When it seems like everyone is on the ketogenic diet, you may wonder if it is right for you. The keto diet is a high-fat, moderate-protein, very low carb plan. People on the diet can eat all the butter and bacon they want, but some people question if that is healthy. Some also wonder if the keto diet is actually the best way to lose weight or if it causes more problems than it solves. These are all valid questions that can be answered by doing some research.
2. Is the Keto Diet Safe to Follow?
Even though it can feel like a radical way to eat, following an extremely high fat diet has not shown any real negative consequences when done in the short term, according to Scott Keatley, RDN, of Keatley Medical Nutrition Therapy in New York City.
3. Is Ketosis Bad?
Your body typically uses carbohydrates as fuel, but ketosis is a state in which it burns fat instead. Ketone bodies are produced when fat is burned and used for energy. There are no significant negative consequences to entering ketosis through diet, according to Keatley.
However, more research is needed in order to determine the long-term effects of ketosis. In other words, temporary ketosis is probably not harmful.
4. How Many Carbs Do You Actually Eat on a Keto Diet?
A keto diet consists of mostly fat, some protein, and very few carbs. The specific amounts are different for everyone, but it is typically around 70-75% fat, 20-25% protein, and 5-10% carbs. Many people following a keto diet also track “net carbs,” which is the total amount of carbs minus fiber. Since fiber isn't digested, it doesn't count towards the carb total. It is important to be careful when following a keto diet, because eating even a small amount of fruit, starch, sugar, or whole grains can kick you out of ketosis.
5. Can You Drink Alcohol on the Keto Diet?
Yes. Although there are carbs in alcohol, you can still drink it occasionally. Just be aware that on days when you do drink alcohol, you may have to adjust your carbs from other sources. This may mean making tough decisions, like having a drink but skipping a small amount of fruit or Greek yogurt.
Spirits are the best choice for alcohol, followed by wine. Try to stick with a half drink to avoid wasting carbs.
Here’s what each alcoholic drink contains, carb-wise:
1.5 fluid ounces of gin, rum, vodka, or whiskey contains 0 grams of carbohydrates.
One serving of red wine is 5 fl oz and has 4 g of carbs.
A glass of white wine contains 5 fluid ounces and 4 grams of carbs.
If you are choosing light beer, stick to 12 fl oz and 6 g carbs.
6. How Much Weight Can You Lose on the Keto Diet?
Some people may lose a significant amount of weight by following a ketogenic diet, especially if they were obese to begin with and had a lot of fat to lose.
A study published in February 2017 in the Journal of Clinical Endocrinology found that people with obesity who followed a very low calorie keto diet for four months lost an average of 44 pounds, mainly from body and visceral fat. In another study published in February 2017, in Nutrition Metabolism, normal-weight adults who followed a non-energy (calorie) restricted keto diet for six weeks lost about 4 lb in both fat and lean body mass.
A study published in October 2013 in the BMJ showed that people on a ketogenic diet (eating less than 50 g of carbs per day) lost weight at the same rate as people following a low-fat diet.
7. What Fruits Can I Eat on the Ketogenic Diet?
Fruit is not a large part of the keto diet because it contains a lot of natural sugar. Some lower-carb fruits like berries can be eaten in small amounts. Avocado and coconut are both higher-fat fruits. Department of Agriculture carb counts, here’s what can fit on keto:
Raspberries: 3 g net carbs per ½ cup
Strawberries: 2 g net carbs per ¼ cup slices
Blueberries: 4 g net carbs per ¼ cup
Blackberries: 3 g net carbs per ½ cup
Coconut contains 2.5 grams of net carbs per half cup, shredded and raw.
Avocado: 3 g net carbs per 1 cup, cubes
Net carbs are the total carbs minus fiber. Fiber is not counted in net carb totals as it is not digested.
8. Can I Eat Snacks Like Popcorn, Oatmeal, and Yogurt on Keto?
High-carb foods like popcorn and oatmeal are not ideal for the keto diet. One cup of popcorn has 5 grams of net carbs, which may be a quarter of your recommended carb intake for the day. It is also worth mentioning that one cup of popcorn is not a large serving. It contains only 30 calories and no fat, so it will not be filling. Oatmeal is also not a good choice for the keto diet, as it contains 12 grams of net carbohydrates for 77 calories and only one gram of fat.
If you eat yogurt, it depends on the type you choose and if it follows the keto diet. 3 grams of carbohydrates are in half of a 7 oz container of Fage plain 5 percent milkfat Greek yogurt. Choose plain versions to avoid extra sugar.
Some good keto-compliant snacks include nuts, seeds, small amounts of low-carb fruits like berries, beef jerky, and nonstarchy vegetables like broccoli and cucumbers.
9. Should I Be Concerned About the Keto Flu?
The keto diet can lead to the keto flu, which is a side effect that is not very fun. “The keto flu is definitely real,” says Keatley. Your body is not designed to burn fat for energy, and when it switches to fat burning, it becomes less efficient at making energy. This may make you feel sluggish and sick, as if you have the flu. As your body adjusts to this new way of drawing energy, the keto flu will go away. This may take a couple of weeks, says Keatley.
10. Will the Keto Diet Give Me Kidney Stones?
Kidney stones may be a concern if you are switching to a diet with more protein. Chief of Urology at Palmetto Health in Columbia, SC, Kimberly Whitmire, MD says “Consuming high levels of red meat and not drinking a lot of water may make stones more likely”. It is important to stay hydrated and replenish electrolytes on a keto diet. electrolytes include minerals like sodium, potassium, magnesium, and calcium. Without replenishing these minerals, you are at risk of developing stones. A study published in the Journal of Child Neurology found that about 1 in 15 people who use the keto diet to control epilepsy develop kidney stones. However, this risk can be reduced by taking oral potassium citrate supplements.
11. How Might the Keto Diet Affect My Period?
You may see a change in your menstrual cycle if you severely limit carbohydrates or lose weight quickly. “Studies on younger women who eat very few carbohydrates for an extended period of time end up with irregular or missed periods,” explains Whitmire. She adds that “women may need more carbohydrates on a keto diet compared to men, especially if a woman is noticing a change in her [cycle].”
A study published in Nutrition & Metabolism found that a ketogenic diet may improve the hormonal balance for women with polycystic ovary syndrome (PCOS). The small study found that a group of women with PCOS who followed a ketogenic diet for 24 weeks lost 12 percent of their body weight, and reduced their testosterone and insulin levels. Women with PCOS should talk to their doctor before starting a ketogenic diet, especially if the diet is part of their treatment plan.
12. How Long Do You Need to Stay on the Keto Diet to Lose Weight?
People who follow a keto diet report weight loss, on average, of 44 lb over four months, according to Keatley. However, he suggests that people spend no more than 12 weeks in ketosis because of the uncertainties of following it long-term and the risk of developing nutritional deficiencies. This is based on research from the Journal of Clinical Endocrinology.
When people transition off a keto diet and add more carbs back into their diet, they usually gain some weight during this period. If they go back to their previous way of eating after feeling deprived on the keto diet, they may regain all the weight they lost, and possibly more.
13. How Will the Keto Diet Affect Your Cholesterol Levels?
Yet this higher intake of fat does not necessarily lead to heart disease. A keto diet can often lead to weight loss, which can improve blood lipid levels. Even though you may be consuming more saturated fat than ever on a keto diet, in the form of butter, bacon, cream, and coconut oil, this higher intake of fat does not necessarily lead to heart disease.
We have been warned for a long time that eating too much saturated fat can raise cholesterol levels and increase the risk of heart disease. For this reason, many experts are concerned that eating more fat may be especially harmful for people who already have heart disease or are at risk of developing it.
A study on obese patients who were following a keto diet found that, after 24 weeks, their total cholesterol levels had dropped, while the levels of “bad” LDL cholesterol decreased and the levels of “good” HDL cholesterol had increased. This could be reflective of the fact that any weight loss, no matter how it's achieved, tends to lower cholesterol. Also, as already mentioned, people who have risk factors for heart disease need to consult their doctors before attempting a keto diet. Research, as in this study in the British Journal of Nutrition in April 2013, has concluded that a diet low in carbs but high in fat and protein impairs arterial function in those who were at risk for cardiovascular disease.
The main difference between a low-fat diet and a keto diet is the amount of fat you consume. A review in the December 2013 issue of the Journal of the Academy of Nutrition and Dietetics found that consuming a high amount of monounsaturated fat (like olive oil or avocado) was associated with increased levels of heart-protective HDL cholesterol, while lower intakes of saturated fat were associated with lower cholesterol levels.
14. How Much Protein Will You Eat on the Keto Diet?
20-25% of calories on a keto diet typically come from protein, as opposed to a high-protein diet where too much protein can be converted into sugar and used as an energy source.
You should not go too low in protein because you want to be able to stay in ketosis while still having lean body mass. Generally speaking, you should have 1.2 to 1.5 g of protein per kilogram of body weight. This means that a 140-lb woman should aim for 76 to 95 g of protein per day. For reference, one 3.5-ounce skinless chicken breast offers 31 g of protein.
Some good sources of protein for a keto diet are fatty fish like salmon or mackerel, according to Keene. These fish offer a healthy heart protein and omega-3 fatty acids. Eggs are another good choice for protein; one large egg usually contains 6 grams of protein and 5 grams of fat.
While a keto diet focuses on high fat foods, that doesn't mean you have to eat fatty meats all day. You can still eat leaner proteins like chicken or fish, you just have to make sure to add fat to those sources as well. Many cuts of beef are also lean, containing 10 grams of fat or less.
15. Can the Keto Diet Reverse Type 2 Diabetes?
Keene says that this tool, though not the first one he would use to help someone control their insulin, may be helpful, especially with the stronger emerging research.
Keto diets may help people with type 2 diabetes, based on early research. A small study from 2017 found that people who followed a keto diet for 32 weeks had lower blood sugar levels than people who followed the American Diabetes Association's recommendations. The keto dieters also lost more weight than the other group.
Dietary experiments like keto might be helpful in the short term, but more research is needed to determine the long term effects. Additionally, people with diabetes who are on medication to lower blood sugar should be closely monitored, as a drastic reduction in carbs might lead to dangerously low blood sugar levels.
If you have type 2 diabetes, you should work with your doctor and manage your expectations. There is no consensus on whether keto is an effective diet approach for diabetes, and it can be tough to stick with, according to research published in the European Journal of Nutrition in March 2018. Keep in mind that type 2 diabetes cannot be reversed, but it can be put into remission.
