Doctors Say Why You Should Be Careful About Going on the Ketogenic Diet

Doctors and nutritionists on why this may not be for everyone.
ILLUSTRATOR Jasrelle Serrano

Low-carb diets like South Beach, Atkins, and variants of those diets have been popular with this generation, but over the past year a new type of diet has been gaining traction: the Ketogenic Diet, which encourages you to ditch carbs and sugar, and eat more fat.

Before you jump on the keto wagon, however, there are many factors to consider before you drastically alter your body’s typical intake of nutrients. We talked to some experts to weigh in on what the fuss is about, and whether the keto diet is something worth trying. 

The Lowdown on Keto
Bianca Dualan, RND, resident nutritionist at Food Lab PH, describes the ketogenic diet’s origins and how the it works. According to her, the ketogenic diet began as nutrition therapy for children with seizures and later on was discovered to be beneficial to cancer patients as well. This is because most tumors feed on glucose (the molecule that the body uses as its main energy source). With the ketogenic diet, the body burns fat instead of glucose for energy.

This is achieved when the body enters a metabolic state called “ketosis” and turns fat found in the body into ketones, which can supply energy to the brain. “We get glucose from carbohydrates (pasta, grains, sweets, bread, starchy vegetables and fruits). In the ketogenic diet, carbohydrates are limited to only about 5% of your daily intake, and the rest is comprised of fat and protein (about 75% and 20% respectively.),” says Dualan.

The idea is, you lose weight and lose fat by drastically lowering your carb intake.


"Because the ketogenic diet requires good quality protein and fat, one becomes more conscientious of the food he eats and he ends up making better health choices.” 

According to Dualan, going on the ketogenic diet safely and effectively requires sticking with good quality protein and fat, and thinking long-term. “Going keto is more like a lifestyle, rather than a crash diet. Because the ketogenic diet requires good quality protein and fat, one becomes more conscientious of the food he/she eats and he/she ends up making better health choices,” says Dualan.

This diet is sustainable when not used simply as a weight loss tool, Dualan continues. Part of going on the diet means consuming fat and protein in calculated proportions, making sure your fiber and micronutrient (vitamins and minerals) intake is sufficient, and staying properly hydrated. She also recommends taking occasional breaks by allowing yourself to eat some carbohydrates once in a while.

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Can You Keep It Up?
Given the nature of the diet, however, some experts advise against going Keto if you’re not fully invested, or realistically won’t have time or the means to follow it meticulously.

According to endocrinology fellow Aoo Felipe, MD, the ketogenic diet works, but only if executed properly, and of course with your doctor’s advice. He points out the dangers that come with fad diets where people jump on the bandwagon without understanding what it takes to make it work.

“It’s difficult to start—not to mention  dangerous—if you don't invest time and proper research into it,” says Dr. Felipe.

“Given the way it’s been thrown around lately, it may be a fad in the sense that everyone and their grandmothers are doing it—but know little about the science and physiology behind it. I don't think it is sustainable long term. You would need to invest hardcore time and money to execute it well over a long period of time,” Felipe adds.

Aside from the simple matter of following through on such a restrictive diet, people who want to hop on the keto wagon should be ready to eat the same food again and again.

According to Fia Batua, RND, CSN, Sports Nutritionist and Elite Fitness trainer, going on the keto diet will require a lot of thorough meal planning and eating the same food on rotation, which probably isn’t doable for many people.

“We usually recommend getting your fat sources from butter, oils, cheese, nuts, avocado, cream, and certain kinds of meat. Aside from carefully sourcing ingredients, someone on the Keto diet would have to measure their food intake to match the standard 5-20-75 ratio of carbs, protein, and fat,” says Batua. “You have to ask yourself if you can realistically follow that pattern for an extended period of time,” she adds.


She also points out that when you drastically restrict one of the macronutrients, especially carbohydrates from your diet, your body will have a hard time processing this nutrient the moment you add it up later on.

“As a dietitian, I recommend avoiding drastic restriction of carbohydrates from your diet. Instead, train your body to properly utilize this nutrient by choosing the right kind, the right amount, and taking it in with proper timing,” says Batua.


You May Be Thin, But Are You Healthy?
Despite its apparent effectiveness at burning fat, it is important to note that the ketogenic diet is very regimented, and Chito Barangan, MD., general surgeon and family medicine specialist, warns against side effects.

“Possible complications and side effects of this diet if not properly done or supervised includes constipation, low grade acidosis, hypoglycaemia , increase level of lipids and cholesterol, tiredness, dizziness, palpitations, muscle cramps and deficiency in micronutrients,” says Dr. Barangan.


To combat these side effects, anyone going on the diet would have to be extra careful about monitoring food intake, measuring your food, and going on the diet only with the guidance of a doctor and/or nutritionist, adds Barangan.

“Before going on any kind of diet, know your history as well."


Alternatives to Consider
All in all, although the ketogenic works for some people people, it’s important to note that going on a restrictive diet like this should not be taken lightly. After all, a lot of factors come into play when following a nutrition plan.

“What's your occupation? Are you on night shift? Do you have access to a kitchen? Are you always on the go? It really depends,” says Felipe. He recommends a more practical way of going healthier: “For the average Joe who goes to work 8 to 5 and eats three meals a day with a morning and afternoon snack, a nice way to go about your diet is to half the amount of rice you usually take, double the vegetables, and take in more lean meat,” says Felipe.


He recommends simple, straightforward tweaks like staying away from drinks and just opting for water. “I think we greatly underestimate sweetened drinks in terms of how much sugar and calories they have. They pack a lot,” adds Felipe.  

Occupational medicine specialist Gia Sison, MD, recommends going for the kind of change in eating habits that is not too restrictive, works with your lifestyle, and is ultimately sustainable. “Before going on any kind of diet, know your history as well. If, for example, you’re diabetic, certain diets may not work for you,” Sison says.

She recommends an alternative that will give you time and space to jumpstart a change in lifestyle. At the end of the day, people should aim for a holistic lifestyle and not just focus on weight loss alone. "Take proactive steps,” says Sison. “Health is indeed wealth.”

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Patricia Atienza
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