Dietitian Dish: Considering a Ketogenic Diet? What You Need to Know

January 10, 2018

By Saba Zahid, RD, LDN
Patient Experience Manager, Unidine Corporation

The arrival of the New Year brings a fresh opportunity to develop healthier habits. If you’ve struggled with weight loss, as many do, you may have considered one of the latest trendy diets to get to a healthier weight, like Whole 30, the Paleo diet, and the fad of the moment, the ketogenic or “keto” diet.  If you’re jumping on the keto bandwagon, however, it’s important to take a deeper look at this diet before you decide if it is something you should consider.

Where the Keto Diet Ranks
Every year, US News and World Report issues a ranking of the year’s best diets. The rankings are determined by an expert panel that evaluates each diet on nine areas including ease of compliance, the likelihood of losing significant weight in the short term and the long-term, and effectiveness against cardiovascular disease and diabetes. The ketogenic diet ranked last on the list (out of 40 diets).  You may be wondering why, especially if you have seen incredible weight loss results from the diet in friends or even yourself.

How the Keto Diet Works
The ketogenic diet is a low-carb, high-fat diet that originated as a therapy for epileptic seizures. The ketogenic diet calls for almost 70 percent of caloric intake from fat and only 15 to 20 grams net carbohydrates per day. The 2015 – 2020 Dietary Guidelines for Americans recommend that 45 to 65 percent of our calories come from carbohydrates. Normally, carbohydrates are converted to glucose in our bodies and then used for cellular function, and in particular, brain function. When there are not enough carbohydrates in a person’s diet, the liver converts fat into fatty acids and ketone bodies. The ketone bodies then serve as fuel for the brain. Individuals are encouraged to monitor if they are in a state of ketosis by testing their urine, because excess ketones end up in the urine to be excreted. Intermittent fasting is recommended to help maintain or achieve the state of ketosis.

Keto Diet Concerns
The obvious appeal of the ketogenic diet is the idea of burning fat and losing weight. However, with such a high fat intake, there are some serious health concerns. When you’re eating a tub of sour cream with some bacon on the side and cup of coffee with some butter mixed in for breakfast, which the diet encourages, you’re getting a serious helping of saturated fat. Saturated fat raises the level of LDL cholesterol (the bad cholesterol), which can damage your arteries and lead to a buildup of cholesterol on artery walls.

Additionally, with a limited intake of healthy carbohydrates to break down into glucose for the brain to use, you could experience headaches. Constipation can also be a side effect due to a lack of whole grains, fruits, and vegetables. Your breath will also smell fruity due to the ketones. Most importantly, the diet is just not a sustainable, healthy eating plan.

Diets that require you to completely eliminate a food group (fruits and whole grains as in the ketogenic diet) should always raise a red flag. You are going to eliminate key nutrients that your body needs from your diet. A healthy eating pattern never eliminates foods, but instead focuses more on balance and portions. The diets that US News and World Report ranked highest include the Mediterranean diet and the DASH (Dietary Approaches to Stop Hypertension) diet. Both diets have a similar premise: eat more vegetables and fruit, choose lean meats, and incorporate whole grains while limiting unhealthy fats.

If you feel like you have tried it all and still can’t lose weight, instead of choosing the keto diet, why not try working with one of Shore Medical Center’s Outpatient Nutrition Counseling dietitians? We would love to help you reach your nutrition and wellness goals in 2018. To schedule an appointment, contact us at 609-653-4600, option 5. To learn more, visit our website at

Saba Zahid, a registered dietitian from Unidine Corporation, is the patient experience manager for Shore Medical Center’s food and nutrition services. She oversees the medical center's patient food service program, clinical nutrition programs, and community nutrition initiatives.

Unidine is a dining management company that provides food and nutrition services to Shore Medical Center. Undine is committed to fresh food and scratch cooking for all of the clients it serves in healthcare, senior living, and business settings. To learn more, visit