The ketogenic, or "keto," diet has gained immense popularity as a weight-loss strategy and therapeutic intervention. Characterized by a strict reduction in carbohydrate intake, high fat consumption, and moderate protein intake, the keto diet aims to shift the body's primary fuel source from carbohydrates to fats, inducing a metabolic state known as ketosis. In ketosis, the body burns fat in the form of ketones, instead of carbohydrates as its main fuel source.
However, the prevalence of misinformation surrounding the keto diet has led to numerous myths and misconceptions. This article aims to debunk these common myths, providing a clear understanding of the keto diet and its potential implications.
Understanding the Keto Diet
Before diving into the myths, it's essential to clarify what the keto diet entails. The ketogenic diet is a strict low-carb, high-fat, and moderate-protein plan that sends the body into a state of 'ketosis'. This metabolic shift involves drastically reducing carbohydrate intake, typically to around 20-50 grams per day, and increasing fat consumption to account for approximately 70-75% of daily calories. Protein intake is moderate, making up about 20-25% of daily calories.
Key Components of a Keto Diet:
- High Fat Intake: 70-75% of daily calories
- Moderate Protein Intake: 20-25% of daily calories
- Very Low Carbohydrate Intake: 5-10% of daily calories (20-50 grams per day)
Debunking Common Keto Myths
Myth 1: Keto Is a High-Protein Diet
Reality: The keto diet is often mistaken for a high-protein diet due to the inclusion of protein-rich foods like meat, fish, eggs, and dairy. However, while moderate amounts of protein are permitted, the majority of calories on a keto diet come from fat. The body converts protein to glucose, which may disrupt your ability to stay in ketosis and burn fat as your prime fuel.
Myth 2: Keto Is the Same as Low Carb
Reality: Keto is not the same as low carb. While both diets restrict carbohydrate intake, the keto diet is significantly more restrictive. Keto typically limits carbs to 20-50 grams per day, equivalent to one small boiled potato, whereas low-carb diets generally allow for 50-130 grams per day. In addition, a low-carb diet may be quite high in protein, but with keto it’s important to consume protein in moderation while keeping fat levels high.
Read also: Easy Low-Carb Cheese Crackers
Myth 3: A Keto Diet Is the Fastest Way to Lose Weight
Reality: Although weight loss can be rapid at the outset (up to 10 pounds or 4.5kg in two weeks), research suggests that, in the longer term (after one year), the effect is the same as other weight loss approaches. The initial rapid weight loss often observed on a keto diet is primarily due to the diet's diuretic effect, leading to water loss. Longevity is key to weight management, and you’ll find that there are much easier paths to weight loss than keto.
Myth 4: Keto Is the Natural Way Humans Should Eat
Reality: The notion that keto is the "natural" human diet is misleading. Fasting is a natural way to bring the body into ketosis, so more likely our ancestors experienced quite a lot of this when food was scarce. Ketosis involves the production of ketones in the body, this process is natural and safe, as the body uses ketones as energy in times of scarcity. During the summer months, it’s likely our cavemen ancestors consumed a lot of fruit, which would be high carb. Equally, after a successful hunt, a lot of meat may have been eaten, which would mean they enjoyed a meal that was relatively high in protein. Both of which suggest it was not a keto approach to eating.
Myth 5: You Can Eat as Much Fat as You Want on a Keto Diet
Reality: While the keto diet emphasizes fat consumption, it's crucial to consider the quantity and type of fat consumed, especially if weight loss is the goal. Excessive amounts of fat will add calorie density and may impede your results. At 9kcal per gram, fat is more calorie-rich than either carbs or protein, which both contribute 4kcal per gram. You should also consider the types of fat. While we do need saturated and unsaturated fats in our diets, too much of one type may have a negative impact on your health. The healthiest way to load up on fats is to limit saturated fats, like bacon and sausage, and to fill your diet with heart-healthy unsaturated fats, like avocados, olive oil, and flaxseed, along with nuts in moderation.
Myth 6: You'll Feel Great on a Keto Diet
Reality: Some people experience unpleasant side effects when they adopt a keto diet, including light-headedness, fatigue, nausea, blood sugar swings, headaches and constipation. Together these symptoms are often referred to as "keto flu". Some followers experience these symptoms as a result of the body’s rapid excretion of fluids, and with it sodium, which happens in response to the diet’s severe restriction of carbs.
Myth 7: Your Body Goes Into Ketoacidosis
Reality: It’s ketosis that causes the fat burn in keto. When you go on a keto diet, you enter ketosis, a metabolic state where your body uses fat for fuel (rather than glucose, its preferred energy source). During this process, the body breaks down fat and converts it into ketone bodies. This is not the same thing as diabetic ketoacidosis, a potentially life-threatening complication of diabetes that happens when your body does not get enough insulin and ketone levels are simultaneously high, according to the Mayo Clinic.
Read also: Keto Calorie Counting: A Detailed Guide
Myth 8: You Can Go On and Off Keto and Still Keep the Weight Off
Reality: Keto cycling is more likely to lead to regaining lost weight. Sometimes, people don’t understand how keto works or can’t keep up with the diet’s restrictions, so they follow the keto diet one day and then eat carbs the next, says Audrey Fleck, RDN, an integrative and functional dietitian nutritionist based in Perkasie, Pennsylvania. In other cases, people deliberately vary their carb intake in a practice known as “keto cycling.” In either case, these inconsistencies won’t allow you to reap the potential benefits of sustained ketosis.
Myth 9: Everyone Has the Same Carb Needs
Reality: How many carbs you should eat really depends on your personal health. When you start a very-low-carb diet like keto, you may not realize how low in carbs it is. Followers typically consume 20 to 50 grams (g) of carbohydrates a day, often beginning on the lower end of that spectrum to help the body enter ketosis. Nonetheless, depending on factors (like physical activity), you may be able to go higher, says Fleck. She recommends teaming up with a dietitian who can calculate your nutritional needs. What’s more, sometimes it’s not even necessary to go keto, she says. “Some people have genetic issues with using fat for energy, making the diet even more difficult or ineffective for them,” says Fleck.
Myth 10: Keto Gives You Permission to Eat as Much Bacon and Butter as You Want
Reality: Keto calls for prioritizing unsaturated fat in your diet. Yes, keto is a diet rich in fats. But that doesn’t mean you’re supposed to fry up a pound of bacon in the morning. “The ketogenic diet doesn’t give you the green light to eat all types of fats,” says dietitian Jill Gulotta, RDN, based in White Plains, New York.
Myth 11: Because Veggies and Fruits Can Be High in Carbs, You Can’t Eat Them on Keto
Reality: You need to eat produce to avoid constipation, a nasty keto side effect. Fruits and veggies are sources of carbohydrates. (The only things that will be carb-free are oils, butter, and meat.) Still, that doesn’t mean you should avoid produce. In fact, these whole, unprocessed foods are important sources of vitamins, antioxidants, and fiber - the latter of which is critical for avoiding constipation, a common keto side effect. Gulotta recommends nonstarchy veggies, like zucchini, cauliflower, cucumbers, peppers, and broccoli, plus small amounts of lower-carb fruits, like berries - think strawberries, raspberries, and blueberries. That said, there are still some healthy foods that are not allowed on the keto diet, so you’ll want to consult the common keto diet food list first.
Myth 12: A Keto Diet Is a Plan That Is High in Protein
Reality: It’s low-carb, but it’s far from the Atkins Diet. Throwing together a bowl of eggs and smoked salmon for breakfast and a big cut of steak for dinner sounds like it’s on plan, but protein needs to be eaten in moderation. (This is also how keto and Atkins differ.) “Excess protein can be converted into glucose, spiking your blood sugar, taking your body out of ketosis,” says Gulotta. What’s more, she points out, “the breakdown of amino acids in protein can also lead to increased ketones, which can be problematic for a keto dieter who already has high levels of ketones in their body,” she says. If you’re unsure about how much you should consume, a registered dietitian can help guide you through the right macronutrient breakdown. You can find one at EatRight.org.
Read also: Magnesium Supplements for Keto
Myth 13: The Keto Diet Is the Best Way to Lose Weight
Reality: There’s no right diet for everyone. Just because your friend lost weight successfully on keto (or it seems as if everyone is talking about it) doesn’t mean keto is the diet that’s best for you. “The biggest misnomer I come across in my practice is that [a keto diet] is the end-all, be-all answer to losing weight,” says Gulotta. There are a lot of trendy diets out there, but in reality, she says, success comes from finding an eating plan that you can be consistent with.
Myth 14: Low-Carb Diets Are Just a Fad
Reality: The term “fad diet” was used for crash weight loss diets that enjoyed short-term popularity. Today, it’s often misused for diets that don’t have common cultural acceptance, including low-carb diets. However, a low-carb way of eating has been shown to be effective in over 20 scientific studies. Plus, it has been popular for decades. Considering the long-term and scientifically proven success of low-carb diets, dismissing this way of eating as a fad seems far-fetched.
Myth 15: Low-Carb Diets Are Hard to Stick To
Reality: Opponents often claim that low-carb diets are unsustainable because they restrict common food groups. This is said to lead to feelings of deprivation, causing people to abandon the diet and regain weight. Still, keep in mind that all diets restrict something - some certain food groups or macronutrients, others calories. Following a low-carb diet has been shown to reduce appetite so that you can eat until satisfied and still lose weight. Scientific evidence does not support that low-carb diets are harder to stick to than other diets.
Myth 16: Most of the Weight Lost on Low-Carb Diets Comes From Water Weight
Reality: Your body stores a lot of carbs in your muscles and liver. When you cut carbs, your glycogen stores go down, and you lose a lot of water weight. Additionally, low-carb diets lead to drastically reduced insulin levels, causing your kidneys to shed excess sodium and water. For these reasons, low-carb diets lead to a substantial and almost immediate reduction in water weight. This is often used as an argument against this way of eating, and it’s claimed that the only reason for its weight loss advantage is the reduction in water weight. However, studies show that low-carb diets also reduce body fat - especially from your liver and abdominal area where harmful belly fat is located.
Myth 17: Low-Carb Diets Are Bad for Your Heart
Reality: Low-carb diets tend to be high in cholesterol and fat, including saturated fat. For this reason, many people claim that they raise blood cholesterol and increase your risk of heart disease. However, some studies suggest that neither dietary cholesterol nor saturated fat have any significant effect on your risk of heart disease. Most importantly, low-carb diets may improve many important heart disease risk factors.
Myth 18: Low-Carb Diets Only Work Because People Eat Fewer Calories
Reality: Many people claim that the only reason people lose weight on low-carb diets is due to reduced calorie intake. This is true but doesn’t tell the whole story. The main weight loss advantage of low-carb diets is that weight loss occurs automatically. People feel so full that they end up eating less food without counting calories or controlling portions. Low-carb diets also tend to be high in protein, which boosts metabolism, causing a slight increase in the number of calories you burn.
Myth 19: Low-Carb Diets Reduce Your Intake of Healthy Plant Foods
Reality: A low-carb diet is not no-carb. It’s a myth that cutting carbs means that you need to eat fewer plant foods. In fact, you can eat large amounts of vegetables, berries, nuts, and seeds without exceeding 50 grams of carbs per day. What’s more, eating 100-150 grams of carbs per day is still considered low-carb. This provides room for several pieces of fruit per day and even small amounts of healthy starches like potatoes and oats. It’s even possible and sustainable to eat low-carb on a vegetarian or vegan diet.
Myth 20: Ketosis Is a Dangerous Metabolic State
Reality: There is a lot of confusion about ketosis. When you eat very few carbs - such as fewer than 50 grams per day - your insulin levels go down and a lot of fat is released from your fat cells. When your liver gets flooded with fatty acids, it starts turning them into so-called ketone bodies, or ketones. These are molecules that can cross the blood-brain barrier, supplying energy for your brain during starvation or when you don’t eat any carbs. Many people confuse “ketosis” and “ketoacidosis.” The latter is a dangerous metabolic state that mainly happens in unmanaged type 1 diabetes. However, this is completely unrelated to the ketosis caused by a low-carb diet, which is a healthy metabolic state.
Myth 21: Your Brain Needs Carbs to Function
Reality: Many people believe that your brain cannot function without dietary carbs. It’s claimed that carbs are the preferred fuel for your brain and that it needs about 130 grams of carbs per day. This is partly true. Some cells in your brain cannot use any fuel besides carbs in the form of glucose. Yet, other parts of your brain are perfectly capable of using ketones. If carbs are reduced sufficiently to induce ketosis, then a large part of your brain stops using glucose and starts using ketones instead. Therefore, because of ketosis and gluconeogenesis, you don’t need dietary carbs - at least not for fueling your brain.
Myth 22: Low-Carb Diets Destroy Physical Performance
Reality: Most athletes eat a high-carb diet, and many people believe that carbs are essential for physical performance. Reducing carbs indeed leads to reduced performance at first. However, this is usually only temporary. It can take your body a while to adapt to burning fat instead of carbs. Many studies show that low-carb diets are good for physical performance, especially endurance exercise, as long as you give yourself a few weeks to adapt to the diet.
Myth 23: Nutrient Deficiencies Are Inevitable on Keto
Reality: This is a misunderstanding just about the ketogenic diet in general. One of the best places is green leafy vegetables. That’s about the most nutrient dense and low carbohydrate food that you can include on a ketogenic diet. And it’s very rich in fiber. There’s some Omega-3s. So, I encourage everyone to have a raw salad every day of some leafy greens. And it doesn’t have to be spinach, it can be a mixture of arugula, spinach, baby lettuce leaves so that it’s interesting. But you know that is a great way to get B vitamins and vitamin A and even vitamin E and even some Omega-3. Nutrition still counts. Food quality still counts. And the term well formulated ketogenic diet is referring to this selection of foods to optimize nutrients and fiber and feed your gut microbiome. These great nutrients that real food has. Well, if someone’s eating dairy, then they’re getting that. So, it just boggles my mind that somebody would say a ketogenic diet is by default deficient in calcium and vitamin D. And then, of course, iron if you’re eating meat, like where do these things come from?
Myth 24: High Fiber Diets are Necessary for a Healthy Microbiome
Reality: High fiber diets have not really been well researched. It’s more based on, I guessing, and looking at the mix of a high carb diet, I have plenty of people getting less than 10 grams of fiber a day who have daily bowel movements, and the recommended fiber intake is 30 grams of fiber a day. You know that’s a huge disparate amount. But what I have come to learn is that there’s a lot more than fiber that affects your microbiome. And one of these is prebiotics. This is a new area of research and there’s non-fiber prebiotics, and olive oil is a rich source, extra virgin olive oil in particular of polyphenols. And the one in particular in olive oil is called oleuropein, and this feeds gut microbiome and makes healthy gut. And you can get a lot of olive oil on a ketogenic diet. And there’s other sources of polyphenols. The dark green leafy vegetables, other vegetables, even sesame oil has some polyphenol in it. So, what science is now turning to is that it’s not just fiber, it’s these non-fiber polyphenol sources of nutrients that microbiota like to consume and that makes healthy bowel movements. And one thing I learned recently, hopefully this isn’t getting too graphic, but two-thirds of the weight of your stool is actually bacteria. Not food stuff. Yeah, two-thirds, that’s huge. So, we want people to have health, excuse me, we want people to have healthy digestion, daily bowel movements. And I’ve been able to work with people to achieve this just by adjusting their intake to better choices. The green leafy vegetables, maybe drinking more fluids, getting magnesium in one of their multivitamins, or even a separate supplement, using herbal remedies, such as, senna teas.
Myth 25: If You're Not Having a Bowel Movement Every Day, It's Constipation
Reality: Just because you’re not having a bowel movement every day, doesn’t by default make it constipation. That there’s a difference between having a perfectly normal bowel movement every two or three days versus being bloated and having pain and discomfort, and that’s the borderline of constipation.
Myth 26: People Who Have Had Their Gallbladder Removed Can't Have High Amounts of Fat
Reality: People without their gallbladder tolerate keto perfectly, just maybe have to go a little bit slower in the transition. When your gallbladder is removed, you actually have a little sack that your body brilliantly creates as the new little pocket for bile acids. So, you compensate and you have this ability to still make bile, still store it away and use it. And I think stool color is absolutely the question that has to be asked because that really tells you if they are making or not making bile.
Myth 27: Sleep Disturbances Are Uncommon on Keto
Reality: A lot of people will report when they start with a ketogenic diet that they have trouble sleeping. I just was with 10 people who I helped initiate a ketogenic diet. I was with them for two weeks, and I ate with them every day. And so I heard all the complaints of keto flu, which only about half of them had. But there were two people in particular that had sleep issues, and one of them, it was hunger. He was waking up hungry, and he knew, he is like, I’m just hungry. I’m like, okay, we could fix that. You just need to eat more, and this was an unrestricted ketogenic diet. I was not calorie controlling at all. But he was trying to be so cautious that he was not indulging himself. And also, he was experiencing ketosis early so his appetite was not robust like it had been. This is a guy that was always hungry. He had about 60 pounds to lose, and he was losing weight fast. In fact, a little bit too fast. I had to talk to him about slowing that down.
Myth 28: Keto Rash Is Uncommon
Reality: That’s another one that some people report, this sort of diffuse rash generally on over their chest, although it can present in different ways, that can be pretty itchy and can be troubling for people getting into ketosis. I’ve looked into this because I’ve had a few people, apparently it occurs more in women and it’s tends to be located in the trunk area and it also in younger people versus older or elderly people.
Myth 29: Keto Always Decreases Bone Density
Reality: There was a study showing increased markers of bone turnover, but I don’t believe there’s ever been a study showing actual decreased bone density or increased risk of fractures. If I hear that concern, I encourage people to go get a. DEXA scan done because really this the best way to do one at baseline. But I can tell you from pediatrics, we did DEXA scans. If anybody was on the diet more than three years, most kids were off in three years, but plenty were because of these genetic metabolic disorders or they kept having seizures. When we tried to take them up, we would do an a DEXA scan and they were fine. They were fine.