Unless you’ve been living buried under a rock for the past year, you’ve probably heard about keto. Maybe you’ve even “gone keto” yourself, or tried to. But what exactly is keto? Is it healthy? And is keto even possible for vegetarians? Read on to find out!
The ketogenic diet – or keto for short – may have come into vogue in the last couple of years, but it’s actually been around for quite a long time; it was developed in the 1920s as a treatment option for epileptic children who were not responsive to medication.
My first exposure to the ketogenic diet was when I was working with a company that made dietary supplements for children with metabolic disorders, and included a ketogenic range in their offering. I learned that this very high fat and very low carbohydrate way of eating was, in fact, quite effective at reducing seizures.
So I was surprised (but also not surprised) when I started to see keto popping up as a popular weight loss diet. My first thought was, ohhhh, so that’s this year’s version of Atkins/South Beach/fill-in-the-blank-here.
Our body’s preferred fuel is glucose (sugar), which comes from carbohydrates. If you starve your body of carbs, however, it will instead break down fat stores. In one of these processes, known as ketogenesis, the liver breaks fat down into ketones, which the body is able to use for fuel.
On the keto diet, your daily food intake is meant to be comprised of roughly 80% fat, 15% protein, and 5% carbohydrates. Many people find high-fat diets easy to stick to because the fat tends to fill you up and leave you feeling satisfied for longer than carbs do, and high-fat diets like keto don’t normally require any calorie counting.
Eating keto is definitely easier for meat eaters, but vegetarians can make this way of eating work as well by including eggs, cheese, nuts, seeds, oil, avocados, and small amounts of low-carbohydrate vegetables such as leafy greens. Grains, beans, legumes, fruits, and starchy vegetables are not included on a keto diet.
So does keto work? Anecdotally, yes. People report feeling great, having more energy, having a clear mind, and, of course, losing weight.
Here’s where keto falls apart for me:
1. Lack of vegetables and dietary fiber.
Since only 5% of your daily food intake is supposed to come from carbohydrates, that really restricts your vegetable intake and completely eliminates fruit, which means missing out on a lot of vitamins, minerals, and other nutrients!
Also, the dietary fiber that is provided by fruits, vegetables, whole grains, and legumes is responsible for maintaining a happy and healthy gut, both by feeding the friendly bacteria that reside there, and by sweeping out the digestive tract.
2. Keto is incredibly restrictive.
As a proponent of intuitive eating and body positivity, I am really uncomfortable with both the restrictive nature and overall intent of keto as a weight loss diet. Although some people genuinely feel better when they’re eating this way, very restrictive eating programs like keto are not appropriate for people who have struggled with restrictive or disordered eating in the past.
We also know that people have a hard time sticking to very restrictive diets such as keto in the long term, and more often than not, although they do lose weight in the beginning, they end up putting it all back on, and sometimes more. In many cases people not only end up gaining more weight than they lost, they end up with poorer health outcomes than if they’d never gone on a diet in the first place. The research is super clear on this, and yet as a society we keep pushing diets on people even though we know that, in most cases, they don’t work.
3. Lack of long term research.
Although there is plenty of research available on the efficacy of ketogenic diets for the treatment of epilepsy, we don’t know what the long-term ramifications of very high fat diets are for otherwise healthy people. We do know that very high fat diets aren’t appropriate for people with liver or kidney disorders, as they can be very hard on these organs.
One should note, however, that in long-term studies comparing different diets, although higher fat diets such as keto result in faster weight loss in the beginning, total weight loss and sustained weight loss are essentially the same for all diets. So the best way to eat is the way that works for you. If you enjoy eating keto and feel that you can stick with it, then by all means give it a go.
Should you try keto?
For people who are interested in trying it out, I recommend a more gentle, modified version of the ketogenic diet in most cases, and especially for vegetarians. One of my clients described this as “dirty keto” and for her this meant unrestricted vegetable consumption, still enjoying a glass of wine (or two!) on the weekends, and eating whatever was served to her when she was eating out.
Keto may not be safe during pregnancy or breastfeeding (and would likely deprive you of a lot of essential nutrients during that time), and is not recommended for type 1 diabetics. If you’re considering giving a ketogenic diet a try, please speak to your health care provider first.