10 Reasons to Avoid a Keto Diet

As a Nutritionist that has been in clinical practice for 40 years, I’ve watched just about every diet you could name come and go.  The Scarsdale Diet, Liquid Modified Fasting, Beverly Hills Diet, Blood Type Diet, Paleo, Grapefruit Diet, Cabbage Soup Diet, Dean Ornish, The Zone, The Phen Fen Craze, the HCG Diet, The Apple Cider Diet, and the Pritikin Diet are just a few that come to mind.  The most popular diet was probably the Atkins Diet, and I’ve watched that one come and go over 3 times in the last 3 decades!  And you know what folks?  It seems the mere oddity of all these diets just continues to attract millions of people back into the dieting roller coaster to give yet another extreme diet a try.

If anyone of those diets had the answer to permanent weight loss, there would be no need for another to emerge, right?  Yet here we are, once again, watching millions of Americans jump on another crazy bandwagon in hopes of discovering a new way to lose weight.  This time, I’m watching another version of the Atkins Diet reemerge with a name that was created in the early 1900’s:  the Keto Diet.  I’d like to think that after 4 decades of this crap people would wisen up and quit seeking out such ridiculous ways to lose weight.  But here I am, once again, trying to explain why doing these extreme diets is so harmful to your body.


1. You’re About to Start a Diet That Was Invented in 1911 and You Could Die.
So what’s so bad about doing Keto? Let me walk you step by step what “going keto” means and what kind of negative impact it’s going to have on your body. But before I do, let me tell you how the Keto Diet came about for use in one subset of people: epileptics. This diet was discovered in the early 1900’s, but its popularity rose by 1921 because a physician discovered that a diet that produced high levels of ketones in the blood had a huge impact on reducing seizures in Epileptic patients. And you know what? It works really well at reducing the number of seizures an epileptic has. Back then, however, the availability of medications doctors had access to was very limited and in fact, they were almost nonexistent. Today, most epileptics don’t need to go on a Keto Diet because of the advancements and the effectiveness of anti-seizure medications that have been created since 1911.

I should point out, however, that all of the patients’ doctors put on the Keto Diet experienced negative side effects the longer they were in ketosis. In a study run by Dr. Kang of the Department of Pediatrics and Epilepsy Center in Seoul, Korea, Kang and his group of researchers set out to determine what, if any, limitations a Ketogenic Diet would have on this demographic. What they found was that all patients who participated in the study showed similar side effects, with dehydration being the most common complication. Other severe side effects both short and long-term included constipation, diarrhea, inflammation, hair loss, dehydration, muscle cramps, muscle loss, hypoglycemia, impaired concentration, reduced platelet counts, nutrient deficiencies, bone loss (osteoporosis), reduced growth rates in children put on the diet, loss of energy, pancreatitis, and heart irregularities. The side effects these patients experienced were similar to a lot of complaints you’ll hear people following a low-carb diet experience, and anyone going on a Keto Diet needs to understand that they, too, will experience at least some of these things the longer they stay on the diet. The worst complication? Death. In fact, out of the 129 patients they were studying, 17.1% had to stop due to serious complications and 3.1% of the patients actually died.

Other similar studies to test the short and long-term effects of a Ketogenic Diet came to similar conclusions as the tests run by Kang and his colleagues. For example, in a study run by Suo had almost half of the participants, 158 children, were removed from the study due to serious long-term side effects. Seven of the participants died during the study. In another study directed by Bank study of Ketogenic Diets, a high incidence of cardiac death was associated with this style of dieting. More recently (2018), a study was presented by researchers at the European Society of Cardiology Congress. They studied the eating patterns of almost 25,000 people across the US for over a decade, and they concluded that low-carb diets, paired with an increase in fat intake, were linked to a higher risk of death the longer a person remained on this type of dieting protocol. But keep in mind, this study wasn’t even looking at Keto dieting; it was only looking at low-carb dieting. It has to make you stop and think, if the risk for mortality increases on a low-carb diet, what on earth will the risk be if you stay on a Keto Diet too long?

It wasn’t just those two studies that serious health implications on the studies participants, but Bank et, al,. 2008 and Stewart et, al., 2001 also found almost the exact same complications in their studies on long term keto diets. So what’s the difference between a low carb diet and a keto diet? Essentially it’s the level that you drop your carbohydrate level down to that makes the difference. The keto diet is ultra low in carbs, so low in fact it creates ketones. The low carb diet is higher in carbs but never goes low enough to produce ketones.

2. You’ll Have Excessive Weight Gain Once You Stop
There are several things that can go wrong when you cut your carbs too low and increase your fat intake, so let me address what happens to most low-carb eaters. When someone tells me they are “going keto,” what I often encounter is a person who cut carbs, but did it so wrong that they never even came close to reaching ketogenesis. Instead, they cut carbs low enough to reach something else, and that’s called gluconeogenisis. For starters, your body always uses carbohydrates as its form of fuel. The body takes all the carbs you eat and converts them into a basic sugar called glucose. All the cells in your body burn glucose for energy, and the glucose it converts into glycogen is stored into the muscles and liver. Having more glycogen in your muscles is what makes your muscles fuller and bigger … and that’s a good thing. When you cut your carbs too low, your body still has to have glucose in order to function. However, without adequate carbs to convert to glucose, your body will go into a state of gluconeogenisis,  the production of glucose from either protein or fats. You’ll never know which way your body chooses to go, but your body will choose either protein or fat to create glucose. Have you ever heard of someone going on a low-carb diet only to find it didn’t work for them at all? In their case, the most likely thing that happened was their body chose to convert their protein into glucose and store the fats they were eating. However, when someone does lose weight on the low-carb diet, its safe to say that their body chose to convert fat into glucose.

No matter which way your body chose to go, whether it converted the fat or the protein into glucose, you’re essentially screwed after that. Why? You’ve created physiological changes within your body that now no longer allows you to burn carbohydrates the way you once did. So when you start eating carbs again your body will simply store them into your fat cells. And WHAM! Now you’re gaining all the weight back that you lost and in many cases, even more.

3. Bad Breath
Ketogenesis is different from gluconeogenesis in that you’ll throw a switch on your metabolism and go from a sugar-burning machine to a fat-burning one. When you cut your carbs low enough for your body to create ketones, you’ll create a process where Acetyl CoA (derived from beta-oxidation of fatty acids) are turned into ketone bodies by your liver. They are released into your bloodstream so that tissues that have mitochondria can meet their energy needs. This is the exact same process that occurs in a period of starvation. In other words, true ketosis is another word for starvation. The term ketone bodies comes from the acetone by-product that is produced by the body to create acetone, and it’s this that produces the smelly breath of people that are truly in ketosis–kind of a nail polish remover smell.

4. Bone Loss
Once your body is creating ketones, you are in a highly acidic state. As the ketone bodies in the bloodstream rise, the pH of the blood drops and in an extreme case, such as that which can happen to diabetics, a condition called ketoacidosis can occur. If you’re healthy, what you’ll encounter is called nutritional ketosis, which isn’t as life-threatening as ketoacidosis. In either scenario, though, your blood cannot remain acidic because if it does, you will die. In order to protect your body from being too acidic, then, your bone will begin to release its stored calcium to buffer the blood and raise the pH base. The longer you remain in a state of ketosis, the more bone loss you will have. Keep in mind that this process of releasing stored calcium in order to buffer the blood occurs in short-term acidic conditions, too. This means you will lose calcium from your bone once you enter ketosis; however, it may not create enough bone loss in the early stages to be detectable in comparison to having been in a state of ketosis for an extended period of time. This bone loss is confirmed by Bank et, al., 2008 as well as all of Kang et, al., 2004, 2005 and 2013 studies.

5. Digestive Disorders
Constipation can occur because the Keto Diet is low in carbs and most of our fiber comes from various forms of carbohydrates. Let’s face it—keto means saying goodbye to complex carbohydrates such as oatmeal, yams, potatoes, brown rice, and fruit because you’ll be swapping those out with more oils, fish, nuts, red meats, and some green veggies. With all that fat and lack of fibrous foods, your bowels can get blocked up, leading to constipation. Some people, however, go in the opposite direction and end up with loose bowels. All the fat they consume can be hard on some people’s digestive systems and the high fat intake can lead to diarrhea. While there are meats with healthier fats to choose from, let’s be honest — a lot of people will lean more toward a heavy intake of red meats. And a diet heavy in red meats has been associated with a higher incidence of colon and breast cancers.

6. Kidney Stones
If you recall, dehydration was the most common complication found occurring within multiple studies. One of the adverse effects of dehydration is the elevated likelihood that kidney stones will develop. In the Chinese hospital study by Suo, et, al., 2013, seven of the children enrolled in the study had to be removed due to renal stone development and thrombocytopenia. Thromboctopenia is a drop in platelets within the blood, and platletes are a component in blood coagulation. More recently, Dr. Koushik Shaw, a urologist at Austin Urology Institute, was quoted on Fox News that he has begun to see a worrisome trend: “I’ve seen a huge spike in the number of kidney stones that we see, and I attribute the increase to these high-protein, low-carb, keto type diets,” he said.

7. You’ll Lose Muscle
Muscle cells are made up primarily of water, glycogen, and amino acids. When you cut your carbs too low, you’ll lose some of your weight from muscle and some from fat. It’s been estimated that for every 10 pounds you lose on a low-carb diet, 4 of it can come from muscle. Why does this happen? Before your body can create ketones, it has to eat up all the glucose and glycogen within your body first. Once the glucose and glycogen are used up, only then will your body begin the process of creating ketones. This explains why so many competitors that cut carbs too low look flat and don’t have a good level of muscle fullness unless they eat a lot of carbs the night before a show. Are they ripped? They can be. Most, though, look more like anorexics or prisoner of war camp survivors than healthy athletes. Since ketosis is a form of starvation, it’s kind of hard to keep muscle while your body is fighting to stay alive.

8. My Doctor Told Me to Do It!
Let’s face it–most doctors have very little training in nutrition if any at all. They are people after all and are just as susceptible to the media food chain as everyone else is. Unfortunately, many of them are giving you advice derived from the same information you found on the Internet or in the pages of the latest diet book. One thing you have to realize is that almost all the diets I listed at the beginning of this article were sponsored by or created by a doctor. These are the people that brought you the Phen-Fen catastrophe, the HCG diet, Protein Modified Fast, and an entire host of other programs … including the Keto-Diet. They are also the ones behind the plethora of weight loss drugs that have serious side effects and never seem to work once the drug is stopped.

9. It’s Not Sustainable
Keep in mind that the method you chose to lose weight is the method you must keep doing to keep the weight off. If you’re “going keto” and giving up foods like rice, potatoes, yams, peas, etc…then what you’re essentially saying as you start keto dieting is you’re giving those foods up … for good. What you need to ask yourself is, “Can I honestly eat that way for the rest of my life?” Just ask the millions of dieters that started and failed on Atkins how well that approach worked for them? Essentially, Atkins and keto dieting are twin brothers of different mothers. Since the success rate of Atkins diet isn’t very high, how successful do you think Keto Dieting is going to be?

10. But Studies Indicate That Blood Lipids Go Down on Keto!
Yes, there are a lot of studies right now touting the benefits of dropping carbs to the point of inducing keto. Studies aren’t the only thing that seem to support the powerful benefits of a keto diet–physicians are also seeing it in their patients’ blood workups. Reduced cholesterol, reduced triglycerides, increased good cholesterol, and even an increased sense of well-being have been reported by some of their patients. Keep in mind, weight loss and changing a person’s diet can both have positive impacts upon blood markers. So is it the weight loss and reduction of junk foods that is impacting the blood lipids, or the keto diet? I don’t know how you can separate the two to be sure it’s one or the other? However, if you’ve read this far I hope you know by now that the information I’m sharing with you about keto diets has to do with long-term outcomes, not short-term results, and there’s a huge difference between the two. I would contend that despite the short-term benefits that can occur in blood lipids, the long-term delirious effects such as bone loss and other issues are way more important to consider. So what’s my point here? What good is short-term benefits if the long-term effects harm your metabolism, health, and body?

I’m the CEO of the Institute of Eating Management & Relapse Prevention Center located in Houston, Texas. I’ve never had to remove carbs from any of my clients’ diets while helping them lose weight. I may reduce carbohydrates along with excess dietary fats, but I have never pulled them so low that they suffer and experience any issues with their health or well-being. In fact, my long-term success rate is extremely high because of an additional factor all of the aforementioned diets never approached: it’s called Relapse Prevention. All the diet books overlook the psychological component of weight loss. I realized that if I don’t change the way my clients think about food, they’d never be able to change what they do with food. In addition, another reason for their long-term success is because we avoid going down a path of deprivation and removal of healthy food groups. People learn how to manage their food, not get rid of it. But more importantly their eating program is sustainable from the very beginning, and if you’re on a program that isn’t sustainable, I would contend that you’re destined to fail. My patients routinely lose 20, 40, 50 or more pounds and keep their weight off for many years because it’s easy to sustain. And they never gave up carbs to lose the weight. What a keto diet teaches you is how to give up carbs, but it doesn’t teach you how to change the behaviors that created the problem in the beginning.

Can people lose weight on low-carb and keto diets? You bet! Are they a long-term solution to weight loss? Nope. Are they healthy? Clearly not! Like so many of the other diets I’ve watched come and go over my 40 years in practice, I can tell you the Keto Diet will be just another one for me to add to that list. We can debate until we’re blue in the face as to why all those diets I listed at the beginning of this article didn’t work, but one thing I will tell you is that all of them have one thing in common: they were short-term solutions and lacked long-term sustainability.


About the Keith Klein, CN, CCN
Want to get into your best shape ever with Keith Klein? Keith is co-founder of Lean Body Coaching, a results-driven one-on-one nutritional counseling Get Lean™ program. For more information, visit www.leanbodycoaching.com

This 6-month online Get Lean™ program is dedicated to showing people how to eat to be healthy and leaner and includes a 3-month relapse prevention program which teaches the clients how to keep their weight off.

Keith trained in Clinical Nutrition at the Institute of Specialized Medicine during the late 1970’s. He spent five years at the Institute working alongside six of Houston’s most prestigious physicians. He ran the dietetic department of all four Houston locations where he treated various patients with clinical disorders. Disorders like heart disease, diabetes, cancer, obesity, and other health-related problems.

In 1984, Keith became the Dietetic Director at Houston’s Bariatric Center with psychiatrist Dr.John H. Simms. It was Keith who designed and implemented the dietary protocol and dietetic programs that were used in all four of Dr. Simms’ clinics. The main focus was on treating patients with eating disorders and obesity. It was during this time that Keith developed most of his work pertaining to the Psychology of Eating Management and Relapse Prevention.

After Dr. Simms retired, Keith (in conjunction with Dr. Ron Preston) opened both The Texas Nutrition Clinic and the Houston Sports Medicine Clinic. During this time Keith combined all of his previous experiences in clinical practice with the dietary protocol for a wide range of athletic endeavors and sports.

Today Keith owns and operates The Institute of Eating Management & Relapse Prevention Center which he opened in 1990 -the present. Here Keith has a wide range of various nutritionists trained in all of his principles where they see a variety of different patients each day.

Other Notable Points:
• Chief of Nutrition for the Houston’s Sheriff’s Department
• Nutritionist for the Houston Areo’s hockey team
• Voted Nutritionist of The Year by the North American Natural Bodybuilding Federation
• Voted Lifetime Achievement Award by the NPC bodybuilding federation

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