Health Benefits and Risks of Keto Diet

Ruth Keller
Ruth Keller
April 27, 2023
min read
Technically reviewed by: 
Charisse Cartin
Health Benefits and Risks of Keto Diet

The keto lifestyle is popular for its many benefits. Apart from its success in weight loss, the ketogenic diet (or keto diet) also has several other health and metabolic advantages. Being overweight exposes you to multiple health hazards, including diseases of the heart, kidneys, bones, and joints and some types of cancer. Keto diets reduce your risks of these health hazards by helping you lose excess weight.

The diet may also help you reduce or reverse insulin resistance, lower your blood pressure, and alter your health and metabolic markers in several beneficial ways. However, the keto diet is rather restrictive and opens you to nutritional deficiencies. Recent research suggests it may increase your risk of heart disease and other significant disorders.

What Is the Keto Diet?

The ketogenic diet, or keto diet, was first used in the nineteenth century as a treatment for diabetes. About a hundred years ago, it was found effective in treating children with epilepsy that could not be controlled with drugs. It is also used for some types of cancer and polycystic ovary syndrome (PCOS). With the obesity epidemic sweeping the world, weight loss diet plans are in high demand, and the keto diet has emerged as one of the most popular.

The ketogenic diet consists of a diet plan high in fat and low in carbohydrates. This makes it unusual since most weight loss plans (Atkins, Paleo, South Beach, and others) are high in protein rather than fats. Keto diets provide as much as 70% to 80% of your daily calorie requirements as fats. Most ketogenic diets prescribe 10 to 50 grams of carbohydrates a day, one gram of protein per kilogram of body weight, and the remaining calories from fat.

The keto diet is one of the most popular diet plans for weight loss. Unlike other weight loss plans, the keto diet is a low-carbohydrate, high-fat plan that forces the body to switch from glucose to fats as a source of energy. Apart from weight loss, it has also been used for treating diabetes, incurable epilepsy, some types of cancer, and the polycystic ovary syndrome (PCOS).

Using fats for energy generates ketones, an alternative to glucose. The altered metabolism of the keto lifestyle raises levels of ketones in the bloodstream (ketosis) and alters blood lipids, insulin secretion, blood sugar levels, and several other crucial metabolic systems.

The rise of ketone levels in the blood is called ketosis.

Health Benefits of the Keto Diet

Weight Loss

Though the keto lifestyle has various health benefits, most people getting on are seeking weight loss. People who can follow the diet plan diligently certainly benefit. A study published in the American Journal of Clinical Nutrition found that a low-carbohydrate diet was more effective than a medium-carbohydrate diet in achieving weight loss. People on the low-carbohydrate diet consumed fewer calories and felt less hunger during the study period.

The ketogenic diet is proven to promote weight loss.

Carbohydrate restriction itself results in significant weight loss compared to conventional calorie-restricted diets. Including enough protein (1.05 grams per kilogram body weight) ensures retaining fat-free, lean body mass. A keto diet helps you achieve weight loss, prevent muscle loss, and preserve lean body mass.

Most weight-loss plans restrict fats in the food plan. According to a study published in the British Journal of Nutrition, people on a keto diet lose significantly more weight in the long term than those on a low-fat diet. The keto lifestyle works in several ways:

  • Eating less carbohydrates reduces the secretion of ghrelin and insulin, the appetite-enhancing hormones.
  • Ketones in the blood also reduce appetite.
  • Eating large quantities of fats suppresses the appetite.
  • Converting fats and proteins to glucose uses up energy.

Reduced Insulin Production

Insulin is a vital hormone produced by the pancreas. It is essential for glucose to enter cells and has an important role in diabetes. Insulin also aids in using proteins and fats for energy, the storage of energy, and other functions.

A study conducted by the University of Milan and associated centers found that the ketogenic diet reduces insulin secretion and insulin levels in your blood after a meal. The levels of C-peptide, a marker of insulin production, are also lower on the keto diet. A meal on the keto diet needs less insulin production than a similarly nourishing Western or Mediterranean meal.

Reduced insulin production and blood levels can prevent or reduce the insulin resistance caused by high insulin levels after meals. People with insulin resistance (those with type 2 diabetes mellitus, T2DM) would benefit from a keto diet since such meals require only small amounts of insulin.

Improved Glycemic Control

Keto diet prevents the sharp rise in blood glucose levels after meals.

The low carbohydrate content of keto diets prevents the sharp rise in blood glucose levels after meals containing higher amounts of carbohydrates. A research article in the American Journal of Physiology found that low-carbohydrate, high-fat diets, with or without exercise, improved glycemic control in people with T2DM.

People on these diets also had lower levels of inflammatory markers. Since inflammation is associated with the causation of T2DM, keto diets may benefit people with this disorder in a number of ways.

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Health Risks of the Keto Diet

Effects on Blood Lipids

The keto diet includes significant amounts of fats, including saturated fats. Saturated fats increase your blood cholesterol levels (dyslipidemia), which puts you at high risk of heart disease.

A recent study presented at the American College of Cardiology's annual conference found that low-carbohydrate, high-fat diets were associated with elevated blood levels of low-density lipoproteins (LDL cholesterol). The lead author of this study states that the keto diet can increase blood levels of LDL cholesterol and enhance the risk of heart disease.

Unsupervised keto diet can increase blood cholesterol levels, elevating the risk of heart diseases.

However, not all studies have found harmful changes in the blood levels of triglycerides, LDL, and high-density lipoprotein (HDL) in people on keto diets. A study with 307 participants conducted by the University of Colorado found that such diets resulted in lower blood levels of LDL and triglycerides and higher blood levels of HDL. Reduced triglycerides and increased HDL are associated with better heart health. Blood pressure readings were also lower, reducing heart risk.

Nutritional Deficiencies

The keto lifestyle avoids important members of the six important food groups (vegetables, fruits, grains, dairy, protein foods, and oils). Keto diets are not balanced diets and can cause deficiencies in dietary fiber, vitamins, and minerals. Calcium, iron, magnesium, phosphorus, and potassium are insufficient on a keto diet, as are vitamins B and C.

Acid-Base Balance

All your body systems and processes work best in a slightly alkaline state. Altering this pH harms many essential metabolic functions, and ketosis is a known danger. Excessive ketones in the bloodstream (ketosis) can cause a lowering of the pH, a situation called ketoacidosis.

Ketoacidosis is a dangerous situation, and people with diabetes are at risk. However, a review in Missouri Medicine states that people in good health are able to maintain a normal acid-base balance in spite of ketosis.

Financial Burden and Social Isolation

Since the ketogenic diet calls for strict guidelines, keto-friendly meals may not be readily available everywhere. Specially-cured keto-friendly meal plans and keto snacks can increase the financial burden on consumers.

The ketogenic diet may also increase your risk of social isolation. You may also find it difficult to participate in meals with friends and family due to the dietary restrictions. According to a Harvard study, social isolation directly impacts our health and happiness. 1 in 5 Americans report that they are lonely. Undesired chronic social isolation increases the risks of diseases and mental health issues.

The Keto Lifestyle

A normal (non-ketogenic) balanced diet provides 45% to 65% of its calories in the form of carbohydrates, with saturated fats making up less than 10% of the energy. The keto lifestyle requires you to cut out carbohydrates and eat a diet rich in fats.

Keto diet comprises of meals and snacks high in fats and low on carbs, such as nuts and seeds.

Your diet plan will include:

  • fatty cuts of meat (rather than lean)
  • nuts
  • seeds
  • avocado
  • oily fish
  • lard
  • butter

What you can't eat is of prime importance. Carbohydrate-rich foods like bread, corn, potatoes, rice, cereals, pasta, and cookies are all prohibited. Beans and legumes — good sources of proteins — are either not included or are allowed in small amounts. Fruits, with their significant carbohydrate content, are also prohibited.

Most keto diet programs advise following such a diet until you have achieved the desired goal. After that, you can follow the keto diet intermittently to maintain a healthy weight.

Keto diets are radically different and include a lot of fats and very little of the foods that provide starchy carbohydrates. Usual staples like cereals, fruits, beans, and pulses are often eliminated completely, creating the potential for nutritional deficiencies.

Ketogenic diets provide great benefits but can potentially harm your health if not followed in a supervised manner. Creating an effective keto diet food plan needs expert knowledge to meet both your weight loss and nutritional requirements.

  1. Harvard TH Chan School of Public Health: Diet Review: "Ketogenic Diet for Weight Loss."
  2. McGaugh, E., & Barthel, B. (2022). A Review of Ketogenic Diet and Lifestyle. Missouri Medicine, 119(1), 84–88.
  3. Johnstone, A. M., Horgan, G. W., Murison, S. D., Bremner, D. M., & Lobley, G. E. (2008). Effects of a high-protein ketogenic diet on hunger, appetite, and weight loss in obese men feeding ad libitum. The American Journal of Clinical Nutrition 2008; 87 : 44–55.
  4. Krieger, J., Sitren, H., Daniels, M., Langkamp-Henken, B. Effects of variation in protein and carbohydrate intake on body mass and composition during energy restriction: a meta-regression. The American Journal of Clinical Nutrition 2006; 83: 260-274.
  5. Gjuladin-Hellon T., Davies I, Penson P., Baghbadorani R. Effects of carbohydrate-restricted diets on low-density lipoprotein cholesterol levels in overweight and obese adults: a systematic review and meta-analysis. Nutrition Reviews 2019; 77: 161–180.
  6. Bueno, N., De Melo, I., De Oliveira, S., & Da Rocha Ataide, T. Very-low-carbohydrate ketogenic diet v. low-fat diet for long-term weight loss: A meta-analysis of randomised controlled trials. British Journal of Nutrition 2013; 110: 1178-1187.
  7. Battezzati A, Foppiani A, Leone A, De Amicis R, Spadafranca A, Mari A, Bertoli S. Acute Insulin Secretory Effects of a Classic Ketogenic Meal in Healthy Subjects: A Randomized Cross-Over Study. Nutrients 2023; 15 :1119.
  8. Myette-Côté, É., Durrer, C., Neudorf, H., Bammert, T. D., Botezelli, J. D., Johnson, J. D., DeSouza, C. A., & Little, J. P. The effect of a short-term low-carbohydrate, high-fat diet with or without postmeal walks on glycemic control and inflammation in type 2 diabetes: a randomized trial. American Journal of Physiology. Regulatory, Integrative and Comparative Physiology 2018; 315:  R1210–R1219.
  9. National Health Service: "Eating a balanced diet."
  10. The University of British Columbia. "Popular keto diet may be linked to higher risk of heart disease, cardiac events."
  11. Foster G., Wyatt H., Hill J., Makris A., Rosenbaum D., Brill C., Stein R., Mohammed B., Miller B., Rader D., Zemel B., Wadden T., Tenhave T., Newcomb C., Klein S. Weight and metabolic outcomes after 2 years on a low-carbohydrate versus low-fat diet: a randomized trial. Annals of Internal Medicine 2010; 153: 147–157.
  12. U.S. Department of Agriculture: "Dietary Guidelines for Americans 2020-2025."
  13. Kenig, S., Petelin, A., Poklar Vatovec, T., Mohorko, N., & Jenko-Pražnikar, Z.  Assessment of micronutrients in a 12-wk ketogenic diet in obese adults. Nutrition 2019; 67-68: 110522.
  14. R. Waldinger and M. Schulz, “The Good Life,” Simon & Schuster, 2023.
About the Author
Ruth Keller

Ruth Keller is a seasoned medical reporter and healthcare writer with over 25 years of experience in the industry. With a passion for uncovering and sharing the latest developments in medicine and healthcare, Ruth has established herself as a trusted and respected voice in the field.

With a deep understanding of healthcare's scientific, social, and political dimensions, Ruth is known for her ability to translate complex medical concepts into clear and accessible language.

As a senior writer for Diagnox, Ruth has the opportunity to work with a team of professionals from various scientific backgrounds and share her knowledge with a broad audience. Whether she is writing about the latest research on disease prevention or the importance of proper nutrition, Ruth is always looking for ways to educate and empower readers to take control of their health.

Ruth continues her passion for healthcare using her extensive knowledge and expertise to inform and educate the public on the most pressing issues in healthcare.

About the Reviewer
This blog was
Technically reviewed by: 
Charisse Cartin

Charisse Cartin is a talented and dedicated editor who has contributed significantly to this blog.

The blog was also reviewed by the Diagnox content team. Diagnox Staff consists of a multidisciplinary team of scientists, content writers, and healthcare professionals with an expertise to create and review high-quality, informative, accurate, and easy-to-understand content for both professionals and everyday readers. Our staff follows strict guidelines to ensure the credibility and authenticity of the information, reviewing them independently and verifying them by various scientific and technical sources to ensure accuracy. Our review team believes in delivering knowledge free from bias to improve public health and well-being.

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