Is The Ketogenic Diet Bone Healthy? Here’s The Evidence-Backed Information

The ketogenic diet is a dietary plan that turns stored body-fat into energy by inducing a process known as ketosis.

The ketogenic, or “keto” diet has come under scrutiny for its extreme dietary limitations and troubling side effects, but many have found it useful for burning excess fat, losing weight, and building muscle.

In this article, we’ll look at the science behind the keto diet, explore its benefits and drawbacks, and determine whether it fits the parameters of the Osteoporosis Reversal Program.

Ketosis

Ketosis is a metabolic state in which the body converts stored fat into energy instead of utilizing carbohydrates.

Ketosis only occurs when the body’s preferred source of energy, glucose, is unavailable. So the ketogenic diet deprives your body of glucose and instead provides fats for conversion into energy.

To enter ketosis, you must severely restrict your intake of all forms of carbohydrates. Fasting can also trigger ketosis when your body enters a stressful starvation state.

Ketosis creates acids called ketones that build up in the blood and are eliminated in the urine. They acidify the body’s pH, and if levels get too high, a dangerous condition called ketoacidosis can occur. It is most commonly caused by illnesses that suppress insulin, problems with insulin therapy, and type 1 diabetes.

Synopsis

Ketosis is the body’s process of breaking down fat for energy, instead of using glucose from carbohydrates.

The Development Of The Ketogenic Diet

In the early 1900s, scientists discovered that fasting reduced seizures in people with epilepsy. Further studies determined that it was the state of ketosis, triggered by fasting, that led to this positive effect.

The ketogenic diet was first developed in the 1920s to induce ketosis as a way to manage epilepsy. It remained the most effective and popular treatment for sixty years.¹

With the rising popularity of low-carb diets, the ketogenic diet has been co-opted for use as a weight-loss regimen.

Synopsis

The ketogenic diet was developed to treat seizures in people with epilepsy.

The Ketogenic Diet

The ketogenic diet is a low carbohydrate, moderate protein, high-fat diet that strictly dictates what foods you can and cannot eat to induce and fuel ketosis.

In a typical ketogenic diet plan, about 5% of calories are derived from carbohydrates, 20% from protein, and 75% from fat. That means that if you intend to consume 2,000 calories a day, you’ll have about 167 grams of fat, 100 grams of protein, and only 25 grams of carbohydrates. For reference, one apple contains 25 grams of carbohydrates.

To meet these restrictions, those who follow the keto diet must cut out sugars and most carbs. That means no grains and severe restriction of fruits and most vegetables.

Ideally, fats come from healthy-fat sources like avocados, eggs, nuts, and fish. However, the need to eat so much fat often leads people to consume large quantities of unhealthy fats found in animal protein and dairy foods.

Healthy individuals who follow a ketogenic diet often lose weight at first, until their body adjusts to ketosis, after which no more weight loss occurs. A similar pattern occurs with muscle growth, at first increasing and then leveling off.¹ This balance of benefits and drawbacks is typical of the diet, as the following pros and cons demonstrate:

The benefits of a short-term ketogenic diet include:^1,2

• Short-term weight loss
• Improved levels of HDL (high-density lipoprotein) cholesterol
• Reduced inflammation, via a reduction of insulin secretion
• Increased satiety (feeling full longer, due to the slower digestion of fats)
• Reduced sugar intake and stabilized blood sugar
• Increased and consistent energy (from stable blood sugar levels)
• Neuroprotective qualities of ketones³

Some drawbacks and challenges of the keto diet include:^1,2,3,4,5

• Loss of important micronutrients, leading to vitamin and mineral deficiencies⁶
• Kidney stones
• Dehydration
• Increase in ketones; ketones acidify the body’s pH, which leads to bone loss
• Elevated cholesterol (if diet includes too much animal protein)
• Potentially insignificant long-term weight loss
• Very difficult to follow at social events and restaurants
• Low fiber intake
• Nausea
• Constipation
• Diarrhea
• Body aches and pains
• Fatigue
• Dehydration
• Vomiting
• Bad Breath

Many of those flu-like side-effects are experienced for as many as two weeks as the body adjusts to the absence of carbohydrates and continual ketosis. This is sometimes known as the keto-flu.¹

Many of the drawbacks are mitigated with careful planning, but they highlight that the diet isn’t universally suitable.

Synopsis

The ketogenic diet requires cutting out sugar and dramatically restricting fruits and vegetables. It necessitates eating mostly fats, with a moderate amount of protein. The diet has benefits including limited weight loss, but also drawbacks like vitamin deficiencies.

The Ketogenic Diet And The Osteoporosis Reversal Program

The ketogenic diet has potential benefits when battling certain conditions, such as epilepsy and metabolic disorders. However, it presents challenges when considered alongside the nutritional needs of bone health.

It is possible to eat a pH-balanced diet that causes ketosis, but because many alkalizing foods are excluded or reduced by the keto diet, it is challenging.

Many of the fats and proteins typically recommended for the keto diet are bone-healthy, but also acidifying, such as wild salmon and eggs. Since an 80/20 pH-balanced diet is 80% alkalizing and a keto diet consists of nearly 80% fats, to meet both conditions a majority of your meals would have to include alkalizing fats, which are scarce..

Even though that balance may be possible, the restrictions of the keto diet are not compatible with the nutritional guidelines of the Osteoporosis Reversal Program. Here are the reasons why a ketogenic diet isn’t conducive for preventing or reversing osteoporosis:

• Ketosis generates acidifying ketones, therefore acidifying the pH, which causes bone loss.^1,5,7
• The keto diet deprives you of fiber, harming the digestive process^1,5
• Reduction in fruits and vegetables reduces antioxidant and micronutrient intake
• The keto diet causes negative side effects^1,4,5
• The keto diet is strenuously difficult to follow
• The keto diet depends upon restriction and self-denial, making it unsustainable
• The keto diet often causes dehydration, which impairs the bone remodeling process^1,5

The above list of detrimental side effects of the keto diet shows that its potential benefits do not outweigh the risks to bone health and overall well-being.

Synopsis

The keto diet can be pH-balanced, but even then, a ketogenic diet isn’t bone-healthy and doesn’t fit in the parameters of the Osteoporosis Reversal Program.

A Balanced Perspective on Keto and Bone Health

It’s important to recognize that the ketogenic diet was developed as a medical treatment for a medical condition, not for weight loss or bone health. Its benefits for managing specific health conditions are well-documented, but for those focused on maintaining or improving bone health, it presents significant challenges.

Our philosophy does not demonize high-quality, grass-fed, organic meats, which can be a valuable part of a balanced diet. However, these should be consumed alongside a variety of alkalizing foods like vegetables, fruits, and nuts to ensure overall health and bone strength.

Synopsis

While the keto diet may offer benefits in specific medical contexts, it is not well-suited to maintaining a pH-balanced diet for bone health.

Sustainable Solutions For Improving Your Health

Following an 80/20 pH-balanced diet, rich in vegetables and fruits, allows you to eat the foods you love while still taking optimal care of your bones and your overall health. It’s not a fad or a trend, or a temporary diet to lose a few pounds. It’s a sustainable dietary practice designed to help you build stronger bones and live a fuller life.

References

¹ Wajeed Masood; Kalyan R. Uppaluri. “Ketogenic Diet.” StatPearls Publishing. 2019. Web. https://www.ncbi.nlm.nih.gov/books/NBK499830/

² A Paoli, et al. “Beyond weight loss: a review of the therapeutic uses of very-low-carbohydrate (ketogenic) diets.” Eur J Clin Nutr. 2013 Aug; 67(8): 789–796. Web. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3826507/

³ Maalouf M, et al. “Ketones inhibit mitochondrial production of reactive oxygen species production following glutamate excitotoxicity by increasing NADH oxidation.” Neuroscience. 2007 Mar 2;145(1):256-64. Epub 2007 Jan 18. Web. https://www.ncbi.nlm.nih.gov/pubmed/17240074

⁴ Kossoff, Eric. “Danger in the pipeline for the ketogenic diet?.” Epilepsy currents vol. 14,6 (2014): 343-4. Web. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4325592/#i1535-7511-14-6-343-b3

⁵ Kang HC, et al. “Early- and late-onset complications of the ketogenic diet for intractable epilepsy.” Epilepsia. 2004 Sep;45(9):1116-23. Web. https://www.ncbi.nlm.nih.gov/pubmed/15329077

⁶ Sirikonda NS, et al. “Ketogenic diet: rapid onset of selenium deficiency-induced cardiac decompensation.” Pediatr Cardiol. 2012 Jun;33(5):834-8. Web. https://www.ncbi.nlm.nih.gov/pubmed/22367552

⁷ Bergqvist AG, et al. “Progressive bone mineral content loss in children with intractable epilepsy treated with the ketogenic diet.” Am J Clin Nutr. 2008 Dec;88(6):1678-84. Web. https://www.ncbi.nlm.nih.gov/pubmed/19064531