A Beginner’s Guide to Keto Diet

Health and Nutrition

A ketogenic diet or keto diet as it is popularly known as is an essentially low carbohydrate, moderate protein and high fat containing diet (1). A keto diet constitutes a significant reduction in carbohydrate content, usually less than 50 gram a day (2).


History of keto diet

Russel Wilder originally formulated ketogenic diet in 1921 and he was the one who coined the term “ketogenic diet”. Russel Wilder used this diet to treat epilepsy. Ketogenic diet was commonly used in treating paediatric epilepsy but gradually lost its importance with the arrival of antiepileptic medications (1).


Popularity of keto diet

In the recent past keto diet has started gaining popularity as a weight loss diet and it has been observed that it is quite successful at least on short on term basis (1). More people are using keto diet for weight loss reasons rather than for treating paediatric pharmaco-resistant epilepsy (3).


Macronutrient composition of keto diet

The proportion or composition of macronutrients of keto diet are about 

Fat 55 to 60 %

Protein 30 to 35 %

Carbohydrate 5 to 10 %    

In a diet which is providing about 2000 kcal the carbohydrate amount was about 20 to 50 grams per day (1).

The fat content of the diet is extremely high as the carbohydrate is proportionately low and protein content is kept moderate.


What happens when a person takes up keto diet?

When the carbohydrate in the diet is restricted the glucose reserves in the body go down. The central nervous system (CNS) can only use glucose as a source of energy. CNS cannot use fatty acids as a source of energy. After 3 or 4 days on such restricted carbohydrate diet the CNS needs another source of energy as glucose supply goes down drastically. 

Ketones which are produced in the liver by breaking down fats and these become the alternative source of energy for CNS. This process of break down of fat into ketones is called ketosis which is physiological mechanism (2).

Ketosis is of 2 types as described by Hans Krebs the great scientist. Ketosis is an indicator of fat loss.

  • Physiological ketosis which is observed in very-low-calorie ketogenic diets
  • Pathological ketoacidosis which occurs in type 1 diabetes


People for whom keto diet is not recommended

People with these problems are advised not to take up keto diet (4)

  • Those with pancreatic disease
  • People who are afflicted with liver conditions
  • Persons with thyroid problems
  • Those with history of eating disorders or who are with eating disorders
  • People who have gallbladder disorders or those whose gall bladder has been removed  


Adverse effects of keto diet

There are some adverse effects also that are observed in people following a keto diet. Some short -term effects are flu like symptoms such as upset stomach, headache, fatigue and dizzy spells. It is sometimes called keto flu. Constipation is another problem they may face because fiber is less in keto diet (4).

Other long-term issues may develop when on keto diet such as kidney stone problem, liver disease and vitamin and mineral deficiencies. The micronutrient deficiency may occur because keto diet is restrictive and it does not include fruits and vegetables. Because the diet includes high amounts of fat and there is lot of research that saturated fat is not heart healthy this aspect also has to be taken into consideration (4).  


Get your doctor to monitor your health when on keto diet

A ketogenic diet may be an effective way to reduce weight as it helps control hunger and it probably improves fat oxidative metabolism by which weight loss occurs. It is essential to take your doctors opinion and take up keto diet under the doctor’s guidance. The renal function has to be monitored and the transition phase from keto diet back to normal diet should be gradual and done in a controlled manner under a doctor’s supervision (3).

The minimum period on keto diet is 2 to 3 weeks because that much duration is needed to induce ketosis and a maximum may be a few months anywhere between 6-12 months. But it has to be done in the correct way and be monitored by a doctor (3).    


Final word

From the research evidence it seems like weight loss can be achieved on a keto diet (1). But it has to be done under medical supervision to see it everything is going the way it should and that there are no adverse effects. Take your doctor into confidence before you start and let your doctor monitor your journey on keto diet.




  1. Masood, W. and Uppaluri, K.R. (2019) Ketogenic Diet, StatPearls Publishing 



  1. Shilpa, J. and Mohan, V. (2018) Ketogenic diets: Boon or bane?, The Indian journal of medical research. Vol. 148 (3).



  1. Paoli, A. (2014) Ketogenic diet for obesity: friend or foe?, International journal of environmental research and public health. Vol. 11(2).



  1. Eat right academy of nutrition and dietetics (2019). What is the Ketogenic Diet?


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