Keto Diet: The Highs and Lows

Keto Diet: The Highs and Lows

by Diana Risell

I first heard of the Keto diet in the 1990s. My colleague, Joe, was following it to lose weight. He had a box of stuff that he bought at a pharmacy, and it seemed to involve more diet pills, supplements, and urine strips than food. Maybe he had some results, but what I recall more vividly were his fatigue, irritability, and bad breath – which might have had more to do with the stress of his job as CFO of a large organization. Nevertheless, we teased him congenially about his diet that made  him nasty. The Keto Diet might be all the rage right  now, but it’s not new: Joe was doing it in the mid-1990s, and it’s actually been around since the 1920s as a treatment for epilepsy.

We know a whole lot more about food and our bodies than we did 100 years ago and even 30 years ago, and thank goodness most quality “diets” respect – and take advantage of – what we now know, such as the fact that lower-carb diets are effective for weight loss and management, and fat doesn’t make us fat. (That was a big ole lie from the 1970s when we were told that fat was bad and it was taken out of everyday foods and replaced with crazy amounts of sugar and salt for flavor, at the expense of our health.)

The fact is, most of us need more healthy fats – unsaturated fats in particular — in our diets. They help protect our organs, build cells, provide energy, absorb vitamins and nutrients, and fight inflammation to name a few reasons that fats are fab. Dramatically reducing the carbs and significantly upping the fats are at the heart of the Keto Diet.

First, know that ketosis is a normal metabolic process and is something your body does to keep working. When it doesn’t have enough carbohydrates from food for your cells to burn for energy, it burns fat instead, and that’s excellent news for paunchy bellies and chunky thighs. Eating to get your body into ketosis – even mild ketosis — where you are using fat stores for energy is the foundation of many successful weight loss programs because it works. (Nutritionally, it’s what I did to lose six dress sizes and half my body fat 12 years ago). But the Keto Diet that we’re suddenly all talking about like it’s new is more than just lowering the carbs. It’s about really low carbs (just 5% of calories) and really high fat (a whopping 75% of calories), and that’s caused divided opinions and controversy about its long-term health effects. It’s good. It’s bad. The jury is out.



  • You’re eating real food, not taking pills or eating processed stuff your body doesn’t recognize.
  • You’re thinking about what you’re eating. Mindfulness is the key to eating more healthfully.
  • You’re in touch with the macronutrients you’re eating. Every food is either a protein, carbohydrate or fat, or some combination of these. Understanding what macros you are eating is just as important as how many calories you take in.
  • You’re eating more fat, especially unsaturated fats like you find in nuts, seeds, avocados, salmon, tuna, and olive oil, which are universally considered necessary to good health and longevity. Stick to moderate amounts of saturated fats (meat, dairy, eggs, coconut oil) and avoid trans fats (fast food, snacks, processed foods).
  • You’re less hungry and eat less because fats are filling.
  • You have lots of energy. It typically takes about three to five days to get into ketosis, after which you may feel a noticeable surge of energy. Fewer refined carbs (and typically lots more water) in your diet will have you revved.



  • You don’t feel good the first few days. Symptoms include fatigue and lightheadedness. You may need to back off hard workouts. A sugar-free sports drink, pickle juice or chicken bouillon broth will help raise the electrolytes and manage the symptoms.
  • You experience constipation, bad breath, and irritability like Joe! But these symptoms are usually more associated with high protein diets like Atkins than with Keto. So, be sure that you are eating enough fats (and not just lowering the carbs and upping the protein) and drink lots of water (half your body weight in ounces every day).
  • You sacrifice vegetables and fruits in your diet because you are focused on such a low percentage of carbohydrates. At the macronutrient level, vegetables and fruits are largely carbohydrates. For the little percentage of carbs, you get with the Keto Diet, try to focus on getting as many vegetables as possible and a little fruit too. You need plant-based fiber and nutrients. Research which veggies and fruits are lowest in carbohydrates so you can eat more of them.
  • You overeat. Know that one gram of fat has nine calories. One gram of protein or one gram of carbohydrate has only four calories. So, up your fats on Keto but ensure you are still watching how much you are eating.
  • You can’t stay in ketosis. It typically takes three to five days of following a ketogenic diet to get into ketosis. (I know I’m there because I do experience this crazy good surge of energy. My whole body feels charged and lighter. You can also test using ketosis urine strips available at drugstores.) If you follow the plan all week but lapse on the weekend with a glass of wine, you’re likely to drop out of ketosis. Then you spend another three to five days getting back into ketosis – until the following weekend when you enjoy that piece of birthday cake. Rinse. Repeat.
  • Which brings us to the most common complaint about Keto: it’s hard. The best eating plans are the ones you’ll follow and make a lifestyle. For many people, Keto is a great way to lose weight and reset, but it’s not the way they can or want to live. It’s too much work.


Embrace Keto’s guiding principles: lower carbs, higher fats, and mindfulness about what you are eating for better health. Check with your doctor to see if following a full Keto Diet is right for you. Here are a few tools for your Keto journey: My Ketogenic Diet Plan, Senza, 8Fit, and for articles about Keto.  Source: Healthline (2017)

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