Why People Love Keto and Experts Hate It

The keto diet is everywhere. You can read endless articles about the diet online, while markets carry all sorts of keto-friendly products. People just love talking about the keto diet, and many dieters attribute their weight-loss success to the plan. On the other hand, many nutrition experts don't promote (and actually hate!) the keto diet. Why is this diet in a love-hate relationship with nutrition experts and dieters?

Dieters all over social media have been touting the benefits of keto, but it's rare to find a full explanation of the physiological response to the diet. This high-fat, moderate-protein and very-low-carb diet has dieters giving up grains, legumes, sugar, low- and non-fat dairy, some nuts and seeds, some vegetables and most fruit. The science behind the diet is that by cutting carbs this low, your body needs to use an alternative mechanism to provide the body energy. As such, your body turns fat into ketones, which are, ultimately, the body's backup mechanism for providing energy. But with so many success stories, why aren't nutrition experts hopping on the keto bandwagon?

What Nutrition Experts Say

Keith Ayoob, EdD, R.D.N., an associate clinical professor of pediatrics at Albert Einstein College of Medicine, says putting your body into a state of ketosis is never recommended, and could even be harmful. "It's certainly a sign of an unbalanced diet. You may lose weight on it, but a ketogenic diet is, by definition, unbalanced and should never be maintained—that's a red flag for a bad diet."

But long-term maintenance isn't the only reason nutrition experts aren't fans. "I hate the keto diet because it limits the amount of fiber you would receive from fruits and whole grains, which could lead to constipation," says Jonathan Valdez, owner of Genki Nutrition and a media spokesperson for New York State Academy of Nutrition and Dietetics "Stay constipated long enough, you will also feel bloated and very uncomfortable. Plus, long periods of time on the toilet due to constipation is not a cute look especially when you're on-the-go with family and kids."

Nutrition experts also don't like the fact that the keto diet omits entire food groups. Ayoob says that food decisions may be easier with limited choices, and might even explain why many people like the diet—until they get bored. "You still need the nutrients from those omitted food groups," Ayoob explains. "No dairy, no grains, no fruit, not even many veggies, and no scientific evidence behind it? No way this is a good diet. I can't get behind any diet that demonizes foods like apples, whole-grain breads, and yogurt."

The diet's rigidity is also a concern to Malina Malkani, M.S., R.D.N., C.D.N., media spokesperson for the Academy of Nutrition and Dietetics and creator of the Wholitarian Lifestyle.  "A lifestyle requiring so many restrictions—like counting grams of carbohydrates, eliminating major food groups, watching protein intake and restricting food choices within allowed food groups—is hard enough to maintain in the long-term as an individual. For parents, maintaining these restrictions over time is even more challenging in the context of feeding a family and socializing within a community, and it can be detrimental when trying to role model a healthy relationship with food for children," Malkani explains.

The Reality

As a registered dietitian, I have developed keto recipes and understand first-hand how difficult it is to stay within the carb limits of this diet. It took me, an expert, a while to compute every single carb in dishes, which means it would certainly be time-consuming for others to get all the numbers right.

Where do these hidden carbs come from? There are so many hidden sources. For example, the keto diet promotes consumption of avocados, but even moderate portions will add a few grams of carbs. The same is true with dried herbs—add one to two teaspoons to a dish and you've got some grams there, too. As such, it would seem that most people are unknowingly doing a modified version of the keto plan and eating more carbs than they think (which, again, isn't a bad thing!).

A modified keto diet tends to be followed by a dieter who is trying to ease off the plan. The diet consists of 55 percent fat, 30 percent protein and 15 percent carbs. It can also be used by those who don't like the strictness of the actual keto plan and need something more doable. It also allows for more fiber and nutrients from fruits, vegetables, nuts and seeds. You can even add a touch of whole grains, legumes, and other foods that are strictly forbidden on the traditional keto diet, all of which would add essential fiber, vitamins and minerals.

The bottom line is this: Although you may be in love with the keto diet now, there are good reasons for nutrition experts to dislike the diet plan. Very strict diets have a very high rate of failure, and the best diet is one that is sustainable for the long-term. Adding a few more carbs through various healthy foods in your diet isn't a bad thing, and that's most likely what's happening without you even realizing it.
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Member Comments

Keto is nothing new as you basically overload with fats. Two issues come up and that is if you sway off the diet you have to start all over again and secondly many overweight clients also have associated heart problems and using a fatty diet also leads to additional heart problems. he best diet is to eat small meals throughout the day with nutritional foods and keep active. The one most important fact is to be ACTIVE. I avoid all fad diets as they are just that a fad and are usually associated with buying something to fulfill that fad. Report
So hard to take the “experts” seriously! If their advice was so great then why do still have the obesity crisis? We’re not getting healthy following standard advice on macros. I’m on a keto diet and I’ve never felt better or been healthier! The labs don’t lie! Report
Keith Ayoob ... says ...ketosis is never recommended [by whom??], and could [or could not, right?] even be harmful ... a ketogenic diet is, by definition, unbalanced [who defined "balanced", and on what authority?] ...

... could lead to constipation," says Jonathan Valdez ... not a cute look ..." ["Could" again. Could does not mean will, or does. It means maybe. And, "not a cute look" is such a non-scientific criticism! If I wanted to know how cute I am, I'd go to a media spokesperson, not an actual scientifically trained dietician. Oh, wait ...]

Keto is not boring. It's filling and satisfying. "Food groups" are an artificial construct, trying to fit all the nutritional variety in the world into 4 or 5 simple categories. Has Mr. Ayoob tried living only on "apples, whole-grain breads, and yogurt"? I don't know how that would go, but I'd be interested to hear.

Conclusion: this is not a useful article. It is based on opinions, not facts. There may be facts behind the opinions, but those are not in the article. Report
Something that is not long-term sustainable is a no-no. Report
I had a bad stomach bug for a month that reacted to carbs, and I was really thankful that there were guides to the keto diet for vegetarians. I would have trouble even when I ate carrot sticks, and I was having a hard time keeping myself fed. It was a relief to see keto recipes and be able to find more foods I could eat, so I wasn't just surviving on almonds.

I tried to stick to my new habits when I was able to eat a wider variety of food and it was impossible without the, um, immediate intestinal feedback, but I'm still thankful that there were food bloggers who published guides to help me in my situation. I lost a lot of weight that month, which isn't something I wanted, but I was still functional at work and able to exercise. Report
I don't think this diet is for me. I enjoy my fruits too much which adds the carbs up too high. Thanks for sharing! Report
My first thought when I read the headline was "And these are the same 'experts' who told us for years that eggs were bad and HFCS & Hydrogenated vegetable oils were good for us.' Report
Great info Report
I do IF for my BRAIN, as a result I experienced a health and energy that interested me in a KETO way of eating. I do not diet.

I continue to be very interested in Keto. I enjoy well researched articles. Report
The KETO diet was never developed for adults!! It was developed for children with epilepsy. It is believed that certain foods may contain minerals or other things that may contain seizures. As the child gets older, foods are added back into the child's diet until a healthy diet could be found. Report
I have always had questions about this diet. Thanks for realistic answers Report
I am not sure how 8 cups of vegies a day can be considered unhealthy. I've lost over 50 lbs and have kept it off for almost 2 years. But the weight is only part of it. I no longer have any prescriptions. I have fixed my prediabetes, insulin resistance, dry eyes, slow metabolism, constipation, high blood pressure, low HDLs, migraines, sinus issues, brain fog and dry skin. I sleep really well at night and have energy during the day. I really do not believe that anyone NEEDS sugar or grains to meet their minimum daily nutritional requirements. I do intake some lemon juice and nutritional yeast to cover the C's and B's but I don't need all those carbs in whole wheat bread and whole piece of fruit to get them. Once I got the hang of it, Keto and IF has been really easy for me and has been the only "diet" that cured my cravings for sweets and being hungry all of the time. I am healthier at age 50 than I have been for the last decade or more of my life. Keto actually helps you get healthy so you can lose the weight. Report
Many of the so called experts were trained inside the box. Not saying there are no negatives but at least in the short term there are many benefits. Report
Umm, ketosis is a perfectly natural state to be in, not at all harmful. Newborns are naturally in ketosis, as well as their nursing moms. Anyone who fasts for a certain period, like pre-surgery, will also go into ketosis of course. There’s plenty of experts who love keto, and have lived on it for years- check out Dominic D’agostino, for example. The US Navy had him study the Seals with keto to improve their diving abilities and oxygen issues. There’s essential amino acids, essential fats, but no such thing as essential carbohydrates. Did you know your body is actually capable of making its own glucose as needed? Almost everything runs better on ketones, anyway. What did our ancestors do? Inuit tribes and others? They mostly ate meat, and seasonal vegetation. Sometimes they went days with no food, waiting to catch some. Researchers who studied the Inuit in the early 1900s found they had no cavities and almost no incidents of heart disease or cancer. For the world as a whole, type 2 diabetes was super rare prior to about 150 years ago, when refined sugar became readily available. And now...
Personally, I’m 5 months on strict keto (and I eat dairy- yogurt, cheese, butter, cream, thank you very much), real whole foods like eggs, meat, veggies, avocado, healthy oils (no omega 6 junk oils), berries, lemon, lime, some nuts and seeds, lots of water. No sugar. No processed foods. Scary, huh? In 5 months, my blood pressure went from high to normal; sleep improved; achy joints went away; skin cleared up; constipation went away, totally regular now; better stamina and energy; mental clarity; improved anxiety symptoms; my teeth always feel smooth and clean now; and I’ve lost almost 30 pounds on top of that. I feel like I’m 20 again. I’m in my 40s, and my last 2 decades of eating “healthy”- whole grains, fruit juices, Special K, low-fat everything, eating 6 small meals, the US food pyramid- all of that- left me yo-yo-ing my weight, exhausted all the time all day every day, dragging around, achy old-lady body, acne, eczema, psoriasis, anx... Report
i'm not sure how great this diet would be long term though Report


About The Author

Toby Amidor
Toby Amidor
Toby Amidor, M.S., R.D., is the founder of Toby Amidor Nutrition and the author of "The Greek Yogurt Kitchen" and "The Healthy Meal Prep Cookbook."