Keto Diet: A Dietitian’s Perspective

Keto Diet: A Dietitian’s Perspective



Hey bacon, what’s shakin’? The keto diet has taken the world by storm. In fact, the keto diet was one of the most searched diets in 2019. If you didn’t know, the keto diet is a very low carbohydrate (30 g or less), moderate protein, high fat diet that promises users fast weight loss and decreased appetite. Keto dieters usually choose foods like meat, eggs, seafood, cheese, oil, and low-carb vegetables to make up their daily menu and limit grains, beans, fruit, certain sauces, and potatoes.

When one starts a keto diet, it usually takes four to seven days for the body to use up glucose stores and transition into ketosis, where the body is using fat for fuel. During this transition time, many people experience the dreaded “keto flu” which brings unpleasant side effects like nausea, tiredness, muscle cramps, brain fog, irritability and possible dehydration. Without much carbohydrates, your body will reduce the amount of insulin it makes, so the body responds by excreting sodium and water which can quickly excite dieters when they see the scale go down a few pounds. To fight these symptoms, however, diet blogs encourage keto dieters to have salt water or mineral supplements, which can cost you a pretty penny right off the bat. Starting a diet in a state of imbalance is something that is a reason for concern, because the imbalance doesn’t necessarily end after the first week.

In the medical world, the ketogenic diet is an approved form of medical nutrition therapy (MNT) for the treatment of epilepsy and other seizure disorders. It is thought that the reduction of neuron excitement and decreased disruptions in energy availability are beneficial to these patients when the body is running off ketones. Only certain medical professionals, like registered dietitians, can provide MNT to ensure that patients (or regular people like you) are meeting their daily needs of nutrients and to reduce their risk for harm. If done incorrectly, this diet could leave you feeling sluggish for weeks on end or just cause your body to rapidly lose and then regain weight later, thus impacting your metabolism. Research comparing 13 trials showed that ketogenic diets can result in more initial weight loss compared to other dieting methods, but after peak weight loss (around 5 months in), dieters started regaining weight. Boo!

Many keto dieters complain of being constipated once they reach ketosis and are encouraged to have laxatives if needed. The solution to this issue is likely the missing fiber, but where did all the fiber go? In the high carb fruits, vegetables, and grains that dieters are not allowed to have! It is recommended that females have 25 g of fiber and men have 38 g of fiber daily and those goals are hard to meet even for someone not on this diet. Dietitians have always cautioned about eliminating entire food groups from diets because it can lead to nutrient imbalances and set you up to binge later. With any strict diet, long-term weight loss success is rarely found and the best methods for sustained weight loss typically include foods from all categories. At the end of the day, your best bet would be to skip this diet, have small meals with a protein, vegetable, grain, fruit, and dairy daily, get 150 minutes of physical activity per week, drink your water, and meet with a dietitian for additional guidance and tools to help you meet your weight loss goals. Happy eating!


Author: Stephanie Kulczycki, RDN, LDN



Dennett, Carrie. “The Ketogenic Diet for Weight Loss – Today’s Dietitian Magazine.” Today’s Dietitian, Jan. 2019,
Roehl, Kelly, and Sarika L. Sewak. “Practice Paper of the Academy of Nutrition and Dietetics: Classic and Modified Ketogenic Diets for Treatment of Epilepsy.” Journal of the Academy of Nutrition and Dietetics, vol. 117, no. 8, 2017, pp. 1279–1292., doi:10.1016/j.jand.2017.06.006.
Ting, Rhonda, et al. “Ketogenic Diet for Weight Loss.” Canadian Family Physician Medecin De Famille Canadien, College of Family Physicians of Canada, Dec. 2018,


Meet the Author

Stephanie Kulczycki

Stephanie Kulczycki

I am a registered and licensed dietitian working as a home health RD. I graduated from Loyola University Chicago's DI program in 2019 and am now the social media chair for CAND this year.
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