While a ketogenic diet is considered to be safe for most people, it does have some potential drawbacks.
Some people experience mild adverse effects when starting a ketogenic diet, and this is sometimes referred to as “keto flu”.[1] The symptoms include nausea, abdominal discomfort, vomiting, fatigue, and headache. These symptoms are likely to resolve within a few weeks.[2] Due to a very low carbohydrate intake leading to a low fiber intake, constipation is also a possibility.[3]
Another potential drawback is the effect that a diet high in fat can have on lipid profiles. This effect varies between individuals, but in some people the ketogenic diet can cause a significant increase in total cholesterol and LDL cholesterol. This could have a serious effect on the risk of cardiovascular disease, and care should be taken in recommending this diet to people with high cholesterol and other cardiovascular risk factors.[4][5][6][7][8][9][3]
The high fat and low fiber intake may increase the risk of developing kidney stones, which are extremely painful and can have serious consequences.[1] The restrictive nature of the ketogenic diet could lead to vitamin and mineral deficiencies in some people.[1]
Another significant drawback to the ketogenic diet is that it can be very difficult to adhere to such strict dietary limitations. A decrease in adherence over time may contribute to the decrease in effectiveness seen in the long term after initial improvements in the short term.[3]
In people who are prone to hypoglycemia (low blood sugar) and people who use insulin, the ketogenic diet should be started with caution. Close monitoring of glucose levels is important, because a sudden drop in blood glucose can be dangerous. Furthermore, the ketogenic diet is not safe for people with certain medical conditions, including porphyria, pancreatitis, liver failure, and disorders of fat metabolism.[1][10]
References
- ^Wajeed Masood, Pavan Annamaraju, Kalyan R. UppaluriKetogenic Diet
- ^Castellana M, Conte E, Cignarelli A, Perrini S, Giustina A, Giovanella L, Giorgino F, Trimboli PEfficacy and safety of very low calorie ketogenic diet (VLCKD) in patients with overweight and obesity: A systematic review and meta-analysis.Rev Endocr Metab Disord.(2020-Mar)
- ^Mohamed Rafiullah, Mohthash Musambil, Satish Kumar DavidEffect of a very low-carbohydrate ketogenic diet vs recommended diets in patients with type 2 diabetes: a meta-analysisNutr Rev.(2021 Aug 2)
- ^Amini MR, Askarpour M, Ghalandari H, Gholizadeh M, Pouraram HEffect of ketogenic diet on blood pressure: A GRADE-Assessed systematic review and meta-analysis of randomized controlled trials.Nutr Metab Cardiovasc Dis.(2024-Apr)
- ^Choy KYC, Louie JCYThe effects of the ketogenic diet for the management of type 2 diabetes mellitus: A systematic review and meta-analysis of recent studies.Diabetes Metab Syndr.(2023-Dec)
- ^Joo M, Moon S, Lee YS, Kim MGEffects of very low-carbohydrate ketogenic diets on lipid profiles in normal-weight (body mass indexNutr Rev.(2023-Mar-17)
- ^Parry-Strong A, Wright-McNaughton M, Weatherall M, Hall RM, Coppell KJ, Barthow C, Krebs JDVery low carbohydrate (ketogenic) diets in type 2 diabetes: A systematic review and meta-analysis of randomized controlled trials.Diabetes Obes Metab.(2022-Dec)
- ^Bueno NB, de Melo IS, de Oliveira SL, da Rocha Ataide TVery-low-carbohydrate ketogenic diet v. low-fat diet for long-term weight loss: a meta-analysis of randomised controlled trialsBr J Nutr.(2013 Oct)
- ^Zhou C, Wang M, Liang J, He G, Chen NKetogenic Diet Benefits to Weight Loss, Glycemic Control, and Lipid Profiles in Overweight Patients with Type 2 Diabetes Mellitus: A Meta-Analysis of Randomized Controlled Trails.Int J Environ Res Public Health.(2022 Aug 22)
- ^Watanabe M, Tuccinardi D, Ernesti I, Basciani S, Mariani S, Genco A, Manfrini S, Lubrano C, Gnessi LScientific evidence underlying contraindications to the ketogenic diet: An update.Obes Rev.(2020 Oct)