The Hidden Cost Of Keto

The ketogenic diet has a simple principle: eat very-low-carb, moderate-to-high fat, force the body to switch to burning fat for energy, by starving it of carbs.

Strengths:

• It’s good against refractory epilepsy in children (this is actually what it was created for)
• It can result in weight loss, which some people want

Weaknesses:

• It’s bad for the heart (low-carb is good for the heart, generally speaking, very-low-carb like the keto, however, is relatively bad for the heart)
• It increases the risk of kidney stones and can lead to renal failure
• Its weight-loss effects are short-term at best
• It increases osteoporosis risk, even in the short term, and especially in the long term

Rather than flood you with links for each of those, we’ll link to our main article about these pros and cons, here:

Ketogenic Diet: Burning Fat Or Burning Out?

That said, we will also quickly mention a few relevant things we’ve written about since that article, namely:

• Why Keto Fat Loss Doesn’t Work So Well For Women ← short version is that in response to a drop in carbohydrate intake (even if made of for with fat, calorie-wise) estrogen tries to save us from starving by prioritizing fat storage to outlast the famine we are obviously experiencing
• The Diets & Supplements That Can Mess Up Your Skin ← keto is in the #1 spot here
• How To Dodge The “Keto Flu” ← this is about the unwanted symptoms of being ketosis, something that is a goal in the ketogenic diet, those less favorable symptoms including bad breath, weight loss, appetite loss, increased fatigue and irritability, digestive issues, and insomnia

But aside from all that…

What else does the ketogenic diet do for us?

❝We’ve seen short-term studies and those just looking at weight, but not really any studies looking at what happens over the longer term or with other facets of metabolic health.❞

~ Dr. Molly Gallop

Researchers (Dr. Molly Gallop et al.) examined this issue, and found that the ketogenic diet reduced weight gain compared with an equal-calorie high-fat Western diet, but any weight that was gained was primarily fat mass rather than lean tissue.

Additionally, in a mouse study (because no ethics board would let them do this humans), they found even when they stayed lean, mice on the ketogenic diet developed fatty liver disease, showing severe liver damage and impaired liver function.

So, what was going on? Let’s break it down…

• Blood lipid changes: the diet caused hyperlipidemia, meaning excess fats accumulated in the blood and the liver rather than being safely metabolized.
• Blood sugar dysregulation: after initial low blood sugar and insulin levels, mice showed extreme and prolonged blood glucose spikes when carbohydrates were reintroduced.
• Insulin secretion problem: the glucose intolerance was driven by impaired insulin release from pancreatic beta cells, not by insulin resistance.
• Cellular mechanisms disrupted: pancreatic cells showed endoplasmic reticulum and Golgi stress that disrupted insulin granule trafficking and secretion.

However, because of the same mechanism that often stops women from losing weight on the ketogenic diet, female mice were more resistant to the liver damage than male mice, who were the most adversely affected by that one.

You can read the paper in full, here: A long-term ketogenic diet causes hyperlipidemia, liver dysfunction, and glucose intolerance from impaired insulin secretion

Want to learn more?

For liver-healthier dietary approaches, you might want to consider:

Top Diets & Fasting vs Fatty Liver: What’s Best?

…and for a more comprehensive overview:

Which Diet? Top Diets Ranked By Experts ← a panel of 69 doctors and nutritionists examine the evidence for 38 diets, and score them in 21 categories (e.g. best for weight loss, best for heart, best against diabetes, best for the liver, etc).

Take care, and enjoy!