The ketogenic diet is an extremely low-carb diet that replaces carbohydrate-rich foods with fats and proteins. Though this diet has become a recent trend, it can be very difficult to maintain (I mean, have you ever ditched bread for more than a week?).
More importantly, it may have some health drawbacks, including deficiencies in important electrolytes.
How Does the Ketogenic Diet Work?
In a regular diet, the body converts the carbohydrates in food into a form of sugar called glucose, also known as blood sugar. In a ketogenic (keto) diet, the lack of carbohydrates forces the body to burn fat for energy instead of glucose, according to Harvard Health Publishing.
When the body breaks down fat, it creates molecules called ketones through a process known as ketosis. When the body starts using ketones instead of glucose for energy, that fat-burning state is known as ketosis. So the ultimate goal of the keto diet is to maintain ketosis at all times.
To achieve ketosis, a person can only eat 20 to 50 grams of carbs per day, per Harvard Health Publishing. To put that in perspective, two slices of bread contain about 30 grams of carbs. The daily recommended carb intake for the average adult is 45 to 60 grams of carbs per meal, according to the American College of Cardiology.
As you can tell, the keto diet is very restrictive. And because of the lack of diet variety, following it can result in a keto mineral deficiency.
Why You Need More Electrolytes on Keto
Sodium (salt) and potassium are critical electrolytes the body needs to function properly, according to the Centers for Disease Control and Prevention. These electrolytes work hand in hand, and starting the keto diet can cause low sodium and potassium levels.
Read more: What Are Electrolytes, Anyway?
When the body starts to use ketones for energy instead of sugar, insulin levels drop. Insulin is the hormone that manages blood sugar and while lower insulin levels are generally a good thing, it can also cause a person to lose sodium at the start of the keto diet, according to the Cleveland Clinic.
Insulin causes salt and water retention. But when insulin levels drop and a person stops retaining so much water, they can lose a lot of sodium through urine, the Cleveland Clinic states. And, because sodium and potassium are closely linked, a person can lose potassium through urine as well, according to Harvard Health Publishing.
This loss of electrolytes can result in what's known as the "keto flu." Symptoms can include dizziness, weakness and exhaustion. To address this, the Cleveland Clinic recommends staying hydrated with sufficient electrolyte replacement (sodium, potassium and magnesium).
So how do you make up for this? Sodium is easy to add into any diet — simply reach for the salt shaker and add a bit more. That's true for potassium, too, which is found in lots of fruits and vegetables. But if you're trying to avoid sugary fruit due to the high carb content, you can look to other potassium-packed produce such as avocados, broccoli, beet greens, tomatoes, spinach and squash, according to the University of Michigan. Potassium can also be found in seeds, nuts, milk and soy milk.
You can also get sodium and potassium by drinking electrolyte drinks, like sports drinks or Pedialyte, or by taking dietary supplements.
Cautions of Doing the Keto Diet Long-Term
If you're considering a keto diet, you should know that many health professionals do not consider it a healthy plan.
Bonnie Taub-Dix, RDN, creator of BetterThanDieting.com and author of Read It Before You Eat It: Taking You from Label to Table spoke with LIVESTRONG.com about some of the drawbacks of the keto diet. "A keto diet is 75 to 85 percent fat. I don't believe in any diet that's as off-balance as that one. I don't think it's sustainable and I don't think it's healthy," Taub-Dix says.
Experts at the Mayo Clinic add that such an extremely low-carb diet can have a number of side effects. These include constipation, headaches and bad breath. Additionally, cutting fruits and whole grains out of your diet can make it more difficult to meet your daily micronutrient needs, including potassium. The Mayo Clinic stresses that there is very little research to show this diet is effective for weight loss or even safe in the long-term.
The keto diet is certainly not appropriate for everyone. But there is strong evidence that it is very beneficial for certain people.
The keto diet is "a standard of care for treatment-resistant epilepsy," according to the Cleveland Clinic. The diet has been shown to effectively reduce seizures in children, sometimes just as well as medication. This diet is also being researched to address other neurological conditions. Early studies show the keto diet may improve Alzheimer's disease, autism or certain brain cancers — but much more research is needed to confirm these findings.
The keto diet has also been shown to be initially effective in both weight loss and blood sugar control for people with type 2 diabetes, per Harvard Health Publishing. However, there is currently no research about the long-term health benefits — or safety — of this diet.
If you're considering starting the keto diet, discuss your plans with your health care provider to figure out if it's right for you.
Read more: 5 Possible Risks of a Keto Diet
- Harvard Health Publishing: "Ketogenic Diet: Is the Ultimate Low-Carb Diet Good For You?"
- American College of Cardiology: "Diabetes: How to Count Carbohydrates"
- Centers for Disease Control and Prevention: "The Role of Potassium and Sodium in Your Diet"
- Cleveland Clinic: "A Functional Approach to the Keto Diet with Mark Hyman, MD"
- Harvard Health Publishing: "Potassium and Sodium Out of Balance"
- University of Michigan: "Potassium Content of Foods"
- Mayo Clinic: "The Truth Behind the Most Popular Diet Trends of the Moment"
- Cleveland Clinic: "What Is the Keto Diet (and Should You Try It)?"