To keto or not to keto, that is the question: A dietitians thoughts about the keto diet
Print Friendly, PDF & Email

Exploring the keto diet for health, sports performance and weight loss

Everywhere you look you will find an opinion about what to eat for weight loss or which foods are the best for health or sports performance. Having been a dietitian for close to 20 years I’ve seen just about every eating style and diet you can imagine – most of which contradict one another. There have been a range of low-carb diets such as the paleo diet that preach the opposite of high-carb eating styles such as plant based vegan diets. We have also seen low-fat diets, detox and cleansing regimes, intermittent fasting and most recently a rise in the keto diet. 

While I do consider the keto diet just another diet that will come and go similar to the Atkins diet and South Beach diet that you now hear very little about, you may be curious about this eating plan. You may be wondering what the keto diet is all about and if there is some benefit. Read on for the answers to these questions and more.keto diet review by registered dietitian andrea holwegner

What is the keto diet?

The keto (ketogenic) diet in a nutshell involves restricting your diet severely of carbohydrates which causes your liver to turn fat and certain amino acids into ketones which is an alternative fuel source for the brain.

  • The brain runs exclusively on either glucose (carbohydrate) or ketones to stay alive.
  • Carbohydrates are found in grains/starches (such as pasta, rice, potatoes, legumes or cereal) as well as fruits, vegetables, yogurt, milk, sweets, sauces and more.
  • Carbohydrates are restricted typically less than 50 grams per day on a keto diet. This is the amount of carbohydrates found in only 1 cup of rice (or 1 banana plus 1 apple).
  • The keto diet is not a high protein diet. It is a low-carb, high-fat diet typically containing a percentage of total calories as follows: 5% carbohydrates, 75% fat, 20% protein. (By contrast, National health guidelines suggest 45-65% carbohydrates, 20-35% fat and 10-35% of total calories as protein).

Which foods are permitted on a keto diet?

I’ve noticed many people say they are on a keto diet but in actual fact, they are not based on the food choices they are consuming. To truly be in ketosis where your body is turning fat and certain amino acids into ketones you must be following an extremely restrictive diet.

Followers of the keto diet eat meat, poultry, fish, seafood, eggs, cheese, bacon, butter, whipping cream, avocados, oil, nuts, seeds, low-carb veggies and lower carb fruits eaten only sparingly. While this may seem appealing, sustainability is a huge challenge because of the long list of restrictions.

Keto followers cut out grains (such as rice, quinoa, bread and oatmeal), starches (such as potatoes and corn), legumes (such as lentils, chick peas and black beans) as well as milk, yogurt, sweets, desserts, potato chips, sweet sauces, most fruit and higher-carb vegetables.

WATCH Andrea’s Facebook LIVE on this topic here:

Are there medical reasons someone would choose to follow a keto diet?

The keto diet has some clinical relevance for individuals with epilepsy for seizure management that has not responded to traditional medication. 

The keto diet is also being studied in some interesting scientific research for multiple sclerosis, parkinson’s disease, alzheimer’s disease, diabetes, high cholesterol levels and cancer. But remember something very important. Just because you saw a single study that showed promise doesn’t mean you should change your eating style based on that study. Research studies vary in credibility and meaning. We can’t make blanket statements about what to eat based on one study on mice or a short term study over a week on a sample size of 10 people that didn’t control for other lifestyle factors. 

Trust science…Remember that science involves both the approach of being inquisitive and skeptical at the same time. This means we should all remain open to what high quality scientific research on the keto diet will show in the future, but we shouldn’t be jumping to conclusions that are not available yet.

Work with an experienced Registered Dietitian and your medical specialist to help you sort through and make sense of the research and determine the best eating plan for your needs.

Would you recommend the keto diet for weight loss?

You might lose weight on a keto diet because:

  • You may reduce your overall calories by simply having less food choices to choose from.
  • Carbohydrates store water and if you eat less carbs you will lose water weight.
  • You may be eating more protein and fat as a result of reducing your intake of carbohydrates which could work to provide satiety.

BUT While you could lose weight following a keto diet (or any other diet) I am not an advocate for unnecessary restrictions or extreme eating regimes or dieting behavior. I stand for balance, variety and maintaining enough fun and flexibility in your eating style to live your best life.

  • It is no surprise not all eating plans are actually good for health. You could follow a keto diet that exclusively had you eating meat, butter, bacon and avocado and this would not lead to good health even if you did lose weight.
  • Given the wide range of foods limited from this diet the keto diet is likely low in fibre, certain vitamins and minerals as well as key phytonutrients supplied by plant-based foods that are naturally high in carbohydrates. Scientific research has clearly shown the benefit of many plant based foods such as fruits, vegetables, legumes and whole grains that are not permitted on the keto diet.
  • Research has shown that over time the same amount of weight will be lost following a low-carb diet or high-carb diet (or any other variation of a diet) as long as the calories are the same. While the initial loss of weight on a lower-carb diet is often higher (often due to the fact that there is a large water loss off the body when you take out carbs from your diet), over time weight loss will be about the same.
  • There are many reasons we weigh what we weigh. Our weight may or may not change following a keto diet (or any other diet) because there are many other factors involved including genetics, sleep, stress, activity level to name a few (for more information visit: Why we weigh what we weigh)

Is the keto diet a good eating style for athletes?

No. While the are some studies that show mixed results, the overwhelming majority of high-quality sports nutrition research supports the benefit of consuming a good amount of carbohydrates for sports performance.

Athletes and fitness enthusiasts that are involved in high intensity or long duration training and following a keto diet will likely not have the adequate muscle fuel required to perform at their best, increase strength, sustain endurance, build muscle and recovery properly. 

What is the bottom line about the keto diet?

  1. Your brain and muscles run on carbs, when carbs are not available you will not be fueled with the gasoline source for your brain and muscles. An insufficient amount of carbohydrate in your diet and running on ketones can cause fatigue, poor concentration and can reduce overall mood, mental health and productivity through your day. Insufficient carbohydrates for your muscles can also lead to worsening athletic performance, poor recovery and inability to repair and build muscle.
  2. Sustainability is a huge concern with the limited variety of foods consumed on this diet and any amount of weight lost on the keto diet due to water loss or to a reduction in overall calories simply will be regained when you return to a normal diet.
  3. Unless in the rare case your neurologist has recommended the keto diet as a potential adjunct treatment for epilepsy, skip this diet. Continue following the science to remain inquisitive and skeptical of keto diet claims and work with an experienced Registered Dietitian and your medical specialist to help you personally review the research and determine the best eating style for you.
  4. If you have a chronic history of dieting or an eating disorder the keto diet will also likely increase obsessive thinking about food, bingeing and further damage your relationship with food and your body.
  5. Before following the keto diet remember that history has shown us that similar diets are difficult to follow and full of restrictions that make living a balanced life difficult. Eating dinner with your family, eating out socially, going on vacation and role modelling a non-dieting relationship for your kids all become very challenging following a keto diet.

Eating well should not be painful, taste terrible or be a punishing regime. There are many ways to eat well. Remove the word ‘diet’ from your vocabulary and go for an eating lifestyle full of as much variety and as few restrictions as possible.  

If you can’t see yourself following a nutrition or food plan FOREVER, your energy, health or weight will continue to yo-yo up or down. The idea you can restrict, cleanse or detox now, and then return to having a life later just won’t work to provide lasting results. The best eating plan is the one you can live with for life.

Check out our freebie resource on the Best Diet for Weight Loss:















Print Friendly, PDF & Email

As seen in


Success stories

"I am a psychologist in private practice and it is very important to me that my clients have the best care with other health care professionals. For that reason Health Stand Nutrition is my only source for exceptional Dietitians. Andrea and her team provide highly knowledgeable, compassionate, and real world support to my clients who require assistance with food lifestyle. I trust my clients to them and you would be in excellent hands making them part of your health care team."
Adele Fox, Psychologist
“This is the first time I feel satisfied; my cravings have diminished dramatically and I have a whole new relationship with food. I am eating guilt-free for the first time in my life. My energy has also dramatically increased and I feel great!
Rhonda Jenkins, Nutrition Counseling Client
“The Dieticians at Health Stand Nutrition help you to take action on the science behind eating well by making it practical, understandable, and fun. Their office is cozy and not at all clinical or intimidating. I felt like I was sitting down with a really smart, caring friend who wanted to help me make the best choices for my lifestyle and food preferences. They really are the best in the business.”
Marty Avery, Nutrition Counseling Client
“I have come to think of the program as a one stop shopping excursion for everything one needs to know about creating a joyous relationship with food and our bodies. In a single word, the course has gifted me with freedom from the punishing rigidity of disordered eating, old stories that never were true, and body dysmorphia that did nothing but make me lose sight of a body that has done everything I've asked, despite my careless dismissal of her needs. Now when I look in the mirror I find myself shifting from harsh criticism to gentle gratitude.”
Lynn Haley, Pursuit of Healthiness Online Course Participant
“I spent 3 hours when first diagnosed with type 2 diabetes. I learned more from my Dietitian about food in those 3 hours than I had learned in all the years of my life. I also love the newsletter, there is always something to learn.”
Peter Whitehead, Nutrition Counseling Client
“I didn’t realize how strong my “diet mentality” was, and all the rules I had in my head about food. I was in a cycle of reward/punish/binge/cringe. I booked with your business very reluctantly, on the repeated advice of my doctor, to get my slowly rising cholesterol levels in check. I thought I knew everything about food, and my behaviour with food, but I was definitely re-schooled. My weight is creeping down, I feel good about my diet, exercise, body image, and lifestyle.”
Amy Floyd, Nutrition Counseling Client
“Thanks Andrea for an amazing presentation, I have heard all positive remarks from attendees and the evaluations show the same sentiment. It is really gratifying when a speaker does their “homework” and weaves in our profession’s day to day challenges within their content, you did an awesome job of this! You truly took the “die” out of Dietician! Your information on healthy eating and simplifying how we can work towards this as we are all so busy really hit the mark. Andrea connects very well with her audience; she is energetic, funny, and very approachable.”
Carole Ann LaGrange, Transfusion Medicine Safety Officer

Event Planner for Laboratory Diagnostic Imaging Annual Event

I am a family physician who sees patients with a myriad of eating concerns – from wanting to know how to plan healthy meals for active families, to weight loss, to eating disorders, and so on. I cannot recommend the Health Stand team highly enough. I have worked with (and been to!) other Dieticians in the past and too often find that they just ask for food logs and make suggestions that are easily obtained online or in books. The Dieticians at Health Stand offer much more than just telling clients what they “should be eating.” In contrast, the team really does more of a counselling practice, and they work hard to help their clients learn more about why their eating habits may be off track and not optimal for them, as well as helping people to effect change at a deep level that, most importantly, is sustainable for lifetime health.”
Dr. Deb Putnam, Family Physician

Nutrition Counseling Client & Referring Physician

“I am a busy mom, with kids in high level sports, working full-time downtown, and running our home acreage outside the City. I now have the knowledge and tools I need to plan for and manage the chaos of meal planning.”
Gillian Gray, Pursuit of Healthiness Online Course Participant
“As a construction company, we select speakers who can relate to our industry and its employees. Andrea’s message was delivered with humor and empathy. She makes people feel as though they can make changes without leaving behind every favorite food. Andrea focused her presentation on healthy eating as a way to keep energy high throughout the day. This message and the way it was delivered resonated with our predominantly male, blue collar culture. I would highly recommend Andrea as a speaker for groups such as ours. She will get your message across without alienating anyone in your audience – which is a huge hurdle when trying to introduce a wellness program in the workplace!”
Stephanie Wood, HR and Safety Manager

Fisher Construction Group, Burlington, WA

I found my Dietitian warm, funny, and skilled at teaching nutrition concepts without the overwhelm. The general approach of each session was to mix science with emotion, which was exceedingly effective in helping me shift my perspective on food from one of anxiety to one of joy and curiosity.”
Erin Kronstedt, Nutrition Counseling Client
“Excellent presentation! What a refreshing change to have a speaker inspire rather than “lecture” about nutrition. Your captivating stories, tips and overall approach to healthy eating uplifts and puts people at ease. It was great to hear we don’t need to strive to be perfect eaters, and that small changes really can make a difference in how we feel and in our health. Thanks to Andrea, we have solutions to our everyday nutrition challenges that can actually work in real life!”
Tina Tamagi, Human Resources

ARC Resources Ltd.

“Had I not joined this course I would have struggled with no focus, low energy, and mindless eating. Excellent teaching and motivation. This is not just a course, it is a nutrition club with mentorship, support, and connections with other people with similar situations.”
Lorri Lawrence, Pursuit of Healthiness online course participant

Pin It on Pinterest

Share This