Keto And Strokes: What's The Link?

The ketogenic diet has been associated with an increased risk of stroke due to its high-fat content. However, recent research suggests that a well-formulated ketogenic diet may improve cardiovascular health and aid in stroke rehabilitation. While the ketogenic diet can be beneficial, it is important to note that it is extremely regimented and challenging to adhere to. The diet restricts carbohydrate intake to less than 50 grams per day and emphasizes the consumption of healthy fats, unprocessed proteins, and non-starchy vegetables.

Although there is some concern about the potential link between the ketogenic diet and stroke, it is essential to consider other factors such as family history, ethnicity, and geographic location, which can also influence stroke risk. Additionally, the ketogenic diet has been found to have neuroprotective effects and improve mitochondrial functioning, making it a subject of interest in stroke rehabilitation research.

Keto can lead to dehydration and a loss of electrolytes

The keto diet is a low-carb, high-fat diet that puts the body into a state of ketosis, where it burns fat for energy instead of glucose. While this diet can be safe and effective for weight loss, it can also lead to dehydration and a loss of electrolytes, which are essential minerals that regulate water distribution to the cells and keep the body hydrated.

How Keto Leads to Dehydration

Dehydration is a known side effect of the keto diet, and it can occur for several reasons. Firstly, on keto, the body excretes more salt, and the more salt you lose, the less water you retain. Additionally, in the beginning stages of the diet, people often excrete a lot of excess ketone bodies, which can be dehydrating. As a result, people following a keto diet need to drink more water to stay properly hydrated compared to those on other diets.

The Role of Electrolytes

Electrolytes such as sodium, potassium, magnesium, and calcium are crucial for maintaining hydration and have a variety of important functions in the body. These include regulating muscle contractions, controlling nervous system function, balancing blood pressure, rebuilding damaged tissue, and carrying messages to cells.

Signs of Electrolyte Deficiency

An electrolyte imbalance can lead to dehydration and a range of unpleasant symptoms, including muscle cramps, headaches, constipation, increased thirst and hunger, and "keto flu," which includes flu-like symptoms such as brain fog and dizziness.

How to Address Dehydration and Electrolyte Loss on Keto

To avoid dehydration and maintain proper electrolyte levels while on the keto diet, it is recommended to:

• Increase water intake, aiming for at least 2-3 liters per day or half of your body weight in ounces.
• Include electrolyte-rich foods and drinks in your diet, such as low-sugar broths, juices, sports drinks, and popsicles.
• Consume whole foods like leafy vegetables, nuts, seeds, avocados, cucumbers, and celery, which are high in water and electrolytes.
• Consider using salt/electrolyte tablets, lite salt (which has a higher potassium-sodium ratio), or simply adding more salt to your food.
• Incorporate mineral water, which is a good source of magnesium and calcium, if it fits your budget.
• Monitor your urine color, aiming for a pale yellow or clear color, as a sign of proper hydration.

Keto may cause nutrient deficiencies

The keto diet is a high-fat, low-carb approach to eating that has become popular in recent years. While it can be effective for quick weight loss, it is extremely regimented and challenging to stick to. It also comes with serious health risks. One of the biggest concerns is that the keto diet can lead to nutrient deficiencies, as it restricts carbohydrates and affects how the body processes certain nutrients. Here are some of the key nutrients that may be lacking on a keto diet:

Calcium

People on long-term keto diets often lose too much calcium in their urine and have more acidic urine. High-fat diets increase the amount of acid in the body, which the kidneys must filter out to maintain stable blood pH. This leads to lower urine pH. Calcium from bones is used to buffer the increased acid production, resulting in higher calcium loss in the urine and lower bone density. Dietary calcium intake may also be lower on the keto diet due to the restriction of calcium-rich foods such as fruits, vegetables, dairy, and enriched grains.

Magnesium

Magnesium is a mineral that is crucial for energy production and the proper functioning of nerve cells and the brain. Deficiency has been linked to various health conditions, including heart disease and migraines. Symptoms of magnesium deficiency include muscle cramps, headaches, anxiety, nervousness, and constipation. The decrease in magnesium levels on a keto diet is likely due to the reduced consumption of magnesium-rich foods such as fruits and grains.

Iron

Iron is essential for energy production and the formation of red blood cells, and its deficiency can lead to fatigue and breathing difficulties during exercise. Evidence suggests that the high-fat content of the keto diet may interfere with iron absorption.

Sodium and Potassium

The keto diet can cause a loss of sodium and potassium, leading to symptoms such as constipation, headache, muscle cramps, diarrhea, and weakness, collectively known as "keto flu." These symptoms typically resolve within a few weeks as the body adjusts to the increased loss of these minerals.

Selenium

Selenium is a mineral that plays a vital role in heart health, reproduction, thyroid hormone production, and protecting the body from oxidative stress. Research and clinical experience have shown that the keto diet can decrease selenium levels and lead to deficiencies, especially in epileptic children.

Carnitine

Carnitine is a compound found in high amounts in the heart and muscles, and it helps transport fatty acids to the mitochondria for energy production. The keto diet can lead to a temporary decrease in carnitine levels, and in some cases, long-term deficiency may develop. This can result in fatigue and muscle weakness.

While the keto diet may offer some benefits, it is important to be aware of the potential risks, including nutrient deficiencies. Monitoring nutrient levels and overall health while on the keto diet is crucial. Working with a healthcare professional to address any deficiencies and ensure a well-rounded and safe diet is highly recommended.

Keto may lead to high cholesterol and an increased risk of heart disease

The ketogenic diet is a low-carbohydrate, high-fat approach to eating that has become popular in recent years. While it can be effective for quick weight loss, it is extremely regimented and challenging to stick to. The diet typically involves reducing carbohydrate intake to less than 50 grams per day, with a moderate increase in protein and fat intake. This means that roughly 70 to 80 percent of calories come from fat, about 20 percent from protein, and as little as 5 percent from carbs.

One potential concern with the keto diet is its effect on cholesterol levels and heart health. The keto diet does not restrict saturated fats, which have been linked to adverse health effects. While the quality of fat is important (for example, there is a difference between bacon and almonds), a well-formulated keto diet should emphasize plant-based, unsaturated fats like nuts, seeds, olive oil, and avocado. These healthier fats have been shown to protect the heart.

Some studies have found that the keto diet can lead to increases in cholesterol and triglycerides, which are risk factors for heart disease. However, other research suggests that keto may actually decrease the risk of heart disease. For example, a systematic review of animal studies found that ketone administration or following a ketogenic diet prior to or after a stroke was beneficial. Ketones provided an alternative fuel source when glucose utilization was decreased, reduced inflammation, improved mitochondrial functioning, and increased neurotrophin expression.

It is important to note that the link between keto and heart health is still being studied, and more research is needed to fully understand the potential benefits and risks. If you have high cholesterol or other risk factors for heart disease, it is recommended to speak with your doctor before starting the keto diet.

Keto can put stress on the kidneys

Keto and Kidney Stress

The ketogenic diet is a high-fat, low-carb approach to weight loss that has become increasingly popular. While it has been around since the 1920s as a treatment for epilepsy, its effectiveness for quick weight loss and its promotion as a remedy for various ailments have made it trendy. However, it is important to be aware of the potential risks associated with this restrictive diet. One notable concern is the stress it can put on the kidneys, which may even lead to kidney stones.

The keto diet's high protein and fat content can increase the levels of uric acid and calcium in the body, leading to more acidic urine. This change in urine composition may contribute to the formation of kidney stones, which are lumps of minerals and salts in the kidneys. While kidney stones may not always cause complications, they can lead to intense pain and even kidney disease if left untreated.

Who Is at Risk?

The risk of kidney-related issues on keto is particularly relevant for those with pre-existing kidney complications or kidney disease. It is not recommended for individuals in these groups to attempt the keto diet without consulting a nephrologist or qualified health professional. Even for those with healthy kidneys, it is important to optimize electrolyte intake, especially positively charged electrolytes like potassium, to minimize stress on the kidneys.

How to Mitigate Kidney Stress on Keto:

To reduce the risk of kidney stones and other issues, it is crucial to stay well-hydrated while on the keto diet. This helps to "wash out" the metabolic products that can contribute to kidney stone formation. Additionally, adding lemon to water can be beneficial due to the citrate in lemons, which prevents calcium molecules from sticking together.

Furthermore, limiting oxalate-rich foods such as spinach, beets, rhubarb, miso, and sweet potatoes, as well as high-sodium foods, can help lower the risk of kidney stone formation.

Research Findings:

Research on the long-term effects of the keto diet is still ongoing, and there is no conclusive evidence of a direct link between keto and kidney disease. Some studies suggest that keto may even have positive effects on kidney function, leading to improved blood sugar control and cardiovascular function. However, it is important to note that these studies may possess certain weaknesses, and more comprehensive research is needed.

While the keto diet may offer certain health benefits, it is crucial to approach it with caution. For those considering keto, consulting a doctor and ensuring proper hydration and electrolyte intake are essential to minimizing stress on the kidneys and reducing the risk of kidney-related complications.

Keto may cause low blood sugar

The keto diet involves hyper-restricting foods that contain carbohydrates, including grains and most fruits, and instead loading up on proteins and fats. This means that your body will convert fat into energy instead of burning carbohydrates.

When you follow a keto diet, your body enters a state of ketosis, which means it has run out of the glucose it gets from carbohydrates and is burning ketones to create energy. Ketones are the fats your body burns when you run out of carb-based power.

However, if your body has run out of glucose, this can lead to low blood sugar, or hypoglycemia. Hypoglycemia is when your blood sugar drops below normal levels, usually considered to be below 3.9 mmol/L (70 mg/dL).

Who Is at Risk?

Ketotic hypoglycemia is the most common type of low blood sugar in toddlers and young children without diabetes, who are between six months and six years old. However, in rare cases, adults can also experience ketotic hypoglycemia, especially if they are following a severely restrictive diet like keto.

Symptoms of Hypoglycemia

Symptoms of hypoglycemia include sluggishness, dizziness, shakiness, fruity-smelling breath, tiredness, irritability, weakness or shaking, moist skin or sweating, nightmares, bad dreams or restless sleep, and headaches and seizures.

Treatment

If you suspect that you or your child is experiencing hypoglycemia, try to give them sugar as soon as possible. The child's blood sugar should increase within 15–20 minutes of consuming sugar. If their blood sugar has not risen after 20 minutes or they cannot eat or drink, seek emergency medical treatment.

Prevention

If you are following a keto diet and are concerned about hypoglycemia, it is important to monitor your blood sugar levels regularly and speak with your doctor about any necessary medication adjustments.

Frequently asked questions