By Maddie Critz, '20
From veganism to Atkin’s, paleo to raw, fad diets are constantly circulating in the fitness world. They promise immediate and life-changing results, slimming down dress sizes in just weeks with magic combinations of superfoods so delicious you’ll forget you’re even dieting. At the tap of an index finger you can watch countless people finally drop that excess fat, all claiming that the answer was this perfect cocktail of macronutrients on which we humans were always meant to thrive. The miracle diet is constantly changing, but the question remains the same: is this really good for you? Now at the center of the hype and the ensuing nutritional contentiousness: the ketogenic diet, commonly referred to as ‘keto’.
What is the Keto diet?
The Keto diet (short for ketogenic) is generally characterized as low-carbohydrate and high-fat. A typical macronutrient ratio would consist of 90% fats, 6% protein, and 4% carbohydrates, but these numbers vary between individuals and their goals regarding the diet.  The titular component of the keto diet is an abundance of naturally-occurring saturated and unsaturated fats paired with very few carbs. These fats can be found in butter, coconut oil, lard, olive oil, and certain nuts and seeds. Dairy and meat products are also a critical component of keto. Beef, poultry, fish, pork, shellfish, and lamb are all encouraged as sources of protein, especially fattier cuts of meat.  Cheeses and eggs are keto-legal, however milk is not due to its sugar content.  The vast majority of carbohydrates in a keto diet come from leafy green vegetables and berries. Starchy vegetables and most fruits are omitted are disqualified by higher carbohydrate levels. Since carbohydrates are the body’s quickest source of energy, this huge carb deficiency propels the body into an alternate method of fuel: ketosis.
Ketosis is a metabolic state in which a body is so low in sugar that it begins breaking down fats into fatty acids called ketones, which can then be used as an energy source in place of carbohydrates.  Although ketosis can be a symptom of certain metabolic disorders, a controlled ketogenic state has also proved to be an effective treatment for many diseases due to its antioxidant, anti-inflammatory, and neuroprotective effects. These effects have been utilized by doctors and nutritionists for over 80 years to treat diabetics an epileptic children, and have also been recently utilized to treat neurodegenerative diseases like Alzheimer’s and Parkinson’s.  In many mouse models, a ketogenic diet has been shown to suppress inflammatory genes and speed post-lesion neurological recovery.  The clinical applications of ketosis are well-documented and widely accepted.
So Why All The Hype?
Let’s face it: keto is all over the internet right now. Just type ‘keto transformation’ into Google and you’ll be showered with staggering subtractions of body size, before and after pictures that resemble two different people, each touting that a high-fat, low-carb, ketogenic diet was the answer they had always been searching for. What’s wrong with success stories like these? If a keto diet makes you lose that excess fat, it must be healthy, right?
The answer to that question is complicated, and highly debated. The issue here lies in the recent trend of maintaining a state of ketosis via a ketogenic diet for the purpose of personal weight loss. On one hand, a long term state of ketosis has been shown to promote dramatic weight loss, reduce diabetic risk, and lower inflammation, as well as improve the quality of life of many people who chose to use the keto diet to shed pounds. On the other, a diet chock-full of animal fats, red meat, and fat-rich dairy, devoid of many fruits and vegetables, sounds like what every doctor and food pyramid has sworn off since the dawn of modern nutrition.
So what does the science say?
It’s no big secret that the consumption of red meat and dairy is directly linked to a plethora of health issues. In a series of studies from 2015 that spanned several European countries, long-term consumption of red meats such as beef, pork, and lamb have been strongly linked to colon, pancreatic, and prostate cancers in humans.  In the infamous China Study, conducted over 15 years and 65 counties in mainland China, the consumption of red meats and animal fats was directly connected to the prevalence of coronary heart disease, as well as obesity and mortality.  In 2011, Swedish researchers found that high consumption of dairy products was associated with a 50 percent increased risk of prostate cancer.  A long-term diet high in animal products has also been found to leach calcium from bone structures, causing osteoporosis and kidney stones.  The evidence against long-term consumption of meats and dairy is concrete and extensive. These findings highlight the critical misconception about a casual ketogenic diet: just because you’re losing fat does not mean you are eating healthy.
Still, people who use a ketogenic diet for weight loss are immediately successful for a reason. Going keto requires eliminating many high-sugar foods from your diet, including soda and fast food and junky snacks like chips and cookies. Keto diets tend to be high in proteins, which keep you fuller for longer and can reduce overconsumption.  There is also some evidence showing that a state of ketosis can reduce the perception of hunger by affecting the hunger hormones leptin and ghrelin.  However, these supposedly ‘miraculous’ results can be replicated by eating the correct portions of whole foods and balancing macronutrient ratios. In fact, a high-carb, low-fat diet (or the exact opposite of keto) has been shown to be just as effective for short-term weight loss.  The reason why keto works in the short term is the same reason why many fad diets show immediate results: cutting out junk food and limiting overall caloric intake leads to weight loss across the board.
So, what happens on the long term?
The issue here is the overarching lack of sufficient data regarding the effects of a long-term keto diet in healthy adults. Most human keto studies have involved obese, diabetic, epileptic, or neurally damaged subjects, and have observed the positive effects of keto as a treatment for these health issues. The majority of long term data about ketogenic diet currently available is primarily from children with epilepsy. The ill effects of this diet in the long-term include constipation and other GI disturbances, dyslipidemia, acidosis, stunted growth, and myriad kidney problems.  However these are considered side effects, since ketosis in this case is being used as a treatment for a neurological disorder, as opposed to a solution to a New Year’s resolution to drop that last 15 pounds.
Another key idea that proponents of the casual keto diet fail to realize is that fat is addictive, just like carbs. Many rat models have shown how unlimited access to high-fat foods induces binge-eating behavior as well as psychological and physical addiction in the course of just a few weeks.  This means that not only is a diet full of meats and oils unhealthy over the long-term, but it is also difficult to quit. A diet as restrictive as keto that limits an essential macronutrient and source of energy, promotes indulging on addictive, carcinogenic, high-fat animal products, and whose long-term health is not scientifically substantiated, is not a nutritious long-term lifestyle. Rather, the cultural phenomenon of keto’s popularity is based on an Atkin’s-esque phobia of carbohydrates and a biological drive to binge on high-fat foods.
My parting thoughts: the ketogenic diet is scientifically proven to be an effective treatment for many health issues when properly suggested by a physician, but long -term weight loss can be achieved through healthier, more sustainable means. Read the literature and consult your doctor before adopting fad diets like this. Besides, if bacon fat and heavy cream work for you, more power to you. As for me, I’d rather have my apple.