The dieting world is not a space we find ourselves sitting comfortably in, so we are dedicating a series of journal entries to unpacking common diets and the impact they have on our health.
The Ketogenic or ‘keto’ diet is a high fat, adequate protein and low carbohydrate diet which originally was designed in the 1920s for treatment of refractory (uncontrollable) epilepsy. The understanding of its mechanism of action for this condition is incomplete, however theories suggest that it plays a role in modifying neurotransmitter function, neuronal metabolism and excitability, reducing seizure frequency.
Since then the diet has also been explored for its use in weight loss and diabetes, cancer and neurological conditions, yet there is a lack of high quality clinical trials for its efficacy and safety in these conditions.
In recent years, there has been an increase in people trying out this diet for themselves in the hopes that it will be able to deliver promising results mainly with weight loss. Unfortunately it is not uncommon for people to experience negative side effects, leading to multiple health risks and long term implications.
The aim of the keto diet is to force your body into utilising a different type of fuel called ketone bodies that the liver produces from stored fat. This in theory seems like a good way to lose some extra weight, however it is not so black and white.
The body and importantly the brain rely on glucose (sugar) as its main fuel source, which can be found in carbohydrate rich foods like grains, legumes, vegetables and fruits.
When we begin to remove important macronutrients and food groups from our diet and alter the way our bodies naturally function, then we are going to see shifts in our health.
Health risks on a ketogenic diet
Nutrient deficiencies
When you restrict carbohydrates which include fruits, vegetables and grains, you are at risk of becoming deficient in important nutrients necessary for general functioning. Some of these include B vitamins, magnesium and vitamin C which have roles in supporting the nervous system, stress response, energy production and immunity.
Digestion & gut bacteria issues
Carbohydrate rich foods provide us with fibre which supports healthy bowel motility and functioning. A common symptom of a low fibre diet includes constipation, which impacts the excretion of waste and toxicity from the body. Removing carbohydrates also impacts our microbial diversity, as fibre supports a healthy gut microbiome by playing a role in feeding and allowing our good bacteria to thrive. When our gut bacteria are imbalanced and there is a lack of diversity present, we can experience multiple health issues including mood imbalance, inflammation, poor immunity, food intolerances, skin rashes and malabsorption of nutrients.
Liver & gallbladder issues
The liver helps to metabolise fat and our gallbladder stores any excess that our body doesn’t need straight away. When you consume a high fat diet, the liver and gallbladder have to work harder to process fat, which can lead to high cholesterol and gallstones. Extra strain on the liver and gallbladder can also exacerbate any pre existing conditions.
Kidney function
Our kidneys support the metabolism of protein. Due to the restriction of carbohydrates in a keto diet, protein consumption increases, which can affect the health of our kidney functioning, leading to symptoms of fatigue, poor sleep, urinary irregularities and fluid retention.
Hormones
Due to the sensitivity of our hormones to change, when we remove an important fuel source and consume a low carbohydrate diet, our bodies view this as a stress and hormone production can be altered. When there is a lack of proper fuel to support our bodies, then reproduction becomes non essential, and our sex hormones that regulate the female monthly cycle become imbalanced. This can lead to symptoms like irregular periods, loss of period and subsequent infertility. A low carb diet can also lead to low blood sugar levels. When the body cannot utilise glucose for fuel, it begins to rely on our stress hormone cortisol to raise our blood sugars. You may experience fatigue, weakness, poor concentration, dizziness and excess feelings of anxiousness and stress. Finally a low carbohydrate diet can also impact our thyroid hormones, with studies showing a drop in T3 levels. Some symptoms you may experience include weight gain and low energy as our thyroid is responsible for energy levels and metabolism.
Relationship with food
The internet is flooded with information on how we should supposedly eat, with diets like keto promising a simple fix to health issues and weight loss goals. Whenever there is restriction or elimination of something from the diet, it is always important to acknowledge the intention behind the change. The ketogenic diet has been trending due to its promise for quick weight loss results, which feeds into body image issues and promotes a fixation with weight. Due to the dip in blood sugar levels on a low carbohydrate diet, the body naturally starts to crave carbohydrates to fuel energy needs. The keto diet conditions you to ignore your bodies natural cravings and signals and can create a barrier of awareness to signs of imbalance. Carbohydrates have been villainised both in the past and still to this day, when in fact they are an important and beneficial part of a balanced diet. Instead of looking at nutrient isolation with a reductionist approach, we need to be looking at food in its entirety, taking into account its nutritional value. There are carbohydrates abundant in nutrition, and also void of any benefit, which can be said for fats and protein sources as well. Following a restrictive diet like keto, can not only cause physical and physiological health implications, it can create a negative relationship with food. Removing a massive food group from the diet and creating rules around eating can increase negative emotions like guilt and shame. Food becomes a burden, when it is a fundamental fuel source for our bodies and can bring us immense joy.
Everyone is unique and individual, which is why it is important to work alongside a degree qualified Naturopath/ Nutritionist to understand your dietary requirements.