There’s no denying that the keto diet is popular. This high-fat, low-carb diet has an ardent following of people who believe it’s an effective way to lose weight — and lose it quickly. At the same time, keto has its share of critics — especially among nutritionists and other health experts — who say the keto diet is not sustainable and can even be unhealthy. In fact, for 2020, it was ranked No. 34 out of 35 diets evaluated by a team of experts for the U.S. News Best Diets rankings.
Nevertheless, keto-labeled food products, glowing testimonials and celebrity endorsements abound. The health editors at U.S. News teamed up with the food pros at America’s Test Kitchen to find out more by surveying people who are following the keto diet.
More than 300 people shared their personal experiences with this trendy way of eating. A little over half were relative newcomers, following the diet for less than a year. But the survey group included diehards as well; some have been doing keto for more than five years.
Why Pick Keto?
Interestingly, over 70% of those surveyed say they chose to do keto based on their “own research of the diet.” Less than 5% say it was because a registered dietitian recommended it to them.
In terms of goals, it’s probably no surprise that weight loss topped the list at 84%. Improving overall health scored second at 66%.
Resources for Following the Diet
The classic keto diet requires eliminating nearly all carbohydrates and using fat as the body’s primary source of energy. This biochemical process is called ketosis — when your body breaks down both dietary and stored fat for fuel and creates ketones in the process. Ketones are a byproduct of burning fat that can be measured in the blood. If you’re going to be strict about the keto diet, you’ll likely be testing your blood regularly to track the level of ketones to make sure you’re in the target zone for fat burning. Yet the survey showed that most (70%) don’t track or measure their blood ketone level.
Part of the reason for that is most people are probably not following the original or classic keto diet, which was originally created to help children with epilepsy. The classic keto diet is composed of 90% fat, 6% protein and just 4% carbohydrates. Following this diet requires work, planning and vigilance. And staying in the magic fat-burning zone can be tricky. Even the so-called modified keto diet — at 80 to 82% fat, 12% protein and 6% carbs — is only marginally easier to follow. But perhaps because of its strict requirements, many versions of keto have sprung up — even a dirty keto diet.
Resources can also help, and most dieters in this survey — 85% — turn to websites for guidance. Another 55% say cookbooks are helpful — including ATK’s ” Easy Everyday Keto,” which offers “easier recipes that deliver inspiration, variety and most importantly, great taste,” says Jack Bishop, creative director at ATK.
The advantage of the cookbook, he adds, is that “when talking about the daily macro targets, we used net carbs, not total carbs.” The daily macronutrient targets in the ATK cookbook are 70 to 75% fat, 20 to 25% protein and less than 5% net carbs. Net carbs are those that the body absorbs and are calculated by subtracting the fiber (and sugar alcohols, if a low-carb sweetener like monk fruit is used) from the total carbs.
While most surveyed (65%) have kept their levels of physical activity the same, 27% responded that they are exercising more since following a keto diet. Similarly, 65% of people who exercise think that exercising is positively impacting the success of the diet.
Survey participants listed the following as their favorite, keto-friendly meals to make:
— Brussels sprouts.
— Roast chicken.
Like any new diet, a new way of eating often offers the opportunity to try new foods. These are the keto-friendly foods that participants especially enjoyed adding to their diet:
— Spaghetti squash.
— Pork rinds.
Challenges of the Keto Diet
About half surveyed are doing the diet with another household member, which can often provide support in sticking with a diet: 45% say that someone else in the house also follows the keto diet, with most (64%) of those households being households of two.
Participants reported that the biggest challenge is maintaining the self-control required to follow the keto diet. A close second was the time it takes to plan meals, track carbs/fat and shop. The third top challenge: the cost of ingredients, special foods and supplies.
Despite the obstacles, less than 5% say they often cheat on the keto diet. In fact, 54% reported that they rarely or never cheat. And the rest answered that they “sometimes cheat.”
Diet Disrupters and Food Temptations
So where does the cheating happen? Not surprisingly, “special occasions” like celebrations are the No. 1 reason (at 57%) for deviating from the keto diet — usually with some type of dessert. Going to restaurants and traveling are also major diet derailers.
The top foods that caused those cheating moments include ones we probably all like to indulge in now and then:
1. Bread and other carbs like pasta.
2. Desserts and other sweets.
3. Potatoes — also in the form of fries or chips.
4. Wine and beer.
Weight Loss Benefits
An overwhelming majority of those surveyed are fans of the keto diet: 80% are likely to recommend it. In addition, 94% experienced “positive” or “very positive” changes in their health since starting the diet. Most changes are associated with weight loss, blood sugar control and greater energy levels. Only 5% say they saw no change in their health.
Similarly, 70% believe the diet was “very” or “extremely” effective at helping them achieve their initial goals — like losing weight, improving overall health, having greater energy, preventing or managing a chronic disease and decreasing body fat.
Some of the weight loss people reported was indeed significant:
— “Lost 148 pounds.”
— “I have lost 55 pounds, reduced my resting heart rate, improved my exercise tolerance and lost 5 inches on my waist.
— “I lost over 200 pounds in two years. My energy level is off the charts.”
— “I’ve lost 60 pounds, and my allergies have reduced in severity.”
Such positive results seem to overshadow any health concerns. For example, following the keto diet requires giving up fruits, whole grains and starchy vegetables — the opposite recommendations for a heart- or diabetes-friendly diet. When comparing the Mediterranean diet to the keto diet, for example — both popular eating plans drawing plenty of interest from people who want to lose weight — the Mediterranean diet allows for a full array of fruits, vegetables and healthy whole grains.
Health experts also note that the diet’s high fat content could be dangerous for people with certain health conditions. Yet about 60% of those surveyed say they are “not at all worried” about health concerns that have been raised about the diet, and less than 1% are “very concerned.”