The keto diet involves getting most of your calories from lots of protein and healthy fats instead of from carbohydrates. But why is that good for you?
Benefits of the keto diet
Like all other low carb diets, the keto diet is incredibly controversial. While some evidence of its benefits is promising, more research is needed in many areas.
However, some research suggests that the keto diet:
- supports weight loss
- helps diabetes management
- provides balance to cholesterol levels
- reduces blood sugar, which can help you manage acne symptoms
- might reduce your risk for certain types of cancer
- promotes nerve cell health
- may reduce seizures in people with certain types of epilepsy
- can help people with polycystic ovary syndrome reduce the impact of complications
Regulating your calorie intake is important in any healthy diet. But whether “regulating” means eating more or fewer carbs (and what kinds of carbs at that) is still a hotly contested topic among dietitians.
A keto diet falls into the “fewer carbs” camp. Carbs make up a significant portion of most people’s diets. Keto enthusiasts maintain that calories are important, but carbs aren’t the best place to get them. Enter protein and fat.
Keto diets have plenty of potential benefits and risks. We’ve laid out a few reasons a ketogenic eating plan might be the right diet for you, as well as when to avoid it.
Keto diet stans acknowledge how hard low carb eating plans are to keep up. But they also believe that the health benefits and general good body vibes far outweigh having to say no to doughnuts (no-nuts?).
1. Keto diet and weight loss
Weight loss is one of the main reasons people choose to diet. The keto diet promotes weight loss in multiple ways.
Processed and refined carbs can contribute to weight gain. By reducing your intake or cutting them out of your diet, you’re removing a key cause of weight gain.
There’s also evidence that a keto diet suppresses appetite. Did you know you get hungry because of hormones your body releases? You do now. Keto foods may make your body release less of these hormones.
Researchers in a 2013 meta-analysis looked at 13 weight loss studies and found that people following ketogenic (low carb) diets lost an average of 2 pounds more in 1 year than people on low fat diets. Neat.
How the keto diet works
The key word in the keto diet playbook is “ketosis.” Ketosis is a specific way your body breaks down your food and stored energy for fuel.
When in a state of ketosis, your body uses stored fats instead of sugars for energy. When does it do this? When there aren’t a lot of sugars in your blood to break down.
This is the crux of a keto diet: forcing your body into a state of ketosis by consuming more fats to break down and holding back on the blood-sugar-boosting carbs.
2. Diabetes management
A keto diet may help people with diabetes manage certain aspects of the condition more effectively.
In super-simplified terms, diabetes is a chronic health condition that messes with your body’s ability to turn food into energy.
You may have heard that the price of insulin is going up and that this is very bad news for people with diabetes. Insulin’s job is to break down glucose and other blood sugars.
The bodies of folks with type 1 diabetes don’t produce enough insulin, so they need regular doses of it from an outside source.
Some people with type 1 diabetes have turned to dietary solutions to reduce their insulin needs. Some studies have suggested that ketogenic diets may be particularly helpful.
Keto and other low carb eating plans lower blood sugar levels, so your body needs less insulin.
People with type 1 diabetes aren’t the only ones who may reap the benefits. In a small 2008 study of people with type 2 diabetes, 95 percent of participants who followed a keto diet reported reducing or eliminating glucose-lowering medication in the first 6 months.
If you have diabetes, it’s important to talk with your doctor before starting or stopping the keto diet, because the dietary change could have drastic effects on your blood sugar.
3. Keto diet and cholesterol
The keto diet might help lower your cholesterol.
Well, “lower” isn’t quite the right term — “balance” is more accurate. When people talk about lowering cholesterol, this is usually what they mean.
There are two kinds of cholesterol in your body: high-density lipoprotein (HDL), which is the “good” cholesterol, and low-density lipoprotein (LDL), which is the “bad” cholesterol.
Lipoproteins carry fat around your body. LDLs pick it up, and then HDLs take the fat-laden LDLs to your liver so they can be flushed out of your system.
A keto diet may help you make sure there’s more HDL than LDL circulating in your body. A 2012 review suggested that the keto diet could boost levels of HDL cholesterol in the bloodstream (although it didn’t dramatically reduce LDL levels).
According to some older research, healthy fats can be great for boosting your HDL levels. So it’s not surprising that low carb, high fat diets can help keep cholesterol levels in check.
But the key word here is “healthy” — stick to mostly unsaturated fats, found in foods like avocado, nuts, fatty fish, and olive oil. Saturated fats, which are found in butter and many fried foods, can increase cholesterol.
4. Reducing acne symptoms
While acne isn’t life-threatening, it can be traumatic to live with (especially in adults). Skin conditions like acne can cause all sorts of psychological issues for folks who live with them.
Many treatments are available for acne. Some involve creams and medications, and some can be quite invasive and painful. But possible links between diet and dermatology may be helpful in managing acne and other conditions.
There may be a link between blood sugar and skin health. Processed and refined carbs can mess with your gut bacteria (the good kind of bacteria that we feed with yogurt, not the bad kind we try to kill with medicine).
If your gut bacteria get out of whack, it can wreak havoc on your blood sugar levels. And that can be bad for your skin. For example, research suggests diabetes can cause skin symptoms.
As we’ve mentioned, keto diets are pretty darn nifty if you want to rein in your blood sugar levels. A 2012 review suggested that the keto diet might be helpful in managing acne. More research is needed, but results so far have been promising.
5. Reducing cancer risk
There’s been a bunch of research into keto diets and cancer treatment. Keeping the carbs low could have a few different effects to help reduce your cancer risk.
For one thing, restricting carbs could cause more oxidative stress in cancer cells than in regular cells. This is super helpful alongside chemotherapy and radiotherapy when the goal is to kill cancer cells while leaving as many healthy cells intact as possible.
Another benefit of the keto diet is lowering blood sugar levels, which can starve some cancerous cells of energy.
During ketosis, your liver burns fat and produces ketones. Because some cancer cells aren’t good at metabolizing ketones, they die when there’s no glucose around for energy.
Relying on ketone bodies for energy instead of glucose and unhealthy fats leads to a drop in blood sugar levels. In certain types of cancer, this can result in the starvation and death of cancer cells.
How safe is a keto/low carb diet long-term?
The keto diet can have some great short-term benefits. But following the keto diet (or any low carb diet) long-term carries some serious risks, including:
- kidney stones
- fatty liver
- low levels of protein in the blood
- nutrient/vitamin deficiencies
It’s generally best to follow the keto diet only for a short time.
6. Boosting your brainbox
Your squishy blood pump isn’t the only essential organ that may benefit from a dip into the keto lifestyle. There’s also evidence that a brief carb fast can be good for the brain.
A 2012 review of studies suggested there may be a link between ketones and the overall strength and health of nerve cells. This has potentially huge ramifications for the keto diet as a treatment for degenerative neurological conditions like Alzheimer’s.
As with many aspects of the keto diet, more research is needed on this, but some results have been promising.
7. Keto diet and seizures (including the epileptic kind)
There is increasing evidence that a ketogenic diet could help people with conditions like epilepsy manage their seizures.
A 2019 review suggests that the keto diet might be a good alternative for managing epilepsy in people who don’t respond to medications. The review also mentions that people have used fasting to manage epilepsy for ages, so the keto diet may be a less restrictive option.
8. Keto diet and PCOS
Polycystic ovary syndrome (PCOS) is a hormonal disorder. It can lead to excess male hormones and cysts on the ovaries (meaning they don’t function as they should).
A 2005 pilot study suggested that a keto diet could help with PCOS complications like weight gain or loss, hormone balance, and insulin levels in women who had both obesity and PCOS.
More recent research from 2020 also supports the keto diet’s use as a short-term method of managing PCOS but suggests that more research is necessary on the long-term effects.
Carbs aren’t inherently bad. We all need some carbs. The reason they crop up so much in discussions about diet is that the diet of the average person in the United States contains way more unhealthy carbs than it should.
However, cutting or severely reducing your carb intake can lead to all sorts of problems.
The keto diet: When treatment becomes a cause
Low carb diets like the keto diet may be helpful for treating certain conditions. But they can also contribute to health problems, including:
- heart disease
- low blood pressure
- kidney stones
- “keto flu”
Keto diets are risky and still largely underresearched. Always consult a medical professional before starting a keto diet.
Keto diets can support diabetes management, but they can also trigger a condition called ketoacidosis in folks with diabetes.
Having too many ketones in your body can increase the acidity of your blood, leading to ketoacidosis. Without treatment, this can be fatal, because the acidic blood damages pretty much all of your organs. If you just said “yikes,” you’re correct.
Ketoacidosis usually affects only people with diabetes. But some people without diabetes have also experienced it, so it’s important to be on the lookout for symptoms if you’re on the keto diet.
Despite its name, keto flu isn’t an illness you can catch. “Keto flu” is the common term for a bunch of symptoms some people experience when entering a state of ketosis (which is the goal of a keto diet). These symptoms can feel a lot like the common flu.
If you have any of the following symptoms after starting your keto diet, there’s a good chance you’re going through keto flu:
- lack of endurance when exercising
- intense sugar cravings
Keto flu can occur anywhere from 2 days to a week after starting the diet. It’s not a diagnosable condition in itself, but many people have dealt with it, and plenty of guidance and advice is available to help you get through it.
Keto flu typically lasts about a week. If you find yourself experiencing keto flu, the best advice we can give is to put a pause on your keto diet and speak with a doctor or a registered dietitian.
Who shouldn’t do a keto diet?
It’s best not to start a keto diet unless you speak with a medical pro beforehand. If they give you the go-ahead, be sure to follow their advice to the letter.
If you fall into any of the following categories, you should probably avoid keto unless the benefits severely outweigh the risks:
- You have kidney disease.
- You’re at high risk of heart disease or have irregular heart rhythms.
- You rely on insulin injections or supplements (usually due to type 1 diabetes).
- You have an eating disorder.
- You’re pregnant or breastfeeding.
- You’ve had liver disease.
- You’ve had your gallbladder removed.
The keto diet and medication
Certain medications just don’t mix with a keto diet.
Your doc will be able to tell you if any of the medications you’re taking will react negatively to ketosis or a low carb intake.
If you’re on any of the following meds, a keto diet probably isn’t a viable option:
- Sodium-glucose cotransporter 2 (SGLT2) inhibitors. These are common medications given to people with type 2 diabetes. Even on their own, SGLT2 inhibitors increase the risk of ketoacidosis, so combining them with the keto diet is extremely dangerous.
- Certain antipsychotic meds. Medications like risperidone (Risperdal), aripiprazole (Abilify), and quetiapine fumarate (Seroquel) may increase insulin resistance, which makes it harder for your body to break down ketones. Again, combining a keto diet with these drugs massively increases ketoacidosis risk.
- Some epilepsy drugs. In particular, divalproex sodium (Depakote), zonisamide (Zonegran), and topiramate (Topamax) may interact with the effects of the keto diet.
A keto eating plan might help you lose weight and manage some health conditions — but some of the diet’s benefits are backed by more research than others.
The keto diet is incredibly controversial. The risks increase when you follow the diet for a long time or have a health condition like diabetes.
If the keto diet is right for you, it may provide huge benefits when done in a healthy way and in the short term. But don’t start a keto diet without getting the OK from a doctor or a registered dietitian.