Why is everyone obsessed with keto, and do doctors recommend it?

Low-fat diets don’t get rid of fat. Until recently, conventional wisdom dictated that losing weight meant limiting the amount of fat in your diet. Then the keto diet exploded into popular culture, and turned that idea on its head. But is the keto diet really as effective as enthusiasts make it out to be? And is there anyone who shouldn’t follow it? Here’s everything you need to know if you’re considering going keto.

What is the keto diet?

While it might seem like a new fad, the keto diet has actually been around for 100 years. The keto diet was first used in the 1920s to treat epilepsy before the discovery of anti-seizure medication, and is still used as an adjunct treatment in some juvenile patients with seizures today.

The keto diet involves restricting your carbohydrate intake to less than 50 grams a day. For reference, that’s about the amount in four slices of bread. Instead of getting your calories from carbohydrates, you’re supposed to sub in fats and fibrous vegetables. To be considered truly “keto”, you’re supposed to maintain a ratio of 70 – 80% fat, 5-10% carbs, and 10-20% protein.

How does the keto diet work?

If you give it the chance, your body will use carbohydrates to power itself. That’s because carbs turn into glucose, which is the preferred source of energy for most of the body’s cells — if it’s available. When your body doesn’t have enough glucose floating around, it switches to breaking down fat molecules instead. These fat molecules turn into ketone bodies, which your cells can also use as a source of energy. This alternative form of powering yourself is called going into ketosis — hence the keto diet.

What can I eat on the keto diet?

Because the ratio of fat to carbohydrates is so high on keto, you’re limited when it comes to many staples of the typical western diet — think no bread, rice, potatoes, or pasta. While this is obvious, keto newbies are sometimes surprised to learn that higher-carbohydrate fruits and vegetables like apples, pears, and carrots are also off the table. There’s room to eat some fruit, such as blueberries, raspberries, or blackberries, provided you don’t go overboard. However,  meat, eggs, fish, nuts, cheese, seeds, and green, fibrous, vegetables are the main building blocks of the diet.

Is the keto diet actually healthy?

One concern with the keto diet is the rise in LDL cholesterol that’s associated with an increased fat intake, including saturated fats. Another concern with this diet is that it’s difficult to stick to. With just about everything starchy off the table, it’s easy to wonder what’s actually left to eat. Some keto dieters find themselves resorting to processed and packaged keto foods — which often contain additives and unhealthy amounts of salt —  as a way of replacing diet staples like crackers and bread. For those who add the high-fat components of the diet but don’t stick to the low carb part of it, their keto-adjacent diet is a recipe for increased weight gain.

Beyond making mealtimes more difficult, cutting out carbs becomes unhealthy if you go about it the wrong way. Apples, carrots, and bananas are some of the most accessible fruits and vegetables for people, but they’re also significant sources of carbohydrates. Cutting out fruits and vegetables like these without replacing them with low-carb ones can result in a nutritionally-deficient diet. Seeing a dietician can help if you find yourself struggling with what to eat.

Who should go keto?

We know that reducing your carbohydrate intake is good for both weight loss and lowering blood sugar levels. This means that the keto diet can be useful for both controlling your weight and managing pre-diabetes. Because the diet helps to control the amount of glucose in your blood, some doctors recommend it as a treatment for obesity, and as a way of managing pre-diabetes and type 2 diabetes. 

While the keto diet itself isn’t inherently unhealthy or dangerous, if you have a pre-existing medical condition, it’s important to consult with your doctor before beginning any new dietary regime. High-protein diets exacerbate conditions like kidney disease, for example, so going keto is potentially risky — especially if you swap your usual carbs for meat. Keto can also heighten your risk of developing kidney stones. As well, if you take medications, know that changes in your nutrition can potentially affect your body’s reactions to them.

The keto diet has the potential to be a great tool for weight loss, and as a way to manage blood sugar. But it’s not all about eating bacon-wrapped cheese. Replacing carbohydrates with protein and fat is only good up to a point — without incorporating the proper amount of vegetables and fruits, you risk losing out on the fiber and vitamins you need to keep yourself healthy. If you’re considering going keto, speaking to a nutritionist can help you to avoid some of the most common keto pitfalls.