10 Potential Health Risks Related to the Ketogenic Diet You Should Know About

The ketogenic (keto) diet, known for its low-carb, high-fat content, has gained popularity for its potential benefits, particularly for weight loss and the treatment of certain medical conditions such as epilepsy. However, like any restrictive diet, the ketogenic diet carries risks that people should consider before adopting it. Here we have listed ten potential health risks associated with the ketogenic diet.

Nutrient deficiency

One of the most immediate concerns of the ketogenic diet is the risk of nutritional deficiencies. Since the diet severely limits fruits, vegetables, and whole grains, essential nutrients such as vitamins A, C, K, and fiber can be lacking. According to a study published in Nutrients, people on a ketogenic diet may suffer from deficiencies in magnesium, calcium, and potassium, which are crucial for maintaining bone health, muscle function, and overall well-being.

Increased risk of heart disease

While the ketogenic diet emphasizes fat for energy, not all fats are created equal. Consuming excessive amounts of saturated fat from sources like butter and red meat can increase cholesterol levels, leading to an increased risk of heart disease. A study published in the European Journal of Nutrition found that people on high-fat diets like the ketogenic diet experienced an increase in LDL (bad) cholesterol, which is a known risk factor for heart disease.

Ketogenic flu

As the body switches from burning carbs to burning fat for energy, many people experience flu-like symptoms, known as the “keto flu.” Symptoms can include headache, fatigue, nausea, and irritability. These side effects typically appear within the first week and are due to electrolyte imbalances and dehydration. A study published in the Journal of the International Society of Sports Nutrition found that 40 to 60 percent of people on the keto diet reported experiencing these symptoms.

Digestive problems

Due to its low fiber content, the keto diet can lead to digestive issues such as constipation and bloating. Fiber, found in fruits, vegetables, and grains, helps regulate bowel movements. A lack of fiber in the keto diet can lead to gastrointestinal discomfort. A 2020 study published in Frontiers in Nutrition found that constipation is one of the most common complaints among those following the keto diet, affecting nearly 50 percent of participants.

Loss of muscle mass

While the ketogenic diet may promote fat loss, it can also lead to a reduction in muscle mass. The body relies on carbohydrates to build and repair muscle, and without enough of them, muscle protein can be broken down for energy. A study published in The American Journal of Clinical Nutrition found that people on a low-carb, high-fat diet lost more muscle mass compared to those on a balanced diet, especially during long-term follow-up.

Increased risk of kidney stones

The high intake of animal protein and lack of water often associated with the ketogenic diet may increase the risk of kidney stones. Animal proteins increase the production of uric acid in the body, which can lead to the formation of stones. In addition, dehydration, which is often a side effect of the ketogenic diet, increases the likelihood of developing kidney stones. A study published in the Journal of Child Neurology noted that children on the ketogenic diet for epilepsy had a higher risk of kidney stone formation.

Impact on bone health

Research indicates that the ketogenic diet may negatively impact bone health. A 2020 study published in Frontiers in Endocrinology found that people who followed a ketogenic diet for extended periods experienced reduced bone density and increased markers of bone turnover, which can lead to weaker bones over time. This is partly due to the restriction of calcium-rich foods in the diet and the resulting decrease in calcium intake.

Liver problems

The high fat content of the ketogenic diet can put a strain on the liver, especially in people with pre-existing liver conditions. The liver plays a critical role in fat metabolism, and over time, excessive fat intake can lead to fatty liver disease. According to the Hepatology Journal, people who follow high-fat diets are at increased risk for non-alcoholic fatty liver disease (NAFLD), which can cause inflammation and damage to the liver.

Increased risk of hypoglycemia in diabetics

While the ketogenic diet may help control blood sugar levels in some people, it can also lead to dangerously low blood sugar (hypoglycemia) in people with diabetes, especially those who take insulin or other glucose-lowering medications. A study published in the Journal of Clinical Investigation found that the ketogenic diet could trigger episodes of hypoglycemia in people with type 1 diabetes, making strict monitoring of blood sugar levels necessary.

Eating disorders and their effects on mental health

The restrictive nature of the ketogenic diet may trigger disordered eating behaviors in some people. Constantly monitoring food intake and adhering to strict macronutrient ratios can lead to anxiety around food and an unhealthy relationship with food. A 2021 study published in Appetite highlighted the potential for diets like the ketogenic diet to increase the risk of disordered eating patterns and contribute to mental health issues like depression and anxiety.