Keto: Health expert explains the ketogenic weight-loss diet
Weight loss isn’t easy and we all want a quick fix, but the keto diet isn’t going to offer you this. It’s time to start ignoring your friend who says they lost a stone in the first few weeks on the carb-free diet because it isn’t what it seems. Express.co.uk chatted to NHS surgical doctor and author of Food Isn’t Medicine – out on April 15, 2021 – Dr Joshua Wolrich (@drjoshuawolrich on Instagram) to find out everything you need to know about the ketogenic diet.
What is the keto diet?
What we know as the ‘keto’ diet was originally brought on the scene in the 1920s to treat epilepsy.
American doctor Russel Morsel Wilder demonstrated the effectiveness of the ketogenic diet in the 1920s to produce a high level of ketones in the blood by increasing fat intake and cutting back on carbs.
A 1925 study by paediatrician Mynie Gustav Peterman on 37 young people with epilepsy saw 95 percent improve seizure control an 60 percent become seizure-free by following the keto diet.
Later studies proved the diet worked on teenagers too, but adults were the least likely to benefit from the diet.
The diet forces the body to use ketones instead of glucose, which we get from carbohydrates, as its main energy source and although this came with some unpleasant side effects, these were outweighed by the diet’s ability to reduce the number of seizures experienced.
This sounds promising, right? Well, NHS surgical doctor Dr Joshua Wolrich, who you may know from his popular Instagram account, says the keto diet is only useful in this instance – and even then, there are much better remedies available to epilepsy sufferers today.
On top of this, most keto fanatics today aren’t even following the traditional keto diet, rendering their rigorous regime utterly pointless and even dangerous.
Keto diet: The keto diet involves restricting carbs and upping fat intake
Keto diet: The ketogenic diet was originally created to manage seizures in epilepsy
We’ve got some bad news for you keto fans… the rigorous keto diet you’re following isn’t actually working in the way you think it is.
The 1920 regime for people with epilepsy was very strict, with about 90 percent of the entire diet coming from fat.
Today, keto dieters split their daily calorie intake into about 70 to 80 percent fat, five to 10 percent carbohydrates, and 10 to 20 percent protein, which is not sufficient to force your body into ‘ketosis’.
Dr Joshua explained: “Research suggests that the majority of people who believe that they are on the keto diet aren’t actually solely using ketones for energy, which is the sole purpose of the diet.
“Ironically, even research studies that claim to be putting their participants on ketogenic diets don’t manage to get their patients to actually be in ketogenesis.”
“Essentially all they’re doing is eating more fat and fewer carbs but it’s not actually converting the body’s energy source, which is fine because that’s not going to do anything beneficial to them anyway.”
Yep, that’s right. You might as well sink your teeth into the sandwich you’re craving because the keto diet is nearly impossible to stick to.
Dr Joshua added that even if you were doing it properly, there would be no benefits to your health anyway.
Keto diet: Cutting back on carbs might help Type 2 diabetes, but isn’t a miracle cure
Does the keto diet impact health positively?
The internet is full of sweeping statements that the keto diet will help you overcome Type 2 diabetes and other illnesses… but it’s simply not true.
While reducing the amount of carbohydrate in your diet might be beneficial in some circumstances, such as in people with Type 2 diabetes, there is no evidence the keto diet can cure these health problems.
Dr Wolrich said: “The only reason why eating fewer carbohydrates can sometimes be beneficial is when you have a problem with using insulin.
“If your body has an issue with insulin and you essentially avoid food that stimulates insulin, you may find that some of your symptoms get better.
“However, it doesn’t cure anything and if you ever eat carbohydrates normally again nothing will have changed.
“It’s a bit like a plaster on a chronic wound. It doesn’t fix the wound, it’s just covering it up – like a plaster, when you take it off you realise the wound is still there.”
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Does the keto diet help you lose weight?
If you’re looking to lose a few pounds, the keto diet isn’t the way to go.
Dr Wolrich explained while the number on the scales might drop in the first few weeks on the keto diet, you aren’t actually losing weight.
He said: “If you stop eating carbs your scales will drop and that’s not because you’re actually losing fat, it’s because you’re losing water.
“Carbohydrates are stored in the liver and muscle as something called glycogen to use later
“This is beneficial because when we exercise our muscles have a store of glucose to use rather than having to waste energy breaking other stuff down or finding it from elsewhere.
“That glucose gets stored with water and when you stop eating carbs, your body uses up the source of carbs that it has left and releases all of that water at the same time.”
The scales might tell you you’ve lost weight but this is purely water weight, you’re not losing any fat whatsoever.
Dr Joshua added: “The number on the scales will drop initially and then stop dropping, but that water will stay off and won’t be stored again until you eat carbs again.
“When you stop doing the keto diet and eat carbs again, your weight will go up and this fuels the idea that carbs make you fat… but that’s not true!”
Keto diet: The keto diet won’t help you lose fat, you’ll just lose water weight
Keto diet: If you aren’t diabetic or epileptic, you won’t benefit from the keto diet at all
What are the side effects of the keto diet?
Not only is the keto diet totally pointless, but it also brings a number of nasty side effects with it.
The most well-known one is dubbed the ‘keto flu’, which includes a range of symptoms such as headaches, tiredness, nausea, lack of energy, and finding it hard to concentrate.
In short, this happens because you are forcing your brain to change its energy source.
Dr Joshua said: “Your brain prefers to use glucose, that’s the way it’s designed.
“Glucose is the primary source of energy for the body and brain, so if you stop giving your body glucose your brain has to adapt to using ketones.
“People with epilepsy can also experience those symptoms on the ketogenic diet, but that is outweighed by the fact that they might have a reduction in seizures.
“If that doesn’t happen, they stop eating that way because there’s no point.”
So if you don’t have epilepsy, there is not a single reason for you to do the keto diet.
Your body wants you to eat carbohydrates and even if it does adapt to using ketones for energy, there is no benefit to that.
Dr Joshua summed it up nicely, he said: “You forced your brain to adapt to using ketones. Good for you. Now what?”
Keto diet: The keto diet has no health benefits and will give you nasty side effects
You may also have some problems with your bowels when you first start the keto diet, from diarrhoea to constipation.
Dr Joshua explained our bowels rely on carbohydrates for health, and there’s no fibre in fat and protein – the main food sources of the keto diet.
A lot of our fibre comes from carbs, so if you take carbs out of your diet you can either end up experiencing extreme diarrhoea or become very constipated.
Dr Joshua said: “All of the microbiomes in your gut that keeps the gut lining healthy and keeps your bowel working well no longer has anything to feed off because it feeds off fibre and it feeds off the carbohydrates you give it.
“On the keto diet, your bowel is struggling to function properly, which is why you end up with bowel problems.”
Why would you want to spend hours on the loo? Especially if you’re not improving your health, losing weight, or reducing epileptic seizures.
Dr Joshua added: “The symptoms are another reason why the keto diet is not a sensible diet to be doing because there is no positive outcome from it unless you have epilepsy.
“For people who are having seizures three times a day, for whom drugs aren’t working, if they reduce the number of seizures they have but they end up constipated they’re probably willing to make that change.”
“But why would you choose to be constipated when you don’t need to be? There’s no reason for it!
“This is another reason why I don’t recommend it for people who have type two diabetes because what is the point in risking all of these other things but you could you could just eat carbohydrates in a different way and have exactly the same benefits.”
Keto diet: You may also experience diarrhoea or constipation
Is the keto diet dangerous?
The keto diet isn’t just pointless alongside dreadful side effects, it is potentially detrimental to your health in the long term.
Dr Joshua explained: “Research shows that the vast majority of people that go on the ketogenic diet end up increasing their cholesterol levels.
“This sometimes happens because eating more fat and less fibre means you’re increasing the amount of saturated fat in your diet.
“This doesn’t have to happen if you are very precise about it, but for the vast majority of the general public who are just doing it by reading something online, that will happen.
“You’re not only causing keto flu, constipation, diarrhoea, but you’re also increasing your risk of heart disease.
“There is no good reason to be doing it, it is just completely unnecessary.”
The weight you lose will come back on again at some point, Dr Joshua said the chances of this happening is almost guaranteed.
He added: “You’re also increasing your risk of colon cancer by not having fibre for a massive chunk of your life.”
Keto diet: You will almost definitely increase your cholesterol levels while on the keto diet
What should I do instead?
If you have Type 2 diabetes, Dr Joshua recommends “being sensible” with your carbs without being “aggressively strict”.
He explained: “Changing the type of carbohydrates in your diet and focusing more on the complex kind and fibre and things like that can have a massive benefit when it comes to Type 2 diabetes and there’s absolutely no reason why going on a keto diet is necessary.
“I personally wouldn’t recommend it to patients who are diabetic either because I believe there are much more sensible ways that mean that you don’t end up with some of the negative side effects and some of the some of the danger from it.”
For those looking to lose weight, it’s time to consider your health rather than yo-yo dieting and restricting yourself.
Dr Joshua said: “The first thing I’d do if a patient told me they want to lose weight is ask them about why and if what they really want to do is get healthier.
“Weight is not a good marker of health, so it’s important to focus on things that are actually going to make you healthy.
“We shouldn’t be focusing on weight loss anyway, we should be focusing on health.
“We shouldn’t be reducing carbs because that is not a health-promoting act.”