CNN reported in December that the #1 health-related question that hit Google last year was “What is the Keto Diet?” If you’re still wondering “What is the Keto Diet?”, check out our blog post from December 3rd.
The fact that this diet approach has gained popularity and interest is undeniable. It is less agreed across the health community whether the Keto Diet is as universally beneficial for the mass of interested individuals. In this second post of the series, we take a balanced approach to Keto to help you determine, “Is Keto Right for You?”
We can’t start this subject without first making a statement about food quality. Consider both of these example meals below. Both fit within Keto Diet macronutrient guidelines, but each would have vastly different effects in the body.
In the first meal, 44% of the fats are saturated, whereas in the second meal only 14% of the fats are saturated. The first meal has fewer vitamins, minerals and fiber. As you can see by this example, the Keto Diet is no different from any other eating plan – it’s important not to lose sight of nutrient balance.
Once we have a Keto Diet that is nutritionally balanced, what are other considerations before applying the Keto Diet?
Keto & stress
Making the change necessary to adopt the Ketogenic Diet can be pretty stressful on its own. What do I eat at work? What do I eat when I dine out? How do I travel? There are loads of cookbooks, blogs and resources out there to help you, but anyone who’s implemented this diet will tell you that it’s a significant change to your lifestyle. Change adds stress to your body.
When your body is under stress, whether from mental, emotional or physical, the body releases the hormone cortisol. Under periodic stressful situations, cortisol drives the body to produce glucose and its counterpart hormone, insulin. It doesn’t require added glucose from your food to do this – only a small amount is needed and your body stores enough for these kinds of stressors. (This is unique in states of high endurance exercise and is a separate topic.) Incorporating a new diet should be a short-term stress that decreases as we adapt our lifestyle.
However, what if you already have high amounts of stress all of the time? When our bodies experience prolonged chronic stress, we can experience symptoms associated with a condition known as “Adrenal Fatigue”, or better defined as HPA (Hypothalamus Pituitary Axis) Dysfunction. In this state, our body’s response to cortisol is muted, or thrown out of balance, and all sorts of other symptoms take over, such as: fatigue, difficulty sleeping, inability to lose weight or blood sugar imbalance. In this state, the body relies more on dietary glucose to meet the demands of cortisol.
Starting a Keto Diet if you have any signs of HPA Disfunction may make your symptoms worse. If you answer “yes” to one or more of these questions below, you should seek support before implementing the Ketogenic Diet on your own. There may be other health changes to make first.
- Are you a new parent? Or someone who has individuals you care for that take priority over sleep?
- Do you take sleep aids to fall asleep or stay asleep?
- Are you chronically highly stressed?
- Are you on medications for anti-anxiety?
- Do you have a diagnosed thyroid disorder?
- Are you a high intensity exerciser?
Keto & digestion
This is a subject that is vast and deep; and for Keto, the research is still new and mostly observational. When it comes to digestion, there are so many other influencing factors – the biggest being the foods that you eat.
Keto and the microbiome
The microbiome (bacteria, fungi and other microbes that support your body’s internal garden) of your gut rely on food from carbohydrates, called microbiota-accessible carbohydrates (MACs). If the Keto Diet is too restrictive of these fibers, then some people may experience a disruption in the microbiome which can create a negative cascade effect over time.  A carbohydrate-restrictive diet is commonly used curatively, as with antimicrobials to prune an overgrowth of gut bacteria or yeast. However, a diet that starves out the beneficial bacteria isn’t good either.
The Keto Diet undeniably alters the gut microbiome but whether positively or negatively depends largely on the individual’s current biome as well as the application of the diet. A 2018 study was conducted using the Keto Diet that measured the changes to the gut microbiome and the impacts it had on brain health for epileptic children. In the study, 20 patients with epilepsy were treated with a Keto Diet. After 6 months, half of the group showed seizure reduction by more than 50% or seizures had stopped completely. What the researchers found was that the microbiome species that were altered actually improved the health of the patients and concluded that the Keto Diet should be considered in treatment for epilepsy. 
In this test for epilepsy, the starving of the microbiome from carbohydrates was a good thing. We don’t yet know how the Keto Diet will affect other health conditions. With any application of the Keto Diet, it is important to make sure the body has what it needs to support a healthy balanced microbiome: probiotics -live bacteria used to help populate the gut microbiome, and prebiotics- the food for the bacteria. Kefir, kimchi and other fermented vegetables along with garlic, onion, dandelion greens, artichoke, asparagus, and flaxseeds are all supportive of the microbiome and are Keto-friendly.
Keto and fat digestion
The ability to use the fats in your diet for energy depends largely on your body’s ability to digest and assimilate them. The liver produces bile that is concentrated in the gall bladder and released when you eat in order to break down fat molecules. Additionally, digestive enzymes called lipases are released by the pancreas to aid in the digestion of fats. If fat is not broken down, it cannot be used and travels quickly through the digestive tract and out in the stool. If your body isn’t currently breaking down dietary fat well, adding more fat, all at once, is going to create digestive discomfort and you won’t be able to use it for energy.
Fiber is important in this process, as well. Soluble fiber helps to slow down the transit and adds bulk to stools. It is also responsible for binding up the bile so that it’s not recirculated. Since fiber isn’t broken down into glucose it doesn’t affect blood sugar. You can support digestion on the Keto Diet by counting net grams of carbohydrates (total carbohydrates minus total grams of fiber).
In summary, starting a high-fat, low carbohydrate Keto Diet if have digestive issues related to an imbalance of yeast or bacteria in your microbiome may be helpful or harmful. Additionally, an existing difficulty digesting dietary fat intake may make your symptoms worse. If you answer “yes” to one or more of these questions below, you should seek support before implementing the Keto Diet on your own.
- Do you have compromised liver function?
- Have you had your gallbladder removed?
- Do your stools float? Are they yellow in color? Do you see an oily residue left in the toilet?
- Do you have pancreatitis or a history of pancreatitis?
- Have you had a history of GI issues related to digestion or motility (SIBO, IBD, ulcerative colitis)?
Other reasons to get support before considering keto
There are a variety of other health conditions in which the Keto Diet should be assessed first. Consult a professional before implementing if you:
- Are pregnant or breastfeeding
- Have type 1 diabetes
- Have active type 2 diabetes
- Have elevated triglycerides
- Are on any medications that impair kidney function (such as metformin)
- Have or have ever had an eating disorder
- Are underweight or have <10% body fat to lose
The application of the Keto Diet may be part of your overall health path, but you may have some prerequisites or special considerations. Keep in mind that results can be achieved at varying levels. Or, the Keto Diet doesn’t have to be right for you, right now.
Celebrate your own individuality!
There is more than one way to achieve your health goals.