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Four Myths and Misunderstandings about the Keto Diet

January 23, 2020

By now, you've likely heard about the ketogenic (keto) diet. And if you haven't tried it yet, you probably wonder if it works. The New York Times also wondered this when they interviewed me this past month for the article "What Is the Keto Diet and Does It Work?" The article uncovers several myths about the keto diet, but it also includes some persistent misunderstandings. Before we go into it let's try to understand what the keto diet is.

By Dr. Will Yancy, Director of the Duke Diet and Fitness Center

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Keto Diet Myths and Misunderstandings
The keto diet is a recent, popular version of a low-carbohydrate (carb) diet.

  • The keto diet is a low-carbohydrate diet
  • The keto diet is a recent, popular version of a low-carbohydrate (carb) diet. Low-carb diets have been around for a long time, and they've been widely studied by scientists. They've gone by many names over the years—Banting, Scarsdale, Atkins, Sugar Busters, Protein Power, low-carb, paleo, and the list goes on.
  • Low-carb diets mostly focus on meat, poultry, fish and shellfish, eggs, non-starchy vegetables, and several other low-carb foods, such as cheese and avocado. They avoid starches, such as bread, pasta, rice, potatoes, and legumes, and sugars, such as sweets, sodas, fruits, fruit juices, and milk.
  • Low-carb diets that are also ketogenic focus on the intake of fats and proteins while substantially reducing intake of carbs, usually to less than 50 grams per day. This helps the body's metabolism find other sources of fuel, such as fats. Fats are good sources of energy. Our bodies metabolize fats into ketones. The ketones then team up with glucose to fuel us.
  • Feeling less hungry is a unique feature of the keto diet. Less hunger usually means less calorie intake, which often leads to weight loss. However, some people also may notice weight loss while on the keto diet because their body is not storing as much water or because it has more energy, so it is doing more and burning more. 

Four common myths and misunderstandings about the keto diet:

1. The keto diet is high in fat so it won't lead to weight loss.


Science says the opposite. In head-to-head trials, low-carbohydrate diets often lead to more weight loss than low-calorie diets. That said, the important takeaway is that low-carb diets are an alternative, effective, nutritional option.

2. People are more at risk for heart disease when on the keto diet.


New research disagrees. The latest research shows that fat intake is less worrisome as it relates to heart disease. But there are still areas of uncertainty and controversy. It's the saturated fats that experts disagree on.

Today, most experts agree that more unsaturated fats, such as fatty fish, nuts, avocado, and olive oil, reduce the risk for heart disease. However, what many don't know is that most foods that contain saturated fats, such as most meats, also have unsaturated fats in similar amounts.

Even so, growing research, including a recent study, shows that saturated fat intake is less concerning for heart disease than we previously thought. And saturated fats may help protect us from suffering a stroke.

You May Also Be Interested In:

What is the Keto Diet?

Red Meat and Your Diet

Five Common Keto Mistakes 

3. More protein intake is hard on the liver and kidneys.

Myth and misunderstanding.

Where's the evidence?

I have struggled to find evidence that low-carb diets lead to liver problems. In fact, some studies show that liver tests improve, including fatty liver disease, with low-carb diets. As for the kidneys, the jury is still out. Most experts agree that higher protein intake is not an issue for healthy kidneys. However, if you have kidney disease, we are less certain. Clinical trials have not shown that lowering protein intake clearly helps. Nor do trials show that more protein intake harms the kidneys. If you have kidney problems or you are concerned, I recommend your kidney function be closely monitored.

4. The keto diet is hard to maintain.


Studies do not support this statement. As a weight-loss physician, this misunderstanding irks me. All healthy diets are hard to stick with. If they weren't, obesity wouldn't be common and on the rise. People who follow a low-carb diet in a study are no more likely to drop out of the study than the people following the comparison diet.

There are many reasons people struggle to reduce carbs or calories, such as temptation, peer pressure, other priorities, sugar addiction, and simply getting past the idea of not eating when we are not hungry. These are not signs of weakness—they are common, natural barriers to overcome.

It's hard to lose weight and keep it off. In addition, it can be overwhelming to wade through all the evidence and opinions out there about weight loss. Rather than trying to find out what other people think is the best diet, I suggest you find a healthy pattern that works for you.

Many people need more than a diet. If you want to take your life back and be your best you, reach out to the Duke Diet & Fitness Center (DFC). The center offers medically supervised programs. From outpatient medical, nutrition and behavioral services to immersive weight loss that ranges from 1 to 4 weeks. The programs help people who are serious about losing weight. They also work for people who want to improve their health and reduce risks for future health problems. Call 800-235-3853 or visit Duke Diet & Fitness Center's webpage at www.dukedietandfitness.com

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