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To keto, or not to keto?

What is a ketogenic diet?

The ketogenic or “keto” diet is very low in carbohydrates and very high in fat. The reduced amount of carbohydrates places the body in a state of ‘ketosis’, which is a metabolic state where fat provides most of the fuel the body requires to function (I’ll speak about this more later).

Interestingly enough, this diet didn’t spark from a celebrity endorsement or some guy missing a medical license, this diet was initially developed in the 1920s to treat children with epilepsy. But now, it has been endorsed by many celebrities and athletes. Even the paleo-cult has turned to this way of eating.

How low is “low carb” when following a ketogenic diet?

General healthy eating guidelines currently recommend 45-65% of calories to come from carbohydrates, 20-30% protein and 20-30% fat. To develop ketosis, however, most people need to restrict carbohydrate intake to 5% carbohydrates, where approximately 10-50g of carbohydrates are consumed each day. While it’s commonly thought that these popular ketogenic diets are high in protein, they are not. The remaining percentages of calories would be coming from only 20% protein and a huge 75% (!!!) of fat.

To put the carbohydrate amount into perspective, there are 40-50 grams of carbohydrate in each of the following foods:

  • 1 cup of cooked spaghetti, rice or quinoa

  • 1 cup of oats

  • 3 cups of cooked carrots

  • 1 ½ large apples

  • 4 cups of milk

But before you get excited and think that doesn’t sound too bad, you can pick only one of those items, not all of them when following a ketogenic diet. And this doesn’t factor in all the other sources of carbohydrate in your diet, like cucumber. Yes, cucumber has almost 5 grams of carbohydrate per cup.

So, what’s left?

People on a ketogenic diet focus on low-carbohydrate vegetables, high-fat milk products, meat, fish, poultry, eggs, and nuts and nut butters. Additionally, it may be recommended to eat something called “fat bombs” (I’ll leave you to look that up and make your own judgement.)

What’s the deal with ‘ketones’ and ‘ketosis’?

Our bodies run well on glucose (carbs)–they give us the necessary energy we need to function on a daily basis. When our body doesn’t get enough glucose (either because we’re cutting carbs too low, OR we haven’t eaten in too long), our body kind of freaks out and looks for other forms of energy to satisfy that role. That’s where the fat comes in. Without carbs, our insulin levels drop and fat is released from our cells. The fat overwhelms the liver which turns it into ketones, our body’s second choice to carbs for energy. Therefore, “keto” comes from the word ketones, which are the source of energy that the body uses when it’s burning fat.

It’s important to recognise however, that ketones are produced in weight loss regardless of the type of diet you are following. So, actually, anyone who is losing weight is actually using ‘ketones’ for energy.

Should you try it?

First, we need to understand that although reducing carbohydrates can reduce your weight, the MAJORITY of the initial weight loss would occur through loss of glycogen and water stores. After we eat carbs, they are broken down and stored as glycogen in our muscles and liver. Each gram of glycogen is stored with 3-4 grams of water. Our body generally holds around 400g – 800g of glycogen so you can do the math as to how much water that is. So in those first few days of a low carb diet, when those glycogen stores are being depleted, a heap of water (ie. water weight) is also being depleted too. So while the scales show weight loss, and you start feeling lighter, most of that loss doesn't actually come from fat reduction, it's mostly water. Water weight usually comes back on as rapidly as its lost.


  • Weight loss

  • Can get you eating more whole-foods

  • Can get you reducing your intake of junk food

  • Fat and protein are very satiating, meaning that you could feel fuller

  • Reduces the frequency of blood sugar spikes and drops

  • Could help improve focus and concentration

But there are always cons:

  • Pretty darn restrictive

  • Keto ‘flu’: Lots of brain fog, fatigue, headaches, nausea and poor endurance

  • Bad smelling breath, sweat and pee from the acetone (a by-product of fat metabolism)

  • Constipation due to the limited fibre intake

  • Golden ticket to eat crappy, low nutrient, high fat food like takeaway, increasing your risk of:

  • High cholesterol

  • Nutrient deficiencies

  • Questionable long-term benefits

  • Probably not maintainable for life, therefore, when you stop being ‘keto’, you’ll likely put the weight back on and a little bit more!

  • Likely compromise ability to do high intensity exercise

  • Social isolation – no one enjoys going to dinner with someone who only talks about their fancy diet and how many foods they CAN’T eat

My personal opinion:

Humans have this tendency to like to point the finger and blame one thing at a time. For example, we’ve demonised fat – good fat and bad fat, for so many years, driving food manufacturers to replace it with refined carbohydrates and sugars… But now, we’re doing the same thing with carbohydrates! We’re now demonising carbohydrates exactly as we did with fat – so even if the carbohydrates are the good, healthy type, we’re plotting them all in this ‘bad pile’ and people are driving this ‘low or no’ carbohydrate approach.

We’ve gone from pointing our finger from fat to carbs, to the point where people will eat a processed high protein low-carb bar made of literally fake ingredients, but they won’t eat a humble banana.

So, it’s not as if when we are told to cut out processed sugar or saturated fat, that we all start eating fruit and vegetables, beans and legumes – no, we just start eating high protein, sugar-free and/or fat-free junk food. And if we don’t lose weight from it, we start blaming everything else except the fact that we are still eating junk food.

What we’re doing is that we are not learning from our past mistakes. ALL nutrients like fats and carbohydrates are essential to the human body. So, we can’t be jumping from bandwagon to bandwagon – one week it’s no carbs and the next week it’s no fat and then no sugar. We need to understand that there is not only one type of good or bad food. We don’t consume single foods, single nutrients, or single food groups – we consume whole diets.

It’s everything you eat, on a weekly, monthly and yearly basis that will make a difference.

Following the “keto” diet may have its pro’s – but it sure as hell ain’t going to last forever. So you could be better off eating a variety of fruits, vegetables, grains, meat and dairy (and/or alternatives). Following a moderate diet is not only healthy, but it can last forever. And so...

It’s the ‘forever diet’ we need to worry about, not the 2 week fads.

That’s all folks.

With love, light, and a whole-lotta common sense,

ADM xx

Joyce Haddad, Director of A Dietitian's Mission, is an Adelaide based Dietitian, Nutritionist and Master Personal Trainer with a passion for health and wellbeing. ADM aims to help the public make informed and realistic nutritional choices and ensure everyone has a healthy relationship with their body and with food.

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