“Diabetics and Diets” is a series here on The Diabetic Trainer where popular diets are explained, examined and their pros and cons are evaluated for how appropriate they are for diabetics.

In case you missed it, check out the first installment of my “Diabetics and Diets” series on Intermittent Fasting.

Just click here.

And now, off to installment number two.

(Number two, haha.)

The ketogenic diet (or keto) is currently one of the hottest diets.  It has been for several years now.

In short, keto is a more extreme version of common low-carb diets. (Think Atkins and South Beach.) It focuses on very low carbohydrate, and very high fat intake.

By drastically reducing the amount of carbohydrates you take in, your body falls in to a metabolic process called “ketosis”.

In short, this process is a back up system your body has in case it doesn’t have enough carbohydrates to use for energy.  Your liver takes fat, turns it into an acid called ketones, which are then pushed into the blood stream and available for muscles to use as energy.

It really is a pretty cool process.  It’s essentially a fail-safe the body has to keep you functioning without the most readily available source of energy-carbs.

THE PROS

When it comes to the “pros” of the ketogenic diet, there are definitely some big ones.

First, and foremost, weight loss.  More specifically rapid weight loss.  People who are able to get into ketosis and stay there for a period of time tend to lose weight very quickly.  Some people tend to report that their joints feel better, they report less inflammation, and they have more energy.  Pretty great, right?

There is also some evidence that suggests it can be beneficial in treating individuals with epilepsy. I haven’t dug into this very much, so I don’t have much to say about it.  However, if there is something to this, it would be incredibly cool.

(SIDE NOTE: it’s worth mentioning that keto, and other low carb diets, not only drastically reduce carbohydrate intake, but they also greatly reduce the amount of high calorie, highly processed foods a person is eating.  While foods like doughnuts, pizza, french fries, etc. are made up of a high percentage of carbs, they also have a high percentage of fat.  There is a strong argument to be made that this reduction in fat, or overall calories in general, could be a major contributing factor in the success of a ketogenic dieter, and not just the reduction in carbs.)

THE CONS

Any time you omit an entire food group, in this case carbs, adherence is going to be tricky.  The ketogenic diet is no exception to the rule.  It is a very strict diet, and keeping the body in ketosis is one of the key components.  This requires someone to take in a mere ~20g of carbs a day.  That’s not much. (A half cup of rice in a day would put you over that.)

Also, I think there is a high probability of developing (or increasing) a poor emotional relationship with carbohydrates.  Omitting them altogether tends to make them seem “bad”, and this can have negative effects down the road.

Specifically for diabetics, if you are fairly active, there is a risk of low blood sugars with the ketogenic diet.  Unless you are truly in ketosis, and have been for a bit, any kind of moderate exercise has the potential to drop your blood sugars to unsafe levels.  And let’s be honest, a hypoglycemic episode is no fun for anyone.

THE VERDICT

I don’t have an incredibly strong stance on the ketogenic diet, but rather some important considerations.

First, it’s very strict.  In fact, it’s one of the most restrictive popular diets out there.  This makes adherence less likely, and more frustrating.

That being said, if someone likes it, can adhere to it long term, and finds it beneficial, great!  Then they can keep rocking themselves some keto, and I won’t ever deter them from it.

In terms of diabetics, if you are fairly inactive AND are pretty adept at managing your diabetes, then I think keto could be a viable option.  But certainly not the only option.

However, if you’re even moderately active, or are using exercise to manage your diabetes*, I wouldn’t recommend it.  I think the risks for a hypo episode are too great, and it’s just not worth the risk.  There are other, less risky, and less restrictive, ways to have the same effect.

I will concede that diets are personal.  Both in preference, and efficacy.  (Although, to be fair, usually efficacy has a lot to do with finding something you prefer.) If something is working for someone, if it improves their health, and if they can sustain it long term, then it’s probably a good diet for them.  And that’s what matters most.

*Need help using exercise to manage your diabetes?  Drop me a note here and let’s work together to do just that.