational purposes only. In addition, it is written for a generic audience and not a specific case; therefore, this information should not be used for diagnostic or medical treatment. This site does not attempt to replace the patient-physician relationship and fully recommends the reader to seek out the best care from his/her physician and/or diabetes educator.


[2] Int. J. Environ. Res. Public Health 201411, 2092-2107; doi:10.3390/ijerph110202092

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