Dangers of Ketosis: How Safe Is the Keto Diet Really?

The untimely death of Bengali actress Mishti Mukherjee has reopened the debate on the dangers of the keto or other fad diets. According to her doctors, the actress developed kidney complications and ultimately died of renal failure which was attributed to a keto diet followed by her.

However, the diet has recently gained popularity as a quick way to reduce weight and has been endorsed by a number of nutritionists and celebrities across the world and even Netflix released a documentary, “The Magic Pill” which explored the benefits of the ketogenic diet.

What Is the Keto Diet and How Safe Is It Really?

The ketogenic diet entails reducing carbohydrates to less than 5% of your total calorie intake and consuming the rest of the calories primarily from proteins and fats. Typically, a keto diet is composed of 75:20:5 ratio of fats, proteins and carbohydrates.

This makes the body produce energy through breaking down fat directly by forming ketones. Thereby making the body extremely efficient in burning fat and eventually reducing weight.

While the diet has gained popularity recently because of its ability to drastically reduce weight, it has been used since the early 1900s to treat medical conditions such as epileptic seizures and PCOD.

However, the debate around the keto diet has divided professionals - highlighted by the trial of Professor Tim Noakes. In 2014, Professor Tim Noakes, a South African scientist, and an emeritus professor in the Division of Exercise Science and Sports Medicine at the University of Cape Town, was reported to the Health Professions Council of South Africa for giving unprofessional dietary advice. He was advocating a low-carb, high-fat diet in a tweet.

The Health Professionals Council of South Africa (HSPCA) accused him of “unprofessional conduct” for giving “unconventional” advice to a breastfeeding mother.

Following four years of litigation and investigation, in 2018, Tim Noakes was adjudged not guilty and the panel held that the tweet was scientifically correct and could cause no potential harm.

While the keto diet has its benefits, it has to be followed in the correct way.

A common misconception is that the keto diet is a high fat and a high protein diet, which is not the case. Not only will an excess of proteins inhibit the body from entering ketosis (the liver can turn protein to glucose), it can also raise the acidity levels of the body, thereby increasing pressure on the kidneys.

This might also lead to kidney stones and in rare cases, renal failure. Studies are ongoing to observe the long-term effects of the keto diet on kidneys and other organs.

Another risk presented by the keto diet is that it might raise the harmful cholesterol levels in the body, especially when the fats consumed are highly processed and filled with trans fats.

Since the keto diet restricts several foods, especially nutrient-dense fruits, whole grains, and legumes, it may fail to provide recommended amounts of vitamins and minerals. In particular, some studies suggest that the keto diet doesn’t provide enough calcium, vitamin D, magnesium, and phosphorus.

Should You Do Keto?

The answer to this question is really simple. That is, if you ask your doctor or a certified nutritionist.

The keto diet proposes a radical shift in your nutritional intake. Therefore, you must consult a professional before starting the diet. Certain pre-existing conditions such as chronic kidney disorder can be aggravated through this diet. Moreover, it is imperative that you conduct regular blood tests to assess your lipid profiles and check other nutrient levels in your blood. No diet is universally beneficial, and is especially dangerous when not followed properly.

The Right Way to do Keto

1. High Quality Fats:

By high quality, we mean fats that are high in Omega 3 Fatty Acids and have no trans fats. One of the classic keto mistakes is to consume fats through processed vegetable oils, processed butter and processed cheese. Instead, you should always choose organic sources like virgin olive oil, virgin coconut oil, avocados and organically fatty food such as avocados and salmon.

2. High Quality Moderated Quantity Proteins:

As with the quality of fats, it is important to incorporate high quality proteins in your diet. It is important to choose proteins that are preferably organically raised and grass fed in case of animal fats. Always choose proteins that are high in omega 3 fatty acids and aim to have a variety of proteins and not get the proteins from once source only. A healthy mix for non-vegetarians would be to rotate between fish, chicken, organic red meat and eggs. Processed food such as salamis and sausages should be strictly avoided. For vegetarians, protein rich sources such as spinach and almonds should be prioritised over dairy proteins such as paneer.

3. Nutritional Supplements:

Some studies suggest that the keto diet doesn’t provide enough calcium, vitamin D, magnesium, and phosphorus. Over time, keto may lead to nutrient deficiencies. Notably, guidelines for clinicians who manage people on a very low-calorie keto diet for weight loss recommend supplementing with potassium, sodium, magnesium, calcium, omega-3 fatty acids, psyllium fiber, and vitamins B, C, and E. The nutritional adequacy of this diet depends on the specific foods that you eat. A diet rich in healthy low carb foods, such as avocados, nuts, and non-starchy vegetables, provides more nutrients than processed meats and keto treats.

4. Gut-Friendly Food:

Since the keto diet restricts carbs, it can be difficult to meet your daily fiber needs. Some of the richest sources of fibre, such as high carb fruits, starchy vegetables, whole grains, and beans, are eliminated on the diet because they provide excess carbohydrates. As a result, the keto diet can lead to digestive discomfort and constipation. Therefore, it is necessary to eat adequate amount of keto-friendly foods that are high in fibre include flax seeds, chia seeds, coconut, broccoli, cauliflower, and leafy greens.

The Bottomline

The keto diet is very radical as it adopts a completely inverted approach to nutrition when compared to conventional dietary habits. While studies suggest multiple benefits, the keto diet has its risks and should not be adopted without consulting a certified nutritionist and a doctor. Even while on the keto diet, it is important to keep monitoring your health. Lastly, in order to minimize risks and achieve results, you should only eat organic and whole foods and eliminate processed foods from your keto diet.

(The author is a lawyer turned business intelligence consultant turned chef. He also designs weekly and monthly meal plans for clients and conducts baking and cooking workshops.)