Over the past decade or so, the ketogenic diet has been a hot topic for dieters around the country. For those wanting to lose weight quickly, going keto has become a potentially useful tool, thanks to a process called ketosis.
What Is Ketosis?
Ketosis is a metabolic state that occurs when the body uses fat to fuel its functions. Severely restricting the amount of carbohydrates you consume forces your body to shift to burning fat instead of its preferred option, glucose, which is a type of sugar broken down from the food you eat. The traditional keto diet is designed to boost this process: It derives 90% of its calories from fat, 6% from protein and just 4% from carbs.
When the body uses fat for fuel, it releases a byproduct called ketones — the hallmark of the ketogenic diet. Ketones can be measured in the blood and urine, and for the strictest adherents of the keto diet, hitting a certain level of these chemicals made in the liver means you’re in the optimal fat-burning zone.
[Read: Low-Carb Diets vs. Keto Diet: What’s the Difference?]
Ketosis symptoms
You can test whether you’re in ketosis and burning fat at a higher rate with at-home test strips. But there can also be some other, sometimes unpleasant, signs and symptoms of ketosis. These include:
— Rapid weight loss.
— Loss of appetite.
— Bad breath, also known as keto breath.
— The “keto flu,” which can include headache and brain fog, nausea, mood swings and irritability, cramps and muscle spasms, changes in sleep patterns, increased fatigue and changes in bowel habits.
[Read: Keto Diet Dangers.]
Is the keto diet safe?
While the keto diet is generally considered to be safe for most people, there can be some serious health problems that arise from it. Some potential problems associated with the keto diet include:
— Dehydration.
— Nutrient deficiencies.
— Constipation.
— Increased cholesterol levels.
— Kidney stones.
— Loss of bone density.
— Mood swings and brain fog.
You should not adopt the keto diet if you have a history of eating disorders or have any health conditions that affect the thyroid, pancreas, liver or gallbladder. Pregnant people should also steer clear of this restrictive diet. Children and teens should not adopt keto unless they are instructed to do so by a health care provider and are carefully monitored.
[READ: The Benefits and Risks of Cheat Days on the Keto Diet]
Signs you should quit keto
Many folks who need to lose some weight opt for an extremely low-carb lifestyle like the keto diet, but you can’t stay in ketosis forever. Even staying on a modified keto diet, which allows you to eat more carbs than you would on a traditional keto diet, can present some challenges over the long term.
“Most people have a hard time staying on a really strict keto diet approach,” says Michelle MacDonald, clinical dietitian supervisor at National Jewish Health in Denver.
What’s more, the keto diet may negatively affect your health. If any of the symptoms of keto flu or ketosis become too intense or begin interfering with your daily activities, it’s time to quit. Some specific signs include:
— Nausea or vomiting.
— Frequent headaches.
— Fatigue.
— Diarrhea or constipation.
— Weight loss stalls.
Unfortunately, stopping the keto diet often leads to weight rebound, as those lost pounds can quickly return when you revert to previous dietary patterns. However, there are strategies you can try to avoid gaining weight after getting off the keto diet.
8 Tips for Transitioning Off Keto
Many followers of a keto lifestyle cycle in and out of the diet over time. If you need to stop keto, here are eight ways to limit how much weight you’ll gain back during that transition.
1. Pay attention and adjust as you go
Anytime you leave one diet for another, you should pay close attention to how your body responds to the revised eating plan. If you notice your weight increasing, make some adjustments.
“Should the weight creep back up, carbs can be reduced to produce weight loss,” suggests Kelly Roehl Nawakowski, an advanced practice registered dietitian nutritionist and a certified nutrition support clinician based in Chicago.
Some people follow a plan called “keto cycling” that has them following a keto diet a few days in a row followed by a day of higher carbohydrate consumption before going back to a stricter keto regimen. That’s a little different from what we’re talking about here, but there are a wide range of ways you can approach following keto for a time, followed by a break, before going back on keto again.
2. Learn to cook
Nawakowski notes that a healthy keto diet will contain a variety of high-quality and minimally processed foods that are less likely to cause weight gain than ultra-processed foods. These nutrient-dense options, she explains, “should be the focus of any long-term healthy diet, including for weight maintenance. Learning to cook and enjoy these high-quality foods will make weight management less of a chore by causing a behavior and mindset shift.”
3. Slowly scale back fat intake
The bulk of the calories you’re feeding your body on the keto diet are from fat, so you’ll need to reduce the amount of fat you eat to make room for more carbohydrates in your diet.
Monica Chan, supervising dietitian with Riverside University Health System in California, recommends transitioning off a keto diet by “slowly decreasing your fat intake, especially saturated fat, while increasing lean proteins, vegetables and wholesome carbohydrates like fresh fruits, whole grains and beans.”
4. Add back carbs slowly
Similarly, once you’ve achieved your goal of being on the keto diet, whether that’s for weight loss or blood sugar control, go slowly when adding back some high-fiber carbs to your diet. How many carbs and when you add them may vary somewhat depending on the amount you’re eating each day while on the keto diet.
For example, if you’re eating about 20 grams of net carbs per day, which is a fairly common amount of carbs for someone following a strict keto diet, “you would try adding 5 or 10 grams of carbohydrates a day for a week and see how you’re doing,” MacDonald says.
For reference, a half cup of berries contains about 7 grams of carbohydrates, and a tablespoon of blackberry jam has about 10 grams of carbs, so these are quite small increments of food.
If you’ve gained weight, you can scale back a bit. If you’re maintaining your weight, you can continue adding carbs and reassessing.
“You keep increasing the amount of carbohydrates up to a threshold of maintaining the weight that you’ve already lost,” MacDonald explains.
This set point will be different for each person, and it’ll take a little trial and error to find the right balance for you.
5. Visit the Mediterranean
Nawakowski recommends slowly transitioning from a keto diet into a diet that more closely resembles the Mediterranean diet through the “gradual addition of high-fiber carbs.”
The Mediterranean diet is a frequent favorite among dietitians and is ranked the No. 1 diet in U.S. News & World Report’s 2024 Best Diets ranking.
6. Avoid previous bad habits
MacDonald notes that for some people, going off keto means reverting to previous bad habits.
“That’s what causes people to come undone — they return to some of the old habits, which is very understandable. We’re hardwired to like sugar,” she points out.
If you’re cycling in and out of keto and trying to maintain the weight loss you achieved, MacDonald notes that you’ll probably “have to accept that you can’t eat a lot of junk. You have to be selective about what foods you eat, particularly carbohydrates,” such as breakfast cereals, snacks, ice cream and sodas.
“Carbohydrates are usually the culprit” behind weight gain, she adds.
7. Select fewer processed foods
When following a keto diet and when transitioning to a less restrictive diet, Chan says it’s important to think about the quality of the foods you’re eating.
“If you eat large amounts of processed meats like bacon, sausage and lunch meat, consider reducing the amount because these have been linked to increased cancer risk,” she notes. “Instead of processed meats, select lean meats like fish, skinless poultry and occasionally lean red meat.”
Tofu and other plant-based proteins can also be an excellent option instead of processed meats.
Chan offers an example of a healthy, post-keto meal: 4 to 5 ounces of lean protein, surrounded by a large amount of vegetables with added olive oil, as well as avocado and a small serving of berries.
8. Boost physical activity
Chan adds that a good way to help maintain your weight as you’re altering your dietary intake is to prioritize your exercise levels.
“Increasing your activity level will help you avoid gaining weight,” she says. “Check with your physician for appropriate types of exercise that are a fit for you.”
Foods to Add Back to Your Plate After the Keto Diet
When you begin transitioning off the keto diet, consider gradually adding these foods to your plate:
— Whole fruits and vegetables.
— Whole grains.
— Beans and legumes.
— Lean proteins.
— Low-fat dairy products.
Foods to Avoid Post-Keto
While your main focus will be on adding in higher-carb foods when you stop keto, there are some foods you should still avoid or limit to help prevent weight regain. These include:
— Highly processed foods.
— Alcoholic beverages and sugary drinks.
— Desserts and baked goods.
— Candy and sweets.
Bottom Line
Keto is not for everyone.
“No matter what diet or lifestyle you gravitate toward, remember that food quality and quantity are important,” Nawakowski notes. “Eat more vegetables, fewer processed carbs, and don’t be afraid of healthy fats.”
It’s also important to remember that all diets will reach a plateau, whether that’s weight loss-related or just you get tired of eating certain foods within the diet.
“The best thing you can do is to focus on healthy eating habits for a lifetime,” Chan says.
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How to Maintain Weight Loss After Keto originally appeared on usnews.com
Update 03/04/24: This story was previously published at an earlier date and has been updated with new information.
