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Pros and Cons of the Ketogenic Diet

Some diet plans work.

Others are dangerous.

Some are just stupid.

Last week, we began talking about the Keto (or ketogenic) diet. Among the hundreds of diets and nutrition plans saturating the market, Keto – in my professional opinion – is one of the best. It has sound science behind it, and it really does align with how the body was designed to operate.

The Perfect Diet?

To review from last week, the Keto diet emphasizes healthy fats over protein and reduces carbohydrate intake (sugars and starches) to almost zero. By doing so, it switches your body’s engine from burning glucose for fuel to burning fat for fuel, which is much cleaner and has a lower inflammatory profile. Anything I can do to get my patients to stop eating sugar, I will do. It’s so unhealthy for you.

That said, the Keto diet is not perfect. For most patients, I would recommend the Mediterranean Diet before Keto, for reasons I will get into later.

The Key to Keto

The key to the Keto diet is to drastically reduce your carb intake. The research behind this actually originated in the treatment of epileptic seizures back in the 1920s. Doctors found that fasting had a positive effect of stabilizing the brain by balancing glucose levels and elevating ketones, which are the food your brain prefers to eat. The problem is that fasting is not a sustainable way to live for more than a few days.

NOTE: Yes, I am familiar with faith-based fasts, like the 21-day Daniel fast and even 40-day fasts. My professional recommendation as a Christian physician is that you better know you heard from God before you go and do that. And make sure your primary care physician knows about it, too.

The Keto diet effectively moves your liver into a fasting state, where it converts fat into fatty acids through beta-oxidation and then into ketones, without depriving your caloric needs beyond what is healthy. As blood sugar and insulin levels drop, and ketones enter the bloodstream, it delivers acetoacetate to your organs, supplying energy.

People who achieve ketosis often describe feelings of stable and prolonged energy, clearer thinking, and weight loss – sometimes significant weight loss. The Keto diet is used effectively in the treatment of diabetes, heart disease, and may be a factor in the treatment of cancer (by eliminating sugars, you are effectively “starving” cancer cells, which feed on sugar).

Other Low-carb Diets

Now, you’ve probably come across several other low-carb diets. Although the Keto diet has technically been around longer than most other diets, it has only recently gotten the kind of large-scale awareness the others have enjoyed.

You have probably heard of diets like the Atkins Diet, the South Beach Diet, and the Paleo Diet. These are all very popular eating programs that helped a large number of people lose weight and get some relief from some of the symptoms of obesity, inflammation, and insulin resistance.

Protein Overload

One shortcoming they all have in common is that they emphasized protein over fat, and that is counterproductive if you are trying to lower your blood sugar and lose weight. Here’s why: your body converts excess protein to glucose. As long as your body can find glucose to burn, it won’t switch over to fat-burning ketosis. That gives the Keto diet a definite advantage over those other diets. It’s also the reason that so many people who have tried the other diets have gone through periods of “yo-yo” weight loss or simply haven’t gotten the results they were hoping for.

Your target protein level should be about 1 to 1.5 grams of protein per kilogram of your ideal body weight. If you figure that 150 pounds is about 68 kilograms, you can estimate that most adults need somewhere between 50 and 100 grams of protein per day. An egg is 6 grams, while 4 ounces (a quarter-pound) of red meat has around 40 grams of protein.

Other Issues

Another caveat is that strict adherence to the Keto diet doesn’t allow for processed meats, like bacon and pepperoni, whereas the other diets often do. They also may not have taken the time to work with a doctor to monitor their blood glucose levels and evaluate their macronutrient needs in the light of their age, body mass index, activity levels, and other lifestyle factors. That’s why it’s always best to set a nutritional guideline with your doctor, instead of just taking tips from a book.

Cons of the Keto Diet

That said, let’s take a look at some of the reasons why you might choose not to embrace the Keto diet.

The Keto Flu

The hardest part of the Keto diet is the detox period that accompanies the first few days. Some people call it “the Keto Flu.” The complications of going cold-turkey on sugar are similar to the complications of going cold-turkey on heroin. The transition to Keto sometimes takes a couple of weeks. During that time, transition symptoms include headaches, difficulty concentrating, mood swings, difficulty sleeping (and fatigue), nausea, cramps, constipation, bad breath, and low energy. It’s really not the Keto’s fault — it’s the fault of a lifestyle addicted to junk that is trying desperately to hang on to you.

Sugar Withdrawal

There comes a point where you begin to recognize that you have been living on sugar and now your body has no more sugar to burn, and that can be a rough couple of days. You will likely want to give up and go back. Then again, whether you move to the Keto diet or not, you should get the sugar out of your diet. So if you want to enjoy prolonged health and wellness, this is a bridge you have to cross anyway. The sooner you get past it, the better. It’s a similar experience to moving from a Third World nation to the USA. Once you get your body off of sugar, you will never EVER want to go back for any reason. It’s not worth going back to the pain and sickness you left behind.

When patients have a difficult detox off of sugar, I recommend that they increase their water intake, increase their healthy fats, like coconut oil and avocado, and drink bone broth. This bone broth is my favorite, hands down. Bone broth contains a good amount of the electrolytes your body needs, including sodium, potassium, and magnesium. In fact, we’re all pretty short on all of these.

Short-term Benefits

One of my biggest problems with the Keto diet is that it is not sustainable as a lifestyle. I know some practitioners teach that Keto can be a permanent way of life, but your body still needs some carbohydrates for muscle mass. There comes a point (depending again on your body chemistry) where your body will recognize carb deprivation as starvation and begin stockpiling fat to protect your organs, instead of burning it. You will stop losing weight, but it can also affect your body chemistry in undesirable ways.

For that reason, I don’t recommend anyone stick to the Keto diet for more than 10 or 12 weeks. And even with that, I would encourage you to take a month to gradually transition into it and another month to gradually transition out of it. It’s also important to work with a nutritionist who understands your biological makeup and reads your blood sugar.

Not Great For Athletes

One of the downsides people talk about with the Keto diet is decreased energy and increased fatigue. If you enjoy high anaerobic activities, like basketball, the Keto diet will leave you feeling dragged out and listless. You might look like a chiseled work of art, but you will feel like a marble statue. (Did you like that? I came up with that myself). One of the reasons Gatorade is so popular with athletes is that it replenishes the electrolytes you burn off while exercising. With the Keto diet, you’re already operating from an electrolyte deficit without running a lap.

Socially Awkward

If you like to eat out, attend a lot of parties or picnics, or just don’t like to discuss your dietary choices with the people around you, the Keto diet can put you in some awkward situations. It’s not impossible to make good choices in restaurants or parties, but it can be difficult in some places. Most restraint meals are heavy on grains, sugars, and processed meats and cheeses.

Then again, it’s a small price to pay for a longer life and better health.

Can Be Hard To Be Consistent

Some people have a hard time letter go of their favorite foods. That’s OK. I totally understand. When the pain of being sick all the time overwhelms the pain of missing your favorite food, come back to this article and we’ll pick it up from here. I’ll wait. It’s like any other diet – self-control is the key and the most difficult obstacle.

Can Raise Your Cholesterol

There are cases where people who don’t balance their meat intake with their fat intake appropriately for their body index, and their HDL cholesterol spikes.

Too Little Fiber

You have to be really intentional with your day to day food choices, not only to keep out the carbs but also to make sure you’re getting enough fiber. It’s easy to forget to eat the right vegetables while you’re pumping up your fat intake. Make sure you’re getting some celery, broccoli, asparagus, bean sprouts, avocado, and beans to give your body the fiber you need.

Is It Right For You?

There are a ton of benefits to the Keto diet for people who want to get control of their metabolism, their blood sugar, their weight, their mood, their concentration, and so many other health concerns. But there are some downsides that you need to take seriously, no matter what the Internet tells you. If you decide you want to try out the Keto diet, get with your doctor to get a full evaluation and plan a diet that makes sense. That’s actually good advice for anyone.

Let’s Get The Word Out

If this article (and the previous post) were helpful to you, please take a few seconds to share them on your favorite social media channel. You never know who might be looking for this, especially when there is so much conflicting advice about diet circulating. In the meantime, have a terrific week, and join me here next Wednesday.

“At the end of your FEELINGS is NOTHING. At the end of your PRINCIPLES is a PROMISE.” — Eric Thomas

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