Thinking of doing the ketogenic diet? Read this first…


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The ketogenic diet has become one of the most popular breakthrough diets of the last 20 years. It’s not necessarily a new diet by any means. The ketogenic diet first rose to fame in the early 1900’s as the default dietary treatment for diabetes.

Essentially, we are talking about a diet that is high fat, low carb. In other words, we are getting the body to use fat (or ketone bodies) as a primary fuel source instead of carbohydrate (this is ketosis). BUT, technically speaking, to be in ketosis, you must be consuming 50 grams or less carbohydrate per day with the remainder of the diet as fat (65-80% of calories) and protein (15-25% of calories). Without going too far down the rabbit hole here – the higher your caloric intake, the higher the fat ratio should be and the lower the carbohydrates; with a daily maximum of 50 grams.

A simpler way of looking at is 80% fats, 15% proteins and 5% carbohydrates

This flies in the face of the low-fat diet that has been recommended (incorrectly I might add) since the 1950’s; and obviously has a lot of people quite puzzled and concerned about the effects of consuming so much fat.

Biologically-speaking, your body was designed to run on two types of fuel: carbohydrates and fats (more specifically ketones). Carbohydrates are quick-burning fuel source that give us quick bursts of energy. Ketones on the other hand provide longer, more stable energy. Clearly there are times where we need both.

Benefits of the Ketogenic Diet

The touted benefits of the ketogenic diet include weight loss, improved energy, better digestion and enhanced concentration and cognitive function. Some of the most well-researched benefits are epilepsy, Alzheimer’s disease and Parkinson’s, autism and bipolar disorder. While both the science and anecdotal evidence support these facts, there are a few points to consider before embarking on this diet.

Default Diet

Perhaps the most glaringly obvious question: “is this our biological default diet”? Historically speaking, if we roll the clock back to paleolithic times, most would agree that we ate less carbohydrates and higher fat. As we started to cultivate grains, our carbohydrate consumption went up (and were only made up of complex carbs). But remember, we are talking about burning fat for energy and cutting out carbs to almost zero.

Exclusively burning fat for fuel was/is usually reserved for times of famine and food restriction. It’s a biological fail-safe so that when we didn’t have access to carbs, we still had a back-up fuel supply – our own fat stores.

Excess meat consumption

The ketogenic diet requires you to up your intake of animal proteins (meat, eggs, fish, dairy, etc). In the short-term these might not pose any problems, but when it comes to long-term consequences, the debate rages on.

True meats stabilize blood sugar, provide beneficial fats and vital cholesterol, and supply essential amino acids, iron, B12 and a host of other nutrients. BUT, animal proteins (aside from fish and perhaps eggs) also come with pro-inflammatory fats as well. Arachidonic acid is important for brain health and is clearly part of a normal diet, but the million dollar question is “will it cause excess inflammation in the long run?”

Low Fiber Intake

With high meat intake, comes low fiber intake. The biggest ‘mistake’ I see with the ketogenic diet is that people take this as license to eat bacon and eggs for breakfast every morning, steak for dinner and essentially turn their diet into a giant “meat-fest”. There is an astronomical amount of evidence that clearly lays out the benefits of fiber; from lowering your risk of bowel and heart disease, to better  blood sugar management and balanced cholesterol levels.

One of the many roles of fiber is to feed good bacteria (aka probiotics) in the gut. High-fat intake causes changes in the gut microbial composition and function, resulting in an increased leakiness of the gut and low grade inflammation of the gut and other organs, including the brain.

Environmental Issues

If everyone on the planet decided to go full ketogenic diet, there would be a considerable strain on resources and the environment. Let’s also not forget the terrible conditions factory-famed animals are raised in. I am not entirely opposed to eating meat by any means, but we would need a radical reform in the way we farm animals for this to work. We would essentially need ALL animals to be 100% pastured (ie. we would not grow any soy or corn for their feed). While I do believe we can do it this way, one has to wonder how fast we could shift in the current agricultural climate to make this a realistic and sustainable option.

On the flip side, we would also not be growing any grains since everyone would be eating substantially less (actually none of you follow Paleo-type dieting). As you can see, the issue becomes quite nuanced and there are many caveats when thinking about this style of eating

Do NOT Go Keto If You Have the Following Conditions!

The ketogenic diet is not for everyone. If you fall into any of the following categories, you should avoid following a ketogenic diet:

  • Any stage of pregnancy
  • Anyone with decreased kidney function
  • All type 1 diabetics (recommended for type 2 diabetics without kidney damage and under doctor supervision)
  • Anyone on medications that decrease kidney or liver function (i.e. metformin). Keto must be discussed with your physician if you are on any kinds of medications or drugs to ensure there are no contraindications with keto
  • Women with irregular menses
  • Anyone with a current or previous eating disorder
  • Anyone with chronic respiratory conditions (COPD and other restrictive lung diseases)

Bottom Line

While the ketogenic does provide massive benefit for things like weight loss and some of the other conditions mentioned earlier, the question remains whether it is sustainable in the long-run. It is a strict diet to adhere to and comes with a few concerning caveats. I do wonder to myself if we could ever do this in a vegetarian/vegan way, but most people I speak with say no. If you are considering going ketogenic, ensure that you still get ample amounts of vegetables in the diet, and always choose organic, pastured, ethically-raised animal foods.

Would love to hear your thoughts on this. Have you tried it? What was your experience? Do you plan to keep it up? Catch up with me on Facebook and let me know…

Some science:

  1. Moreira AP et al. Influence of a high-fat diet on gut microbiota, intestinal permeability and metabolic endotoxaemia. Br J Nutr. 2012 Sep;108(5):801-9. doi:10.1017/S0007114512001213. Epub 2012 Apr 16. Review. PubMed PMID: 22717075.
  2. Cani PD, Everard A. Talking microbes: When gut bacteria interact with diet and host organs. Mol Nutr Food Res. 2016 Jan;60(1):58-66. doi:10.1002/mnfr.201500406. Epub 2015 Aug 26. Review. PubMed PMID: 26178924; PubMed Central PMCID: PMC5014210.
  3. Guillemot-Legris O et al. High-fat diet feeding differentially affects the development of inflammation in the central nervous system. J Neuroinflammation. 2016 Aug 26;13(1):206. doi:10.1186/s12974-016-0666-8. PubMed PMID: 27566530; PubMed Central PMCID: PMC5002131.
  4. Cani PD. Gut microbiota – at the intersection of everything? Nat Rev Gastroenterol Hepatol. 2017 Jun;14(6):321-322. doi:10.1038/nrgastro.2017.54. Epub 2017 Apr 26. PubMed PMID: 28442782.
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