It seems like everyone is talking about the low-carb, high-fat ketogenic diet. It’s the eating style of choice for celebs like Vanessa Hudgens and superstar trainers like Kirsty Godso, and has been touted as the go-to food plan for treating diabetes, anxiety, and to lose weight. But a big question that keeps popping up is, how long are you supposed to keep it up, exactly? It is meant to be a lifelong plan or a short-term fix?
Expert opinions are divided on the topic. Case in point are the two I asked for this article. Everyday Ketogenic Kitchen author Carolyn Ketchum has been eating low-carb for seven years (and all-out keto for almost four). She offers recipes and tips from her popular website, All Day I Dream About Food—she says sticking to it long-term is crucial for managing her diabetes. But registered dietician and Read It Before You Eat It author Bonnie Taub-Dix, RD, CDN, not only cautions against doing keto long-term, she doesn’t think it’s all that great to do for a short while, either.
Here, both argue their cases, leaving you to be the judge.
Is the ketogenic diet a sustainable long-term eating plan? Keep reading to find out.
The case against following the keto diet indefinitely
“This is just another fad diet,” Taub-Dix says of keto. While she does say it can be an effective way to lose weight relatively quickly, it’s not something she advises, let alone recommends, for a lifelong eating plan. “Carbs are not bad for you,” she says of the food group demonized by devout keto followers. “They’ve really gotten a bad rap over the years, but it’s more about choosing the right carbs.”
Taub-Dix says whole grains, for example, are a great source of vitamin B and fiber, a nutrient that’s even more important than you might realize. She points out that there’s a difference between cutting out croissants and muffins and cutting out all carbs. Another reason why she’s pro-carbs: They make you happy. “Studies have shown that they boost serotonin levels,” she says. “I know people who have started doing keto and have become really moody because they’re missing out on that.”
“I know people who have started doing keto and have become really moody.” —Bonnie Taub-Dix, RD
While the ketogenic diet has become popular for people with diabetes, Taub-Dix warns against it, saying it can lead to some serious health problems. “It can cause DKA, diabetic ketoacidosis,” she says. “This happens when your body is producing a lot of ketones and can lead to vomiting, diarrhea, feeling faint, and being [excessively] thirsty.” Yeah, not fun. “Why take a risk of that happening?” Taub-Dix asks.
Okay, so she’s not into keto. What does she advocate instead? Good old-fashioned moderation. “It’s boring and common sense, but eating a wide variety of foods and using portion control is really what works in the end,” she says.
And for sticking with keto for life
Even though Ketchum has written a book on keto, keeps on top of the scientific research about it, and has been living the keto life for years, she stresses that she is not a medical expert. “I read a lot of studies, but I’m not the person doing the research,” she says. Still, she has pretty compelling reasons for why the ketogenic diet works long-term.
“In my case, [since I have diabetes], I have a visual representation of why it works, which is my blood glucose meter,” she says. “I know that if I didn’t stick to the ketogenic diet, I would likely have developed Type 2 diabetes and be on insulin.”
“If I didn’t stick to the ketogenic diet, I would likely have developed Type 2 diabetes and be on insulin.” —Everyday Ketogenic Kitchen author Carolyn Ketchum
But even if you don’t have diabetes, Ketchum says it works in the long-term. “People use it for weight control, anxiety, and other neurological disorders, and also for sustained energy and to combat brain fog,” she says. “Carbs can make you feel fuzzy because they spike your blood sugar, then it drops and you feel tired, which makes it harder to focus.”
And even though the word “diet” has a temporary connotation, she says it’s absolutely sustainable—as long as you like the food. “The key is having recipes for dishes you love on hand,” she says. “Food is pleasure, celebration, and fun. So as long as there are some keto-friendly foods around when you’re socializing, you won’t fall off the wagon.”
Even though Ketchum is an all-out keto advocate and, for her, there’s no turning back, she does offer up one caveat: “Because the diet is newly popular, there haven’t been any substantial long-term studies done,” she says. “I would love for someone to do one, following people on keto for 20 years!” But as for herself, she hasn’t seen any negatives to the diet, only positives.
While the wait for more research is on, for now, the best barometer is likely yourself. As with any eating plan, it comes down to how what you’re eating makes you feel. When finding the best diet for you—and whether that includes a plate full of eggs, avocado, and a side of bone broth (or not)—you are your greatest advocate.