Long term, isn't keto kinda silly?

[slackerinabox]

I just quit after two months of keto and, after a really uncomfortable amount of time feeling miserable (keto flu, constipation, sweaty constantly, muscle cramps) am now just watching what I eat to much better results. I did lose quite a bit at first on keto then averaged out to the standard 2 poundsish a week - I'm getting the same results but without all the gross side effects. Nutrient intake's the biggest issue for me - I was cramping up constantly because, no matter how much green leafy veggies I ate, I never got enough potassium (and supplements provide a max 2% of your recommended allowance), not a problem now at all. Charting a few weeks into my more sensible diet's showing similar results that's recently accelerated after I massively increased my fruit and veg intake, without the discomfort and honest expense of a protein/fat heavy diet (without the concern that a tiny slice of b-day cake will cause me to gain 5 pounds while feeling miserable). Most concerning with keto was what I'd call an "awareness" of my heart - palpitations, exhaustion, a weirdly high resting heart beat, etc - and I wasn't pounding high sodium lunch meat either. I just feel much better these days.

I do know that keto's genuinely helpful to many people but, long term, is it really as viable as all the hype makes it seem? Is keto more the fad of the moment than a real solution?

 

[ArchAngel777]

Keto is not just a fad. When fat cells shrink, water takes their place and the body eventually flushes the system of this water and all of a sudden, overnight, you look much leaner. This often happens with a carb-up meal. If I had to guess, several of the pounds you lost from a "balanced" diet were actually lost while on keto, and didn't flush out until your balance diet which is leading you to believe balanced diet worked better.

That said, a balanced diet will lose weight just fine. Keto isn't magical, it is just easier to adhere to from a hunger perspective. However, if you are happier on a balanced diet, then that is better for you.

Keto is probably best for non-active people. For active people, get this can get muddy... Endurance sports work well with keto, but explosive sports do not. Additionally, keto is often very anti-inflammatory, so endurance training has less aches and pain.

Keto works great for many people. I often go keto for 2 months a year. I don't have any of the problems you are reporting, nor do I understand how you possible couldn't get enough potassium on greens. If you truly at as many as you said, then your cramping had nothing to do with potassium.

 

[dasherHampton]

I think where a person comes from matters as well.

I started Atkins (a non-zero carb diet) on Jan 3. I've lost about 25 pounds and I feel great. I've added things like peas and carrots back into my diet.

My problem was my pre-Atkins diet. WAY too much fast food. That stuff is so unhealthy when it comprises too high of a % of your overall intake. No way is a low carb diet worse for you than eating too much crap.

 

[Kaido]

It really depends on the person & their situation. If following through on your intentions was as easy as we think it is, then everyone would be walking around with a six-pack, haha!

My personal food philosophy has boiled down to this, over time:

1. If you don't care about results, eat whatever you want, whenever you want.

2. If you do care about result (ex. losing fat or building muscle) & want to get the best results (because why would you settle for sub-par methods?), then simply follow IIFYM. Because:

a. It works
b. It's sustainable, because you don't have to give up the foods you love
c. No supplements or meal timing or special dietary requirements are involved...just eat according to your macros every day, which are goal-oriented against weight loss, maintenance, or gain
d. You can adjust it to your individual needs, i.e. if you're diabetic & have to babysit your daily carb intake
e. It forces you to actually make food, so you have food to eat (I'm easily distracted & sometimes work through lunch or run out the door in the morning without breakfast, otherwise)
f. It's defendable, because it's how your body works - it uses macros, which add up to calories, which controls your weight, which gives you the results you're after (lose/maintain/gain) over time when followed strictly

IIFYM is annoying at first, because hitting your numbers every day requires some prep work & learning how to count & measure your food is a pain, but it gives the best results of anything I've ever used. You can go through my post history here on H&F...I think my first thread was back in 2008 when I was like 50 pounds overweight. I had no idea what TDEE or macros or anything were, but I had made a decision to get in shape, and my initial approach was doing the "clean eating" thing, which was not fun, but did help me lose weight. After that, I went through a variety of dietary approaches (vegan, raw vegan, fruitarian, vegetarian, keto, paleo, you name it) just to shake things up. I'm a bit of a slow learner & didn't settle on macros until almost a decade later, but I'm happily sticking with it these days! And really, the only reason I stick with it is because I have an excellent meal-prep system, which lets me separate out the work so that everything is pretty easy to do.

 

[JJChicken]

Everybody is different. Losing weight is partly motivational (to break bad habits and follow a good routine). I used to do the low carb approach with great success, now I’m slowly getting back into it.

But as I get older I’m moving more to complex carbs and veggies vs a heavy meat / protein diet

 

[whm1974]

Yes Keto Is a Fad Diet, that may have short term results, but could have dire long term consequences.

I would simply eat a balance diet, and low consumption of package, junk, and fast food.

 

[Mai72]

We don't know t he long term consequences. 5, 10, 20 years later. TBH, most people who do keto do it for the wrong reasons, and they do it wrong. They eat dirty keto foods like bacon all the time. They go off, go on, go off, etc. They yoyo all the time which can have huge negative effects than just eating the typical American diet. I tried keto. Wasn't for me. But, I've kept my good fat intake in a good range. I'll still have my pasta with unsalted butter. Coconit oil on the side. I still eat a ton of healthy greens. Avacados are awesome. I'll eat one a day. The good fats will help with the carbs, and slow down the carb to sugar process. I just bought a Contour Next glucose monitor. I'm going to try it out tomorrow. I'll test my blood sugar level in a fasted state. 30 minutes after my first meal which is a 1500 calorie Nutribuller. Then 1 hour later. In that NB I have oats, banana, spinach, kale, peanut butter, avacado, flax seed oil, greens powder, collegen powder, protein, and a few other things. I'm very curious. Will my blood sugar level go thru the roof, or will it still be in the safe range because of the good fats.

 

[whm1974]

Get a blood Sugar Meter, that will tell if your blood sugar if in the right range.

 

[WhiteNoise]

Keto works great. I have done it twice myself without any of the issues the OP is mentioning.

 

[RPD]

Yes Keto Is a Fad Diet, that may have short term results, but could have dire long term consequences.

I would simply eat a balance diet, and low consumption of package, junk, and fast food.

What dire long term consequences?

 

[Kaido]

What dire long term consequences?

When anyone is presented with anything new & gets attached to it (i.e. love at first sight or "blind hope"), you have to ask yourself 3 questions:

1. What do I want to be true?
2. What do I hope to be true?
3. What do I fear to be true?

Imagining that something is true vs. doing some research to find out how things really are are two very different things. I use a little auditing checklist in situations like this:

1. Just because someone says something
2. Even if they say it with confidence
3. Even if they say it with authority
4. Even if they really believe it
5. Doesn't mean its true

This is mostly because of three things:

1. Once someone says something, it's out on the public stage & in your head
2. We tend to believe experts without question
3. People who get results & have success don't necessary understand the full extent of the real root causes of why they got good results

I'll use myself as an example:

1. I got married about 15 years ago & took a desk job & gained like 50 pounds
2. I had never been overweight in my life, so in 2008 I decided to get in shape
3. I created several motivational & tracking posts right here on H&F over the years; I initially started out with clean-eating - plain chicken breast, broccoli, sweet potatoes, etc. & got great results
4. However, it wasn't sustainable, and truth be told, I had no idea what I was doing nutritionally; I tried many diets over the years to experiment with food (keto, paleo, vegan, etc.), all with great results of keeping me in shape
5. But it wasn't until I learned about macros, TDEE, how my digestive system really worked, etc. that I began to truly understand how things actually operated & why I was getting the results I was getting
6. I eventually switched to IIFYM, probably a few years back now, and have been enjoying that ever since - I have an introductory guide here
7. That doesn't give me a free pass to eat junk food 24/7, but it's a sustainable approach that works off the principles of how your body actually works

So the problem in the public headspace with keto is twofold:

1. A lack of education about where keto came from, what it was designed for, and how it actually operates
2. A lack of actual, medical, long-term studies on adults under non-therapeutic (i.e. non-medically-supervised) management of a keto diet

Let's start with the history of keto & some of the risks:

Sorry, keto fans, you're probably not in ketosis

The keto diet was never supposed to be fun.

www.popsci.com

The TL;DR is that the keto diet was used as a medical treatment to treat epilepsy in childrens & infants under the care of of trained nutritionists & physicians. Getting an adult body into true ketosis & stay that way is hard & comes with risk, once you really dig in & research how keto truly, actually works in the human body:

Of course, ketosis itself comes with its own risks. Circulating ketone bodies make your blood too acidic, and your body will draw calcium from your bones as a buffer. This also happens in ketoacidosis, which is when you have so many ketone bodies that it becomes dangerous and will draw far more calcium out of your bones. Giancoli notes that dieters usually aren't in such an extreme starvation mode that they develop ketoacidosis. There are few to no studies on healthy adults undertaking a non-therapeutic ketogenic diet, but studies of epileptic children on the diet show increased bone demineralization and high calcium levels in the blood.

The high fat content in the diet, especially if you're eating saturated fats, can raise your cholesterol levels and contribute to developing cardiovascular disease. Without the fiber from whole grains and fruits, you're also likely to get constipated and have other digestive issues. Plus you need fiber to maintain a health gut microbiome, which tends to come from the kind of whole grains that you can't eat on the diet, and though it is possible to get enough fiber from vegetables on the keto diet you have to carefully monitor your eating to ensure that. Neither Giancoli nor Fung any of the other dietitians and nutritionists who evaluated keto for a recent US News & World Report diets ranking would recommend it. Many of them said they had serious concerns about long-term safety of doing keto. Though you may very well lose weight, most people on most diets gain the weight back (and sometimes even more) when they go off the diet, which many dieters do because radical shifts in what you eat are hard to maintain for long periods of time.

Just getting recipes off Pinterest & listening to a few podcasts isn't necessarily going to get you into true medical-grade ketosis, which has some risks if you don't have an extremely carefully-designed meal plan:

Keto weight loss is mostly a sham

Like your opinion on most fad diets, your thoughts on keto and ketosis are probably based on rumors. Here's what the science says.

www.popsci.com

One passage from the article:

Eating 90 percent fat isn't good for your heart health, and though limiting your carbs is generally a positive thing, the excessive limitations of keto make it hard to get the nutrients of a "balanced" diet. You're taking in almost no fruit and, unless you're vigilant about eating a ton of leafy green vegetables, you're limiting most of your fiber sources and missing out on some essential nutrients. Epileptic patients require careful meal planning to make sure they're still getting everything they need, but fad dieters often don't put the same thought into their daily food. It's hard to design a whole diet when you're not a professional nutritionist.

As it turns out, the argument that people like the Inuit, who eat a high-fat diet, were "good to go" doesn't pan out too well either:

“There’s not a single historic traditionally living human population that was in chronic nutritional ketosis,” Guyenet pointed out. Even the Inuit, who mainly subsisted on fatty whale, seals, and fish, were not in chronic ketosis because they developed genetic mutations that prevented them from overproducing ketones.

Another article:

The keto diet, explained

Is eating a lot of fat really the best way to lose weight?

www.vox.com

Another common effect of the ketogenic diet is “keto flu”: fatigue, lightheadedness, and dizziness people feel when they greatly reduce their carb intake. This effect should go away after the body adjusts to the diet, but staying on keto for a long time could lead to kidney stones, high cholesterol, constipation, slowed growth (in young people), and bone fractures. We actually don’t know whether keto is safe in the long term.

Among other things:

Ketogenic Diet

What is the ketogenic diet? The "classic" ketogenic diet is a special high-fat, low-carbohydrate diet that helps to control seizures in some people with epilepsy. It is prescribed by a physician and carefully monitored by a dietitian. It is usually used in children with seizures that do not...

www.epilepsy.com

Are there any side effects? A person starting the ketogenic diet may feel sluggish for a few days after the diet is started. This can worsen if a child is sick at the same time as the diet is started. Make sure to encourage carbohydrate-free fluids during illnesses. Other side effects that might occur if the person stays on the diet for a long time are:

• Kidney stones
• High cholesterol levels in the blood
• Constipation
• Slowed growth
• Bone fractures

What most enthusiasts of any diet do is stick their heads in the sand, don't bother digging in too deeply to find out what the real story is behind any diet (the "blind hope" thing), and because they get results (i.e. weight loss), they correlate their behaviors with the consequences & think everything is OK. For keto in particular, according to the current set of available data, the long-term impact of the keto diet on an adult body with a non-medically-supervised & carefully-designed keto meal plan has not been studied, and there are known risks with doing it both incorrectly & correctly.

On the flip side, anyone is free to do anything. People smoke, drink, do drugs, jump out of airplanes with parachutes, live off fast-food & junk food, eat sporadically, binge-eat, etc. So is eating a keto diet a step up from what many people do to their bodies already, and will it help make them healthier, at least in the short-term? I'd argue yes. I've really grown to love learning about nutrition - if you're interested in keto, there are a LOT of benefits that people experience, and there's a really good podcast that I listen to on my often long commutes that covers a lot of the modern science & results of doing keto:

2 Keto Dudes - Ketogenic Lifestyle Podcast

The ketogenic diet and lifestyle in plain English

2ketodudes.com

Personally, I vacillate between the see-food diet & IIFYM. Sometimes I just eat whatever, but most of the time I'm eating against my macros. I still eat plenty of fast-food all the time (and count it against my macros), but I've also learned how to cook better & do meal-prep in order to get more whole, real foods into my diet, simply because I have more energy & I feel better doing so. And that doesn't mean being restrictive - again, you can eat whatever "if it fits your macros". Also, the one argument I'd make in favor of a low-carb diet, aside from food allergies or intolerances & personal perferences, is if you have insulin issues (hypoglycemic, pre-diabetic, diabetic Type II or Type I, etc.). There's an excellent TED Talk by Dr. Sarah Hallberg, who has an excellent argument about how eating 20 grams of carbs or less per day can reverse Type II diabetes in most cases & how that can affect your life from a health perspective:

So kind of the TL;DR is people are going to do whatever they want, but it pays to be aware of the history & risks of doing new things, because it's really easy to be an ostrich, stick your head in the sand, and say something like "yay fat!" & eat bacon non-stop without stopping to take a look at the big picture & all of the elements behind the concept of things like the keto diet.

 

[ArchAngel777]

So kind of the TL;DR is people are going to do whatever they want, but it pays to be aware of the history & risks of doing new things, because it's really easy to be an ostrich, stick your head in the sand, and say something like "yay fat!" & eat bacon non-stop without stopping to take a look at the big picture & all of the elements behind the concept of things like the keto diet.

Although I agree in large part with your analysis, I think it is important to note that that "eat bacon non-stop" characterization of Keto is no different than the characterization of IIFYM to "eat junk food to hit macros". They can both be used improperly and probably are by most people, to some large extent. But that doesn't make those two diet methods inherently unhealthy. You do, in fact, have entire people groups who subsisted on fatty meaty diets, with zero vegetables and zero grains. Clearly, we are a very complex organism capable of running on many different fuel mixtures.

 

[Kaido]

Although I agree in large part with your analysis, I think it is important to note that that "eat bacon non-stop" characterization of Keto is no different than the characterization of IIFYM to "eat junk food to hit macros". They can both be used improperly and probably are by most people, to some large extent. But that doesn't make them unhealthy. You do, in fact, have entire people groups who subsisted on fatty meaty diets, with zero vegetables and zero grains. Clearly, we are a very complex organism capable of running on many different fuel mixtures.

Absolutely! I lived off nothing but junk food for many, many years & still survived somehow, lol. That's why I have the bit at the end - is keto 100% completely safe? The science is still TBD on that. But is it healthier than what probably the majority of people eat? I'd argue probably yeah.

The more I've dived into nutritional research, the more shocked I've become at just how little we know about nutrition. We do know some things:

1. The minimum food requirements needed to keep you alive
2. How to keep coma patients alive when they can't eat normally (or Soylent, if you're just a lazy cook like me lol)
3. How to get shredded using IIFYM

But there's so much more to food, nutrition, and digestive science that we just have nooooooo clue about. I'm hugely interested in the microbiome right now, which is just beginning to take off in the medical field. I've struggled with low-energy, ADHD, allergies, and other health issues for most of my life, and everything was primarily tied to food & more recently undiagnosed sleep apnea. My life has gotten enormously better as a result of getting more educated about my health & taking action steps to implement that knowledge, and I'm really looking forward to what the next 10 or 20 years of medical science has to offer regarding all of this stuff about how we eat! On a tangent, this is another really good TED Talk that I enjoyed:

 

[RPD]

When anyone is presented with anything new & gets attached to it (i.e. love at first sight or "blind hope"), you have to ask yourself 3 questions:

1. What do I want to be true?
2. What do I hope to be true?
3. What do I fear to be true?

Imagining that something is true vs. doing some research to find out how things really are are two very different things. I use a little auditing checklist in situations like this:

1. Just because someone says something
2. Even if they say it with confidence
3. Even if they say it with authority
4. Even if they really believe it
5. Doesn't mean its true

This is mostly because of three things:

1. Once someone says something, it's out on the public stage & in your head
2. We tend to believe experts without question
3. People who get results & have success don't necessary understand the full extent of the real root causes of why they got good results

I'll use myself as an example:

1. I got married about 15 years ago & took a desk job & gained like 50 pounds
2. I had never been overweight in my life, so in 2008 I decided to get in shape
3. I created several motivational & tracking posts right here on H&F over the years; I initially started out with clean-eating - plain chicken breast, broccoli, sweet potatoes, etc. & got great results
4. However, it wasn't sustainable, and truth be told, I had no idea what I was doing nutritionally; I tried many diets over the years to experiment with food (keto, paleo, vegan, etc.), all with great results of keeping me in shape
5. But it wasn't until I learned about macros, TDEE, how my digestive system really worked, etc. that I began to truly understand how things actually operated & why I was getting the results I was getting
6. I eventually switched to IIFYM, probably a few years back now, and have been enjoying that ever since - I have an introductory guide here
7. That doesn't give me a free pass to eat junk food 24/7, but it's a sustainable approach that works off the principles of how your body actually works

So the problem in the public headspace with keto is twofold:

1. A lack of education about where keto came from, what it was designed for, and how it actually operates
2. A lack of actual, medical, long-term studies on adults under non-therapeutic (i.e. non-medically-supervised) management of a keto diet

Let's start with the history of keto & some of the risks:

Sorry, keto fans, you're probably not in ketosis

The keto diet was never supposed to be fun.

www.popsci.com

The TL;DR is that the keto diet was used as a medical treatment to treat epilepsy in childrens & infants under the care of of trained nutritionists & physicians. Getting an adult body into true ketosis & stay that way is hard & comes with risk, once you really dig in & research how keto truly, actually works in the human body:


Just getting recipes off Pinterest & listening to a few podcasts isn't necessarily going to get you into true medical-grade ketosis, which has some risks if you don't have an extremely carefully-designed meal plan:

Keto weight loss is mostly a sham

Like your opinion on most fad diets, your thoughts on keto and ketosis are probably based on rumors. Here's what the science says.

www.popsci.com

One passage from the article:


As it turns out, the argument that people like the Inuit, who eat a high-fat diet, were "good to go" doesn't pan out too well either:


Another article:

The keto diet, explained

Is eating a lot of fat really the best way to lose weight?

www.vox.com

Among other things:

Ketogenic Diet

What is the ketogenic diet? The "classic" ketogenic diet is a special high-fat, low-carbohydrate diet that helps to control seizures in some people with epilepsy. It is prescribed by a physician and carefully monitored by a dietitian. It is usually used in children with seizures that do not...

www.epilepsy.com

What most enthusiasts of any diet do is stick their heads in the sand, don't bother digging in too deeply to find out what the real story is behind any diet (the "blind hope" thing), and because they get results (i.e. weight loss), they correlate their behaviors with the consequences & think everything is OK. For keto in particular, according to the current set of available data, the long-term impact of the keto diet on an adult body with a non-medically-supervised & carefully-designed keto meal plan has not been studied, and there are known risks with doing it both incorrectly & correctly.

On the flip side, anyone is free to do anything. People smoke, drink, do drugs, jump out of airplanes with parachutes, live off fast-food & junk food, eat sporadically, binge-eat, etc. So is eating a keto diet a step up from what many people do to their bodies already, and will it help make them healthier, at least in the short-term? I'd argue yes. I've really grown to love learning about nutrition - if you're interested in keto, there are a LOT of benefits that people experience, and there's a really good podcast that I listen to on my often long commutes that covers a lot of the modern science & results of doing keto:

2 Keto Dudes - Ketogenic Lifestyle Podcast

The ketogenic diet and lifestyle in plain English

2ketodudes.com

Personally, I vacillate between the see-food diet & IIFYM. Sometimes I just eat whatever, but most of the time I'm eating against my macros. I still eat plenty of fast-food all the time (and count it against my macros), but I've also learned how to cook better & do meal-prep in order to get more whole, real foods into my diet, simply because I have more energy & I feel better doing so. And that doesn't mean being restrictive - again, you can eat whatever "if it fits your macros". Also, the one argument I'd make in favor of a low-carb diet, aside from food allergies or intolerances & personal perferences, is if you have insulin issues (hypoglycemic, pre-diabetic, diabetic Type II or Type I, etc.). There's an excellent TED Talk by Dr. Sarah Hallberg, who has an excellent argument about how eating 20 grams of carbs or less per day can reverse Type II diabetes in most cases & how that can affect your life from a health perspective:

So kind of the TL;DR is people are going to do whatever they want, but it pays to be aware of the history & risks of doing new things, because it's really easy to be an ostrich, stick your head in the sand, and say something like "yay fat!" & eat bacon non-stop without stopping to take a look at the big picture & all of the elements behind the concept of things like the keto diet.

That is quite the word salad. But you really didn't state the _DIRE_ long term consequences. People bouncing back and forth the two states are usually what contributes the constant "keto flu" issues. I don't know anyone that does keto that a) does 90% fat for food consumption and b) eats bacon non-stop. When I hear those terms (keto or low carb) I think of eating a mostly protein/meat diet balanced with greens. It was brought up in another thread, but the history of eating meat and greens for humans is pretty much everything before modern farming aka the last ~1-2 thousand years (being generous here). Our digestive/genetic makeup hasn't generally changed much since then, but advances in hygiene and medicine have (the reason life spans have greatly increased).

I think the easiest and simplest solution for most people to lose weight and eat healthier is to reduce the amount of carbs one consumes. I never realized just how many carbs are EVERYWHERE in foods I'd never think twice about. Read labels and be cognizant of what goes in your body.