A ketogenic diet can improve some health markers.
But it can also create problems that should not be overlooked.
One of the most important is LDL cholesterol.
Clinical trials show that some ketogenic approaches can increase LDL cholesterol. This matters because persistently elevated LDL contributes to the development of atherosclerosis and cardiovascular disease.
Body composition is another consideration.
Some ketogenic approaches have reduced body weight and body fat but have also been associated with a reduction in muscle mass.
For healthy aging, losing weight while unnecessarily losing muscle is not an ideal outcome.
Diet quality matters as well.
Restricting carbohydrates removes or substantially reduces many foods. If the diet is poorly designed, this can reduce the intake and variety of whole grains, legumes, fruits and other fiber-rich plant foods.
These foods provide more than carbohydrates. They supply fiber, vitamins, minerals and plant compounds and help support the gut microbiome.
The source of dietary fat is equally important.
A ketogenic diet dominated by foods high in saturated fat is very different from one emphasizing unsaturated fats from olive oil, nuts, seeds and fish.
Keto therefore should not be judged simply by whether the body is producing ketones.
For someone following a ketogenic diet, LDL cholesterol, overall nutritional quality and body composition deserve attention, particularly if the diet is continued for longer periods.
