The Ultimate Keto Diet Questions and Answers

Common questions about the Keto Diet, by Sherene Kershner, owner of Evolve 180 Weight Loss

Diets seem to go through a lot of fads.  Why is the Keto diet better than others?

I hesitate to use the term ‘The Keto Diet’ since there isn’t really any such thing. That’s shorthand for a diet that relies on the biological state of ketosis to induce the body to burn fat. With that said, I think diets that focus on ketosis keep coming around because of the many proven health benefits associated with them. 

At least half of the population in the US are hyper-sensitive to carbohydrates.  This means that even the amount of carbohydrates in the typical USDA “balanced diet” will cause them to gain weight.  It is not a coincidence that these statistics match the roughly 50% of Americans who are overweight/obese and who have developed either Type 2 Diabetes or pre-diabetes.  Those are diseases with insulin resistance at their core, and ketosis can help reduce and even reverse insulin resistance. 

So if you’re overweight, you’re statistically likely to be carb-sensitive. If you’re carb sensitive, you’ll improve your metabolism (thus lose weight) with ketogenic plans.  That’s why ketogenic diets work so well and are so popular. 

There are rumors the keto diet increases heart risk.  Is the keto diet heart healthy?

If you were to research it yourself, you’d see there are more studies that show improvement in cardiovascular health from ketogenic diets than those showing detriments. 

However, the one caveat to this is that once you adapt to a ketogenic lifestyle (which means increasing DIETARY FAT and non-starchy veggies, moderating protein, and reducing carbs) but then start to “cheat” by adding back carbs without adjusting the other nutrients you’ve been eating, you will regain the weight and all the problems that come with it -- i.e. metabolic syndrome, insulin resistance, and increased risk for heart disease, Type 2 Diabetes, stroke, etc. 

So the most important thing to remember is that while true ketogenic programs can help you lose weight and improve health, going back to your old ways of eating while STILL KEEPING your DIETARY FAT LEVELS high will be a recipe for weight regain and health problems.  This is why a long-term low-carb or keto maintenance plan is just as important - and really MORE important - than the weight loss plan itself. 

Is the keto diet compatible with pregnancy?

Eating in a low-carb or low-glycemic way during pregnancy and breastfeeding can be very healthful as long as your total nutrition is sound.  This is especially true for those who have metabolic syndrome.  But it’s important to note that you should not attempt to lose weight during pregnancy or breastfeeding unless specifically instructed to do so by your OBGYN and under the supervision of a Registered Dietician.  Caloric restriction during pregnancy and breastfeeding can reduce nutrients available to the baby and harm their health. Dieting in general is not recommended during pregnancy or breastfeeding.  But moderating carbohydrate intake may be beneficial - as long as you’ve checked it out with your doctor. 

Should a person take supplements during the keto diet?

There is no ‘one size fits all’ recommendation for this. A proper ketogenic plan is adapted specifically for you. Some folks need some extra potassium or magnesium. Others like to use electrolyte mixes or branched chain amino acids.  But for some people, these supplements may cause undesirable or even dangerous effects if they are combined with other factors like prescription medications. It’s important to have a proper health screening and expert customization before you begin a ketogenic program to determine what’s right for you. 

But if there is one supplement that comes closest to being a ‘universal’ requirement for feeling good during a ketogenic weight loss plan, it’s SALT.  Almost all keto dieters need at least ½ tsp /day of a good quality sea salt to replace lost sodium while they diet. I’ve never run into anyone who had a contraindication for this supplement, but lots of folks who felt crappy because they didn’t know to take it. 

Do clients feel fatigued in keto?

My experience is that the vast majority of people who feel fatigued during “keto” are doing something wrong.  We can almost always track through food/nutrient journaling what might be off. Usually, folks aren’t getting enough salt - the main reason for the foggy thinking and sense of fatigue that people associate with keto programs. I’d say 70% of the time, adjusting salt intake fixes the problem. However, sometimes it’s a lack of another nutrient (electrolyte), eating too little, eating too much (and not getting into deep ketosis), exercising too much or too intensely, or another issue.  For those folks, journaling is key to helping us find the problem so we can help  them feel better. 

I’d say that most people, if they follow expertly designed and properly tailored programs, will feel good right away and during the whole weight loss process. 

Does the weight come back if someone stops doing keto?

The weight comes back from any diet if you go back to eating in ways that promote weight gain. It doesn’t matter how you lost it when it comes to weight re-gain.  

However, I’d say that having done a ketogenic program gives you a better edge to maintain your weight loss if part of the reason you were overweight to begin with was metabolic syndrome, insulin resistance or carb-sensitivity.  That’s because the ability of ketogenic programs to reduce or reverse insulin resistance can make your metabolism healthier by the time you reach your goal. Healthier metabolism means a better chance of burning more of your calories once you start a maintenance program. 

The biggest reason for weight regain is not having or following a solid maintenance plan which takes into account your level of carb-sensitivity, basal metabolic rate, hormonal issues (such as PCOS or menopause) or your *actual* activity level. The safest way to maintain weight if you tend toward metabolic syndrome is to stay low-carb, and sometimes ketogenic. The best way to do this is with a professionally designed plan tailored specifically to you. 

Adding back a high number of carbs and calories without dropping the fat levels you got used to on your keto program is a recipe for disaster for pretty much everyone.

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