Is the Keto diet recommended for everyone?



NO. A ketogenic diet is one in which carbohydrates are severely restricted (nearly eliminated), fat consumption is high and protein intake is moderate-low. The body’s process of converting its metabolism to fat-burning ketosis is a survival mechanism when carbohydrate supply is inadequate and dietary fat is plenty. [It shouldn’t be confused with diabetic ketoacidosis which also produces ketones, but with extremely high blood sugar.] Despite its short-term effectiveness for weight loss, I rarely recommend a Keto diet. Looking at all the available evidence, my professional opinion is that such an extreme approach is in opposition to a sustainable eating style that supports the whole body across one’s entire lifetime.

Following a ketogenic diet can cause long-term adverse effects such as hepatic steatosis, hypoproteinemia, kidney stones, and vitamin and mineral deficiencies1. Since the ketogenic diet is very high in fat, those with gallbladder, kidney, liver, or pancreatic disease or problems with delayed gastric emptying should not follow it. Just as they shouldn’t be consuming a high sugar/refined carb diet, pregnant or nursing women also should not be on a keto diet. It may be ideal for certain populations, though. Healthcare practitioners may prescribe a classic or modified ketogenic diet for patients with epilepsy2. It may be prescribed for morbidly obese patients in the weeks leading up to bariatric surgery3 and for some patients with Type 2 Diabetes4.  


  1. Masood W, Uppaluri KR. Ketogenic Diet. [Updated 2019 Mar 21]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-. Available from: Accessed 12.26.2019 
  2. Roehl K, Sewak S. 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. 2017; 117:1279-1292. 
  3. Leonetti F, Campanile FC, Coccia F,et al. Very Low-Carbohydrate Ketogenic Diet Before Bariatric Surgery: Prospective Evaluation of a Sequential Diet. Obesity Surgery. 25, 64–71 (2015) doi:10.1007/s11695-014-1348-1 
  4. Azar ST, Beydoun HM, Albadri MR. Benefits of Ketogenic Diet For Management of Type Two Diabetes: A Review. Journal of Obesity & Eating Disorders. 2016; 2:2. doi: 10.21767/2471-8203.100022 

– Debbie J., MS, RD

This article should not replace any exercise program or restrictions, any dietary supplements or restrictions, or any other medical recommendations from your primary care physician. Before starting any exercise program or diet, make sure it is approved by your doctor.

Some questions have been edited for length and/or clarity.

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