- From bad breath to serious fatigue, the keto diet can cause a range of uncomfortable and annoying side effects.
- INSIDER reached out to Sarah Marjoram, MS, RDN, LD to better understand the issues people may encounter when following the ketogenic diet.
- Many people who follow the ketogenic diet report achieving successful weight loss goals.
- However many people struggle to stick with the diet for various reasons.
- Visit INSIDER’s homepage for more stories.
If you don’t know at least one person doing keto in 2019, consider yourself an exception. The ketogenic diet plan has been one of the biggest health trends over the past few years, and the number of loyal followers only seems to be going strong.
Although there are some variations, the popular ketogenic diet plan usually requires a person to modify their diet to consist of 5% carbs, 20% protein, and 75% fat. Proponents of the extremely low-carb regiment claim that strict adherence to the plan helps them feel more energised and curb their sugar cravings. And of course, there’s the added benefit of supposed rapid weight loss.But it’s important to remember not everyone who follows the diet has such a pleasant experience. Take a look at any #ketoproblems hashtag on social media, and you’ll find lots of people commiserating over various keto-related struggles. From the limited food options to physical side effects, there are several factors that can make committing to the keto plan a challenge.INSIDER did some research and reached out to Registered Dietitian Nutritionist Sarah Marjoram to learn more about the common issues people can encounter while following the trendy diet.
As a general reminder, always consult a registered dietitian or your physician before starting any diet plan.
Issue #1: The keto diet can make you feel sick.
“People [who follow keto] often complain of flu-like symptoms when they first start the diet,” said Marjoram. “They can experience headaches, nausea and feel lethargic. Some also complain of irritability, dizziness, and difficulty focusing.” To better understand why this happens, we have to consider the science behind why the keto diet works. Normally, the body gets most of its energy from the carbohydrates in the food we eat, said Marjoram.
However, during the keto diet, a person drastically reduces their carbohydrate intake, while increasing their fat consumption. The depleted levels of carbohydrates can force the body to use fat cells to produce compounds called ketones, which become the new source of energy. When this process happens, people can lose weight.However since most people aren’t used to their diet consisting of only 5% carbs, this can immediately have a negative impact on energy levels.
Marjoram told INSIDER “When you make a cut [in your diet] that drastic, there’s a transition that happens in your body. You don’t start immediately start breaking down fat. It first has to use up the stored carbohydrates before it turns to fat for energy.”
It’s during the transition period that people experience “keto flu” because of all the unpleasant symptoms it produces. Your body is being shocked into this new way of processing energy, and it can be a lot to handle.Generally, these symptoms last anywhere from two to five days while the body adapts to the carbohydrate restriction, she said. However, if these problems persist for weeks, you may want to consult your physician.
Issue #2: While following keto, you may have trouble getting through your normal gym routine.
Don’t be surprised if you find yourself struggling to finish your treadmill routine while on keto.
Typically the body turns to carbohydrates to keep you going during your workout. But during the keto diet, you’re depriving the body of that form of fuel. While some people who follow keto may be able to easily exercise at their normal pace, research suggests that this isn’t the case for everyone.
A study conducted at Saint Louis University found that a low-carbohydrate diet can actually have negative effects on a person’s athletic performance by lowering their overall endurance. Other research has shown that depleted carbohydrate stores can make a person more susceptible to muscle damage during exercise and cause them to feel fatigued much faster.
Does this mean you should skip on exercising entirely? Absolutely not. But to be safe, you should consider reducing the intensity of your workouts while your body adjusts to ketosis.
Issue #3: Following the keto diet can make you feel pretty “backed up.”
Although keto can cause your weight to come off rapidly, it can also cause other bodily processes to slow down — particularly, digestion.
This occurs because people who follow the diet rarely enough dietary fibre, said Marjoram. She told INSIDER, “One thing dietitians worry about [when people follow keto] is that they are eating little to no fibre [because] carbohydrates are the primary sources of fibre.”According to Mayo Clinic, fiber is an essential nutrient that helps the body maintain regular bowel movements. Generally, you can get your daily recommended amount of fibre by eating foods like whole grains, beans, and fruits.The problem is the keto diet restricts how much of these foods you can eat because they contain a lot of carbohydrates. (For reference one banana has 22 grams of carbs, and most keto plans don’t allow more than 20 to 50 grams of net carbs for the entire day.) On top of that, the plan encourages you to eat a high level of fat, which can cause you to feel even more constipated.
Issue #4: Your ketosis may also give you halitosis.
If you started keto recently, you may have noticed an unusual stench coming from your mouth. While this is a pretty embarrassing side effect, rest assured you’re not alone.When the body experiences ketosis, it means the liver is using fat cells to produce organic compounds called ketones. These include acetoacetic acid, acetone, and beta-hydroxybutyric acid. And while this is all happening at the cellular level, these byproducts have a tendency to show up in your breath.”When your body starts to break down fat for energy, gases called ketones are produced, ” said Marjoram. “The body [then] releases those ketones [through exhalation and urination.]”As a result, during the first week or two of the keto diet, people may complain that their breath has unpleasant, or even ammonia-like smell. Some people even report that their mouths smelling distinctly like nail polish remover because if you recall, acetone is an ingredient found in that beauty product.
On the bright side, this stench can signal that your keto diet is effective because it usually means the body has achieved fat-burning that ketosis state.
In the meantime, if you’re concerned, it’s can be a good idea to drink more water and be extra mindful of your oral hygiene.
Issue #5: Keto can make you exceptionally thirsty.
Normally, when you something like a piece of toast, the body converts the carbs from that toast into glucose. This stimulates the pancreas to start making a hormone called insulin, which carries some of that glucose to your cells for energy while it stores the rest as glycogen. According to Healthline, this glycogen acts a special reserve for energy that the body uses to keep you going in between meals. Meanwhile, the elevated insulin levels that made this possible cause your kidneys to retain sodium.
But when you’re not eating that many carbohydrates, your body isn’t going to be producing that same amount of insulin.
Instead, the elevated levels of ketones disrupts your overall electrolyte levels. This causes the kidneys to release water and salt, which leads to frequent urination and consequently, a loss of fluids.
When this happens, you’re likely to experience a dry mouth a lot faster than you normally would, especially if you’re not drinking enough water.
Issue #6 : Ketosis can seriously lower your alcohol tolerance.
If you’re currently on the keto diet, you may have noticed that you feel tipsy a lot faster when sipping your favourite adult beverage. You also may have noticed that you suddenly experience some pretty gnarly hangovers, too.
This is because when you’re not eating a lot of carbs, your body can be more susceptible to alcohol’s effects.Remember those glycogen stores mentioned before? Normally these energy reserves help to absorb the alcohol that goes into the bloodstream. But when you’re on keto, your body doesn’t have as much glycogen as usual, which means there are fewer places for the alcohol to go once it enters your digestive system. Instead, the alcohol moves to the liver where it becomes rapidly metabolized. Cue your blood alcohol concentration rising and you feeling drunk.
For this reason, keto followers should take extra precaution before deciding to ingest any liquor. Plus, tons of alcoholic drinks contain carbs, so it’s tough to drink on plan anyway.
Of course, it’s a good idea to limit your alcohol consumption regardless of whether you’re on keto or not. But if you want to minimise your chance of experiencing a severe hangover, you may want to lay off the drinking entirely while in ketosis.
Issue #7: It can be challenging to sustain the keto diet long-term because of how restrictive it is.
Given the physical effects ketosis can have on the body, adopting a keto lifestyle for the long haul may not be the right choice for everyone.
For one, there’s the fact that it’s very restrictive. Following the keto diet eliminates most fruits and many starchy vegetables because of their high carbohydrate content. This seriously limits the variety in the types of meals a person can enjoy. Although little research has been done into how the keto diet specifically affects the body on a long-term basis, Marjoram said following any diet plan that eliminates or severely limits entire food groups is generally not advised for optimal health. Consider that while many vegetables have high levels of carbs, they also contain some essential vitamins and nutrients the body needs to be healthy. Even though following a low-carb diet may help you lose weight, skipping out on these foods in lieu of less nutrient-dense foods can lead to deficiencies down the road.
Issue #8: It’s possible for the weight you lose during keto to come back rapidly once you stop the diet.
Marjoram told INSIDER,“A lot of people may lose weight in the short term, but as soon as they reintroduce carbohydrates and get back to a normal way of eating, the weight comes right back.”This is because unlike other diets, keto relies on the very specific process of ketosis in order for it to be effective. As a result, once the body is no longer in that state, it can be easy for a person to pack on the pounds if they aren’t careful of how much they’re eating.
Marjoram added, “That’s the science of how metabolism works. Your body is not meant to be in ketosis [for an extended period of time].”You can avoid potentially regaining weight after stopping keto by transitioning to a more balanced, plant-based diet.
Issue #9: And despite your efforts, you might not lose any weight at all.
It turns out getting into ketosis and maintaining isn’t exactly as easy as cutting out bread. Even if you successfully keep your carbohydrate intake below a certain level for a few days, it can be easy to send your body out of ketosis by simply eating a few extra grams of carbs. Marjoram added, “[On the keto diet] You’re forcing this physiological state by eliminating carbohydrates. Once you start eating carbs again, you’re right back out of ketosis.”Moreover, some research suggests that because keto is not necessarily a high-protein diet, it can be challenging to feel satiated from your meals. You may be compensating for your hunger by adding extra fat, like butter to your meals. But keep in mind that doing this also means you’re increasing the number of calories you’re eating, too. You can, however, help alleviate this by eating high protein and keto.While keto isn’t necessarily a calorie-restrictive diet, it’s still possible to overeat while following the plan. Instead, try incorporating more non-starchy vegetables into your low-carb regiment, like spinach. You can eat three full cups of spinach for only three grams of carbs per serving and less than 50 calories overall.
Issue #10: Some believe keto may mess with your cholesterol levels and affect your overall health.
Although many people enjoy that keto allows them the freedom to eat tasty foods like burgers and bacon, it turns out this perk may be too good to be true. In fact, this may even be detrimental to your overall health.
Marjoram told INSIDER, “Research shows a high-fat diet, particularly one [that contains] saturated fat and trans fat negatively impacts your blood cholesterol level.”Unlike other low-carb diets, keto relies on high fat consumption more than high protein to be effective. If you’re not careful about the kinds of fats you’re eating, it’s likely that you’ll see an increase in LDL (low-density lipoprotein) cholesterol, aka the “bad cholesterol.”
It is worth noting that other studies have found that people on keto saw a decrease in LDL cholesterol, so it’s possible the reverse is true but more research is needed. In addition, Marjoram said it’s also possible for the keto diet to raise your risk of developing kidney stones, which can be painful. This is linked to increased protein consumption, which causes an overwhelming amount of acid to impact the kidneys. Although keto encourages people to eat a higher ratio of fat than protein, it’s still possible to overindulge on animal proteins, like hamburgers, while following the plan. Still, Marjoram notes that further research is needed to better understand the long term effects of the keto diet on healthy individuals.
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