A dietitian explains why everyone thinks the keto diet is so dangerous.

I want to preface this by saying that I’ve been an accredited practicing dietitian for over a decade. I’ve worked with everyday people through my practice on the Mornington Peninsula for both general weight loss, as well as within hospitals and bariatric clinics to help weight loss patients. I’ve now brought this expertise to the weight-loss industry as co-founder of Be Fit Food, a whole-food based weight-loss meal delivery program.

With all this in mind my advice below won’t suit everyone. But that’s the nature of the game in health as it is all about the individual, and seeing that I don’t have the medical history of all those that will read this article, I can’t say that it will work the same for everyone.

It’s not for everyone.

I’m know how cliché this sounds, but everyone is different so what works for one may not work for the next. This is true for a ketogenic diet and some people will hear the term and want to know more, while others may see it as nothing more than another ‘trending’ diet. I’d like people to look at it and apply the same individualistic thinking that we attribute to people’s health; that ketosis might be different for everyone and it’s allowed to be.

Listen: Journalist Brigid Delaney tackled the ‘wellness’ cult and came out the other side. She talks to Mia Freedman, on No Filter. Post continues after audio. 

It’s not what it used to be.

Traditionally, ketogenic diets were quite unbalanced and were based more in a medical setting than in a weight loss setting for treating conditions such as Epilepsy and Type 1 Diabetes. You can imagine that to treat medical conditions such as these the diets were extreme and this is why I think people still treat the modern day version with apprehension. The new age approach to a ketogenic diet is much milder and recommends to reduce your intake of carbohydrates as opposed to the extreme of cutting out food groups altogether.

So, what is ketosis?

Ketosis is a metabolic state in which our body produces ketone bodies as an alternative energy source to glucose. Our body’s preferred fuel source is glucose which you largely consume in the form of carbohydrates found in breads, cereals, grains, legumes, fruit, starchy vegetables, dairy products and sugar.

If you only consume a very low amount of carbohydrates, moderate amounts of fats and have an overall caloric deficit, your body begins to look elsewhere for fuel and starts to burn ketones rather than glucose. One of the key benefits of using ketones for energy rather than glucose, and what often yields weight loss results, is that the body is no longer relying on dietary intake for energy but rather stored fats.


The most important thing to understand is that there are different levels of ketogenic diets and no one size fits all approach. There is a state called ‘mild nutritional ketosis’ which is just as it sounds, a milder state of ketosis which is sustainable for longer. The really strict ketogenic diets belong in the medical world and they’re not recommended for general use and should only be used under medical supervision. What I want people to aspire to is a balanced, nutritionally whole approach to a ketogenic diet.

The long term benefits of rapid weight loss.

The good news is, the science is on our side if rapid weight loss through ketosis is something you want to achieve. Research is beginning to suggest that there is an association between the rate of initial weight loss and long term success. When you’re losing weight you want to see results but you also want to keep it off, so naturally, ways to avoid regaining weight are just as important.

Which is why it’s good to know that initial rapid weight loss has been found to actually reduce your susceptibility to regaining weight in the long term. So, losing weight quickly in the short term means you achieve your goals sooner and have the motivation to stick to new-found healthy habits, as well as the added benefit of having a greater chance of success over time.


What happens to your body in Ketosis?

You might have heard stories around what can happen to your body when it’s in ketosis, and there are a few key things to look out for. First, you’re likely to be less hungry; because one, a high protein intake has a higher satiety effect; and two, ketone bodies themselves have a direct appetite suppressant action.

Second, and this one isn’t as pleasant, although easily managed, is that your breath might smell as one of the by-products of the breakdown of ketones is acetone (the source of any unpleasant odour). Acetone is exhaled through the lungs, thus making your breath smell a little like nail polish remover. Aside from the need to use breath mints, this is not harmful and is a sure-fire sign that your body is in ketosis.

Lastly, you’ll get control of your blood sugar levels as you’re limiting the spikes in blood sugars that come with frequent carbohydrate and sugar intake. As a result, your body doesn’t need to produce as much insulin. Low insulin levels mean that your body is better able to break down fat to be used as fuel. This may also be a good result for people with Type 2 Diabetes who can use their own insulin better and possibly get to the stage where they can rely less on medication in the long term.


It takes dedication.

People need to keep in mind that this sort of diet takes dedication, and that ‘falling off the wagon’ will drop you out of ketosis. Ketosis may not be unnatural for your body, but for the average Australian it’s unnatural for their lifestyle. The level of restriction you need to place on your diet to enter ketosis will be different for everyone, for some it will be more than others. If you can’t maintain that long term, don’t.

In my experience it’s not uncommon for people to undertake a ketogenic diet and enter ketosis for perhaps a 4 week period in order to achieve a short term goal. Once you’ve achieved that goal you can ease off on the restrictions. You might drop out of ketosis but the healthy eating you’re doing will still be beneficial.

Get personalised advice.

I get it, life can be busy, and sometimes speaking to a professional can be time intensive and expensive but I genuinely believe that if you’re going to undertake such a big diet change that you should speak to someone. Don’t get me wrong, do your research first, but the information that is available online is not always applicable to individuals, it’s applicable to populations.

If seeking professional advice isn’t an option for you, take into consideration the following. It’s safe to reduce some carbohydrates, it’s safe to moderately reduce portion size but if you begin to cut things out altogether I recommend you don’t do so without supervision and health care advice.

If you want to ease into it, cut back on processed foods.

Most of our food that we consume at the moment is tampered in the sense that it’s processed, commercialised, and it’s not coming from whole sources. So the good thing about the interest in ketogenic diets is the broader awareness it brings to the benefits of cutting out processed foods. Used in the right way, a ketogenic inspired diet encourages your intake of plant foods, healthy fats and proteins.

As I said it’s completely safe and common practice to reduce processed carbohydrates and portion size to an extent. So if you want to dip your toes in the water you can. Seek out recipes online, find programs that promote whole foods and keep you clear of processed foods. Meal delivery programs are great to help you get started as you can be confident that they are safe, healthy and follow the correct guidelines.

If a ketogenic diet is of interest to you, I encourage you to learn more. Extreme is a relative term, if a keto diet sounds extreme to you, that’s fine, if it doesn’t, that’s fine as well.