Ketogenic Diet for Weight Loss: Myth or Reality?

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^{In collaboration with ÉquipeNutriton’s professional}

The ketogenic diet, or “keto,” is everywhere: social media, magazines, and even at the gym. Promoted as a quick solution for weight loss, this diet is attracting more and more curious individuals. But what does science really say about it? Is it an effective long-term method or just a passing trend?

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What is the keto diet?

The ketogenic or keto diet is based on drastically reducing carbohydrates (less than 50 g per day), increasing fats, and maintaining moderate protein intake. Normally, carbohydrates are the body’s primary source of energy, but by limiting their intake, the body turns to fat for energy, a process called “ketosis.” As a result, the body starts using stored fat to produce energy.

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Does keto really lead to weight loss?

The short answer is yes, in the short term. Studies show that by following a keto diet for several months, some people lose more weight than those on a low-fat diet (1, 2). However, this rapid weight loss is often linked to water loss, not just fat. Additionally, the severe restriction of carbohydrates can reduce appetite, leading to eating less and thus losing weight (3).

But what about the long term? Well, this is where things get complicated. Over a period of more than a year, the difference in weight loss between ketogenic diets and other diets seems to diminish (4). In other words, what truly matters for maintaining long-term weight loss is finding a diet that can be followed sustainably.

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What are the health impacts?

It’s not just about losing weight but also understanding how this diet affects your overall health. Here’s what science tells us:

• Cholesterol: The keto diet may increase LDL cholesterol (the “bad” cholesterol) in some people, but other studies show an increase in HDL cholesterol (the “good” cholesterol) (5). Results are mixed, so it’s important to monitor your health with a professional if you’re considering this diet.
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• Side effects: Many individuals experience side effects in the first weeks of the diet, commonly referred to as the “keto flu.” These symptoms include fatigue, headaches, nausea, and low energy (6). These effects are generally temporary and disappear after a few weeks.
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• Nutritional deficiencies: Following the ketogenic diet often limits nutrient-rich foods, such as fruits and whole grains. This can lead to deficiencies in essential vitamins and minerals. Additionally, the low fibre intake is a notable concern, as fibre plays a crucial role in digestive health, helping prevent constipation and supporting a healthy microbiome (7-8).
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Is it sustainable?

While the keto diet may seem effective in the short term, it’s difficult to maintain over the long term due to its strict restrictions. Moreover, the majority of experts agree that a balanced and sustainable diet is preferable for long-term health (9).

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So, is the ketogenic diet for weight loss myth or reality?

The keto diet can help some people lose weight quickly, but it’s not a miracle solution. In the long term, it’s not necessarily more effective than a balanced and varied diet. Additionally, it can be hard to stick to and may pose health risks if not properly managed.

The key to sustainable weight loss lies in a balanced diet that’s rich in nutrients and, most importantly, tailored to your needs and lifestyle. If you want to explore different options for healthy and lasting weight loss, consult a registered dietitian nutritionist who can guide you towards the best approach for you.

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Consult a dietitian-nutritionist for personalized advice

For personalised advice, take advantage of the exclusive services for Bonjour-santé members. Log in to your Bonjour-santé account or subscribe to enjoy exclusive benefits, including unlimited quick advice with Bonjour-santé nutritionists, as well as a special discount on your first consultation with a dietitian-nutritionist from our partner, ÉquipeNutrition. This professional will help you achieve your health goals with advice tailored to your needs.
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References

1. Bueno NB, de Melo IS, de Oliveira SL, Ataide TD. Very-low-carbohydrate ketogenic diet v. low-fat diet for long-term weight loss: a meta-analysis of randomised controlled trials. Br J Nutr. 2013;110(7):1178-1187.
2. Mansoor N, Vinknes KJ, Veierød MB, Retterstøl K. Effects of low-carbohydrate diets v. low-fat diets on body weight and cardiovascular risk factors: a meta-analysis of randomised controlled trials. Br J Nutr. 2016;115(3):466-479.
3. Feinman RD, Pogozelski WK, Astrup A, et al. Dietary carbohydrate restriction as the first approach in diabetes management: Critical review and evidence base. Nutrition. 2015;31(1):1-13.
4. Johnston BC, Kanters S, Bandayrel K, et al. Comparison of Weight Loss Among Named Diet Programs in Overweight and Obese Adults A Meta-analysis. JAMA. 2014;312(9):923-933.
5. Kirkpatrick CF, Bolick JP, Kris-Etherton PM, et al. Review of current evidence and clinical recommendations on the effects of low-carbohydrate and very-low-carbohydrate (including ketogenic) diets for the management of body weight and other cardiometabolic risk factors: A scientific statement from the National Lipid Association Nutrition and Lifestyle Task Force. J Clin Lipidol. 2019;13(5):689-711.
6. Bostock ECS, Kirkby KC, Taylor BV, Hawrelak JA. Consumer Reports of “Keto Flu” Associated With the Ketogenic Diet. Front Nutr. 2020;7:20.
7. Yancy WS, Olsen MK, Guyton JR et al. A low-carbohydrate, ketogenic diet versus a low-fat diet to treat obesity and hyperlipidemia: a randomized, controlled trial. Ann Intern Med. 2004;140(10):769-777.
8. Muscogiuri G, Barrea L, Laudisio D, et al. The management of very low-calorie ketogenic diet in obesity outpatient clinic: a practical guide. J Transl Med. 2019;17(1):356.
9. Wharton S, Lau DCW, Vallis M et al. L’obésité chez l’adulte : ligne directrice de pratique clinique.CMAJ. 2020;192(49):E1757-E1775