Before You Start The Keto Diet Here Are 10 Things Licensed Dietitians Want You To Know.

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Here are some things certified dietitians want you to know before you start the keto diet.

To follow a ketogenic diet successfully, Emilie Vandenberg, a registered dietitian nutritionist at The Ohio State University Wegner Medical Center, says it needs a sound foundation of nutrition knowledge and the ability to read labels. "Most foods' macronutrient content must be known. Giving up or avoiding certain meals may sometimes be challenging.

However, there may be some benefits to this diet, such as better blood sugar control for type 2 diabetics, weight loss, and fewer seizures in epileptic patients.

Experts detail many key considerations before starting the keto diet, including how you'll feel immediately away and potential health risks if you stick with it for a long time.


1. You may experience changes in digestion

The most common gastrointestinal side effects of the keto diet, according to Vandenberg, include diarrhea, acid reflux, nausea, and constipation.

Because the keto diet forbids entire grains and starchy vegetables, as well as limiting fruits to extremely modest quantities of just low-carb fruit, constipation is common. All of these meals are high in fiber, which helps you pass your stool more easily.

According to Paula Dietrich, MPH, a registered dietitian with her own private nutrition practice, the keto diet often contains the following (but ratios may vary):

  • 70-90 percent of all calories come from fat.
  • 1 gram of protein per kilogram of body weight (so 68 grams for a 150 lb person)
  • Carbohydrates are the calories that are left behind (usually somewhere between 100-200 calories or around 50 grams)

GI “symptoms may persist for as long as someone is on the diet,” according to Vandenberg. “Some people's GI troubles may improve as a result of the dietary changes.”

2. You might experience flu-like symptoms

Some people experience a cluster of symptoms known as the keto flu within the first week of commencing the keto diet.

The symptoms are similar to those of the common flu and might include:

  • Headache 
  • Brain fog 
  • Nausea 
  • Vomiting 
  • Weakness 
  • Irritability 
  • Muscle cramps 
  • Dizziness 
  • Difficulty sleeping

Fortunately, according to Doebrich, this is typically simply a transitory side effect of drastically reducing carbohydrate intake, and it should go away after a week or so.

To alleviate these symptoms, Vandenberg recommends reducing carbs gradually over a few weeks and being properly hydrated.


3. Your energy levels may dip

According to experts, it's typical to feel tired for a brief period of time when you first start the keto diet. This is due to your body gradually adjusting to a new metabolic state that does not rely on carbohydrates for energy.

"As your body adjusts to using fat instead of carbs for fuel, your energy levels may return to normal," says Doebrich, who adds that lethargy normally lasts one to three weeks.

People who routinely participate in high-intensity exercise, however, may continue to feel tired after workouts if they don't consume enough calories, according to Doebrich. Because the keto diet is heavy in fat, which is incredibly filling, you may find that you need to quit eating before you have the stamina to complete your workouts.


4. You may notice a decrease in blood sugar levels.

Carbohydrates are broken down into sugars in the body, causing blood sugar rises, particularly if they're simple carbohydrates.

The keto diet has been demonstrated to significantly improve blood sugar levels, especially in those with type 2 diabetes, because it substantially reduces carb intake.

If you're used to the crash caused by blood sugar rises, you could notice a boost in energy and alertness after you start keto.

Findings from studies on the keto diet's impact in

Long-term results for type 1 diabetic patients are still unknown, according to a 2019 analysis, and there's no consensus on what amount of ketosis is appropriate in these individuals.


5. Your heart health could suffer 

The results of research on how the keto diet impacts heart health have been varied. According to certain studies, it can cause a rise in "bad" LDL cholesterol, which has been associated to an increased risk of cardiovascular disease. Other research has discovered that the keto diet lowers cardiovascular risk factors such as obesity.

Ketogenic dieters consume a lot of fat. And saturated fats, such as those found in red meat, bacon, cheese, butter, and coconut oil, can elevate LDL cholesterol levels.

According to Vandenberg, one method to reduce these risks is to consume more unsaturated fats like olive oil, nuts, seeds, and avocado.


6. You'll probably lose some weight

According to a study published in 2019, ultra low-carb diets are "not superior to other dietary options for weight reduction."

Most research on the keto diet and weight reduction have been performed in a controlled setting, and the participants typically have a metabolic disease like insulin resistance or type 2 diabetes, so it's difficult to tell what a regular, healthy dieter may anticipate, according to Doebrich.

Doebrich further claims that the early weight reduction is primarily water weight.

"Glycogen holds water, and when carbohydrate consumption is reduced, glycogen reserves are utilized as a fuel source, resulting in fast weight loss," she explains. "Weight reduction is said to peak around five months but is difficult to maintain after that."


7. You'll likely have hunger pains, but only in the beginning

When you first start the keto diet, you may suffer hunger pains as your body adjusts to the substantial adjustments in your carb consumption.

While these hunger and desires are to be expected at first, Doebrich recommends keeping track of whether or not they go away as your body adjusts to your new diet.

Fortunately, this impact appears to be temporary; in fact, a 2015 study indicated that ketogenic diets may enhance appetite suppression in the long run.

Make sure you're eating as much protein and fiber as your diet permits, and drink lots of water to stave off hunger pains and cravings.


8. You're at risk of nutritional deficiencies

Because the keto diet excludes grains and a variety of fruits and vegetables, there is a danger of nutritional deficiency.

"This diet tends to be deficient in vitamin C, potassium, magnesium, calcium, and folate," Doebrich explains. "In addition, a lack of fiber may affect gut flora, and the microbiome is known to have a role in immunity, endocrine function, inflammatory processes, and even brain health."

Many of these deficits may be avoided by eating a wide range of vegetables, fruits, and protein sources. To remedy these dietary deficits, Vandenberg advises the following supplements:


9. You run the danger of losing some bone mass, especially if you're really active.

In a small 2020 study, elite athletes who did intense training on the keto diet showed more signs of bone breakdown and less signs of repair than athletes who ate a diet with more carbs.

Not only that, but those athletes' bone health only partially improved after reinstating additional carbohydrates into their diets.

The majority of research on the keto diet and bone health has been done on athletes. However, because vitamin D and calcium deficiency is so frequent in the general population, Doebrich advises that you make sure you're receiving enough of these bone-strengthening elements once you've started the keto diet.


10. Who should avoid the keto diet

The ketogenic diet is not suitable for everyone. According to Vandenberg and Doebrich, anyone with the following medical problems should avoid it:

  • Disordered eating (or a history of an eating disorder)
  • Type 1 diabetes 
  • Hypertension
  • Kidney disease
  • Cardiovascular disease
  • Pancreatic conditions
  • Kidney stones
  • Osteoporosis 
  • Low body weight
  • High cholesterol

According to Doebrich, athletes should be careful about trying the keto diet. Before beginning this diet, speak with your doctor about your specific nutritional needs, especially if you routinely engage in rigorous or high-intensity activity.



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