What You Need to Know:

“What is the ketogenic (keto) diet?” was one of the most searched questions of 2019 as this trendy weight-loss plan gained national and international popularity. This “long-chain triglyceride diet” is low in carbohydrates (5-10% of total calories), moderate in protein (15-20% of total calories) and high in fat (70-80% of total calories), inducing a state of ketosis by burning fat for energy, instead of carbohydrates. This diet has been widely researched and used by the medical community to help reduce seizures in children with epilepsy for nearly 100 years, but the body of research regarding the keto diet for weight loss is lacking.

Evangelists of the keto diet testify to significant weight loss in record time, with added benefits such as improved blood glucose levels. Following this diet can result in short-term wins, but it can also have negative consequences. Healthcare providers warn there are risks associated with the keto diet, mainly due to the robust intake of high fat meats and the absence, or near-absence of carbohydrates. Risks include the development of renal calculi, hypotension, constipation, increased risk of cardiac disease, and certain nutrient deficiencies (folate, vitamins A, E, D, chromium, magnesium, and iodine). Often patients who experience significant weight loss may regain all the lost weight plus additional pounds after stopping the keto diet.

Many dieticians and nutritionists caution that following the keto diet is not a sustainable weight loss plan, or a “one size fits all” approach to successful weight loss. Healthy patients without comorbidities may be good candidates, while persons with conditions involving the pancreas, gallbladder, thyroid, or liver should avoid this diet. Anyone considering keto as part of their New Year’s resolution should first have a conversation with their healthcare provider to ensure it is safe. 

Read more about ketosis:

Harper’s Illustrated Biochemistry, 31e: Chapter 22. Oxidation of Fatty Acids: Ketogenesis

Tintinalli’s Emergency Medicine: A Comprehensive Study Guide, 9e: Chapter 226. Ketoacidotic Syndromes

Symptom to Diagnosis: An Evidence-Based Guide, 4e: Chapter 4. Acid-Base Abnormalities