KETOGENIC DIET: Overview, Uses, Side Effects, Precautions, Interactions, Dosing and Reviews (2024)

Overview

The ketogenic diet is a high-fat, very low-carb diet. It usually limits carbs to 20-50 grams daily. This forces the body to break down fat for energy.

The body breaks down fat into molecules called ketone bodies. These ketone bodies can be used for energy. The classical ketogenic diet, which is used to reduce seizures in children, requires up to 4 times as many calories from fat as from carbohydrate and protein.

A very strict form of the ketogenic diet is used for seizure disorders in people with hard-to-treat epilepsy. Less strict forms of the ketogenic diet are used for obesity, diabetes, Parkinson disease, and many other conditions, but there is no good scientific evidence to support many of these uses.

Don't confuse the Modified Atkins Diet, a type of ketogenic diet, with the Atkins diet. Also don't confuse the ketogenic diet with "Keto diet pills." These are not the same and don't have the same effects.

Uses & Effectiveness ?

Possibly Effective for

  • Diabetes. Following a ketogenic diet seems to improve blood sugar control in people with type 2 diabetes.
  • Seizure disorder (epilepsy). A strict ketogenic diet that is high in fat and very low in carbohydrates can reduce seizures in some people with hard-to-treat epilepsy. Following less restrictive forms of the diet seems to be less effective.
  • Obesity. Following a ketogenic diet that limits carbohydrate intake to less than 50 grams daily can reduce body weight by 10% to 30% in 1 year. But it's not clear if it works any better than other diets that limit calorie intake.

There is interest in using ketogenic diet for a number of other purposes, but there isn't enough reliable information to say whether it might be helpful.

Side Effects

When taken by mouth: The ketogenic diet is likely safe for most adults when used for up to 1 year. The most common side effects include constipation, fatigue, dizziness, weakness, nausea, diarrhea, and stomach pain. The long-term safety of the ketogenic diet in adults is unknown. It is important to ensure any diet remains balanced and contains nutrient-rich foods.

Special Precautions and Warnings

When taken by mouth: The ketogenic diet is likely safe for most adults when used for up to 1 year. The most common side effects include constipation, fatigue, dizziness, weakness, nausea, diarrhea, and stomach pain. The long-term safety of the ketogenic diet in adults is unknown. It is important to ensure any diet remains balanced and contains nutrient-rich foods.

Pregnancy: There isn't enough reliable information to know if the ketogenic diet is safe when pregnant. Ketone bodies are chemicals made in the body when people follow a ketogenic diet. There is some concern that these chemicals might pass to the baby and slow down growth during pregnancy and after birth. Don't follow this diet unless under the care of a healthcare professional.

Breast-feeding: The ketogenic diet is possibly unsafe when breast-feeding. Following a very-low carbohydrate ketogenic diet when breast-feeding might increase the risk for a serious health issue called ketoacidosis. Don't follow this diet unless under the care of a healthcare professional.

Children: The ketogenic diet is possibly safe when used by children under the care of a doctor, short-term. There is some concern about the ketogenic diet when used long-term. When used for more than 2 years, the ketogenic diet has been linked with slowed growth, fractures, and kidney stones in children.

Heart conditions: Use with caution. The ketogenic diet might worsen certain heart conditions.

Diabetes: Following a very-low carbohydrate ketogenic diet might increase the risk for diabetic ketoacidosis (DKA), a serious complication of diabetes. If you have diabetes, speak with a healthcare professional before starting the ketogenic diet.

Acid reflux: Some ketogenic diets are high in fat. High-fat diets can worsen symptoms of acid reflux.

High levels of fat in the blood: Some ketogenic diets are high in fat. Diets high in fat can increase levels of cholesterol and other fats called triglycerides. This might be a problem for people who already have high levels of these fats in the blood. Talk to your doctor before starting the ketogenic diet.

Liver disease: The ketogenic diet might cause liver injury and may worsen symptoms of liver disease.

Problems breaking down fats in the diet: The ketogenic diet forces the body to break down fat for energy. For people unable to break down fat, the ketogenic diet might lead to serious adverse effects, including coma or death.

Kidney disease: The ketogenic diet may worsen kidney disease and has been linked with kidney stone development.

Weak and brittle bones (osteoporosis): Long-term use of the ketogenic diet may weaken the bones. Use caution if you are at risk for or have a history of osteoporosis.

Swelling (inflammation) of the pancreas (pancreatitis): The ketogenic diet may increase the risk of developing pancreatitis. Use caution if you have a history of pancreatitis or have very high triglyceride levels.

Surgery: Certain medications used during surgery contain carbohydrates. Talk to your healthcare provider before any surgery if you are using the ketogenic diet to reduce seizures. Changes to some medications used during surgery might be needed.

Dosing

The classical ketogenic diet requires 90% of daily calories to come from fat. But there are many other, less restrictive versions of the ketogenic diet that typically allow 20-50 grams of carbs daily. Variations include the medium chain triglyceride diet, modified Atkins diet, modified Mediterranean diet, and low glycemic index treatment. Speak with a healthcare provider to find out which variation of the ketogenic diet might be best for a specific condition. The ketogenic diet isn't suitable for everyone.

CONDITIONS OF USE AND IMPORTANT INFORMATION: This information is meant to supplement, not replace advice from your doctor or healthcare provider and is not meant to cover all possible uses, precautions, interactions or adverse effects. This information may not fit your specific health circ*mstances. Never delay or disregard seeking professional medical advice from your doctor or other qualified health care provider because of something you have read on WebMD. You should always speak with your doctor or health care professional before you start, stop, or change any prescribed part of your health care plan or treatment and to determine what course of therapy is right for you.

This copyrighted material is provided by Natural Medicines Comprehensive Database Consumer Version. Information from this source is evidence-based and objective, and without commercial influence. For professional medical information on natural medicines, see Natural Medicines Comprehensive Database Professional Version.
© Therapeutic Research Faculty 2020.

KETOGENIC DIET: Overview, Uses, Side Effects, Precautions, Interactions, Dosing and Reviews (2024)

FAQs

What are the precautions for keto diet? ›

The keto diet could cause low blood pressure, kidney stones, constipation, nutrient deficiencies and an increased risk of heart disease. Strict diets like keto could also cause social isolation or disordered eating. Keto is not safe for those with any conditions involving their pancreas, liver, thyroid or gallbladder.

What is the keto diet summary? ›

What Is It? “Ketogenic” is a term for a low-carb diet (like the Atkins diet). The idea is for you to get more calories from protein and fat and less from carbohydrates. You cut back most on the carbs that are easy to digest, like sugar, soda, pastries, and white bread.

What are the side effects of the ketogenic diet? ›

Common short-term side effects resulting from the initiation of KD have been referred to as “keto flu,” which encompasses symptoms including fatigue, headache, dizziness, nausea, vomiting, constipation, and low exercise tolerance [6].

What are the basic rules of a keto diet? ›

Ketogenic diets vary but will consist of about 70–75% fat, 15–20% protein, and 5–10% of carbs per day. Focus on high fat, low carb foods like eggs, meats, dairy, and low carb vegetables, as well as sugar-free beverages. Be sure to limit highly processed foods and trans fats.

Do and don'ts in keto? ›

Opt for healthy fats: Focus on healthy fats like avocados, olive oil, coconut oil, and fatty fish. These fats provide essential nutrients and support ketosis. Choose quality protein: Opt for lean and high-quality protein sources like poultry, lean cuts of meat, and fish. Avoid processed and high-fat meats.

What are the main foods to avoid on a keto diet? ›

10 Foods You Can't Eat on the Keto Diet & Their Substitutes
  • Grains and Starches. ...
  • Sugary Foods and Sweets. ...
  • High-Carb Fruits. ...
  • Starchy Vegetables. ...
  • Legumes and Beans. ...
  • Processed Foods with Hidden Carbs. ...
  • Alcohol and co*cktails. ...
  • High-Carb Sauces and Condiments.

Is keto hard on the kidneys? ›

The ketogenic diet is becoming more popular as a weight loss regimen; however, the evidence has failed to show clinically significant benefits over comparator diets. Even worse, it may cause hyperlipidemia, vitamin and mineral deficiencies, fatigue, and kidney damage, among other complications (Figure 1) [6].

Who shouldn't do keto? ›

TABLE 2
Main contraindicationsMain arguments in support of contraindications
Recent stroke or myocardial infarctionIncreased risk of arrhythmia
Heart failureIncreased risk of arrhythmia, hydroelectrolitic alterations
Respiratory failureAcidosis
Active/severe infectionsImmunosuppression
11 more rows
Jul 10, 2020

Is 5 ketones in urine bad? ›

Generally, a reading of 2 or more on a simple urine ketone test is a cause for concern.

Can you eat banana on keto? ›

Bananas. Bananas may be great for muscle recovery, reducing bloat, and calming an upset stomach, but they're on the list of foods you can't eat on the keto diet. With 25g of carbs per 100g serving, bananas are too high in carbs.

How many eggs a day on a keto diet? ›

It's totally fine and safe to eat up to 6 eggs a day while on the keto diet. You can consume even more eggs per day occasionally, as long as you make sure that you eat your greens, healthy fats and proteins from other sources.

Can you drink coffee on keto? ›

Both coffee and tea are low in carbs and can be enjoyed on a keto diet as long as they are unsweetened,” says Winnifred, noting that adding a bit of dairy milk or cream is fine as long as you stay within your daily carb limit. For those following a keto diet, feel free to drink unsweetened plant-based milks, too.

What are the key rules for the keto diet? ›

Simply put: carbs must be avoided if you want to stay in ketosis. Generally, you want to stay under 25 grams of net carbs (total carbs minus fiber) per day. You also want to watch your protein intake. Protein is not the enemy, as with carbs.

What restrictions are given about when to eat on a keto diet? ›

Incorporate intermittent fasting aka limiting your food consumption to an 8 hour window. This will allow you to get to ketosis faster. According to Healthline it typically takes around 2-4 days to reach ketosis. However, for some people it can take more than a week.

How long is it safe to be in ketosis? ›

Gulotta recommends staying on keto for six months max before reintroducing more carbs to your diet. And Scott Keatley, RDN, of Keatley Medical Nutrition Therapy in New York City, agrees: “The science hasn't gotten to the point where I would be comfortable recommending it as a forever diet,” he says.

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