At 63 years old, Janet Colson says she’s lived through the various phases of the ketogenic diet, also known as the keto diet.
“I remember people carrying around their lists of the carb content of foods and trying to keep carbs below the 50-gram mark,” says Colson, a registered dietitian and nutrition professor at Middle Tennessee State University. “They also carried keto sticks to check their urine to see if the low carb diet was forcing the body to convert fat to ketone bodies and excrete in their urine.”
The keto diet is a low-carb, moderate-protein, high-fat diet that puts the body into a metabolic state known as ketosis. When the body is in this state, the liver produces ketones that become the body’s main energy source.
According to Colson, the diet was used in the early 1900s to treat epilepsy. “There was a resurgence of using the diet over the last few years,” she says.
Low-carb, no-carb diets are not new. And like any trendy diet, they all come with their own set of risks and rewards.
Give and take
Although it is a high-fat diet, with virtually no carbohydrates, some studies show that the keto diet may help lower blood cholesterol and fat levels. “Also, people typically stay full longer after eating the high-fat content,” Colson says.
In addition to weight loss and maintenance, Marcelle Pick, a keto expert and nurse practitioner in Yarmouth, Maine, says the diet might help treat seizures, Alzheimer’s disease, sleep issues, inflammation and energy production.
“It keeps blood sugars stable and certainly affects mood, keeping many happier and having a sense of well-being inspired of their age,” Pick says.
But the body needs carbs, and Pick says the keto diet can be hard to follow and stick to being that it’s low carb. “It’s hard to miss many carbohydrates,” Pick says. “It takes some getting used to.”
Colson agrees, adding that the diet is not totally well-balanced. “The healthy part of the diet is giving up candy, cookies, cake, pies, sugar-sweetened soda and ice cream,” Colson says. “But you also must give up fruits, many vegetables, whole grains and milk because they are loaded with carbs. We get most of the vitamins, minerals and fiber from these foods. In fact, one problem eating keto is constipation due to the lack of fiber.”
Proceed with caution
Switching to a keto diet isn’t something dietitians typically recommend. “It is a diet some people choose to follow,” Colson says. "The only people that would benefit from it are those with epilepsy."
Dr. Robert Zembroski, a clinical nutritionist in Darien, Connecticut, has witnessed eating binges once a specific food is available, which sets the person back in the quest to lose weight, thus creating the mindset of “another failed diet.”
“I don’t recommend any trendy or popular diet for reasons based on my personal experience with patients who have followed such diets,” Zembroski says. “Like some other diets, the keto diet is restrictive, which can create poor relationships with food and unhealthful eating habits.”