A healthy living blog from Marshfield Clinic Health System

Is the ketogenic diet right for you?

Editor’s note: We’re inundated with promotions, ads and infomercials for weight loss. They tout the latest-greatest-fastest way to reach your goal but what’s right for you? In this occasional series for Shine365, Marshfield Clinic Health System Dietitian Chrisanne Urban takes a look at popular diets, weighs the pros and cons, and shares her thoughts.

Diets - What to know about the keto diet, or ketogenic diet

What should you know before starting the ketogenic diet?

Ketogenic diet

A popular choice right now, the ketogenic or “keto” diet is about cutting carbohydrates and eating fats and proteins. Fiber…not so much.

Originally, this diet was prescribed to treat severe epilepsy especially in children, Urban said.

Carbs – sugars or starches that are a major food source and form of energy – are cut to 10-15 grams daily with remaining calories coming from fat and some protein. According to the U.S. Department of Agriculture Dietary Guidelines for Americans 2010, 45-65 percent of daily caloric intake should be from carbs. If you follow a 1,500-calorie diet, that’s 168-240 grams of carbs.

Modified keto diets are “repackaged” or “rewrapped” diets, like Atkins and South Beach, Urban said, and call for consuming 20-50 grams of carbs.

So when we hear about keto today it’s really modified from the original diet with variations,” she said. “A distinct difference is the original keto diet was meant to be followed under direction of a physician and dietitian, with close attention paid to a person’s lab work.”

This diet’s goal is to keep you in ketosis, “a normal metabolic state or process that keeps the body working,” she said. “When you don’t get enough carbs for energy the body burns fat, switching from using glucose as energy to ketones from body fat.”

Besides burning fat you may feel less hungry, too.


A positive aspect of this diet, Urban said, is “you do lose weight and studies have shown this to be true. In the first year, you lose more weight and keep it off better than people following low-fat diets.”

It’s also good if you enjoy eating more protein and fats.


After the first year, overall weight loss is about the same as other diets, she said.

A significant disadvantage is that “it’s high fat, which leads potentially to high cholesterol and an increased risk of cardiovascular disease,” Urban said. “It’s also low in fiber so there is a chance of increased constipation because you’re cutting whole grains, too.”

Other side effects are bloating, bad breath and increased fatigue.

It’s not good or healthy in the long term and hard to maintain,” she said.

Also, U.S. News & World Report’s 2018 diet rankings show it’s not highly recommended. Many lose weight but most gain weight back once the diet is no longer followed.

“We want to focus on sustainable diets, things you can do long-term,” she said.

“Basically, this diet is not one of my favorites and we need to remind ourselves that there’s no miracle to achieving a healthy weight. If that were true, everyone would be thin and we wouldn’t have obesity.”

Compare diets

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Mediterranean diet

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