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Long-Term Effects Of The Keto Diet

One of the common misconceptions about keto is that it’s not healthy long-term. Many people see the ketogenic diet as a way to lose weight quickly, or a diet to cycle in and out of.

But when you take a look at the research, a whole other perspective emerges. In fact, following a ketogenic diet may be one of the most impactful ways that you can increase your longevity and overall well being. 

Here are some research-backed examples of the long-term effects of the keto diet.

Promotes Weight Loss and Maintenance 

While many people think of weight loss as an issue of aesthetics, for people who are chronically overweight, health risks become much more serious. 

Whether excess weight comes from genetics, environment, or a metabolic disorder, the side effects that can occur with being overweight range from uncomfortable to potentially life-threatening. 

These include[*]:

  • High blood pressure
  • All-cause mortality
  • Several types of cancer
  • Type 2 diabetes 
  • Coronary heart disease 
  • Stroke
  • High LDL cholesterol levels
  • Gallbladder disease
  • Sleep apnea
  • Depression and anxiety

Unlike most weight-loss diets, the ketogenic diet not only promotes weight loss, but it also helps you sustain the weight you lose.

Research shows that when you consume a low-carb diet, the hormone ghrelin is decreased. Ghrelin, also known as your hunger hormone, tells your body that you need to eat more.

When this hormone is high, people tend to overeat and gain weight. When this hormone is low, on the other hand, they’re less interested in food. 

There are a couple of hypotheses as to why low-carb diets work so well for weight loss. 

One line of reasoning is that fat and protein increase satiety, and produce less blood sugar fluctuations. Therefore, you aren’t a slave to the whims of your blood sugar and less likely to give in to cravings. This leads to reduced food intake, producing a calorie deficit, and reduced body weight[*]. 

Another hypothesis is that low-carb dieting may increase the amount of energy you expend daily — AKA your burn more calories[*]. Some research shows that there may be up to a 300 calorie metabolic advantage daily of eating low-carb. This may be the reason that many people find that when they lose weight on a low-carb diet, they keep it off long-term. 

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Preserves Muscle Mass

Maintaining a healthy muscle mass is crucial for health and longevity, and can protect your body from chronic diseases. 

You can think of your lean muscle mass as a reservoir of amino acids that your body can pull from in time of need. Amino acids not only serve as precursors to glucose but play a role in the maintenance of all your vital organs, including your heart, liver, and brain[*]. 

Some research even shows that consuming a low-carb diet helps to preserve muscle mass, giving the keto diet a “muscle-sparing effect.” 

While some sources argue that when glucose is low, your body will turn to muscle tissue as a source of energy, research shows that this is likely not the case. In the absence of glucose, ketone bodies can be used to displace glucose — leaving your lean muscle mass undisturbed[*]. 

One study found that the presence of the ketone body beta-hydroxybutyrate decreased the oxidation (breakdown) of the amino acid leucine while promoting muscle synthesis[*].

Other research shows that when you lose weight on keto, the majority of it comes from fat — not muscle[*].

In other words, eating a low-carb keto diet can help you burn away excess fat while preserving your lean muscle mass and your reservoir of amino acids.

Supports Blood Sugar 

Naturally, as you reduce your carb intake, your blood sugar becomes less of an issue. However, when you eat a low-carb diet, it does much more for your glucose response than simply diminishing it.

Weight loss is one strategy that doctors suggest to help reduce the risk of developing type 2 diabetes. However, research shows that for people with metabolic syndrome (a precursor to diabetes), following a low-carb diet can turn around metabolic syndrome regardless of weight loss.

That’s because low-carb dieting has a positive effect on health markers like triglycerides, cholesterol, and blood sugar[*]. 

In one study, researchers put a group of patients with type 2 diabetes on a ketogenic diet to assess its role in blood sugar regulation. After 16 weeks on the ketogenic diet, 80% of the participants either reduced their medication dose or discontinued medication altogether[*].

Considering the side effects that can come along with diabetes medications like kidney complications and risk of liver disease, treating diabetes with diet as opposed to medicine could present a safer and healthier alternative[*]. 

Reduces Inflammation

Chronic inflammation goes hand in hand with diseases like stroke, respiratory disease, heart disease, cancer, and diabetes. And what makes this so disturbing is that, Worldwide, three out of five people die due to these chronic inflammatory diseases[*].

Therefore, controlling chronic inflammation in your body may be the single most vital thing you can do for long-term health.

Due to its anti-inflammatory effects, the ketogenic diet has been used since the 1920s to help children with epilepsy control their seizures[*].

While the exact mechanisms for the anti-inflammatory effect of keto are still being uncovered, the ketone body beta-hydroxybutyrate (BHB) is one interesting area of focus. 

Research shows that BHB can block something called the NLRP3 inflammasome. The NLRP3 inflammasome is a protein complex that releases inflammatory chemicals in your body, initiating an inflammatory response and can even result in cell death[*]. 

Other research suggests that glucose metabolism is linked to inflammation. Therefore, by reducing carbs (glucose), the ketogenic diet offers an alternative fuel source that does not instigate inflammatory responses[*]. 

What’s more, animal research shows that following a ketogenic diet not only diminishes inflammation — but it also helps to reduce pain[*]. 

Promotes Heart Health

Among the chronic inflammatory diseases, heart disease is by far the most pervasive. In fact, heart disease is the number one leading cause of death worldwide[*]. 

For years the popular theory was that saturated fat was the primary cause of heart disease, and therefore diets low in fat should be followed to protect heart health. Of course, as history would show, this led to low-fat dieting and the subsequent obesity epidemic[*]. 

In the last decade research has finally come out to debunk the old “low-fat for heart disease” myth, and revealed that there is, in fact, no link between saturated fat and heart disease[*][*][*].

How did this widespread myth gain so much traction? It’s hard to say, but Inadequately controlled trials are likely to blame[*].

Now that we’ve covered why saturated fat is not to blame for heart disease, let’s talk about why the ketogenic diet may be the answer for optimal heart health. 

Heart disease has several biomarkers associated with it, including inflammation and high blood lipids. 

Studies suggest that inflammation may play an instigating role in heart disease by causing damage to the walls of your arteries and initiating the oxidation of cholesterol in your blood. These two factors combined result in the formation of arterial plaques that lead to heart disease[*].

Meanwhile, lowering inflammation in your body can lead to a reduced risk for heart disease[*].

Therefore, the antiinflammatory effects of the ketogenic diet alone may be able to protect your heart from disease. But that’s certainly not the only benefit that keto offers for your heart. 

Research shows that following a low-carb ketogenic diet can have a positive impact on your blood lipids associated with heart health. For example, when a group of obese subjects were put on a ketogenic diet for 24 weeks, they experienced the following changes in blood lipid markers[*]:

  • Lowered blood triglycerides
  • Lowered LDL cholesterol
  • Increased HDL cholesterol

In addition, the group also saw lowered blood glucose. 

While these markers are impressive, what truly sets the ketogenic diet apart regarding heart health is its effect on LDL particle size. Not all LDL cholesterol is created equally, and the size of the particle can make a big difference as to whether its a risk factor for heart disease or not.

Small, dense LDL particles are much more likely to lodge into your artery walls and create a buildup of plaque. Large, fluffy LDL particles, on the other hand, are too big to lodge and don’t pose a threat to your artery walls. 

Studies show that when you follow a ketogenic diet, the size of your LDL particles changes resulting in the larger, fluffier LDL that won’t contribute to heart disease[*].

Finally, it’s been reported that adults with diabetes are two to four times more likely to die from heart disease than adults without diabetes. Since the ketogenic diet can support healthy blood sugar, it offers yet another way to protect your heart[*]. 

Affects Athletic Performance

Whether you’re an endurance athlete or prefer resistance training, the keto diet can support your athletic endeavors, and research shows may even improve performance.

Contrary to popular belief, carb-loading may not be the answer for endurance athletes that are looking for sustained energy. While keeping glucose flowing may sound like a good idea on paper, the fact of the matter is that glucose is a temperamental fuel source that fluctuates much more than ketones.

In endurance athletes, keto-adaptation not only enhances body composition, but it also increases fat oxidation. That means that when athletes are training, their body more efficiently taps into their fat stores to produce ketones that fuel their muscles. 

This is evidenced by increased sprint power, as well as longer periods of peak power before reaching fatigue[*].

In one study, ultra-endurance runners that were keto-adapted burned over twice as much fat as high-carb runners[*].

In regards to strength training, the old adage “fat burns in a carbohydrate flame” falls flat when you look at keto-adapted athletes. 

For years it was believed that carbohydrates were needed to protect muscle breakdown. The thought process was that once glucose was diminished, your body would turn to your muscles to break down amino acids for fuel. 

In reality, however, research shows that when you’re keto-adapted, your lean body mass is protected from catabolic breakdown. In fact, ketogenic resistance athletes lose more fat than high-carb athletes and preserve their lean body mass as they do[*]. 

Cognitive Health

Having a sharp mind as you age is just as vital as having a healthy, fit body. 

Unfortunately, neurological diseases like Alzheimer’s and Parkinson’s disease are on the rise in the United States, with more and more people being diagnosed each year[*]. 

Neurological diseases are marked by both neuro-inflammaton and disruption in energy utilization. This disruption in energy comes from dysfunction in cellular organelles called mitochondria. Your mitochondria, also known as the powerhouse of the cell, provides the energy you need on a cellular level for all the vital workings of your brain[*][*][*]. 

Research shows that ketones act as powerful brain-protecting compounds in neurological disease by not only decreasing inflammation but also enhancing the function of your mitochondria[*][*].

Studies also show that neuroinflammation can affect cognitive function and that the anti-inflammatory activity of ketones may be a way to enhance memory in those with brain inflammation[*

What’s more, elderly patients consuming a ketogenic diet show improved working memory, visual attention, and task switching on-demand[*]. 

Rich In Dietary Fiber

Many people claim that low-carb diets lack dietary fiber because they avoid foods like beans and whole grains. 

In reality, nothing could be farther from the truth. The ketogenic diet is packed with fiber-rich foods like low-carb vegetables, nuts, and seeds. Some examples of high-fiber foods that should be consumed in abundance on the keto diet include:

  • Flax seeds
  • Chia seeds
  • Broccoli
  • Brussels sprouts
  • Cauliflower
  • Avocado
  • Shredded coconut 
  • Asparagus
  • Artichoke
  • Almonds

And many, many more. 

Dietary fiber not only supports digestion and prevents constipation, but it also supports heart health, helps in the prevention of diabetes, and aids in weight loss. 

The keto diet is rich in both soluble and insoluble fiber, with soluble fiber helping to reduce cholesterol and blood glucose levels, and insoluble adding bulk and promoting healthy stools[*].

Rich In Vital Micronutrients

Some sources claim that following a ketogenic diet that restricts carbs can lead to vitamin and mineral deficiencies due to low intakes of fruits and vegetables. This comes from the common misconception that the keto diet is meat and fat heavy and low in plant foods.

However, a well-balanced low-carbohydrate diet is full of veggies like broccoli, cauliflower, bok choy, peppers, sprouts, leafy greens, radish, and so on. These foods provide a wide array of vitamins and minerals, as well as antioxidants and other phytonutrients that are necessary for the function of every cell in your body[*].

In contrast, diets that are full of processed foods and refined carbohydrates lack the essential nutrients your body needs and are linked to weight gain, insulin resistance, diabetes, and potentially heart disease[*][*][*][*].

The Takeaway: A State of Ketosis is Healthy Long-Term

The short-term effects of being in ketosis often look like increased energy, weight loss, and enhanced cognitive function.

The long-term effects of low-carb high-fat dieting, however, offer many more benefits than what you see after a month or two on keto. 

By reducing your carbohydrate intake, you support the health of your heart, reduce the impact of glucose on your body, support your athletic performance, and reduce your risk for obesity as well as neurological and inflammatory diseases.


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