Thinking About Keto? Read This First.
- Nichole Dandrea-Russert
- Jan 16, 2019
- 4 min read
Updated: Nov 13
Read This Before You Hop on the Keto Train
Every few years a new “miracle diet” wins the spotlight… and right now, keto is still one of the loudest voices in the room.
If you’ve ever wondered:
“Should I try keto for weight loss?”
“Is keto good or bad for heart health?”
“Is a plant-based keto even a thing?”
…you’re not alone. Keto can sound tempting — fast results, promises of fat-burning mode, and glowing online testimonials.
But as with any nutrition trend, the real question is: What does solid evidence say about keto… and is it healthy long-term?
Let’s break it down simply, clearly, and without diet dogma.
First: What Exactly Is Keto?
The ketogenic diet is:
Very low carb
High fat
Moderate protein
It pushes the body into ketosis, where you burn ketones instead of glucose for energy.
Keto was originally created in the 1920s as a medical treatment for epilepsy, not as a general wellness diet. Over time, it gained popularity as a weight-loss tool — often promoted with dramatic before-and-after photos.
But medical use and wellness trends are not the same thing.
What the Research Actually Shows About Keto
1. Keto may help with short-term weight loss.
Yes — many people lose weight early on due to:
Cutting carbs (which reduces water weight)
Eating more protein and fat (which may increase satiety)
Reduced appetite for some in ketosis
BUT…Studies consistently show that:
⚠️ Keto is no better than other diets after 12–24 months.
⚠️ Keto may lead to loss of lean mass, not just fat.
⚠️ It’s difficult to maintain for most people.
Long-term success depends on sustainability — and keto is one of the hardest diets to sustain.
2. Keto’s impact on heart health is mixed — and depends heavily on fat sources.
A keto diet built from:
❌ butter, cheese, bacon, meat, and coconut oil often raises LDL (“bad”) cholesterol and may increase heart disease risk.
A plant-forward keto with:
✔ nuts, seeds, avocados, olives, tofu, olive oil shows more favorable outcomes.
Bottom line: It’s not “low carb” vs. “high carb.” It’s what foods are being chosen.
3. Keto may help blood sugar at first — but long-term depends on the type of keto.
Short-term, lowering carbohydrates can reduce blood sugar numbers.
But evidence shows:
Low-carb diets high in animal fat/protein increase diabetes risk over time.
Low-carb diets high in plant fat/protein lower diabetes risk.
This comes down to inflammation, insulin sensitivity, and saturated fat intake.
4. Keto is typically low in fiber — and that’s a problem.
Because keto restricts:
whole grains
beans
most fruits
starchy vegetables
…it often provides far less than the recommended 30-40 grams of fiber per day.
Low-fiber diets are linked to:
Fiber is not optional. It’s a foundation for health.
5. Keto may increase risk of nutrient deficiencies
Removing whole food groups can lead to insufficient:
B vitamins
Folate
Vitamin E
Vitamin C
Magnesium
Antioxidants
Phytonutrients
Plants provide thousands of protective compounds that simply don’t exist in animal foods.
6. Long-term safety? Still questionable.
Some studies suggest potential concerns for:
Kidney stones
Higher LDL
Reduced insulin sensitivity
Increased all-cause mortality
Bone loss
Liver fat accumulation
Most positive outcomes come from short-term trials, while long-term studies raise more red flags.
So… Is There a Safer, Science-Backed Alternative?
Yes: A whole-food, plant-based diet consistently outperforms keto for heart health, cancer prevention, gut health, longevity, inflammation, and metabolic health.
Plant-based diets help:
improve cholesterol
lower inflammation
reduce cancer risk
balance blood sugar
support gut health
increase longevity
promote sustainable weight loss
And they’re far easier to maintain long-term.
If You’re Considering Keto, Ask Yourself…
✔ Can I eat this way for the rest of my life?
If not, weight typically rebounds.
✔ Does this diet include plants as the foundation?
That’s where the health benefits consistently live.
✔ Am I relying mostly on saturated fats?
This matters far more than carb counting.
Keto Isn’t “Bad”… But It’s Not the Best Path Forward
There’s no shame in exploring keto. Curiosity is good.
But before jumping on any trend, zoom out:
💚 Is it sustainable?
💚 Is it nutrient-rich?
💚 Does it support heart, brain, and metabolic health long-term?
💚 Does it encourage more plants — or restrict them?
When we look at the research, health outcomes, and lived experience of thousands of people, the answer is clear:
A plant-forward, whole-foods approach consistently provides the biggest long-term benefits — without the restrictions, risks, or rebound cycle of keto.
And honestly? It feels way more joyful and delicious.
References
1. HM Dashti, TC Mathew, T Hussein, et al. Long-term effects
of a ketogenic diet in obese patients. Exp Clin Cardiology. 2004;9(3):200-205.
2. Kosinski, C., & Jornayvaz, F. (2017). Effects of Ketogenic Diets on Cardiovascular Risk Factors: Evidence from Animal and Human Studies. Nutrients,9(5), 517. doi:10.3390/nu9050517
3. De Koning L., Fung T.T., Liao X., Chiuve S.E., Rimm E.B., Willett W.C., Spiegelman D., Hu F.B. Low-carbohydrate diet scores and risk of type 2 diabetes in men. Am. J. Clin. Nutr. 2011;93:844–850. doi: 10.3945/ajcn.110.004333.
4. Noto H, Goto A, Tsujimoto T, Noda M (2013) Low-Carbohydrate Diets and All-Cause Mortality: A Systematic Review and Meta-Analysis of Observational Studies. PLoS ONE 8(1): e55030. doi:10.1371/journal.pone.0055030
5. Paoli, A., Rubini, A., Volek, J. S., & Grimaldi, K. A. (2014). Beyond weight loss: A review of the therapeutic uses of very-low-carbohydrate (ketogenic) diets. European Journal of Clinical Nutrition,68(5), 641-641. doi:10.1038/ejcn.2014.47
6. Tuso, P. (2013). Nutritional Update for Physicians: Plant-Based Diets. The Permanente Journal, 17(2), 61-66. doi:10.7812/tpp/12-085
7. Vegetarian and vegan. (n.d.). Retrieved from http://www.aicr.org/patients-survivors/healthy-or-harmful/vegetarian-and-vegan.html
8. Ellenbroek J.H., van Dijck L., Tons H.A., Rabelink T.J., Carlotti F., Ballieux B.E., de Koning E.J.P. Long-term ketogenic diet causes glucose intolerance and reduced B- and a-cell mass but no weight loss in mice. Am. J. Physiol. Endocrinol. Metab. 2014;306:E552–E558.
