Is the Ketogenic Diet Right for You?

By: Shelby Stoner, MS, PHASE IV Exercise Physiologist

What is the Ketogenic (Keto) Diet?

Although the ketogenic diet has been around for 100+ years, it has gained popularity only recently as an approach to weight loss. The treatment of obesity and obesity related illnesses such as cardiovascular disease is one of the largest challenges facing our society today. Weight loss is often offered as a therapy geared towards reducing and/or eliminating cardiovascular risk factors which are commonly components of the metabolic syndrome. The term “ketogenic” characterizes diets that are very low in carbohydrates and higher in fats and proteins.

Ketogenic Diet and Weight Loss

In literature, diets that are rich in carbohydrates (typically in the form of refined sugars and fructose) have been associated with the metabolic syndrome. Therefore, to lose weight, different diets have been suggested. Since the publication of the Atkins’s book in the early 1970’s, low-carbohydrate diets have become increasingly popular, particularly ketogenic diets that suggest a reduction in carbohydrates, usually less than 50g /day. The theory behind the ketogenic diet and weight loss is the shift of fuel utilization from carbohydrates (glucose) to fats (fatty acids / triglycerides) known as a process called ketosis. Most of our cells naturally prefer to break down blood glucose, which comes from carbohydrates, as a main source of energy. After a few days of ketogenic dieting, glucose reserves become too low to meet the energy demands of the body. This leads to the production of ketone bodies by the liver which are then used an as alternative energy source. The shift, from using circulating glucose to breaking down stored fat for energy, usually happens over two to four days of eating fewer than 30-50 grams of carbohydrates per day. Keep in mind that this is a highly individualized process and every person will respond differently.

Dangers of the Ketogenic Diet Because the ketogenic diet lacks carbohydrates, it is high in fats and proteins. One of the main criticisms of the diet is that many people tend to eat too much protein and poor quality fats from processed foods, with very few fruits and vegetables. Patients with kidney disease should be especially cautious of this diet as it could make their condition much worse.

One proposed benefit of the ketogenic diet is improving blood sugar control for type 2 diabetics. Although some evidence suggests this helps short-term, there have been studies showing that ketogenic diets in the long term have negative effects on blood sugar control. By limiting carbohydrates, glucose-induced insulin secretion is affected which causes an increased accumulation of lipids in the liver (in extreme cases, this could lead to nonalcoholic fatty liver disease which is a predictor of cardiovascular disease), and negatively affects insulin’s ability to reduce hepatic glucose production which can lead to problems in blood glucose control and insulin sensitivity all together. Another important note is the fact that the brain must be continuously supplied with glucose, even between meals or times of fasting when nutrients aren’t actively being taken up from the digestive tract.

In addition, some studies suggest that ketogenic diets reduce cardiovascular risk factors such as high cholesterol and blood pressure, however, most of these studies are short in duration and don’t show the long-term effects. The few that have examined long-term effects show the best results come from a short period of ketogenic dieting followed by a more sustainable Mediterranean diet. A lot of cardiovascular risk factors come from being overweight or obese, which is why the ketogenic diet is so popular in the first place as it has been shown to significantly reduce body weight. However, what many articles fail to mention is that although yes, some of this weight is fat, some of it also comes from a loss in lean muscle mass too.

Take Away Message

Short-term, the ketogenic diet may be an alternative to treating certain conditions and accelerating weight loss. However, it can be hard to follow and is typically not sustainable. In most cases the ketogenic diet is heavy on red meats and other processed, salty foods that are considered unhealthy. It is also important to note that most yo-yo diets that lead to rapid weight loss fluctuation are associated with cardiovascular and metabolic risk factors. Instead of engaging in popular diet trends, opt for embracing lifestyle changes that are sustainable over the long term. A diet that integrates colorful fruits and vegetables, lean meats, fish, whole grains, healthy fats and lots of water has the best evidence for living longer, happier, and healthier lives.


While changing the way you look at food sounds simple, many need more guidance and support. For more information on the ketogenic diet, schedule your FREE Nutrition consultation today by calling (310) 582-8212 or email Shelby directly at

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