In recent weeks we have heard that the keto diet is associated with a number of side effects ranging from bad breath to something called a keto crotch.
The good thing about these issues is that they become apparent to us pretty early on, giving us a chance to make the necessary changes to our diet should we not be so fond of these unwanted side effects.
Far less frequently mentioned is that dramatic changes to dietary intake can have profound health consequences over time, and it can be months or even years until we realise this.
Here are a few to be aware of if keto is your thing…
When dietary intake suddenly shifts from plant based eating where fruits, vegetables, legumes and grains are consumed regularly, to literally no plant matter at all it is not surprising that the body misses its daily fibre and constipation results. For some keto fans this issue may resolve over time, especially if special attention is paid to consuming plenty of vegetables and fruits that are low in sugars but in general dietary fibre intake is relatively low on any keto plan. As a high intake of dietary fibre is associated with gut health, chronically low intakes of dietary fibre may in turn have digestive consequences long term.
When entire food groups are eliminated, so too are key nutrients. The issue with this is that it is unlikely we are aware of these deficiencies as we need some of these specific nutrients in relatively small amounts and they gradually become depleted over time. As keto fans will often eliminate dairy in favour of nut based milks, and too may be watching their daily intake of protein rich foods, Vitamin B12 can take a substantial daily hit as can iron and zinc. A low intake of Vitamin B12 over time can cause fatigue, nerve pain, low mood, dizziness and mouth ulcers and is becoming increasingly common as more people follow strict diets that eliminate a number of food groups.
Chronically low calcium intake
Like dietary fibre, calcium too tends to take a real beating for those who strictly follow a keto regime. With relatively high recommendations of 800-1000mg of calcium per day for optimal bone health as we age, it is challenging to reach anywhere near these targets when no dairy, soy or fortified milks are being consumed. The key thing to keep in mind with a chronically low intake of calcium is that the effect on bone health will not be felt for several years, when it may be too late to undo the damage to the bones that has led to osteopenia or osteoporosis. This is not to say that there is anything wrong with choosing not to eat dairy or follow keto, but you may need to add a calcium supplement into the mix to preserve the health of your bones as you get older.
Weight regain is easy
When you are following keto, it will work like a charm BUT when you stop, falter or slip back into your old lifestyle patterns you will regain weight quickly, and find it more and more difficult to lose again each time you try. One of the reasons for this is that unlike more gradual fat loss regimes that combine calorie deficits with exercise, keto programs that do not include training will result in significant amounts of muscle loss. As muscle is the metabolically active tissue, the less of it we have, the fewer calories we burn. As such losing weight quickly on keto is one thing, but long term there will be some reduction in metabolic rate which will make weight control more difficult long term if you are not strict with your keto diet, or diet in general.
It may impact heart disease risk
As keto tends to achieve relatively quick weight loss, in many cases improvements in blood fats, blood pressure and blood glucose levels are reported, but not always. While some individuals may respond well metabolically to keto, there are also plenty who do not, especially if they do not get the right types of fats in their diet mix. From a population health perspective, a high fat diet is associated with an increased risk of developing a number of chronic diseases. For this reason if you are choosing to follow keto, it is crucial that you also keep an eye on your medical markers to ensure you are getting the proposed benefits and not the potential side effects.