The ketogenic diet has been described as the biggest diet sensation ever seen in the nutrition industry. So it’s worth looking into for that reason alone.

A ketogenic diet is very high in fat (about 75%), moderate in protein (about 20%), and very low in carbohydrates (about 5%). It is meant to put the body into a state of ketosis. In ketosis, the body breaks down fat to create ketones for energy, instead of burning glucose.

Keto Benefits?

The benefits of ketosis that we often hear about are weight loss, increased HDL (“good”) cholesterol, and improvement in type 2 diabetes, as well as decreased epileptic seizure activity and inhibition of growth of cancerous tumors.

Small studies have shown promise for women with PCOS (polycystic ovarian syndrome), an insulin-related condition. This may be due to its possible (inconclusive) ability to restore insulin sensitivity.

Is everything old new again?

The current Keto diet isn’t the first time we’ve targeted carbs as a dietary villain. Medical trials with low-carb eating and/or fasting date back to the 1850s and even earlier.

In 1967, Stillman introduced The Doctor’s Rapid Weight Loss Diet, which contained essentially nothing more than low-fat protein and water.

Then came the Atkins diet in 1972, high in fat and protein, low in carbs. It helped with weight loss and also with diabetes, hypertension and other metabolic conditions. It is still popular today.

In 1996, Eades and Eades introduced Protein Power, a very low carbohydrate diet that appeared to help patients with obesity, high blood pressure, high cholesterol, and/or diabetes.

Therefore, cutting carbs, like the Keto diet does, has a history of helping people lose weight and/or improve metabolic factors. Anecdotal evidence supports that.

Does Keto have other benefits?

Probable benefits can be seen with neurodegenerative conditions, such as multiple sclerosis, Alzheimer’s, or Parkinson’s, probably because these brain disorders are related to metabolic disorders. In fact, Alzheimer’s is now called type 3 diabetes.

Care of these conditions is best done under medical supervision.

Ketones also appear to improve traumatic brain injuries, according to research done on rats.

In the interest of full disclosure…

Initial weight loss on the Keto diet is rapid. The body has used its stored glycogen (carbohydrates stored in muscle) and disposed of the stored water with it. After that, weight loss can continue, but at a slower rate.

Metabolism shows an initial increase that seems to disappear in 4 weeks.

Keto does not appear to offer any long-term benefits in either fat loss or lean mass gain.

In some people, Keto seems to raise LDL (“bad”) cholesterol.

What about the negative effects?

The often-mentioned “cons” of a keto diet are nutrient deficiencies due to lack of food groups and an unpleasant transition state called the “keto flu,” which can last for days. It includes hunger, dehydration, headaches, nausea, fatigue, irritability, constipation, brain fog, sluggishness, poor concentration, and lack of motivation. Because these symptoms are so similar to those of people who give up caffeine, Keto has been postulated as a “detox” plan.

Other negatives include problems with gut health on such a low fiber diet and difficulties with adherence.

When it comes to workouts, the Keto diet probably doesn’t offer any advantages for most people. In fact, the glycogen depletion it induces can lead to bonking. Athletic performance involving speed and power may be less without glucose and carbohydrates for fuel.

The International Olympic Committee has urged athletes to avoid low-carb diets. They can lead to maladaptations to training and decreases in both power output and endurance. A colleague of mine induced cardiac arrhythmias in rats that were exercising on a low-carb diet.

Due to the low carb nature of the Keto plan, my concern is how women fare with regards to serotonin synthesis and function. Carbohydrates play an important role in the transport of tryptophan (the precursor to serotonin) to the brain, so serotonin levels might drop without these carbohydrates. How does that affect women in terms of mood, appetite, impulsiveness, and more?

What is the end result?

Keto seems to be viable for short-term weight loss and the other health issues described above. It is still debated whether the approach is suitable in the long term. Its benefits are still up for debate, too. Critics cite possible kidney damage and a lack of long-term studies and scientific evidence.

Overall, Keto doesn’t seem like a long-term cure or the ideal solution for those who just want to “get healthier.” Not least, the diet is difficult for many people to follow consistently.

A preferable long-term eating plan might be a more balanced one that is low in sugar and “junk” carbohydrates and emphasizes healthy, high-fiber foods, including vegetables.