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What The Science Says About Following A Keto Diet

The keto diet is a low-carb, high-fat diet that includes meat, dairy, eggs and low-carb vegetables.
Ted Eytan | Flickr

A few weeks ago on St. Louis on the Air, we learned about a brand-new medical device that allows users to measure nutritional ketosis with a breathalyzer. Nutritionists say they’ve witnessed the reemergence of the keto diet as a means for weight loss in the past few years.

Both during and after that segment aired, we received a lot of questions about the keto diet, as well as some concern that this may be an unhealthy choice for some people. So, we looked into it on Thursday’s show with people who follow the latest research on the topic.

What does a keto diet entail?

Keto diets alter energy metabolism for the body. As ketones levels rise, the way the body metabolises nutrients for energy shifts. Transitioning the body into ketosis sparks a major shift in metabolism, and there are changes to the body’s neurotransmitters as well.

According to the director of the Center for Human Nutrition at Washington University’s School of Medicine, Dr. Sam Klein, with this type of diet you eat few enough carbs that the body releases fatty acids. Then, insulin levels get low. He said that it changes the fuel use of organs, and makes it so you don’t need as much insulin.

What’s the concern?

The metabolic process of ketosis has the possibility of being a life-threatening problem for people with Type 1 diabetes. If their insulin levels become too low, they may suffer from diabetic ketoacidosis. This condition occurs when the body starts breaking down fat at much too fast a rate. The liver processes the fat into ketones — a fuel that causes the blood to become acidic — leading to dehydration, vitamin and mineral deficiencies, and gastrointestinal stress. 

St. Louis University’s Dr. Whitney Linsenmeyer, a spokesperson for the Academy of Nutrition and Dietetics, said she sees more people trying the keto diet on their own without physician supervision, which has her concerned. She said patients should be medically supervised when transitioning into ketosis.

She also only recommends this diet to patients with epilepsy. She said that at SSM Health St. Louis University Hospital, when patients are shifted into ketosis, the patients typically spend three to four days in the hospital, so they can manage symptoms that occur.

Simon Lusky, the owner of Revel Kitchen, also joined the conversation. Lusky’s restaurant menu caters to many diets, including gluten-free, vegan, paleo, keto and “Whole30” options.

Hear the entire conversation:

St. Louis on the Air” brings you the stories of St. Louis and the people who live, work and create in our region. The show is hosted by Sarah Fenske and produced by Alex Heuer, Emily Woodbury, Evie Hemphill and Lara Hamdan. The engineer is Aaron Doerr, and production assistance is provided by Charlie McDonald.

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Emily is the senior producer for "St. Louis on the Air" at St. Louis Public Radio.

Send questions and comments about this story to feedback@stlpublicradio.org.