What do Canadians think?

The keto diet is less common in Canada than one might think; only 4% of Canadians follow the keto diet.¹ Ontario is the province with the second-highest percentage of individuals following the keto diet – 5% of Ontarians follow the keto diet.¹

Additionally, research suggests that those who have tried the keto diet don’t stick to it. More than twice as many Canadians have attempted the keto diet and have dropped it. While these numbers aren’t huge, 10% of Canadians are considering the keto diet.¹ This reinforces the notion that Canadians need accessible, relevant, and trustworthy information on the keto diet.

What is the Ketogenic Diet?

The keto diet is a very-low-carbohydrate diet. Someone following a keto diet would have an intake of 20-50g of carbohydrates each day. To get an idea about how this relates to recommended intakes, below is a table that compares the acceptable macronutrient distribution ranges (AMDRs) with the distributions recommended in the keto diet:²

The main differences to keep in mind are that: 1) Carbohydrate intake is extremely restricted; 2) Fat intake is significantly increased.

Keep in mind that the ultimate purpose of eating is to provide our body with energy. Carbohydrates are easily broken down into glucose and are the body’s main energy source. Our brain, muscles, cells, and other systems rely primarily on the breakdown of carbohydrates to produce energy and function properly.

The mechanisms behind energy production in the keto diet is similar to a state of starvation. Once carbohydrate intake is restricted and existing stores have been used up, the body will start using alternative energy sources, such as protein and fat. This brings the body into a state of ketosis. The breakdown of fat produces ketone bodies, which are used as an energy source in the absence of glucose. This happens after a period of time, and to keep the body in ketosis, the keto diet must be followed with extreme precision. 

The Ketogenic Diet and Weight Loss

To reach the recommended intake of 20-50g of carbohydrates per day, you must cut off all processed sources of sugar but also fruits, starchy foods, legumes, and many other beneficial foods. Are you able to commit long term to never having a slice of bread, a piece of fruit, or a bowl of chili soup? Like any other restrictive diet, rapid weight loss is common, especially if you originally consumed many liquid sugars (juice, pop, etc.), deserts, chips, or starchy foods (pasta, rice, potatoes, fries, fast foods). There is an important distinction between quick weight loss and long term, sustainable weight loss.

According to research, weight loss peaks at about 5 months on the diet, then the weight is slowly regained.⁶ To be clear, a lack of compliance with the keto diet is not related to a lack of willpower. It’s related to an overly restrictive diet.

So, what does the research say? Various meta-analysis studies have been completed in this area to examine the keto diet. Researchers have compared studies assessing weight loss achieved on a keto diet compared to low-fat diet interventions. The findings suggested minimal differences in weight loss between the type of restrictive diet.³ Additionally, there were many inconsistencies between studies.⁵ In other words, there is a lack of strong evidence to support the claim that the keto diet is more effective at inducing weight loss than other restrictive diets.

Negative Health Outcomes

As mentioned earlier, the keto diet was originally created as a treatment for children with epilepsy. Since its creation, various negative health outcomes associated with following the keto diet have been identified.³ Below are some of the commonly documented side effects in the literature:³

• - Fatigue, weakness, headaches
• - Cramping, constipation, diarrhea
• - Cardiac arrhythmias, muscle cramps
• - Vitamin and mineral deficiencies
• - Restricted growth, bone fractures
• - Kidney stones, pancreatitis
• - Halitosis, or chronic bad breath

Additionally, one of the biggest concerns is the restriction of healthy carbohydrates. Carbohydrates found in fruits, whole grain complex carbohydrates are known to have health benefits.³ In fact, a high intake of these carbohydrates are part of the recommendations for sustainable weight loss and chronic disease prevention.

Are there Benefits to the Keto Diet?

Some research suggests that the keto diet can help treat obesity, type 2 diabetes, and other chronic diseases.³ In type 2 diabetes, carbohydrate restriction can help improve glycemic control, and weight loss can help improve insulin resistance. Both of these characteristics can help with diabetes management.

However, these factors are not exclusive to the keto diet; weight loss can be achieved in other ways, and it’s well documented that a diet rich in healthy carbohydrates can help glycemic control.³ At this point, there is no research examining the long-term health impacts of following the keto diet.³ To be clear, we have no evidence that following the keto diet is safe.⁷

 The health benefits of the keto diet are also dependent on the quality of fats you include in your diet. It’s important to understand the difference between fats: good fats vs. saturated and trans fats. Choosing good fats in your diet is key for heart health, brain health, and balanced gut flora. Good fats are polyunsaturated and monounsaturated fats, and they’re found in foods like fish, avocados, nuts, seeds, etc. If you decide to attempt the keto diet, limit intake in fatty red meats and processed meats such as bacon, sausages, cold cuts, etc. These may increase your risk of cancer and cardiovascular diseases.