Is Keto Safe for Everyone? What Experts and Science Say

The ketogenic diet, or keto, is a low-carb, high-fat eating plan that induces ketosis, a metabolic state where fat becomes the primary fuel source instead of carbohydrates. The typical breakdown of a keto diet is as follows:

• 70–75% fat
• 20–25% protein
• 5–10% carbs (usually under 50g per day)

Keto, originally designed to treat epilepsy in kids, has become popular for its quick weight loss, potential to reverse type 2 diabetes, and supposed mental clarity boost. But is it for everyone? That’s where things get more complicated.

Who Might Benefit from Keto?

1. People with Type 2 Diabetes or Prediabetes

Keto may significantly reduce blood sugar and insulin levels.

• A 2021 study in Frontiers in Endocrinology found improved glycemic control in people with type 2 diabetes on a well-monitored keto diet.
• Note: This should always be done under medical supervision.

2. People with Epilepsy

Keto is clinically proven to reduce seizure frequency, especially in drug-resistant epilepsy in children.

3. Those Seeking Weight Loss (Short Term)

The keto diet may lead to rapid weight loss, mostly due to:

• Water loss (from glycogen depletion)
• Appetite suppression from ketones and fat intake

Who Should Avoid Keto or Proceed with Caution?

1. People with Liver, Kidney, or Gallbladder Issues

• Keto increases the workload on these organs due to the high fat and protein intake.
• It may worsen kidney stones or liver dysfunction.

2. People with a History of Disordered Eating

Restrictive diets can trigger unhealthy patterns or food obsession.

“Keto can be a slippery slope for anyone with a past of bingeing, purging, or orthorexia,” says Dr. Alissa Rumsey, RD, an eating disorder specialist.

3. Pregnant or Breastfeeding Women

Keto can interfere with fetal development if not carefully managed.

• There’s limited research on the safety of keto in pregnancy.
• Nutrient restriction during pregnancy can be harmful.

4. Athletes Requiring Explosive Power

Keto may reduce performance in high-intensity, anaerobic sports like sprinting or weightlifting due to low glycogen availability.

What Science Says About Long-Term Safety

The long-term effects of keto are still under research. Some key findings:

• Heart Health: Some studies show improved HDL (“good”) cholesterol and triglycerides, while others show a rise in LDL (“bad”) cholesterol, especially in those genetically predisposed.
• Gut Health: Low fiber intake on strict keto can negatively affect your gut microbiome, leading to constipation or inflammation.
• Bone Density: A small study in elite athletes on keto showed reduced bone mineral content after just a few months.
• Micronutrient Deficiencies: Keto may lack important nutrients like:
  • Magnesium
  • Potassium
  • Vitamins B, C, D, and E
  • Fiber

Listen up, folks! If you’re on a diet that cuts out entire food groups for a while, keep a close eye on yourself. You don’t want to miss out on any essential nutrients.

So Is Keto Safe?

For certain individuals, yes—especially when supervised. It can offer therapeutic benefits in:

• Metabolic syndrome
• Type 2 diabetes
• Obesity
• Neurological disorders (epilepsy, Alzheimer’s—emerging evidence)

But it’s not ideal or necessary for everyone.

If you fall into any of the high-risk groups—or just don’t feel great on it—consider other evidence-backed options like:

• Mediterranean diet
• DASH diet
• Low-glycemic or high-fiber plans

When to Talk to a Doctor or Dietitian

If you’re considering keto, speak to a healthcare provider if you:

• Have a chronic condition (especially liver, heart, kidney, or thyroid)
• Take medications for blood pressure or blood sugar
• Are pregnant or breastfeeding
• Have a history of eating disorders

A registered dietitian can help you do keto safely, ensuring you meet all your nutritional needs.

The Bottom Line

Keto isn’t a magic pill for everyone. It can be a great fit for some people, but it can also have some downsides, especially if you stick to it for too long or without talking to a doctor. If it works for you and your goals, go for it! Just make sure you have someone to support you. If it doesn’t, that’s totally fine too. Eating healthy and balanced is more important than any fad diet.