Should you go keto? The Ketogenic Diet

Author: Ivy Chua APD


Ketogenic diet – the low carbohydrates, high fat and moderate protein?

You may see #KETO everywhere on social media. Ketogenic diet is a diet low in carbohydrates (5%), moderate in protein (10%-20%) and high in fat (70%-80%). People on the ketogenic diet have a moderate amount of protein-rich food including meats, lots of high-fat food like avocado, butter, cheese and olive oil and minimal amounts of carbohydrates food sources like grains and starchy vegetables.


The Ketogenic diet mechanism?

Our body converts carbohydrates into glucose as the first source of energy. However, when the carbohydrates are not available, our body breaks down our fat into ketones as an alternative source of energy. The ketogenic diet aims to trigger the process of ketogenesis in the body. ketogenesis is an alternative pathway our body uses to release energy in terms of emergency. For example, if you are not having any carbohydrates, which is the first source of energy the brain prefers to use, our body produces ketones from our fat storage to keep us alive.

This diet is not new diet and it is known in the medical field as a therapy for epilepsy (seizure disorder) in children for years. Evidence shows that getting more calories from fat helps control seizures. However, this diet for epilepsy should be managed along with the health care team since it is very complex. It requires very precise calculation and measurement of the ratio of fat, carbohydrates and protein intake to ensure the expected response of ketogenesis of epilepsy patients.


Is ketogenic diet safe to follow?

The Ketogenic diet has become popular with the general public recently as a weight loss diet. Ketogenic diet can lead to short term weight loss. However, it is a restrictive diet and it is very difficult to sustain. This diet eliminates particular food groups and promotes restrictive behaviour which can cause overeating or Yo-Yo effect. It is very hard to eliminate carbohydrates in the long term since it is the main source of energy and most of the food contains carbohydrates, especially dietary fibre.


This diet pattern is not recommended for the following groups of people:

  1. People with diabetes who are undertaking insulin or medication that may pose the risk of hypoglycemia (low blood sugar)

  2. Liver conditions – The high fat intake in the Keto diet increases the burden of the liver. If there is an excess amount of fat to metabolize, it can worsen the existing liver conditions.

  3. Kidney conditions - a Keto diet may lead to an increase in protein intake, which increases the burden on the kidneys.

  4. Pancreatic diseases

  5. Eating disorder

This diet causes the body to undergo ketogenesis, production of ketone bodies through breakdown of fatty acids and ketogenic amino acids. This can lead to symptoms including stomach discomfort, fatigue and troubled sleeping. Cutting out food with carbohydrates including fruits and vegetables can reduce the fibre intake in your diet, which may lead to constipation. Whole grains, fruits and starchy vegetables provides multivitamins and minerals which are important to support body function. Also, carbohydrates promote insulin response, and this helps protein to enter the muscles for muscle growth. Therefore, low or even no carbohydrates intake in your diet can affect the growth of your muscles.


Overall, Ketogenic diet is not a long-term fix in weight management and it is very restrictive. It is very hard to stick to and the results are not sustainable. You may easily regain the weight once you resume a normal diet. The restrictive behaviour in the diet may also trigger disordered eating in the long term. When it comes to weight management, the plan should be consistent and should fit your lifestyle well. It is always important to consult with doctors and dietitian before starting a special diet.

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