Keto may be the next ‘fad’ diet but is it healthy?

By Katy Askew

- Last updated on GMT

Keyto diets are gaining popularity but long-term health implications questioned ©iStock/Droitsd'auteur yulka3ice
Keyto diets are gaining popularity but long-term health implications questioned ©iStock/Droitsd'auteur yulka3ice
The keto diet has been tipped as the next big fad by analysts – but evidence over its longer-term health implications is less clear cut.

The ketogenic diet is high-fat, moderate-protein and low-carbohydrate. Ketogenic diets make the body produce ketones, which are used as an alternative fuel when blood sugar levels are low. Keytones are produced in the liver from fat and keto is becoming an increasingly popular weight loss diet.

“Keto is evolving to become more than just a high-fat diet and is becoming a lifestyle diet, akin to the Paleo diet,”​ noted Mintel associate director of food science Stephanie Mattucci. “Keto is moving from specialised and sports nutrition into mainstream products as more people turn to this diet for weight loss.”

Meeting the keto demand

Food makers can capitalise on growing demand for products that align with a keto diet, Mattucci suggested.

“Keto's move to mainstream creates new opportunities for high-fat, low-carb products to reinvent themselves as keto friendly,”​ she said.

In particular, Mattucci said manufacturers can help make keto diets easier to follow throughout the day by providing foods that meet various meal states – from breakfast, to snacks, to evening meals.

Macronutrient profiles could be brought in-line with keto requirements through the addition of butter as an ingredient in some instances, she noted.

Mattucci said that some markets have seen a rise in the number of keto friendly products. For instance, at the Natural Products Expo West trade show in the US, Keto-friendly products, including Know Brainer's Ketogenic Creamer and Bhu Foods' vegan keto cookie dough, were spotted.

Focus on clean label, healthy fats and natural sweeteners

To meet growing demand for keto products, Mattucci believes manufacturers need to concentrate on delivering products that promise clean labels, “healthy” fats and natural sweeteners.

Consumers turning to keyto are interested in consuming clean label foods. "While the focus of the original diet was on macro intakes, today's keto diet encompasses other aspects of free-from and clean-label diets. While recommendations vary, blogs dedicated to the keto diet and lifestyle emphasise avoiding soy, sugar, grains, legumes, and artificial ingredients. Similar to Paleo, seafood should be wild-caught and dairy and meat should be grass-fed.

“Eating plenty of fats is a critical part of the keto diet, and keto-friendly products should aim to contain 70% of their calories from fat. Use healthy fats from olives, avocados, coconuts and MCTs. High-fat nuts and seeds, especially macadamia nuts and pumpkin seeds, and grass-fed meat are recommended as good sources of fat.”

Pointing to the fact that 55% of UK consumers are concerned about the amount of artificial sweeteners products contain, she added: “Natural sweeteners, such as stevia, monk fruit, or erythritol will likely be received more favorably than artificial sweeteners, especially for more mainstream consumers who are following the keto diet as part of a healthy lifestyle.”

Health concerns are emerging

Mattucci acknowledges that the keto diet carries some implications for health and wellbeing. This, she said, is also an opportunity for food makers. “Since following a low-carb diet can impact electrolyte balance, low-carb foods that can also provide a boost of sodium, such as jerky, bacon, pork rinds and cracklings, could be successfully repositioned as keto-friendly snacks,”​ the Mintel analyst suggested.

However, recent studies point to evidence that keto diets can be linked to the development of non-communicable diseases such as diabetes.

According to a recent study by ETH Zurich and University Children's Hospital Zurich, published in the Journal of Physiology​, ketogenic diets may cause an increased risk of Type 2 diabetes in the early stage of the diet.

In mouse studies, the researchers showed keto diets impair the system for controlling blood sugar through the development of insulin resistance in the liver. When the liver is unable to respond to normal levels of insulin to control blood sugar levels this may lead to an increased risk of Type 2 diabetes, they suggested.

These findings raise new questions about ketogenic diets and whether or not they are actually healthy.

“Although ketogenic diets are known to be healthy, our findings indicate that there may be an increased risk of insulin resistance with this type of diet that may lead to Type 2 diabetes,”​ said Christian Wolfrum, one of the paper’s authors. “The next step is to try to identify the mechanism for this effect and to address whether this is a physiological adaptation. Our hypothesis is that when fatty acids are metabolized, their products might have important signaling roles to play in the brain.”

Meanwhile, fresh evidence has emerged to suggest that people who follow low or high carb diets could have a shorter life expectancy​.

According to a recent study published in The Lancet​, diets both low and high carbohydrates were linked with an increased risk of mortality.

Moderate consumption of carbohydrates, at 50-55% of daily energy intake, was found to be associated with the lowest risk of mortality.

The researchers estimated that from the age of 50, people in the moderate carb group were on average expected to live for another 33 years. This was four years more than those with extreme low-carb diets.

“Low-carb diets that replace carbohydrates with protein or fat are gaining widespread popularity as a health and weight loss strategy. However, our data suggest that animal-based low carbohydrate diets, which are prevalent in North America and Europe, might be associated with shorter overall lifespan and should be discouraged. Instead, if one chooses to follow a low carbohydrate diet, then exchanging carbohydrates for more plant-based fats and proteins might promote healthy aging in the long-term,​” said lead researcher Dr. Sara Seidelmann, Clinical and Research Fellow in Cardiovascular Medicine from Brigham and Women’s Hospital, Boston.

Sources

Journal of Physiology
Published online ahead of print: DOI: 10.1113/JP275173
‘Ketogenic diets may lead to an increased risk of type 2 diabetes’
Authors: Gerald Grandl, Leon Straub, Carla Rudigier, Myrtha Arnold, Stephan Wueest, Daniel Konrad, Christian Wolfrum

The Lancet Public Health
Published online ahead of print: DOI: 10.1016/S2468-2667(18)30135-X
‘Dietary carbohydrate intake and mortality: a prospective cohort study and meta-analysis​’
Authors: Sara B Seidelmann, Brian Claggett, Susan Cheng, Mir Henglin, Amil Shah, Lyn M Steffen, Aaron R Folsom, Eric B Rimm, Walter C Willett, Scott D Solomon.

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