Maria Emmerich, a wellness expert in the areas of nutrition and exercise physiology and international best-selling author, has built her practice and her own life on the ketogenic diet and lifestyle. The ketogenic diet is based on a low carb, high protein eating plan that has recently gained popularity as an effective weight loss treatment and in treating certain illnesses. However, there are lots of misconceptions and myths about the ketogenic diet. Here, Emmerich clears up 9 common myths about the ketogenic diet, including whether your brain needs sugar to function and whether the ketogenic diet is dangerous to your health, and explains how a well-formulated ketogenic diet works.
After struggling with my weight for years, I finally found the way of eating that helped me improve my health and achieve permanent weight loss. I am now a wellness expert in nutrition and exercise physiology with a mission of educating everyone on the benefits of a ketogenic diet and to explain how the ketogenic diet works. Unfortunately, the true meaning of a ketogenic diet is one of the biggest areas of misconceptions among bloggers and even in scientific studies. The problem with a lot of studies and critics of ketogenic diets is that they don’t focus on ketogenic diets done they way they are intended to. A ketogenic diet need to be done the right way to have the powerful results that I’ve experienced!
A well-formulated ketogenic diet
In my practice, I encourage my clients to aim for what I call a “well-formulated ketogenic diet.” This means eating a diet that consists of enough protein to reach your protein goal (0.8 times your lean mass), keeping carbs low enough to achieve ketosis (20g or less) and then adjusting fat as needed based on goals. Less for more weight loss, more for maintenance or gaining weight. Doing this this for more than 4-6 weeks or so will result in you being in nutritional ketosis and feeling all the benefits of this lifestyle.
In reality, there are very few studies that test a true, well-formulated ketogenic diet. Many studies use flawed definitions of ketogenic diets. These flawed and incorrect formulations of the ketogenic diet then lead to flawed results and lots of misconceptions about the ketogenic diet and its benefits.
Here are some common myths about the ketogenic diet and my explanation and recommendations on how the ketogenic diet really works:
Myth 1: The ketogenic diet is a high-protein diet
A well formulated ketogenic diet is moderate protein. This doesn't mean to fear protein. Get enough to meet your protein goal. Calories still matter so overdoing any macro could cause some slowing of weight loss.
Other studies will use carb counts that are too high. They will have upwards of 100g of carbs a day in their “ketogenic” diets. In actuality, these are not ketogenic diets and the participants are not in ketosis. Sometimes, they will also count net carbs by subtracting fiber, not the total number of carbs. This error can also limit the number of people who will really experience ketosis because too much fiber can make it impossible to achieve full ketosis.
Myth 2: I can eat a lot of fat, regardless of the source, on the ketogenic diet
Another overlooked aspect of the ketogenic diet is the importance of the content of the fat. While you could come up with a diet that includes 70-80 percent of fat coming from trans fat, no one would agree that it’s a healthy diet. I have seen studies that have a large portion of the fat in their ketogenic groups coming from Omega-6 oils such as vegetable oil or soybean oil. But these are the fats we need to limit in our diets to reduce inflammation and oxidative stress. A well-formulated ketogenic diet will not have a high percentage of fats coming from Omega-6 oils. Instead, the majority of fats will be from saturated fats such as coconut oil, butter, ghee and MCT oil.
Myth 3: I can achieve ketosis after two weeks
Wishful thinking! This is a common misconception and fundamental flaw of a lot of studies.
The reality is that only two weeks, or even a month, is not enough time for the body to become fully keto-adapted and experience all the benefits that come from full keto adaptation.
The adaptation period, during which the body converts to using fat as a fuel source, can take from two to four weeks for some, and up to six to eight weeks for others. Every cell in our body can run on two fuel sources: sugar (glucose) or fat (ketones). However, the body cannot make the switch instantly and needs time to change from using sugar as its fuel source to using fat. While your body is in this adapting stage, it’s important to remain on a ketogenic diet. If you go back to eating carbs, the process of adapting will take even longer.
This misconception on how long you need to be on a keto diet is also where the majority of the claims about the ketogenic diet’s side effects come from. During the transition time, there can be fatigue, headaches, withdrawal symptoms, low energy, muscles cramps or weakness, gas, diarrhea, bloating and impaired mood or cognition. There may also be an increase in cholesterol, triglycerides and other blood markers. When your body converts to being a fat burner, the liver releases much of the salt (and associated water) that it holds onto with higher-carb diets. Eventually, many of these symptoms will be alleviated with a well-formulated ketogenic diet, including the addition of extra salt, potassium and lots of water (at least half your bodyweight in ounces per day).
And all this passes with time and with a well-formulated ketogenic diet. In fact, when the ketogenic diet works, it is the best way to reduce triglycerides, reduce A1c and increase HDL. The diet will also drastically increase energy, mood, focus, reduce cramps, chronic pain and much more. The hardest and most important part is getting past the adaptation period in order to see the results.
Myth 4: The Brain Needs Sugar to Function
Many people will say that the “brain needs sugar” to function properly. This is true if the body is in sugar-burning mode. But once you’re on a well-formulated, keto-adapted diet, the brain primarily runs on ketones, not sugar. There is still some glucose required, but this can easily be supplied from protein (through gluconeogenesis and from the 20g or so of carbs you are getting). Not only is a keto diet a preferred fuel source for the brain, you will see improvements in cognition, mental acuity, focus and moods as well.
Once fully keto-adapted and eating a well-formulated ketogenic diet (with little to no carbohydrates), the brain can actually flourish. Memory and cognition improve, focus and moods are better and overall you’ll have more mental acuity.
Indeed, there are many studies showing the benefits of a ketogenic diet for Alzheimer's (which is often referred to as type 3 diabetes, or insulin resistance of the brain). Switching the brain to run on ketones can have huge benefits in reducing the symptoms of Alzheimer’s patients.
Myth 5: Ketogenic Diets Are Dangerous
Some critics of ketogenic diets argue that they are “dangerous” for our health, but this is yet another misconception of the diet. Some of the most popular claims are that a keto diet elevates cholesterol (thereby affecting heart health), and leads to ketoacidosis and lack of vitamins and minerals. Let’s take a look at each of these items.
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Cholesterol and Heart Health
The first thing we need to know is that cholesterol has no correlation to coronary artery disease (CAD). Instead, the cause of CAD is inflammation. So better predictors of CAD risk are inflammatory markers like triglyceride-to-HDL ratio, CRP and A1c. The goal is to have a low triglyceride count, low CRP and A1c levels. The one thing the keto lifestyle has proven time and time again is that it drastically lowers triglycerides, raises HDL and lowers CRP and A1c. Also, it is important to note that weight loss can temporarily elevate your cholesterol. An accurate cholesterol reading won’t happen until 6 months after weight has stabilized.
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Ketoacidosis
Ketoacidosis is another condition that is often cited as a risk of a ketogenic diet. Ketoacidosis is a state where ketone levels get so high (15 mmol or higher) that the body becomes very acidic. It is a life-threatening condition that is very real and very dangerous. But understanding how it occurs shows that it’s not really a concern for most people eating a well-formulated ketogenic diet.
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Lack of Vitamins and Minerals
Once again the “well-formulated” aspect of this lifestyle is very important. Anyone on any diet can end up lacking proper vitamins and minerals. But a well-formulated ketogenic diet can supply you with 100 percent of the recommended daily allowance for vitamins and minerals even though you’re limiting your carbs and eliminating fruit. Even though you may hear otherwise, the keto lifestyle can easily get you all the nutrients you need to be happy and healthy, without the added sugar and carbs of fruit and grains.
Myth 6: Ketogenic Diets Negatively Affect Our Hormones
There are many claims that ketogenic diets can cause issues with moods, low energy or hormones. Most of these are based on studies done on people before their bodies have fully adapted to the keto lifestyle. (See Myth 3). If you follow a well-formulated ketogenic diet, these issues will not only disappear after keto adaptation, but you will have far fewer symptoms than you may with other diets.
Some women see shifts in their menstrual cycle when switching to this lifestyle. This happens because the keto diet helps in detoxing bad estrogens, such as plastics, soy or flaxseed. As these bad estrogens are detoxed and the body returns to a more natural hormone balance, the cycle can also shift after a month or two. After a few months, the menstrual cycle normalizes and most women feel better than ever!
Some critics also claim that ketogenic diets lead to “lower-thyroid function.” While many studies have shown that the thyroid hormone T3 can be lowered with a ketogenic diet, this isn’t necessarily a bad thing. The fact that T3 is lower in ketogenic dieters is probably part of the mechanism that protects lean mass when fat is being lost. In addition, low T3 may possibly even be an indicator of a life-extending effect.
In the small percentage of cases where symptoms that happen because of the changes in thyroid hormones don’t go away after full keto adaptation, the simple addition of selenium (two or three Brazil nuts a day) and iodine (from a food such as kelp) can alleviate most symptoms.
Myth 7: Ketogenic Diets Can Stunt Children’s Growth
It is often pointed out in studies that ketogenic diets are not healthy for children, and can even stunt their growth. But every one of the studies that are cited to prove this point were conducted on children with epilepsy or cerebral palsy. It is well known that these conditions on their own can result in growth issues.
Correlation doesn’t equal causation, and unfortunately there are no peer-reviewed studies of ketogenic diets on kids without these pre-existing conditions such as epilepsy or cerebral palsy.
We used the ketogenic diet on our sons who came to us from an orphanage in Ethiopia; both of them were underweight and undernourished and below 1 percent on the growth charts. Within one year on the keto diet, our sons were around 50 percent on the growth charts, and after 2 years they were within 50-75 percent on the charts!
Myth 8: Ketogenic Diets Should Only Be Done for a Short Period of TIme
Another misconception about ketogenic diets is that they are a short-term fix for weight loss but shouldn’t be done for longer periods of time. Most of this relates to the perceived health risks of ketogenic diets.
Many scientific studies show that inflammation is the cause of most diseases (including heart disease). A well-formulated ketogenic lifestyle results in very low inflammation. So why wouldn’t a lifestyle that greatly lowers inflammation be conducive to a long, healthy life?
This lifestyle is just that, a lifestyle. It leads to both short-term health benefits (reversing metabolic syndrome, reversing autoimmune issues or losing weight) and long-term health benefits (staving off Alzheimers, cancer, diabetes or coronary artery disease). There is absolutely no reason a well-formulated ketogenic diet cannot be followed for life.
Myth 9: If You Are Very Active or an Athlete, You Shouldn’t Be on a Ketogenic Diet
It is common for critics to say athletes cannot eat a ketogenic diet because they need more carbs. This is also not true, and many, if not all athletes and active people do better on a well-formulated ketogenic diet.
Once you are fully adapted to the keto diet, fat becomes your body's fuel source. You are able to use dietary fat and body fat equally. Even the most lean athletes will have 20,000 calories stored in fat cells. Glucose storage (stored as glycogen) is limited to the muscle and liver, where on average you can only store about 2,000 calories. So keto-adapted athletes will have a much larger fuel tank. This is especially valuable for endurance athletes.
Summary:
- The benefits of the ketogenic diet only apply when it’s done right. In my practice, I encourage my clients to aim for what I call a “well-formulated ketogenic diet.”
- The adaptation period, during which the body converts to using fat as a fuel source, can take from two to four weeks for some, and up to six to eight weeks for others.
- Once you’re on a well-formulated, keto-adapted diet, the brain primarily runs on ketones, not sugar.
- Some claim a keto diet elevates cholesterol (thereby affecting heart health), and leads to ketoacidosis and lack of vitamins and minerals. However the keto lifestyle has proven time and time again is that it drastically lowers cholesterol, and understanding how ketoacidosis occurs shows that it’s not really a concern for most people eating a well-formulated ketogenic diet. Finally, a well-formulated ketogenic diet can supply you with 100 percent of the recommended daily allowance for vitamins and minerals even though you’re limiting your carbs and eliminating fruit.
- If women follow a well-formulated ketogenic diet, hormone issues will not only disappear after keto adaptation, they will have far fewer symptoms than with other diets.
- A well-formulated ketogenic lifestyle results in very low inflammation, which is a healthy way for the body to function.
- Once you are fully adapted to the keto diet, fat becomes your body's fuel source and you are able to use dietary fat and body fat equally. So keto-adapted athletes will have a much larger fuel tank.
I am living proof that the ketogenic diet can be a healthy and sustaining lifestyle option. If you are interested in transforming your health, I recommend reading about the ketogenic diet and learning about it from multiple sources. Seek complete information from those of us who have lived it and are here to tell you that it can change your life.
To learn more about the keto diet and how it can help you lose weight and heal disease, sign up for an online course by Maria and Craig Emmerich here.
Learn more about the keto diet and its benefits in Maria Emmerich's book, Keto: The Complete Guide to Success on the Keto Diet; Including Simplified Science and No-Cook Meal Plans. Available on Amazon here.
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