To Keto or not to Keto?

The ketogenic diet. The diet that seems to be on the tip of everyone's tongues these days whenever the topic of weight loss comes up. Those who pronounce the benefits of the keto diet claim rapid weight loss with little repercussions. So the question is, how accurate are these claims? Should YOU follow the ketogenic diet?
Let's start with the basics. What is ketosis? The ketogenic diet was actually created as a treatment for epilepsy in the 1920s. Patients would have a 100% controlled ketogenic diet in the hospital to put them in a state of ketosis. Fueling the brain with ketones instead of carbs seems to reduce the number and severity of seizures in epilepsy patients. It was only in recent years that the keto diet became widely known among the general population as a weight loss diet. Put simply, ketosis is when the body is using ketones as its main fuel source instead of carbohydrates. Okay, so what are ketones? Ketones are actually waste products formed due to the breakdown of fat in times of starvation. Let me lay it out for you...
Carbohydrates are the body's (and brain's) preferred fuel source.
When carbs are very low in the body, the body breaks down fat and converts it into energy.
This releases ketones into the blood. When the body is using primarily ketones to fuel the brain and body, the body is in a state of ketosis.
I know what you may be thinking: "Breaking down fat sounds great!". It does sound great, however there are 3 big dangers to discuss regarding ketosis.
Ketones are a waste product. As with any waste product, it can become dangerous very quickly. The ketones make the blood more acidic and therefore the body must work extra hard to return the blood to a desirable pH level. If levels get too high, ketones can actually poison the body. This is known as ketoacidosis.
It is difficult to keep the body in ketosis. In order for the diet to work properly, it must be HEAVILY controlled. Something as small as 25 grams of carbs per day can break the body out of ketosis and it will revert back to using carbs as the main fuel source. It is very undesirable for the body to be going back and forth between both states all the time.
All fat is not the same. The goal of the keto diet is to eat a diet of ~60% fat, ~30% protein, and ~10% carbs. However, these are meant to be healthy fats. Trans fats should never be consumed and saturated fats can be consumed in moderation, but unsaturated fats like those found in olive oil, nuts, seeds, etc. are what should make up the bulk of that 60%. Many times this is not the case for those following the keto diet and the results can be detrimental. Fatty liver, high triglycerides, and high cholesterol can all result.
SO, can the keto diet be done properly? Yes, but it takes a ton of self-motivation and discipline to stick to the perfect percentages of macros. For this reason, I do not, as a Registered Dietitian, recommend this diet unless under desperate circumstances. There are much healthier ways to lose fat such as the Mediterranean Diet and a plant-based whole foods diet. The process of weight loss will not happen overnight. It takes time, commitment, and trust in the process.
If you decide keto is the right choice for you, make sure to do ample research before starting. Some great resources for this information are the Academy of Nutrition and Dietetics and Today's Dietitian. Make sure you take your recommendations from verified professionals.
Written by: Braeden Yacobucci, RDN/RD, LD, CF-OL1