The Hidden Dangers of Ketogenic & Low-Carb Diets

Evidence based

| 9 min read

The Hidden Dangers of Ketogenic & Low-Carb Diets

PLEASE NOTE: The information in this blog is for educational purposes only. It is not a substitute for professional medical advice. Consult your healthcare provider if you’re seeking medical advice, diagnoses, or treatment. 

The therapeutic use of ketogenic dieting (in the form of fasting) has been around since at least 500 BC. It resurfaced as a treatment for epilepsy in the 1920s (1). 

The current popularity of eating in a way that activates ketosis results from the potential weight loss and health benefits. Adopting a low-carb diet that removes easy carbs and forces your body to metabolize fat for energy instead seems like a reasonable way to lose weight.

And there’s evidence that putting your body into a ketogenic state does confer benefits. Eliminating problematic foods is one benefit. Burning unwanted fat is another. 

In a ketogenic or “very low carbohydrate” diet, you eat less than 50 g of carbohydrates daily. In a broader sense, most people consider a “low carb” diet to be any diet where less than 40% of calories come from carbohydrates.

The problem arises when ketogenic diets are presented as long-term solutions to health and fitness.

Ketosis is a remarkable survival function that would have allowed our ancestors to deal with food scarcity. When your body stays in ketosis for too long, problems may arise. 

In this article, we’ll discuss some of the problems with low-carb diets, the importance of carbohydrates, and ways to use an animal-based diet to hit your goals! 

The Problems With Low-Carb Diets

Man dealing with muscle cramps as a result of a low-carb diet.

If you’ve spent more than a few months observing a low-carb diet such as Atkins, ketogenic, paleo, carnivore, or even plant-based, you may have experienced some adverse side effects.

These can include muscle cramps, decreased energy, trouble sleeping, and thyroid issues. 

A low-carb diet often puts your body into a ketogenic state, burning fat for energy instead of carbohydrates. This approach has shown amazing results for people seeking to lose weight or improve cognitive function. 

However, ketosis isn’t always healthy or sustainable long-term. Your body isn’t designed to survive this way outside of short periods. 

Ketosis raises your cortisol levels, which can be harmful if done for long periods. It can be challenging to stay in ketosis, leading to unhelpful obsessiveness around food or disordered eating. 

Paul Saladino, MD, author of the Carnivore Code and founder of Heart & Soil, used the carnivore diet for about two years before he felt it was time to address the negative side effects.

After introducing raw honey and fruit into his diet, he began to see improvements in testosterone levels, electrolyte levels, and sleep quality.

Insulin and the Ketogenic Diet

Another issue that arises from long-term ketosis is the absence of insulin.

When you stop consuming carbohydrates, the glycogen in your liver is depleted, and that organ switches to ketone production. When this happens, the body’s other tissues (muscle, other organs, etc.) receive signals telling them to refuse the actions of insulin and to stop taking up glucose from the blood. 

The body’s periphery becomes “physiologically insulin resistant” to spare any remaining glucose for the brain, red blood cells, kidneys, testicles, or ovaries.

While the liver makes ketones, it also makes glucose for the body from the glycerol backbone of triglycerides and gluconeogenic amino acids in gluconeogenesis (often termed GNG).

While in this ketogenic state, fasting blood glucose levels rise, especially in the morning, with the circadian peak of cortisol upon awakening.

If you’d like to learn more about the phenomenon of elevated fasting blood sugar levels while eating a low-carb diet, check out the two podcast episodes with Dr. Saladino and Kara Collier from Nutrisense. 

Ketosis dramatically reduces the amount of insulin in your blood. Insulin plays a crucial part in maintaining your body’s electrolyte balance. Although carbohydrates and insulin have been implicated in the battle with obesity and diabetes – they are essential aspects of a healthy human diet and body, respectively.

The Importance of Carbohydrates From the Right Sources

People eating carbs instead of a ketogenic diet.

Contrary to popular belief, carbohydrates don’t cause metabolic dysfunction and insulin resistance.

We can see this demonstrated by the good metabolic health of indigenous groups like Kitavan islanders and Tukisenta, who consume carbohydrate-heavy diets and remain insulin-sensitive and free of modern disease. 

Not only do carbohydrates not cause metabolic dysfunction, but they play an essential role in your physiology.

Dr. Paul encourages metabolically healthy individuals to include some form of carbohydrate to assist in the vital function of electrolyte maintenance within our bodies and many other important functions.

Electrolyte management occurs within the kidney. The kidney relies on insulin signaling to properly manage electrolytes like sodium, potassium, magnesium, and calcium.

When insulin signaling is weak for prolonged periods, the kidney will allow our electrolytes to excrete through the urine. 

We get a small insulin signal when consuming protein but nowhere near the insulin signal that occurs when consuming carbohydrates. Paul has dramatically improved his electrolyte regulation by including honey with his meals.

Having some regular insulin signaling is also beneficial for muscle protein synthesis. Now, it’s possible to build or maintain muscle without carbs. People do it all the time, but it is significantly easier to build and maintain muscle with the help of carbohydrates.

Consuming carbohydrates also helps to lower Sex Hormone Binding Globulin, which makes it much easier to maintain healthy levels of testosterone, estrogen, and other sex hormones. 

Not only that, but carbs help to ensure that your glycogen stores are full and your muscles are ready for action! Both of these factors lend themselves to building muscle as well.

Excess Omega-6 Polyunsaturated Fatty Acids & Metabolic Dysfunction

There’s another factor in the metabolic dysfunction equation that is worth considering. Even if you’re successfully following a ketogenic diet, the type of fat you consume matters. 

The accepted medical wisdom on omega-6 polyunsaturated fatty acids (PUFAs), specifically linoleic acid, is that they’re good for you, and you should eat them instead of saturated fats (2). 

However, emerging research implicates excess linoleic acid consumption as a driving force of insulin resistance and obesity across the developed world – risk factors for heart disease and other health conditions.

We believe that excessive levels of omega-6 PUFAs are the real culprit for challenges like obesity, not carbohydrates or even sugar from natural sources. 

The evidence isn’t black and white, so we’ll try to highlight a few facts and then touch on the conflicting evidence. It’s a complicated medical issue.

Hopefully, this explanation will give you a basic understanding. 

  • Your body needs omega-6 and omega-3 fatty acids. 
  • Your body cannot synthesize these PUFAs, so they’re called essential fatty acids.
  • The ratio of omega-6 to omega-3 acids varies widely by diet.

Consuming a diet with a near 1:1 ratio of omega-6 to omega-3 PUFAs is beneficial, reducing the risk and severity of certain health issues (3). By contrast, the Western diet delivers roughly a 15:1 ratio of these fats (4). 

One of the issues with omega-6 PUFAs is that they compete with the healthy omega-3 PUFAs for enzymes in our bodies (5). That means you can overwhelm your body with omega-6 PUFAs to the point where you aren’t getting the benefit of the omega-3s in your diet.

Subsequently, excess linoleic acid can cause your fat cells (“adipocytes”) to grow based on how our cellular mitochondria (the powerhouse of the cell) use the fat molecule. 

When fat cells of the visceral adipose tissue (the fat surrounding our organs) get too large (there’s a unique individual threshold for this), they release excess free fatty acids into the blood, which signals the rest of the body to become pathologically insulin resistant.

Metabolic dysfunction ensues, eventually leading to pre-diabetes, diabetes, and all its complications (heart disease, hypertension, cancer, neurodegenerative disease, etc.). 

In frank diabetes (also known as pre-diabetes), fasting insulin rises because the cells throughout our body are resistant to its signals, and gluconeogenesis (the breakdown of non-carbohydrate substances into glucose) proceeds unchecked in the liver, leading to significantly elevated levels of glucose in the blood both during fasting and after meals. 

It would be presumptive to say that all metabolic dysfunction results from insulin resistance from excess linoleic acid consumption.

However, as stated in this white paper by Zero Acre Farms (6), “There is no tribe, population, or nation that has started consuming vegetable oils and not seen obesity rates climb.” 

The Animal-Based Lifestyle

Dr. Saladino’s journey away from ultra-low-carb eating is the foundation of what we now call the animal-based lifestyle.

It emphasizes well-raised meat and organs alongside whole food sources of carbohydrates such as maple syrup, honey, and low-toxicity plant foods.

The animal-based diet is designed to be sustainable and enjoyable. The animal-based lifestyle also includes several behaviors (sunlight, exercise, sleep, etc.) that support your body’s natural capability to produce energy, heal, and engage in life. 

Animal-based eating offers a path to lose weight, feel great, and have additional flexibility in your food selection.

It also helps you avoid the pitfalls of low-carb diets and eliminate the need for processed and pre-packaged ketogenic products such as protein powders, bars, and snacks. 

There’s no need to obsess over your caloric intake or macronutrient ratios. This way of eating is excellent for athletic performance and is much easier to follow when traveling or eating away from home.

Although beneficial for short periods, most people develop thyroid, sex hormone, electrolyte, and glucose issues if they lean on ketosis too heavily. 

If you have persistent issues with carbohydrate intake. It may be time to work with a medical professional for additional testing.

Feel free to check out The Society of Metabolic Health Practitioners, where you can find physicians from all around the globe who understand the immense value of making animal foods the center of the diet.

Another option for those looking to take a functional medicine approach is The Institute for Functional Medicine.

Subscribe to future articles like this:

Enjoyed this read?
Get new articles