The use of a keto diet, which involves high fat and low carbohydrate levels, is controversial and not usually recommended during pregnancy.

A ketogenic diet is a high fat, low carbohydrate, and adequate protein diet. It is a popular lifestyle diet for weight maintenance and body building. In addition to weight loss, the keto diet can help regulate blood sugar levels and normalise menstrual periods.

It is more difficult for the body to use fats as fuel in comparison to carbohydrates. For this reason, people who are on the keto diet are advised to eat less than 50 grams of carbohydrates per day, whilst increasing the fat requirement. The reasoning for this is to obtain most of your daily calories from fats in order to stimulate the natural burning of body fat.

Doctors sometimes recommend the keto diet for people with medical conditions, including diabetes, polycystic ovary syndrome (PCOS), and epilepsy. However, choosing to remain on a keto diet during pregnancy is controversial since it involves burning fat through ketosis. Ketosis is when fats are used to burn energy rather than carbohydrates. This causes the liver to produce ketones, which replaces glucose as an energy source.

Here we provide an overview of the potential benefits and risks of a keto diet during pregnancy:

There is some suggestion that a keto diet can be beneficial during pregnancy, particularly for women who are overweight or obese.  

Eating a low carbohydrate, high fat diet, including foods such as celery, cauliflower, eggs, fish, meats, avocado, and cheese, has been associated with a reduced frequency of morning sickness, nausea, miscarriage, pre-eclampsia, and gestational diabetes.

There is some evidence to suggest that a keto diet may help manage seizures in pregnant women who suffer from epilepsy. A study published in Seizure found that symptoms of epilepsy were able to be controlled using keto therapy in two pregnant women. These women had normal, healthy pregnancies with reduced seizure frequency. Mild side effects included lowered vitamin levels and raised cholesterol levels. However, more investigation is required to evaluate the benefits and risks, as well as long term side effects, of using the keto diet in the management of epilepsy.

Risks of a keto diet during pregnancy

Although the keto diet is normally used to lose weight, a diet during pregnancy is not advised. Eating a balanced diet becomes even more important during pregnancy as the growing baby requires foods that are rich in vitamins, nutrients, minerals, iron, and folate. Since fruits and vegetables are high in carbs and natural sugars, their consumption has to be limited in the keto diet. An inadequate level of nutrient intake can lead to problems in the baby’s growth and development.

Eating carbohydrates during pregnancy is important since grains like wheat flour, rice, and pasta are rich in folic acid, which is critical for fetal development. Since protein is part of the keto diet, it can cause people to eat foods that are higher in saturated fat. Although healthy fats are vital for pregnant women and the growing baby, excessive saturated fat can lead to health problems, including higher cholesterol levels.

Animal studies have found that a keto diet during gestation can lead to changes in embryonic organ growth, such as a larger heart and a smaller brain. This may be associated with organ dysfunction and behavioural changes. A study published in BMC Pregnancy and Childbirth found that a low carbohydrate diet in pregnant mice caused smaller brain development and neurobehavioural changes in offspring. Another study published in Brain and Behavior discovered that pregnant mice on a keto diet had babies that were more likely to suffer from anxiety and depression in adulthood.

The keto diet can cause side effects, known as the ‘keto flu’. This can consist of fatigue, dizziness, nausea, headaches, and muscle cramps. This adds to the side effects that already exist in pregnancy.

A keto diet increases the risk of starvation ketoacidosis, which is a metabolic issue caused by a dangerously high level of ketones. This usually occurs after the body is deprived of glucose as the primary source of energy for a sustained period of time and leads to acidity in the blood. Since ketones can pass freely through the placenta to the baby, a keto diet is generally not advised during pregnancy.

There is evidence that a low carbohydrate can aid the management, treatment, or prevention of gestational diabetes, which is a type of high blood sugar that occurs during pregnancy. A study published in International Journal of Case Reports and Clinical Images found that a low carbohydrate diet lowers the need for insulin. However, it may not be necessary to completely adhere to a keto diet to reduce your risk of gestational diabetes.

It is essential that pregnant women eat a balanced diet with a combination of fats, protein, and carbohydrates. Eating a low carbohydrate diet that has an adequate level of healthy fats, protein, fibre, fruits, and vegetables may be more suitable than a keto diet during pregnancy. The health and development of the fetus should always be the priority. Please consult a doctor if you are planning on following a keto diet or other eating plan during pregnancy.

Written by Albina Babu, MSc

References:

Is low carb and keto safe during pregnancy? (2019). Diet Doctor. Retrieved from: https://www.dietdoctor.com/low-carb/keto

van der Louw, E.J., et al. (2017). Ketogenic diet therapy for epilepsy during pregnancy: a case series. Seizure, 45, pp.198-201.

Sussman, D., et al. (2013). Effects of a ketogenic diet during pregnancy on embryonic growth in the mouse. BMC Pregnancy and Childbirth, 13(1), pp.109-120.

Sussman, D., Germann, J. and Henkelman, M. (2015). Gestational ketogenic diet programs brain structure and susceptibility to depression & anxiety in the adult mouse offspring. Brain and Behavior, 5(2).

Tóth, C. and Clemens, Z. (2014). Type 1 diabetes mellitus successfully managed with the paleolithic ketogenic diet. Int J Case Rep Images, 5(10), pp.699-703.

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Fats may be keto superstars, but some are definitely better than others.   Nutrition Myth Buster and keto follower Jonny Bowden, Ph.D., CNS, reveals  which fats are good for you this holiday season and which deserve a lump of coal.

How to eat keto on holiday?

Staying on the keto diet full time can be demanding, especially around the holidays. “Let’s be realistic. I know you’re probably not going to give up your favorite holiday pie or cookies,” says Nutrition Myth Buster Jonny Bowden, Ph.D., CNS. “But there are a few tricks to use over the next few months.” The keto diet encourages followers to cut their carb intake and include more fats in their diet. Cutting down on carbs has once again been shown to be heart healthy. A 12-month human clinical study involving 577 healthy participants found that a high-carb diet was much more likely to increase an otherwise healthy person’s heart disease risk factors than a high-fat diet. Fat didn’t move the needle one way or the other. Considering heart attack rates go up in the winter, this is a good time to stay the course and limit the sugar-laden and bread heavy seasonal treats.

Some fats are healthier than others

When it comes to boosting fat intake, however, there’s a naughty way and a nice way. Some fats, are healthier than others. Most of the participants in this study consumed Malaysian palm oil, which is 50% saturated fat (and 40% monounsaturated fat, the same kind found in olive oil!).

Bowden suggests being discriminating about which fats you eat because unhealthy choices will affect your health in other ways. Stay away from corn oil, sunflower oil, safflower oil and soybean oil. “These seed oils are filled with omega-6s, and are very pro-inflammatory. Excess amounts of so-called “vegetable oils” are a primary source of inflammation in the American diet,” says Bowden. “Inflammation is a significant factor in just about every degenerative disease known to man.”

What else you need to know about keto?

The keto diet is currently America’s favorite. It is extremely low in carbs. Here’s why: Your body only has two fuels it can use: fats and carbs (which break down into sugar/glucose). Being a sugar burner doesn’t help with weight loss. Many people have plenty of fat on their bodies waiting to be burned for fuel, but their bodies won’t use it because it prefers to use sugar.The keto diet forces your body to use fat as its predominant fuel. This is known as nutritional ketosis. There’s a caveat however: Your body can enter ketosis regardless of the quality of fat you eat. It doesn’t care if you’re eating corn oil that’s been refried 25 times or the highest quality Malaysian certified sustainable palm oil. Either one will raise your ketones. But one’s junk food and one’s a health food.Ketosis

Clean keto

“If you’re only looking at getting into ketosis, you can do it with crummy foods,” comments Bowden. “As long as you cut the carbs and eat enough fat, you’ll get into ketosis. But so what? You still won’t be healthy. It would be like losing weight on coffee and other stimulants! It’ll work, but who wants that? I advocate what’s called clean keto. It’s much healthier to get into ketosis by eating really good foods such as grass-fed beef, fresh fruits and vegetables you prepare in your kitchen, and using better-for-you cooking oils like ghee and Malaysian palm.”

How to “do” keto during the holidays

Bowden has several suggestions for following keto this holiday season.

• Be kind to your heart. Restrict goodies to just a few days during the holiday season.
• Reduce consumption of the inflammatory oils. Replace them with healthier fats, such as olive, coconut and palm oil. Bonus: All Malaysian palm oil is non-GMO, while more than 90% of corn, soybean and canola grown is genetically modified. Palm oil also offers a unique, heart-healthy 50-50 blend of saturated and unsaturated fat. It also has health benefits for the brain and liver.
• Minimize the hidden sugars in your holiday meals. Prepare dishes from scratch instead of from a package. Surprising sources of hidden sugars include canned soup, salad dressings and pasta sauces. While you’re at it, put the brakes on eating refined grains such as white flour and white rice,” Bowden suggests.
• Do keto by day: Follow a ketogenic diet as much as possible during the day. Then enjoy your special meals with family and friends at night.
• Consider keto cycling/flirting with keto: A lot of keto advocates are into this. They follow a ketogenic diet for three to four weeks, a few times a year. It can be very therapeutic. Think of keto cycling as hitting the reset button on your metabolism. It helps jumpstart your weight loss. And here’s a way to adapt this idea: Try following a keto diet for the 10 days before a big holiday meal. Or it doesn’t have to be 10 days. It can be five days. Then you’ll be able to enjoy your holiday meals pretty much guilt-free.

By using one of these tactics, you’ll start training your metabolism to become more flexible and get your toes wet on the keto diet without completely giving up your favorite holiday foods.

About Jonny Bowden Ph.D.CNS

Jonny Bowden, PhD, CNS, also known as “The Nutrition Myth Buster” is a nationally known board-certified nutritionist and expert on diet and weight loss. He has appeared on the Dr. Oz Show, Fox News, CNN, MSNBC, ABC, NBC, and CBS as an expert on nutrition has contributed to articles in The New York Times, Forbes, The Daily Beast, The Huffington Post, Vanity Fair Online, Men’s Health, Prevention, and dozens of other print and online publications.

Dr. Jonny is the best-selling author of 15 books including The 150 Healthiest Foods on Earth, Living Low Carb (now in its fourth edition), Smart Fat (with Steven Masley, MD), The Most Effective Ways to Live Longer, and his latest, The Great Cholesterol Myth: Revised and Updated Edition. (co-written with cardiologist Stephen Sinatra, MD). Follow him @jonnybowden  www.jonnybowden.com Facebook: Dr. Jonny Bowden

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The high-fat, low-carb keto diet has been around for 100 years as a therapeutic treatment for epileptic seizures, but it’s recently gained favor with celebrities and heath enthusiasts alike as a foolproof way to lose weight. The idea with keto is to shift the body into a state of fat-burning ketosis, by banishing nearly all carbs (no sweet apples or bread allowed), and fueling up on 70 to 80% fat every day.

It’s been tried by Hollywood stars including the Kardashians and Halle Berry, while Silicon Valley tech workers swear by its ability to lift their mental fog. Doctors are also starting to believe the plan holds promise for staving off diabetes. There’s even evidence to suggest that maybe it could one day help some drugs better combat cancer.

Health experts are still cautious about recommending the plan across the board, however, not only because it’s difficult to follow, but more importantly, because there isn’t much long-term data about what it may do to heart health after years or decades of use. Cardiologists and kidney doctors are already expressing serious concerns about what they’re seeing in practice when certain patients go high-fat.

Going low-carb can be bad for your heart

Cardiologist Elizabeth Klodas says not all of her patients have done well on the trendy plan.

“Stop. Stop!” she told Insider. “In my own practice, the people that have adopted it, their cholesterols can just go crazy.”

She’s not the only heart doctor to have pointed this out.

Cardiologist Ethan Weiss, who himself has become an ardent follower of a high-fat keto diet plan, says that while high cholesterol isn’t a common issue with keto, it can happen.

“I think the vast majority of people who go on this diet will have no trouble with their cholesterol,” Weiss told Business Insider last year. “But I’m not going to tell the people that do have trouble with their cholesterol that it’s not a problem.”

He sometimes suggests a high-fat keto plan to his patients working to manage diabetes, obesity, and other metabolic issues. But he’s cautious about how and when he prescribes it, recommending what he calls a “heart healthy” keto, with lots of fatty fish, olive oil, nuts, and avocado in the mix.

Klodas said those are all healthful additions to any diet that she would endorse to her patients, too.

“It’s not about high fat, low fat, it’s good fat, bad fat,” she said. “The oils in nuts and seeds, oils in fish, avocados, you don’t have to worry about those, those appear to be anti-inflammatory, they help cholesterol.”

But evidence suggests people tend to fuel up on bacon, cream, and coconut oil when going keto instead of favoring unsaturated, healthy fats.

Perhaps this is why studies show that people who follow low-carb diets tend to have a higher risk of death, and in particular, tend to die from coronary heart disease far more often than people who eat more carbohydrates. (Not everyone who goes low-carb will restrict their carb intake enough to enter fat-burning ketosis, however.)

Whether your diet is low-carb or high-carb, make sure you’re eating plenty of fruits, vegetables, and nuts

Klodas also doesn’t buy into the idea that going low-carb, while shunning the fruits, vegetables, beans, and grains that we know are linked to positive health outcomes, is a good idea.

“If you look at populations that eat a keto-type diet, the Inuit, for example, very few fruits and vegetables, right? Their average lifespan is 10 years shorter,” Klodas said. “None of these Blue Zones where people live long, well … none of them follow a keto diet.”

Klodas said the secret to better health lies in cooking more for yourself and incorporating more produce, like fruits, vegetables, and beans into what you eat. These can be high-carb, but also promote overall health.

Instead of overhauling people’s diets completely (often a failing strategy), Klodas has asked many of her patients to shift their eating routines through small, incremental changes. She started a line of packaged “Step One Foods” six years ago, which all include lots of fiber, alpha-linoleic acid, and plant sterols to help lower cholesterol.

The idea is that patients might make two simple “swaps” to their diet a day, switching out an afternoon candy bar or a breakfast pastry with something from her line like a serving of oatmeal or a smoothie.

At an American Heart Association scientific session in 2018, Klodas presented academic research conducted (in conjunction with the Mayo Clinic and University of Manitoba) on 54 patients, which suggested that her swaps really work. They helped people reduce their total cholesterol by about 5% in a monthlong trial, without any additional drugs.

She sees her program as one small way to start people down a path to choosing more healthful foods, lowering their overall cholesterol without the potential for some of the mind-altering side effects that statins can have.

“What I see are deficiencies of fiber, antioxidants, healthy fats,” she said. “That’s the thing that’s really missing in people’s lives.”

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For the third consecutive year, the annual U.S. News and World Report ranked the exceeding popular keto diet as one of the worst possible diets to follow. The ranking is culled from medical journals and government data, plus input from a panel of health and nutrition experts; since at least 2018, this review process has placed keto at or just above the very bottom of the list. Yet people continue to follow this diet, shoveling heaps of protein and fats into their mouths and eating so little carbs it makes them physically ill.

The core notion within keto (short for ketogenic) is that it forces the body into “ketosis,” where it preferentially burns fat because there is no carbohydrate-derived fuel to use. (Never mind that your body can absolutely burn fat without being in this state of forced stress.) To achieve ketosis, the keto diet advises getting most of your calories from fat, eating moderate amounts of protein, and eating fewer carbs per day than are in an apple. Studies have shown that sort of diet to be helpful for children with epilepsy and people with diabetes, but in an otherwise healthy person, it’s routinely discouraged.

As the old adage goes, third time’s the charm!!!!! Even though doctors and scientists have been hollering about this for years, it seems the idea that keto is Bad may finally be working its way into the grander ether. A recent CNN report (published on “National Keto Day,” a thing made up by Vitamin Shoppe) poses the obvious question: how has a diet so despised by health experts remained so popular? “Experts say it’s because its legions of fans are focusing on the short-term benefits of fast weight loss, without factoring in possible long-term risks,” CNN reports. And in a recent keto explainer in the New York Times, Whitney Linsenmeyer, a spokeswoman for the Academy of Nutrition and Dietetics, chalked the diet’s popularity up to America being in “a state of carbophobia;” additional experts warned against the long-term effects (like increased risk of cardiovascular disease) keto might have on the body.

Keto can seem like a fun, flirty diet compared to other, even more rigorous options: you can eat cheese, steaks, even hamburger patties. That’s fun! But eating fewer than 20 grams of carbs per day, as the diet advises, is unhealthy and unsustainable, as David Katz, founding director of the Yale University Prevention Research Center, told CNN. (The average recommended range, for comparison, is between 225–325 grams of carbs per day.) Eating so few carbs even sends many new keto-ers into something called the “keto flu,” a sure sign your body is extremely pissed off at what you’re doing to it.

VICE has routinely (rightfully) admonished keto for some time, and now it finally seems, with this third slap on the wrist, many others are catching on. Thank god, and god speed.

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They claim that ditching carbs has helped them to target stubborn areas of fat without having to cut out lots of calories.

However, dietitian Robbie Clark has revealed that going keto could actually make you gain weight – if you’re not following the right steps.

And he says that many dieters make some big mistakes which mean their body doesn’t get into a state of “ketosis” and “burn fat for energy instead of glucose”.

Here, Robbie explains common mistakes people make on a keto diet that could be making you fatter…and how to avoid them.

1. Dramatically cutting carbs

Robbie says one of the most common mistakes he finds in terms of clinical practice is that people are reducing their carbohydrate intake “cold turkey.”

“They’ve gone from a diet that is probably consumed moderate or high amounts of carbs to an extremely low amount, and this is a drastic change for the body,” he told.

“This is when they’re at risk of the keto flu.

“The keto flu is the body adapting to the whole process in a large depletion in glucose.

“And the symptoms can include nausea, headaches, fatigue, insomnia, constipation and reduced exercise tolerance.”

Robbie recommends tapering down carb intake instead of reducing the level at an extreme rate.

2. Not drinking enough water

An important thing to do on a keto diet is to keep drinking enough water.

The drastic decrease in carbs can cause shifts in fluids and electrolyte balance.

“The body is washed-out of a lot of fluid especially when losing fat mass as well,” Robbie says.

“The body flushes out the ketones in the urine which also depletes not just water but sodium, an important electrolyte, from the body.”

According to Robbie, this is something that needs to be replaced.

3. Eating the right veg

Vegetables have carbohydrates and for a lot of people, this means watching how much is actually consumed.

If you’re not careful of the types of carbs on the keto diet, the affect is that people won’t stay in that ketosis state.

Robbie says: “On the other hand, the ketogenic diet is a ‘low carbohydrate diet’ and not a ‘no carbohydrate diet’.

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Keto diet is the new mantra when it comes to weight loss and physical fitness. It is rightly said that physical fitness is a state of health and well-being and, more specifically, the ability to perform aspects of sports, occupations and daily activities. Today’s generation understands this and takes every possible step to achieve it.

Developed in 1920, the main motive of the keto diet was to cure epilepsy in children, however, it wasn’t long when its benefits in weight loss were identified. Since then, this diet has become a mantra to achieve weight loss.

How Does Keto Diet Work? Understanding the Mechanism

This keto diet works by feeding the body on an excess of fat stores.
This is easily achieved by limiting the supply of carbohydrates which are the source of energy to the body. This, in the absence of energy, the body meets the crunch through the breakdown of excess fat thereby resulting in weight loss.

This diet develops molecules called Ketones through the process of ketogenesis. This in no way is harmful to the body because of it being a normal physiological process.

Contents of the keto diet – What to Eat?

This diet is rich in protein contents such as fish, meat and poultry. Even cheese and butter, along with creat, and other fatty dairy products also form part of the keto diet. Vegetables that are low on carbohydrates such as green vegetables, tomatoes, and even onions and tomatoes also form a part of this diet.

Side Effects of the Keto Diet

However, there are some side effects associated with the intake of the keto diet. These include constipation, nausea, dizzy, headache, fatigue, and dehydration. All of this happens because of the improper intake of food leading to energy crunch in the body. They last for a few weeks until the body adjusts to the new developments.

The worst side effect of this diet is the keto breath. This is a result of ketones that are produced because of this diet. The keto breath usually lasts for about six weeks.

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Even if you’re fuzzy on the finer points of what precisely the keto diet is, you’ve likely heard the term more often within the past year. According to the Mayo Clinic, the keto diet’s high-fat, low-carbohydrate regimen means your body begins burning fat for energy, a state called ketosis. (All that fat plus a prohibition against many nutrient-rich vegetables and fruits, the Clinic notes, is “a concern for long-term heart health.”) A lack of studies on keto’s long-term effects hasn’t slowed the popularity of the diet, and “keto-friendly” foods are popping up everywhere from the cereal aisle to strip-mall pizza chains.

Enter Blaze Pizza, the second fastest-growing restaurant chain in the country, which today launches its new keto pizza at its more than 300 locations nationwide. According to a press release, the crust has just six grams of carbs; Blaze’s website lists its ingredients as cauliflower rice, mozzarella cheese, casein protein, flaxseed, eggs, whey protein, yeast, spices, and cultured brown rice. It’s topped with spicy red sauce, mozzarella, ovalini mozzarella, bacon, cherry tomatoes, mushrooms, and spinach. Blaze is also rolling out three other new pies, including a “protein pizza” with the keto crust plus lots of meat; a vegetarian pizza; and a vegan pizza.

We at The Takeout are less interested in the keto pizza on face, and more interested in what Blaze’s launch means about the diet’s ongoing popularity. Companies as large as Blaze have done their research before launching new products—they’ve crunched the numbers, analyzed the trend data, and are banking on the keto trend continuing to deliver enough sales to offset the research and development that goes into new product launches. That keto pizza has reached a chain posted up in strip malls across 41 states indicates the high-fat, low-carb revolution has no doubt hit the mainstream.

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311 may released their first chart-topping single nearly 25 years ago, but frontman Nick Hexum is arguably in the best shape of his life.

Before the funky rock band’s 13th studio album Voyager dropped last week, the “Down” singer told People that eating the ever-popular ketogenic diet keeps his frame lean and mean at nearly 50 years old.  

“Most of the year I just eat a lot of eggs, salmon, I love macadamia nuts, stuff like that,” he said. All three are also part of the scientifically sound Mediterranean diet. But other foods on Hexum’s menu aren’t quite as clean.

“I eat out plenty. I don’t feel like I’m depriving myself. Some people try to eat too clean on [keto]. I’m like, ‘Just go crazy with the fats: butter, cheese, bacon.’ Let it be fun!”

While Hexum doesn’t indulge in full-blown cheat days, he does work in a carb-heavy homemade pizza every on occasion. 

“I don’t like to be too strict,” Hexum said. “I don’t want to take the fun out of it and completely deprive myself.”

“I figured I could just eat as much as I want and have more energy,” he added. That’s a good thing, as 311 is currently on a coast-to-coast tour in support of their latest release. 

“Once you get through that little keto bump and get adapted, you have much more sustained energy,” he said. “It’s not up and down like it is on a carb-rich diet.”

As the post above would suggest, the dude also works out hard. But just as he does with the diet, Hexum keeps things interesting with a mix of exercises that includes surfing, weights and interval training. 

“Musically, I like to try a lot of different things, and physically, I try a lot of different things too,” Hexum said. “When I’m in shape and I’m on stage, I feel very comfortable and focused.”

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