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a woman cutting up avocado for a keto-friendly snack

How to Succeed on the Keto Diet

Claire Sykes
This content originally appeared on 

The keto diet's ability to achieve rapid weight loss makes it popular. It can help with digestion, too, but some people find it worsens digestive issues. Let's explore why, and see if anything can be done to prevent it.

Keto Basics

The diet's whole-food meals of roughly 75 percent of calories from fats, 20 percent from protein, and 5 percent from carbohydrates mainly rely on fuel from steadier-burning fats versus the rollercoaster ride from sugar. That's good news for weight loss.

Restricting carbs forces the body to use ketones for energy. The liver makes these chemical compounds as it breaks down fat with the help of bile, sending any excess bile to the gallbladder for storage.

"Lowering carbs in general also reduces the fermentable ones that bad gut bacteria feast on. This can reduce and prevent gas and bloating," says Michael Smith, ND, BHSC, of Planet Naturopath, in Victoria, British Columbia, Canada.

"Keto can be a great diet for some. But to make the most of it, your fat digestion has to be optimal," explains Ann Louise Gittleman, PhD, CNS, New York Times bestselling author of Radical Metabolism. "If you have congested bile from blocked ducts, too little bile, fatty liver disease or other digestive issues, or your gallbladder has been surgically removed, then you can't digest all the fats the keto diet requires you to eat."

What Can Go Wrong on a Keto Diet

The keto diet can fail when its carb restrictions make you overdo it on fatty meats and dairy products, and you don't eat enough healthy proteins, green leafy veggies, and other nutrient-rich plants.

"Too much animal fat and too little fiber cause diarrhea," Dr. Smith says. This is also true with too much MCT [medium-chain triglycerides] oil, which is found in coconut oil. On the flip side, too much cheese and too little water cause constipation.

Following the diet causes an initial loss of water weight.  "But the flushing causes toxins to concentrate, giving you the 'keto flu,' with symptoms from digestive upset and skin rashes to headaches and body aches,"  says Dr. Gittleman. Good thing it lasts only a few days.

How to Succeed on a Keto Diet

Drink plenty of water. Since you'll urinate more, you'll lose electrolytes, so increase those with bone broth.

Keep only keto-diet ingredients in your home, plan all meals, study restaurant menus before you go out, don't go to parties hungry, and track everything you eat. And forget cheat days. Not everyone can obey such a strict diet, but millions wouldn't try unless they felt it was worth the potentially positive results. If you're one of them, see your healthcare practitioner before starting.

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Personal communication: Ann Louise Gittleman, Michael Smith, 7/19