February 20, 2022

SMITH | I Don’t Want to Hear About Your (Keto) Diet

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Content Warning: Discussion of dieting and restriction

As a senior in nutritional sciences, simply stating my major usually results in some comment from somebody about their diet, be it defensive or inquisitive. I’m usually unbothered by these encounters, and I view eating as a deeply personal activity, since people’s eating habits can be driven by complex factors. However, there is one topic that comes up so often that I feel it’s necessary to make my opinion abundantly clear: You probably should not try the keto diet.

Even for people not specializing in nutrition, I don’t think anyone will fight me when I say that protein is the golden child of nutrition. Compared to its macronutrient siblings (carbs and fat), protein can essentially do no wrong. However, carbs and fat have a much more complicated reputation, with the diet industry especially villainizing carbs for decades. This is partly why low-carb, protein-centric diets such as the paleo diet and keto diet may not initially raise red flags to people. After all, if carbs are bad, protein is good and fat is somewhere in between, all those diets seem like the way to go, right?

Keto diets in particular take this logic to the extreme, restricting carbohydrate intake to less than 50g per day. For a visual representation of this, eating a banana and a half a cup of rice already puts you over this threshold. If this sounds really sad to you, you’re not alone. But I think that diet culture has conditioned us to adopt a “no pain no gain” mentality — if a task is hard, then you’re probably doing it right. 

The biggest kicker for me is this: The keto diet wasn’t designed for weight loss. It was designed to reduce seizures in those with epilepsy. While the mechanism through which the diet works isn’t precisely known, the medical community believes that ketones and the state of ketosis can somehow reduce seizures. This is a medical diet, prescribed and monitored by physicians. 

Furthermore, the keto diet induces a metabolic state that your body isn’t meant to exist within.  Before the idea of dietary ketosis (for example, putting yourself in controlled ketosis via the keto diet), starvation ketosis (as seen in malnourished individuals or those with certain metabolic disorders) was the main form of ketosis discussed in the nutrition realm. 

Starvation ketosis is the metabolic process that dietary ketosis aims to exploit, minus the starving and muscle wasting. Starvation ketosis  is the metabolic switch your body makes from using glucose as its primary source of energy to using ketone bodies in order to keep you from, well, dying. Your body is meant to run off glucose. and that is the preferred fueling method of your brain and your red blood cells. Your body typically turns to amino acid (protein) for energy creation next and will break down muscles to get the materials it needs. In contrast to starvation ketosis, the keto diet means eating “just enough” dietary protein to prevent endogenous protein breakdown (marked muscle loss) and carbohydrates to keep your red blood cells alive, but not enough to prevent the body’s switch from glucose use to ketone use. 

My question is — how feasible is this in someone who isn’t being medically monitored? In day-to-day busy life, how do you strike the balance between dietary and starvation ketosis within the range of a few grams of carbs and fat?

Additionally, this brings up the point that the keto diet isn’t so much a protein diet as it is a fat diet. Those following the diet should aim for roughly 90 percent of their energy to come from fat. While losing weight eating bacon and coconut oil may sound like a pretty good gig, this is a source of concern for cardiologists. The restriction of vegetables because of their carbohydrate content also puts people following the diet at risk for nutritional deficiencies and constipation from lack of fiber. You may also experience what is called the “keto flu,” or some mix of nausea, brain fog and constipation a few days into this restrictive diet. 

In a society that equates weight to health, it can be hard to drive home to people that losing five pounds at the cost of potential lethargy, nausea, constipation and a higher risk for scurvy is not actually taking control of your health. In four years of nutrition education from staff with RDs and PhDs and decades in the field, not one of them has ever mentioned the keto diet for any reason other than to educate us on its existence and prevalence and to acknowledge that it is an active area of research we’re still waiting to hear back on. 

Whenever I express my dislike for the keto diet, I am usually met with an anecdotal rebuttal about how it worked “so well” for someone or a story about how their “aunt lost 20 pounds.” While I don’t want to discredit people’s personal experiences because every body is different, there is not sufficient evidence to suggest the diet’s more well-studied short term effects equate to long term benefits. There is not sufficient evidence to suggest the weight will stay off or that your health will especially improve with keto in comparison to other dietary interventions. 

As someone disillusioned by diets, there is also nothing inherently “magical” about the keto diet in terms of benefits that a well-rounded diet low in processed food could not achieve. To me, it just seems like the next punishing diet for those out there that think nutrition and eating well means restriction or those looking for a magic “hack” the experts aren’t telling us. It’s true that there is research looking into the diet’s benefits for people with epilepsy, diabetes and other health conditions. But as a run-of-the-mill, try it at home diet? Pass. 

Emma Smith (she/they) is a senior in the College of Agriculture and Life Sciences. They can be reached at [email protected] Emmpathy appears every other Monday this semester.