Considering trying a ketogenic low carb diet, but warnings make me concerned - What's the truth?

I’m currently slowly losing and maintaining a regular 3 times a week apt. with a personal trainer for an hour of intensive exercise. I’m 55 with no outstanding health issues other than needing to lose weight. I’m 6’3" and my goal weight is approx. 235-240 at which point given my fairly robust build I will actually be fairly lean. I’m slowly getting more fit, but the weight loss over the past 7 weeks or so at 2500 calories a day on average has dropped to almost nothing. I can crunch down to 2000 calories a day, but to be frank it’s already somewhat a challenge to keep it at 2500 with high protein low carb ratios.

I know even with working out and being fairly muscular my metabolism is extraordinarily slow, but that’s just the cards I’m been dealt so I’m looking at the possibility of a ketogenic diet for a change of pace and possibly a more rapid rate of weight loss than the current 1/2 a lb a week semi-plateau. I maintain at 9-10 calories per lb of body weight per day so I realize if I get to 235 I have to figure out how to live on 2300-2400 calories a day which is going to a whole other challenge.

When I look up ketogenic diet you see a huge divide in opinions. On one side it’s the best thing ever, on the other you are potentially beating your kidneys to death and risking gout etc. I know the state of knowledge about diets is constantly changing. What’s the current straight dope on ketogenic diets. Dangerous or not?

I was listening to NPR the other day, and they were talking about a plateau at the 4 or 5 month mark, maybe. The woman they interviewed said she hit a plateau, at which point it took a month or two to even get the scale to budge. Then, her weight loss resumed as before.

They also talked about the fact that 2500 calories may be enough to help you lose weight at the beginning, but that you might need fewer calories as your body got smaller as a result of the weight loss.

I’m no expert.

I’ve done a low-carb diet of sorts for a long time now, and I drink an enormous amount of water in an attempt to keep my kidneys healthy. No idea what is happening down there, though.

IANAD, but I have always been under the impression (and my own diet and subsequent bloodwork support this understanding) that a high-protein diet is not harmful for the kidneys, as long as there are no pre-existing health issues with those kidneys. If there is any sort of deficiency in kidney function, however, a high-protein diet is not advised.

A ketogenic diet isn’t high protein, at least compared to any other recommended diet for those working out.

To do it right, you should eat 25-35 grams of net carbs per day (preferably from green vegetables like spinach), 0.8 grams or so of protein per lb of lean body mass, and fill the rest of your calories with fat. Some people do it by ratios, but these numbers are more precise. The website below is a handy calculator.

I am using it to control my narcolepsy and to lose some weight. I’m 6’4" and 24 years old. I started about 2 years ago at 270, got down to 215 last year, then got hit with mono and then divorce and fell off the wagon big time. I put some back on and when I really decided to get serious again around the 4th of July, I was at 235-240. This morning I weighed in at 225.

As far as health goes, as long as I make sure to get some extra potassium and salt and drink plenty of water, I feel great, otherwise I get low blood pressure and headaches. Eat plenty of green vegetables (fairly easy when you can eat things like creamed spinach) or you might have some digestive issues.

My blood pressure is down to around 105/65 from the 140/90 it used to be, and my cholesterol even improved slightly (triglyceride numbers are fantastic) although it wasn’t bad to start with, despite the fact that I drink buttered coffee for breakfast and eat at least a dozen eggs a week on average.

AFAIK there just isn’t enough evidence on this to make a determination. You search “ketogenic” on Google Scholar and what comes up is a lot of stuff about treating epileptic children, and one study that showed promising results for weight loss. I have yet to see a long-term study involving all-cause mortality and ketogenic diets (if someone knows of any, please send them my way!), and as a result I’m skeptical of this particular fad. It might be perfectly healthy, and it might not. We just don’t know.

Personally, what’s worked for me is a more balanced, boring, and “traditional” approach, where I don’t really limit whole grains or fruits (oatmeal mixed with strawberries and flaxseed for breakfast, stir-fries with brown rice, that kind of thing) but I do avoid processed grains, added sugars, and I seek out high-fiber food like beans. No pasta, no potatoes, no sandwiches, no baked goods or candies or anything, except on rare occasions. I also track what I eat; LoseIt makes that pretty easy, although you have to ballpark it when you eat someone else’s cooking or at certain restaurants.

What? You put butter in your coffee??

I either have a cup of black coffee for breakfast if I’m not hungry or I have a cup of coffee with a pat of Kerrygold butter (grassfed, tastes fantastic) or a small amount of coconut oil in it.

If you stir it well, you don’t drink the whole oil slick in one sip and it tastes really good, at least to me. Less than 200 calories for that sort of breakfast and I’m good until I get off work usually.

My wife pushes buttered coffee as a folk cure for colds/sore throats, and it makes me sick to think about. Bleccch.

I mean, great that you like it and stuff.