Ask any keto diet devotee and they’re going to tell you that the high-fat, low-carb diet plan delivers real results: Lots of people who follow the restrictive plan lose weight, and unlike with other diets they may have tried, they do not experience hunger or deprived.
But the keto diet also has its downsides. For starters, its entire premise is based on a complex metabolic state known as ketosis, in which the body is instructed to burn fat instead of carbohydrates for energy. It is sometimes complicated to send the body into ketosis, says Melissa Bailey, RD, a clinical dietitian in the Hospital of the University of Pennsylvania, in order to keep it there to have an longer timeframe of your time.
“Even within the hospital under strict controls, when we send patients into ketosis for medical reasons, it may be extremely difficult to do,” says Bailey. “On your personal, it’s virtually impossible to do it consistently.”
Nutritionists aren’t the only real ones who say going keto can be challenging. Online forums and blogs are filled with stories of newbie keto mistakes and misconceptions, too. Here are some of the biggest blunders people have a tendency to makeCand the biggest concerns health experts have.
The keto diet limits individuals to just 20 to 50 grams of carbohydrates a day and encourages increasing fat intake to make up for the missing calories. That already goes against most nutritionists’ recommended ratio for any balanced diet, says Bailey-but it’s much more concerning when people choose mainly saturated fats to fill that gap.
“I know people following keto, and lots of times I’m simply because there’s a lot of bacon in their day, or perhaps a large amount of really processed meat,” says Bailey. “And those activities are super-high in sodium and super-high in saturated fats, which can really affect your cardiovascular health.”
Although evidence linking saturated fats to cardiovascular disease continues to be mixed, one of the largest and most recent studies on the subject found that individuals who ate probably the most saturated fat were 18% more likely to develop coronary heart disease compared to those who ate the least. The U.S. dietary guidelines currently recommend limiting saturated fat to a maximum of 10% of your daily calories.
“If people want to follow this diet, there is a method of getting that extra fat in your diet but still choose healthy fats,” Bailey says. “But not enough people are by taking your extra step.”
Eliminating entire foods or food groups-like milk or grains, both of which are off-limits (or near to it) around the keto diet-can result in deficiencies of certain micronutrients, says Bailey. Dairy is a good source of calcium, for example, while bread and cereal are often enriched with iron or magnesium.
“When you’re limiting those sources, you’re not going to get exactly the same nutrients when you eat bacon and steak,” says Bailey. “Anytime you eliminate something out of your diet, I recommend speaking with your physician or perhaps a nutritionist about going for a supplement in its place.”
Then again, Bailey adds, supplements often contain glucose or other types of sugar as filler ingredients. (Some prescription and over-the-counter pharmaceuticals do, too.) “In some cases, taking supplements or medications can in fact keep people from achieving ketosis,” says Bailey, “which goes back to the idea that achieving ketosis really isn’t an easy or sustainable goal.”
It’s important to stay hydrated on any diet, but keto dieters often cite this as you big mistake they’ve made once they started on their new plan. A big part of the drop in pounds that people see within their first few weeks originates from lost water weight, says Bailey; if that water does not get replenished, it can result in constipation and bring about the crappy feeling referred to as keto flu.
When a commenter on Reddit recently asked people to share their biggest keto screw-ups, several chimed in with warnings about maltitol, a sweetener used in many keto-friendly products. (Low-carb snack bars containing the ingredient were “delicious,” one individual stated, “but the incoming gastrointestinal apocalypse isn’t worth it.”)
It’s correct that maltitol along with other sugar alcohols may cause diarrhea and bloating, especially when consumed in big amounts. That’s one good reason it’s a good idea to choose whole foods or homemade meals over processed and packaged foods with long lists of ingredients, says Bailey, even when you’re going keto.
Cutting back on carbs sounds fairly simple: Just give up eating bread and pasta, right? This is a good start, but actually, there are numerous other foods that contain carbohydrates-including some that are traditionally regarded as proteins or fats.
“Didn’t know milk isn’t keto,” one commenter wrote with that same Reddit thread. “I was chugging milk like there’s no tomorrow whenever I’d a sugar crave [sic].” Another commenter shared a similar anecdote: “Ditto! How many carbs can be in a sugar-free latte?! Lots.”
The problem with keto, says Kristen Kizer, RD, a dietitian at Houston Methodist Clinic, is the fact that there’s not a lot of room for this type of error. “Overconsumption of carbs is certainly very easy,” she says. “And if you are eating carbs and not realizing it-unless your are monitoring your ketones regularly-you’re going to drop out of ketosis and never know it.”
The keto diet does produce fast results, Kizer admits: People have a tendency to lose weight quickly, that is one good reason the program is so popular. But, she notes, they almost always gain it when they try to transition from keto to a less restrictive, more sustainable method of eating.
Even more worrisome, she adds, is always that people initially have a tendency to lose both fat and muscle. The pounds they gain back, on the other hand-due to alterations in their muscle mass and metabolism-tend to be a higher percentage of fat.
Bailey agrees that the together with your keto diet, besides short-term weight loss, are questionable. “There aren’t any long-running studies to exhibit what this really is doing to our overall health,” she says, “and we all know when you’re eating a lot of saturated fats, it may possibly be harmful.”
That’s why Bailey doesn’t recommend the keto diet for weight loss or overall health reasons, even temporarily. “And if you really are passionate about giving it a try, ask your physician or a nutritionist that will help you come up with a plan which includes healthy foods in healthy proportions,” she says. It is possible for most of us to follow along with a low-carb diet in ways that’s not harmful, she adds, “but it will take work and smart choices.”