Ketogenic Diet: Safe to Try at Home?

Yesterday, we looked at how the ketogenic diet can be used to treat certain medical conditions such as epilepsy. Even for those without these conditions, this low-carb, high-fat diet has been growing in popularity in recent years. When you search online, you’ll find lots of information touting the health benefits and weight-loss potential of the diet.

You’ll also see articles that say that the diet isn’t right for everyone and can have serious risks. So, is the ketogenic diet safe to try? We followed up with registered dietitian Diana Gulotta to get her recommendation.

Go On a Ketogenic Diet? Not Without Medical Supervision

Research has shown that the diet can help heart health and weight loss. However, Gulotta says she does not endorse the diet for the general public unless someone is very passionate about trying it out and is willing to seek medical advice. “At UVA, we use the ketogenic diet as a medical therapy for epilepsy and some other diseases such as multiple sclerosis. We currently do not accept weight-loss patients and do not advise that people go on this diet without medical supervision.”

Dietitians closely monitor people on a prescription diet, looking at:

• Liver function
• Serum lipids
• Vitamin and mineral levels
• Blood counts

“This allows us to see the effects that the diet is having on the body and correct them before there is a serious negative side effect,” Gulotta says.

Harsh Side Effects of Ketosis

When you’re on it, your body switches from carbohydrates as its main energy source to fat and proteins. This causes your body to enter a state called ketosis, producing ketones. Ketones are an alternative form of fuel that are created when the liver breaks down fats. Ketone production can be dangerous for those with diabetes.

This process can be rough at first, until your body becomes used to the new diet. That can take anywhere from a day to a couple of weeks.

“Initially, we can see nausea, vomiting and lethargy,” says Gulotta. Vitamin and mineral deficiencies can occur if you’re not properly supplementing. There’s also a small risk of kidney stones, elevated triglyceride levels and pancreatitis. “Constipation and gastric reflux are probably the most common, long-standing side effects,” she notes.

Gulotta also warns that, “If someone starts this diet without medical supervision and has a disorder of fat metabolism, they can become seriously malnourished and sick.”

Nutritional Counseling

For more information about healthy eating strategies, check out the nutrition services offered at UVA.

A Dietitian’s Advice

Most restrictive diets, like the ketogenic diet or Atkins, can be very difficult to stick with. Many people tend to try it for a few months, stop, gain the weight back and go back on a diet again. Then this dieting cycle continues all over again. There is research to support low-carbohydrate, higher fat diets for heart health and blood sugar control, but this doesn’t need to be as extreme as a medical ketogenic diet.

For the most part, Gulotta’s advice is to keep it simple. She recommends that people focus on:

• Decreasing portion sizes
• Cutting added sugar
• Exercising more.

Before making any drastic changes to your diet, talk with your doctor or a dietitian about what options may be right for you.