The ketogenic, aka keto, diet has been getting a lot of buzz recently, but is this just the hype of another fad diet? As with most things, there is a little bit of truth mixed into the hype. And depending on your goals, a ketogenic diet might be a useful tool. Chances are you have a ton of keto diet questions.
The Keto Diet: An Overview
A keto diet involves altering your body’s energy source from stored glycogen to ketones. In English, that means severely limiting carbohydrate intake and eating a ton of fat to fuel your organs and movement.
Fat is used as your primary source of energy as it is broken down into ketones, putting your body in a state of ketosis. When you’re in ketosis, fat is fueling energy expenditure. When carbs are included in your diet, they provide the energy and are your body’s preferred fuel source.
A true keto diet, however, is unlike other low-carb diets. Keto emphasizes a high fat intake, while other low-carb diets tend to emphasize protein. In fact, to achieve ketosis, only about 75 grams of protein per day (based on a 2,000-calorie diet) would be consumed.
The high-fat, low-protein, and low-carb diet can lead to weight loss for a short period—as can any most diet if you’re eating fewer calories than you’re burning.
But restrictive diets, as you may be aware, are not always great for your health. Here’s a little keto Q&A to help keep you informed:
Keto FAQs
1. Keto vs. Atkins: Are Keto and Atkins the Same?
On the surface, the keto and Atkins diets seem pretty similar: both are low-carb, both offer a seemingly clear path to weight loss, and they are each fairly restrictive.
That should put an end to the keto vs. Atkins question. But wait! A closer look reveals that each diet is distinct.
To get into ketosis—where your body is using fat for energy—about 75% to 85% of calories should be coming from fat, with around 10% to 15% coming from protein and 5% to 10% from carbs.
Atkins, on the other hand, varies in its macronutrient prescription based on your goals and which stage of the diet you’re at.
The most extreme version, the classic Atkins 20 Diet, has four stages. As you lose weight and move through the stages, your carbohydrate intake gradually increases. This does not happen on a keto diet.
Another version of the diet, the Atkins 40, is more flexible without stages or food restriction.
Both can be effective diets for weight loss; however, Atkins might be a little easier to maintain. Atkins offers some more flexibility overall without going into a “high” or even “moderate” carb phase.
In the keto diet, achieving and maintaining ketosis is quite difficult because of the necessary fat intake. It will take a little more patience—weighing and counting macros in food to make sure you hit fat targets, while being careful to limit high-fat foods like avocado and nuts because they also feature carbohydrates.
So even though the diets are both low carb, the keto and Atkins diets are different.
2. Does Keto Work without Exercise?
You can experience weight loss results from a keto diet without exercising, provided your daily caloric intake is below your caloric expenditure.
The keto diet doesn’t differ from other dieting methods in that a caloric deficit is required for weight loss. If you’re eating keto as a therapeutic tool for a specific health condition, like controlling epileptic seizures, and not concerned with weight loss, restricting calories is not important.
If you do exercise on keto, you may feel a little more sluggish during workouts. This will be most noticeable during the first few weeks after you have adopted the diet. Your body will be using up the last of its stored glucose, potentially leaving you less explosive, weaker, and feeling like your endurance is dropping.
If your goal is to build muscle or get stronger, keto is not recommended.
Once you’ve moved into ketosis, you may feel some flu-like symptoms including brain fog, headaches, chills, and fatigue that might keep you out of the gym as well. These are normal and not the flu, so getting to the gym is still worthwhile.
Making sure you increase water intake during a keto diet is also important if you’re exercising.
You do not need to exercise to experience weight loss from a ketogenic diet. You do, however, need to be in a caloric deficit, so it is important to track calories.
3. Is the Keto Diet Bad for You?
It can be argued that any restrictive diet can be bad for you, and keto is no different. This is typically true when a particular style of restrictive eating is maintained for a prolonged period.
For example, because keto allows for such little wiggle room when it comes to carbohydrate intake, it can be very difficult to consume adequate amounts of fiber. Fruit and whole grains are great sources of fiber, and many don’t have a place in the keto diet.
Berries can fit into keto, as can leafy greens, but it might be hard to hit your 28 to 38 grams of recommended fiber per day. It could also put you at risk for specific nutrient deficiencies.
Keto diets can pose a health risk for people who don’t make good choices. Even though high amounts of whipped cream, bacon, and butter may be ketogenic, it doesn’t make eating them healthy.
Too many saturated fats can lead to health troubles, so selecting quality cuts of meats, fish, and healthy fats alongside leafy greens is the best way to get the most from the diet.
4. What Is Keto Crotch?
Keto crotch is a potential effect that some women claim to experience after going keto. It’s marked by an unpleasant odor coming from the vagina, and is likely caused by an altered pH level.
Switching to any new diet can produce a change in vaginal pH and produce an odor for a few days before subsiding. If it lasts longer than a week, talk to your doctor.
5. Are Tomatoes Keto?
Because carbohydrate levels must be kept extremely low to achieve and maintain ketosis, it can be hard to find room for fruit. Tomatoes, fortunately, are low enough in carbohydrates that they can be safely included in a keto diet.
There are only six grams of carbs in a cup of tomatoes, so the content is fairly negligible. However, it should be noted that keto-friendly fruits like tomatoes and blueberries only keep you in keto if your daily carb intake stays within the 5% to 10% range of total calories.
6. Are Carrots Keto?
Eating a carrot, or a few pieces of a carrot, will not necessarily throw you out of ketosis. Carrots will, however, eat up a lot of your carbohydrate allowance in a relatively small serving.
One cup of carrots, for example, provides 12 grams of carbs. That might not look like much, but if you’re only eating 20 to 50 grams of carbs per day, you’re not leaving yourself much room to get high-fiber, low-carb fruits and veggies.
Although carrots are extremely healthy and a great source of vitamin A and antioxidants, they might be difficult to regularly include in a keto diet. They can be enjoyed moderately, however.
If you include a serving of carrots per day, the rest of your carbs will likely have to come from leafy greens.
7. Are Peanuts Keto?
Peanuts and peanut butter are great sources of healthy fat that can be useful on a keto diet. This is only true if the nuts and/or butter are consumed without any added sugar.
There are about eight grams of carbohydrates in a 100-gram serving of peanuts (about three handfuls), which is pretty good if you control portion sizes.
Still, peanuts, like many other nuts, can be hard to stop eating once you’ve started. Other nuts like pecans, macadamia, and Brazil nuts offer fewer carbs per serving.
8. Are There Keto Diet Pills?
There are ketogenic diet pills that include ingredients like ketones to suppress appetite and electrolytes to limit the effects of dehydration during the initial switch to a keto diet.
Caffeine is another common ingredient in diet pills that is used to rev-up the metabolism.
But overall, these pills are not worth the money. If you’re going keto, just make sure to drink water and eat sufficient electrolytes and fats. An electrolyte-beverage supplement (low carb) may be useful and much cheaper.
9. Is There a Keto Diet for Vegetarians?
It is possible to go keto if you’re a vegetarian, but the reality is that if you are struggling to lose weight as a vegetarian, it’s advisable to look at the overall quality of your diet.
If you’re looking to go keto as a vegetarian for a change from the typical, it is possible to achieve. However, it might be difficult—after all, you will be taking an already restrictive diet and restricting it even more so.
Items that a vegan/vegetarian would focus on for a keto diet would include coconut oil, olive oil, avocado, seeds and nuts, and berries, while eliminating starchy veggies, sugary fruits, beans and legumes.
10. Is Keto Bad for Your Heart?
Although there is no research available to establish the long-term effects of a keto diet on your heart, it is safe to assume that the food choices you make will play a significant role on cardiovascular health.
If you are sticking mainly to cheeseburgers, bacon, and saturated fats, and limiting your leafy green intake, you can bet you’ll be putting your heart at a greater risk than someone who chooses healthy fats and leafy greens.
The keto diet can take healthy and unhealthy forms, so it is best to be smart when selecting foods. Including steak, fish, broccoli, spinach, olive oil, avocado, nuts and seeds (healthy fats) and plenty of low carb-leafy greens and fruits is the best way to protect your heart health on a keto diet.
11. Is Keto Bad for Your Liver?
If you have an existing liver condition like liver disease, the keto diet could cause problems due to the high levels of fat the organ would have to metabolize. If you have a healthy liver, there may not be any adverse effects of a keto diet.
12. Is Keto Gluten Free?
Because of how difficult it is to find room for grains on a keto diet, it is almost by default gluten free. You won’t find gluten in the cornerstones of the keto diet, which include meat, eggs, leafy greens, and healthy fats.
13. Is Diet Soda Keto-Friendly?
Technically, yes, Diet Coke and Diet Pepsi, along with other artificially sweetened beverages, are keto-friendly. They don’t contain any carbohydrates or calories, and can therefore fit into your diet once in a while.
But their keto-friendly status doesn’t mean it’s a wise idea to make them a regular part of your diet. The compounds in these drinks might compromise gut health, and they should really only be used sparingly as tool to satisfy occasional cravings for something sweet.
14. Can I Have Caffeine on Keto?
Caffeine is not a carbohydrate, so you can have it on keto. Black coffee, coffee with milk, and caffeine pills can all fit into your keto diet. The only difference to your morning coffee in the keto diet is no sugar.
15. Are There Keto Drinks Besides Water?
Yes, there are a number of beverages you can enjoy on the keto diet besides water. Coffee, tea, and even certain alcoholic drinks can fit into a keto diet. Fruit juices, soda, sweet tea, sports drinks, energy drinks, and some alcoholic beverages will need to go, though.
Some keto-safe libations include: low-carb beer, red wine and white wine (about four grams of carbs each, and not sweet ones like Moscato), and clear spirits. When you drink, have no more than one or two glasses.
Should You Go Keto?
If you want to give keto a try, go for it. It may lead to some weight loss if it’s done properly and can add to your collection of life experiences. But the truth is, any new diet will likely exhibit similar adaptions in the short-term.
Unfortunately, going keto for a few months may only promote further weight gain when carbs are reintroduced. And if you remain keto for an extended period, you risk nutrient deficiencies and will, of course, experience diminishing returns with fat loss.
If you’re interested in losing weight, the best (and healthiest) approach might be to look at your overall diet and find a balanced approach to achieving a caloric deficit. This would involve eating a variety of fruits, vegetables, and healthy fats, in addition to high-protein animal products. Steering clear of processed foods—whether keto or not—is essential.
Sources:
Migala, J., “Answers to 15 Burning Questions About the Keto Diet,” Everyday Health, October 10, 2018; https://www.everydayhealth.com/ketogenic-diet/diet/burning-questions-about-keto-diet-answered/, last accessed March 19, 2019.
Matthews, M., “Keto vs. Atkins: What’s the Difference Between the Low-Carb Diets?” Men’s Health, November 28, 2018; https://www.menshealth.com/nutrition/a25319225/keto-vs-atkins-diet/, last accessed March 19, 2019.
“Keto Crotch’ Might Be A Surprising Side Effect Of A Low-Carb Diet,” Women’s Health, March 1, 2019; https://www.womenshealthmag.com/weight-loss/a26449357/keto-crotch/, last accessed March 19, 2019.
“Should you try the keto diet?” Harvard Medical School, October 2018; https://www.health.harvard.edu/staying-healthy/should-you-try-the-keto-diet, last accessed March 19, 2019.
Dashti, H., et al “Long-term effects of a ketogenic diet in obese patients,” Experimental & Clinical Cardiology,” Fall 2004, PMID: 19641727; https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2716748/, last accessed March 19, 2019.
Seegert, L., “The Keto Diet Is Gaining Popularity, but Is It Safe?” Healthline, June 7, 2016; https://www.healthline.com/health-news/keto-diet-is-gaining-popularity-but-is-it-safe-121914, last accessed March 19, 2019.
