Is Keto Safe?

One of the biggest questions surrounding a ketogenic diet is regarding safety.  Since we have been trained to think that fat is bad for us, of course it seems plausible that a high fat diet would be bad for us, but this is that true?

The Truth About Fat

Fat has been demonized for decades, especially ever since researcher Ancel Keys reported results from his research correlating fat intake with high rates of cardiovascular disease.  This led to the hypothesis that fat is bad for our health and over the course of the next several decades this hypothesis has become accepted as truth.  The problem is that the scientific evidence supporting this claim isn’t there.  If you want to read more about some of the history of our dietary recommendations, read The Big Fat Surprise by Nina Teicholz.

It should come as no surprise to note that we have seen an increase in the rates of many different diseases which has led to a panic in society.  This panic has put the pressure on researchers to find something to put the blame on and the blame has falsely fallen on dietary fat.

The majority of the research saying that fat is bad for us is based on research where we follow different populations for certain periods of time and have them report their diet.  From there we make claims like, “higher dietary fat intake leads to increased risk of cancer”.  The problem is we are only looking at one aspect of nutrition.  What about sugar, or alcohol, or processed food? 

The truth is that fat by itself isn’t the problem.  The problem is high fat consumption in conjunction with high carb consumption (the Standard American Diet), which is what is happening in the majority of the research reporting fat as being bad.  Since it is easier to burn carbs than fat, when both are consumed, the body will tend to burn carbs and store fat.  This can lead to a lot of health issues.  However, when we consume fat by itself, we are more likely to burn the fat while also keeping our blood glucose and insulin levels low.  This is a recipe for improved health!

To steal a common phrase in the keto world, “Don’t blame the butter for what the bread did!”

Keto and Kids

Did you know that babies are actually born in a ketogenic state?  It is believed that fat and ketones are important for the development of the fetal brain.  Additionally, breast milk is rich in MCTs, which are fats that can be converted to ketones. 

While there is much more research needed to determine the safety and efficacy of keto in children, it has been well established in the research that children suffering from drug resistant epilepsy can follow a ketogenic diet with limited or no negative symptoms (1). 

Keto and Elderly

The next question tends to be whether or not the diet is safe for the elderly.  Again, more research is needed, however, we do have a lot of research supporting the use of the diet for Alzheimer’s and Parkinson’s and for improving cardiovascular risk factors.  This makes it plausible that the ketogenic diet could be safe for the elderly but it may be recommend to consult with a physician who understands what Keto is.

Can Anyone Follow a Keto Diet?

It has been shown in longer term studies that the ketogenic diet is safe for most people (2).  However, there are certain conditions where it may be advised against. 

Individuals who have disorders that prevent them from digesting or breaking down fat may want to avoid keto. Conditions where keto special considerations should be made include pancreatitis, impaired liver function, gallbladder disease, gastric bypass surgery, kidney failure, and several others.  If you suffer from any condition, you should consult with a physician educated on nutrition for any change in your diet.

Is Keto the same as Ketoacidosis?

Unless your physician is familiar with the ketogenic diet, if you tell them you’re interested in trying the diet, their first recommendation may be to watch out for “keto-acidosis”.

Ketoacidosis is a condition that commonly occurs in those suffering from diabetes.  Under these conditions, we see an uncontrolled rise in ketones (10-25 mmol/L) in conjunction with elevated glucose levels.  This can be life threatening and affect the functions of your organs.

Nutritional ketosis, which is what occurs on a keto diet, typically demonstrates ketone levels between 0.5-5.0 mmol/L and does not have any of the life-threatening side effects seen in ketoacidosis. Well adapted ketogenic dieters who have been on the diet for years rarely increase their ketone levels >5.0mmol/L and have low blood glucose therefore ketoacidosis should not be a concern for healthy individuals.

Make sure to properly understand the difference, especially when speaking to a physician to make sure you are not discredited for trying to make a change and take control of your health!


Contrary to common belief, it appears that the ketogenic diet is both safe and effective across several different populations. I think it is worth mentioning that Keto may have to be modified to fit the needs of the different people attempting to follow it.  It is unlikely that children and elderly people will be following the same exact diet, and this is why we need to continue researching keto for different situations!

If you are looking to learn more about keto, check out my article What is Keto? If you are ready to start keto, sign up for my newsletter below and I’ll send you all of the info you need to be successful on keto!

Christopher Irvin