Keto 101: A Beginner's Guide To The Popular Diet

Clinical Editor: Megan Dodson, PA-C

You probably know your diet can play a major role in overall health. The food you eat can impact your energy levels, mood, sleep, weight, and even affect your risk for serious diseases, from diabetes to heart disease and cancer. But with all the potential diets out there, it can be hard to determine which approach is right for you.

One popular approach is a low-carb diet known as keto. As with any diet, it’s important to weigh the pros and cons before you toss all the carb-laden foods in your pantry. Here’s what you need to know about the keto diet, and how to decide whether it’s a good fit for you and your health.

The keto diet involves eating very few carbs and high amounts of fat. People who follow the keto diet eat about 70-80% of their daily calories in fat, 10-20% in protein, and 5-10% in carbohydrates.

The word “keto” is short for “ketogenic”. The goal is “ketosis,” a physiological state of elevated ketones in the body. Typically, the body prefers to use glucose — aka blood sugar — for energy. Instead, keto uses fat as energy.

When you eat very few carbohydrates each day — keto usually includes fewer than 50 grams, which is less than a couple slices of bread — your body begins to use a form of fatty acids called ketones for energy instead of relying on sugar. Ketones come from the process of converting fat stored to be used for fuel.

The most robust studies show a keto diet can help some individuals with epilepsy by controlling seizures. Some studies suggest keto may improve cognitive function in individuals with Alzheimer’s disease, and help manage symptoms in people with autism.

Fat loss and weight loss in general is one of the most purported benefits of eating a keto diet, but research is still shaky. Some research suggests limiting carbohydrate intake may support healthy blood sugar levels, and other work shows it may help with weight loss in the short-term.

Research about the low-carb, high-fat diet is still in its early phases. Many of these studies are based on short-term results, which makes it difficult to know whether keto is an effective long-term diet. Plus, it’s also possible keto could be harmful to health.

In the short term, many people on the keto diet experience what’s known as “keto flu”. These symptoms are due to the body adjusting to ketosis in the first couple of weeks of the diet, and include headache, increased thirst, dry mouth, bad breath, frequent need to urinate, brain fog, nausea, fatigue, and decreased appetite.

While certain people, including those with epilepsy, may benefit from a keto diet, it isn’t safe or healthyfor everyone. Keto could be risky for a few reasons. Your body needs foods with carbohydrates for energy, but carb-rich food also often contains other essential nutrients. Fruits and vegetables, for example, contain carbs, but they also contain fiber that helps promote healthy digestion and nutrition absorption. Carb sources often also contain vitamins and minerals your body needs for optimal health. People with kidney disease should talk to their healthcare provider before starting a keto diet.

Secondly, keto includes plenty of healthy fats (like avocados and nuts), but it also doesn’t limit unhealthy fats. The keto diet encourages people to eat saturated fats from oils, butter, and lard, which may contribute to high cholesterol and heart disease. Consuming too much fat could also be harmful to the liver, especially in people who have pre-existing liver conditions.

Keto is also a restrictive diet, meaning it focuses on cutting out food groups. This mindset can contribute to stress and even promote disordered eating. While you may initially lose weight or feel good on a diet like keto, it’s difficult to maintain over time. You may find yourself craving other foods — in this case, sugary items — which can potentially lead to overeating.

Certain aspects of the keto diet can be beneficial. Limiting processed foods, which are often high in carbohydrates, can certainly promote overall health and assist with weight loss, as can being more mindful about sugar intake.

But given the lack of research and known risks of following a keto diet, it’s not typically the best approach for most people’s long-term health. If you want to nourish a healthy lifestyle, focus on eating plenty of fruits, vegetables, whole grains, and lean proteins, such as fish and chicken. Eat plenty of whole foods, and try to limit saturated fats that are known to increase your “bad” cholesterol.

It’s also important to consider your portion sizes and choose a calorie intake that makes sense for your body type and level of physical activity. Integrating exercise into your daily routine is another important way to achieve a healthy weight and reduce your risk of disease.

If you want to hone in on your eating habits to improve your health, your healthcare provider is a great resource. Improving your health can feel overwhelming, but with a little guidance, you can meet your nutrition and well-being goals.

Have more questions about the keto diet and your nutrition? Our providers are ready to partner with you to help you achieve your health goals. Learn more about our primary care services.