Is Keto Safe? [7 Myths About Keto Being Dangerous That Aren’t True]
The Keto diet (aka Ketogenic diet) has been getting a ton of press as an amazing weight-loss diet. But is Keto safe to do? Are there any dangers of Keto dieting?
That’s why we’ve written this post. To clear up all the myths surrounding the Keto diet…
- Is keto safe in general? Don’t you need carbohydrates?
- Is keto unhealthy for you? Isn’t fat bad for you?
- Is being in ketosis for a long time good for you?
First, we’re going to discuss the most common myths around the dangers of Keto, plus explain why they’re not true. (Based on solid evidence, of course.)
Then we’ll go over two important topics:
- How do you do Keto in a safe way?
- Should you do Keto long term?
A ketogenic diet is safe, but there are healthy and unhealthy ways to do it.
Note: we are not doctors or nutritionists and the information provided in this article is based on our research and designed to help you educate yourself on the Keto diet. And now for our medical disclaimer:
Note that information contained in this article (and website) is not intended to and shall not convey or recommend any medical or nutritional advice or course of action. Any diet, health, or nutritional program you undertake should be discussed with your doctor or other licensed medical professionals. All opinions expressed in this article are based solely on personal experiences and research. We are NOT licensed doctors, dietitians, or nutritionists.
7 Myths About the Keto Diet Being Dangerous That Aren’t True
You might have seen these myths mentioned in articles online – that doesn’t mean they’re true, though.
MYTH 1: The Keto Diet Causes Nutritional Deficiencies
TRUTH: If you eat a ketogenic diet in a healthy way, then it becomes a highly nutritious diet.
Technically, you could eat a variety of non-nutritious foods in order to reach nutritional ketosis. Just like you can eat pizza and be a vegetarian.
The main requirements for getting into ketosis are:
- Restricting your carbohydrate intake,
- Limiting your protein intake, and
- Increasing your fat intake.
Eating this way causes your body to start burning fats for fuel instead of sugars.
And yes, you could do this by eating only mayo, beef patties, and margarine, which could definitely lead to severe nutritional deficiencies.
But this isn’t the only way (or even a recommended way) of doing Keto.
Instead, you can eat on a healthy ketogenic diet plenty of:
- Healthy fats (e.g, coconut oil, ghee, and olive oil)
- Low-carb vegetables (e.g., spinach, kale, cauliflower, and others)
Dr. Andreas Eenfeldt, M.D. recommends a Keto diet that includes plenty of low-carb veggies. “On a keto diet, vegetables with less than 5 net carbs may be eaten relatively freely —have them with butter and other sauces! It is hard to over-eat spinach, zucchini, lettuce, asparagus and kale on a keto diet.”
He adds, “On a keto diet, vegetables with less than 5 net carbs may be eaten relatively freely —have them with butter and other sauces! It is hard to over-eat spinach, zucchini, lettuce, asparagus and kale on a keto diet.”
A ketogenic diet packed with low carb vegetables, grass-fed beef, pastured pork, fish, shellfish, organ meats, healthy fats, and berries can be highly nutritious and packed with essential vitamins and minerals.
MYTH 2: The Keto Diet Causes Dangerous Ketoacidosis
TRUTH: If you’re not a Type 1 diabetic (or late-stage Type 2), ketoacidosis is not something you should be worried about.
According to Registered Nurse, Tammy Shifflett, RN, “For people with Type 1 Diabetes, you probably have heard of their diabetic emergency, diabetic ketoacidosis, also referred to as DKA. This can be life threatening condition for people with Type 1 diabetes and Certified Diabetes Educators spend many hours teaching preventive care for DKA. This condition should not be confused with nutritional ketosis, the fat burning state reached when following the Ketogenic diet. The two conditions are quite different.”
In reality, you can’t go into ketoacidosis if your body is producing insulin normally.
You have a hormonal feedback loop which prevents this happening.
Why Ketosis From a Keto Diet Is Different From Ketoacidosis
Check out this video for the difference between ketosis and ketoacidosis:
Now that you’ve had a short introduction, let’s crunch some numbers…
For Nutritional Ketosis: Your ketone levels are usually between 0.5 to 6 mmol/L.
Your Feedback Loop Is Triggered:If your blood ketone levels go above 6 mmol/L.
Ketoacidosis Occurs:If your blood ketone levels go above 20 mmol/L.
As you can see, there’s a vast difference between mild ketosis (the level most folks aim for when using a Keto diet for weight loss – and often you don’t even need 0.5 mmol/L) and ketoacidosis.
And your body prevents you from ever reaching ketoacidosis, thanks to that feedback loop.
How Your Body Prevents Ketoacidosis for Most Of Us
If your blood ketone levels go above 6 mmol/L, your body releases insulin.
And this has a few knock-on effects…
Your fat cells stop releasing fatty acids, which are the thing your body uses to make ketones.
Your liver starts producing ketones much more slowly.
Your body moves ketones out of your bloodstream and they’re excreted in your urine.
All of this has one consequence – to bring your ketone levels back to a healthy range.
So, as long as your body produces insulin normally, there’s no need to be afraid you’ll get ketoacidosis! If you want to read more about this and what ketoacidosis is and whether you should be testing for it, then check out our detailed article here.
Nutritional ketosis and ketoacidosis are very different. And as long as your body produces insulin normally (i.e., you’re not a type 1 diabetic or late stage type 2 diabetic), then your body has built into feedback loops to prevent ketoacidosis from occurring.
MYTH 3: A Ketogenic Diet Causes Severe Dehydration
TRUTH: If you take care to drink enough water and get enough electrolytes, you won’t be dehydrated.
There’s an easy way to avoid dehydration on the keto diet –
Drink more water!
But there’s more to it than that…
You’ll also need to replenish your electrolytes since you’ll flush a lot of them out along with “water weight” when you first go keto.
Pharmacist and Certified Health Coach Dr. Christina Tarantola, PharmD, CHC, describes the effect this can have on someone new to Keto. “As a person goes into ketosis, it is likely that he or she might experience the “keto flu,” because the body is not yet adapted to the lower amount of carbs present in the bloodstream. Electrolyte shifts may cause some of the symptoms associated with the keto flu, so, having a plan to supplement with magnesium, potassium, and plenty of water can ameliorate any unpleasant feelings.
So make sure you get plenty of sodium, potassium, and magnesium in your diet, whether that’s through foods like leafy greens, broccoli, and salmon or by taking supplements. And drink plenty of teas, soups and broths, and water.
You will need to drink more water and ensure you replenish your electrolytes on Keto.
MYTH 4: The Keto Diet Increases Your Risk of Heart Disease
TRUTH: In fact, the Keto diet could reduce your risk of heart disease.
Although some folks think eating a high fat keto diet will increase your risk of heart disease…
The opposite is often true!
Provided you’re eating a healthy low carb diet which is full of good fats, of course.
A 2003 study conducted by Hussein M. Dashti, M.D., PhD, et al, concluded, “The administration of a ketogenic diet for a relatively long period is safe and favorably modi?es the risk factors of heart disease in obese patients.”
There are a few ways keto reduces your risk of heart disease –
It reduces your triglyceride levels:
A study investigating the long-term effects of a Ketogenic diet followed 83 patients and found a “significant decrease in the level of triglycerides” (you can read more here).
It reduces your levels of “bad” cholesterol:
That same study also found the participants’ levels of LDLs (aka bad cholesterol) decreased significantly.
It increases your levels of “good” cholesterol:
Another study which followed 63 patients found that their levels of HDLs (aka good heart-healthy cholesterol) significantly increased, thanks to the healthy fats the diet provided (check it out here).
Despite conventional fears of high fat diets, there’s significant research showing that a low carb and high fat diet can be beneficial to your health.
MYTH 5: The Keto Diet Leads to Muscle Loss
TRUTH: Going Keto doesn’t mean you lose muscle mass – there are bodybuilders who follow the keto diet.
Some people find they lose muscle while losing fat on the diet…
But that’s true for every weight loss diet!
And if you add some strength training to your exercise routine, you can combat this.
There are also suggestions that a strict keto diet can actually preserve muscle mass.
Keto, like other weight-loss regimes, can make it hard for you to retain your muscle mass while losing fat. So make sure to add a strength-training component to your diet.
MYTH 6: The Keto Diet Causes Gallstones
TRUTH: There’s no scientific evidence for high-fat diets causing gallstones although low-fat diets have been linked to gallstone formation.
The conventional belief is that a high-fat diet causes gallstones. But science actually points the other direction – suggesting that a low-fat diet is actually more likely to cause gallstones to form.
If you eat a very low-fat diet, then all that bile that your body produces (in order to digest fats) sits unused in your gallbladder. And this could then lead to gallstones forming.
Several studies point to this hypothesis:
- In one study, 4 out of 51 participants developed new gallstones after going on an extremely low fat diet.
- In this smaller study, half of participants on the low-fat diet developed gallstones whereas none of the participants on the higher-fat diet developed gallstones. The study concluded: “In the obese during rapid weight loss from a very low calorie diet, a relatively high fat intake could prevent gallstone formation, probably by maintaining an adequate gallbladder emptying.”
Eating a low fat diet has been linked to gallstone formation when using a low-calorie diet to lose weight. While there’s no definitive answer to what causes gallstones, the suggestions that Keto could cause gallstones don’t make scientific sense.
MYTH 7: The Keto Diet Causes HPA Axis Dysfunction (Adrenal Fatigue)
TRUTH: Following a ketogenic diet doesn’t cause HPA Axis Dysfunction (which is still often called adrenal fatigue) – but if you already have adrenal fatigue, you might struggle with the Keto diet.
HPA Axis Dysfunction is likely caused by being in a chronic state of stress.
Whether that’s mental and emotional stress from work/relationships/life or physical stress from over-exercising or eating too few calories. Stress disturbs your body’s hormone balance which has a bunch of negative knock-on effects.
According to Dr. Tommy Wood, M.D., PhD., “Much of the data used to support the idea that the ketogenic diet causes thyroid/adrenal issues come from studies where people are in a calorie deficit. If you’re on a ketogenic diet and eating enough calories, then this problem often goes away.”
So make sure to keep nourishing your body instead of using keto as a crash diet to lose weight.
While a low carb diet has been linked to HPA Axis Dysfunction (adrenal fatigue) in the past, it’s much more likely that prolonged calorie restriction and continuous stress are the main causes. However, if you already have HPA axis dysfunction, then a low carb diet could be an additional stress on your body that is best avoided. Heal first, and then give Keto a try to lose extra weight.
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How to do Keto in a safe way?
A lot of the potential negative side effects of Ketogenic diets are caused by three things…
- Not eating enough calories for a prolonged period,
- Not eating a healthy and varied diet that actually provides your body with vitamins and minerals and other much-needed nutrients, and
- Not drinking enough water.
…and these are mistakes you could make no matter which diet you choose to go on!
That’s why we suggest you follow the tips below and enjoy your Keto diet and lifestyle.
8 Tips to ensure you do Keto in a safe way:
1. Eat plenty of leafy green vegetables
Supplement with a greens powder if necessary!
2. Make sure to nourish your gut
Eat fermented foods like kimchi and coconut yogurt and kefir. Take probiotics as well to boost your friendly gut bacteria.
But also remember to get enough prebiotic fiber (from vegetables) to ensure your friendly gut bacteria flourishes instead of dies off!
Most people on a ketogenic diet may need to supplement with additional prebiotic fiber to ensure they get enough fiber (since most Keto folks don’t eat enough veggies for fear of getting too many carbs).
3. Always use high-quality ingredients in your cooking
If it’s within your budget, then go for grass-fed beef, pastured pork, free-range chicken, and organic produce.
Food quality does make a difference to your health.
4. Stick to only healthy fats
Hydrogenated cooking fats high in omega-3s like sunflower oil, soybean oil, and canola oil can cause long-term inflammation.
That’s why it’s better to stick with fats like coconut oil, olive oil, tallow, lard, and ghee.
5. Avoid low-carb junk foods
While diet sodas and sugar-free chocolate bars fall within the ketogenic macros framework, they are still not healthy for you.
Make long-term health your goal and you’ll see not only short-term weight loss but also a decrease in health problems down the road.
6. Add healing nutrient-dense foods to your diet
Food isn’t just macros (carbs, protein, and fat). Food is designed to provide you with calories for energy but also vitamins and minerals to ensure your entire body functions like a well-oiled machine.
So don’t just eat chicken breast with butter! Add other nutrient-dense foods into your diet, like:
- seafood (like oysters and sardines)
- organ meats (like liver)
- bone broth
- green leafy vegetables (like spinach and kale)
7. Drink plenty of water and add in electrolytes
This will help you get over the keto flu as well as avoid feeling tired and getting dehydrated.
8. Remember to eat!
A lot of people find that they’re not very hungry on a low carb diet, and so they forget to eat. While this might be great for helping you to lose weight in the short-term, it’s not a good plan long-term.
So, remember to eat and fill up with healthy fats, lots of green leafy vegetables, and nutritious seafood.
Long-term Effects of a Keto diet
There aren’t any scientific studies showing that following a keto diet long term causes any serious negative side effects.
Here are some of those long-term studies on Ketogenic and low carb diets:
One-year study of low carb dieters showed a decrease in risk of heart disease
A one-year study followed 63 folks: half of them were on a low-carb diet (similar to keto) and half were on a conventional weight loss diet.
By the end of the year, the low-carb dieters showed a greater decrease in their risk of heart disease. And no diet-caused health problems had been reported.
You can read the study here.
Six-month study found low carb to be better for short-term weight loss without increased risk of heart disease.
A six-month study followed 53 women: half followed a very low carb diet (similar to keto) and the rest were on a more conventional calorie-restricted diet.
After six months, it was found that the very low-carb diet was better for short-term weight loss and did not cause an increased risk of heart disease.
You can check out the study here.
56-week study of the ketogenic diet found it to be beneficial for obese patients with high cholesterol
In this study, 66 obese but healthy participants were observed before and after a Keto diet. Total cholesterol, LDL, and triglycerides were found to have decreased whereas HDL increased.
You can read the study here.
Ketogenic diets have been used for long-term treatment of epilepsy in children
Some folks with epilepsy stick to a very strict ketogenic diet for decades in order to reduce the frequency of their seizures.
In this study, the children studied had been on a ketogenic diet for between 6-12 years.
While some slowed growth side effects were observed, those could be due to eating a keto diet low in nutrients (like vegetables) which causes malnutrition.
But these could be avoided by eating a healthier keto diet with more vegetables, healthy fats, and no processed foods. Plus, supplementing with vitamins, green powders, probiotics, and prebiotic fiber.
Conclusion & The Best Way to Use Keto
The Keto diet is a safe and effective tool you can use to boost your weight loss and increase your energy levels.
But there are some folks who should be cautious when trying keto:
- Anyone who’s currently clearing up existing health conditions (e.g an autoimmune disease) – it’s best to heal your autoimmune condition first before trying keto
- Folks with Type 1 diabetes – watch out for ketoacidosis
- Pregnant women and breastfeeding moms – you may need to add in more carbs
For everyone else, here’s a great way to use Keto:
- Use the Keto diet for 1-2 months – You’ll get into nutritional ketosis, so you’ll lose some excess weight and increase your mental clarity.
- After that period – Switch back to a higher carb diet which is still very clean and full of healthy foods, like Paleo.
- Then use Keto whenever you need it – If you want shed a bit more fat or if you need a boost of mental focus for a project, then go back to the keto diet for a while until you meet your goals.
Keto is a tool for you to use. Learn about it, try it out, and personalize it for your lifestyle.
Is the keto diet safe? Yes!
But remember that health is a life-long journey, not a crash diet!