The keto diet (low-carb, high-fat, moderate-protein diet) is a more extreme low-carb diet that simulates a state of starvation and takes advantage of its biochemical and neurological benefits to treat obesity, diabetes, epilepsy, and other medical conditions. However, for people with certain diseases, especially those who are unable to metabolize fat properly, the use of the keto diet requires extra caution! Who is unsuitable for the keto diet?
Contraindications to The Keto Diet
According to the recommendations of the International Keto Diet Study Group, the keto diet is contraindicated for people with the following specific medical conditions.
- Carnitine deficiency (primary)
- Carnitine palmitoyltransferase (CPT) I or II deficiency
- Carnitine translocase deficiency
- b-oxidation defects
- Medium-chain acyl dehydrogenase deficiency (MCAD)
- Long-chain acyl dehydrogenase deficiency (LCAD)
- Short-chain acyl dehydrogenase deficiency (SCAD)
- Long-chain 3-hydroxyacyl-CoA deficiency
- Medium-chain 3-hydroxyacyl-CoA deficiency
- Pyruvate carboxylase deficiency
- Porphyria
(All of the above diseases are very rare and most of them are congenital and rarely unknown to the patient.)
Who is Unsuitable For the Keto Diet?
The keto diet can be used with special caution in people with the following medical conditions.
- impaired liver function
The liver plays a very important role in the keto diet: producing ketone bodies, secreting bile, and digesting fat. The liver can easily perform these tasks in normal people, however, people with inadequate liver function may have an increased burden on their liver with a keto diet, and it is recommended that they consult a doctor before going on a keto diet.
- Pancreatic insufficiency
Some medical case studies have found that an underactive pancreas can lead to excessive fat not being fully digested and can easily lead to pancreatitis.
- Gallbladder disease
While bile is used to help break down and digest fat, the gallbladder is used to concentrate and store bile. If you have gallbladder disease, you need to be careful before going on any high-fat diet.
- Kidney disease
As we have stressed many times, a keto diet should use “moderate protein”, not “high protein”. If a high-protein keto diet (Atkins diet) is used, especially in people with kidney disease, it can place a greater burden on the kidneys and speed up the process of kidney failure.
- Abdominal tumors or impaired bowel function
Any high-fat diet may be challenging for people with abdominal tumors and impaired bowel function, and it is recommended that such people consult a physician before going on a keto diet.
- Type 1 diabetes and type 2 diabetes are treated with insulin
The keto diet can be used to treat diabetes, but it also needs to be used with extreme caution. If not done carefully, it can easily cause hypoglycemia and in severe cases can lead to ketoacidosis in type 1 diabetics.
- Patients on blood pressure-lowering medication
As with diabetes, the keto diet is very effective in treating high blood pressure. However, for patients on blood pressure medication, a keto diet may lead to hypotension and requires great caution! If available, it is best to use a keto diet with the assistance of a physician and check your blood pressure frequently and lower the dosage of medication if necessary.
- Pregnant women and breastfeeding
Pregnant and breastfeeding women can go on a less strict low-carb diet (carbohydrate >100 g per day), but not strictly keto. Wait until the baby is stable and developing after 6 months before considering a gradual reduction in carbohydrate intake, preferably under professional guidance. After all, the baby’s safety is most important!
- Weakened bowel movements
Certain cancer treatments and medications may prevent normal bowel movements, which can aggravate constipation during adaptation to the keto diet. …… Please consult your doctor before using the keto diet in this group.
- Malnutrition, gastric bypass surgery
Patients with malnutrition and gastric bypass surgery need special care from a doctor or nutritionist, so please consult a professional before choosing any diet recipes.
