The Ketogenic Diet, (Keto) is a special high-fat, low carbohydrate diet designed to control seizures in individuals diagnosed with epilepsy. In recent pop culture, the Keto diet is viewed as a quick weight loss solution. Because the Keto diet is an extremely strict, nutritionally unbalanced diet, we do not recommended it for PCOS management. In order to create a lifetime of nutritionally sound habits, follow the advice of your dietitian to manage you PCOS. Avoid the Keto diet.
Below are a few reasons why the Keto Diet is not a good fit for people with PCOS.
"Trying to reach Ketosis" can have unpleasant side effects
In practice, many people who claim to practice the keto diet actually fail to ever reach ketosis. This result rarely happens because of a lack of effort. Instead, it's just really hard to restrict total carbohydrates to the ~5% level needed to bump your body into fat-burning ketosis.
The unpleasant side effects can include:
- Carbohydrate withdrawal can include headache, chills, brain fog, dizziness and irritability
- Sugar cravings, which can cause the inflammation associated with PCOS
- An uncomfortable link to disordered eating: Women with PCOS are more likely to also experience disordered eatings (two studies, here and here). We do not recommend these typos of restrictive diets for women with PCOS.
The Keto Diet for PCOS is very difficult to sustain for a long term
Multiple studies have demonstrated that a very-low carbohydrate keto diet can help you lose weight quickly. The first study was published in London-based Nutrition and Metabolism, and the second study was presented in the Journal of Translational Medicine. The major shortcoming of these studies is that participants either:
Were not closely monitored; i.e. only had monthly check-ins:
Only followed the ketogenic diet for 12 weeks
The Keto Diet may actually make your PCOS symptoms worse
The glands that regulate the hormones in your body are very sensitive. When you severely restrict carbohydrates , the physiological stress on your body may cause your adrenal glands to start producing more cortisol (one of your body’s stress hormones).
Cortisol causes blood sugar levels to increase and can actually make insulin resistance worse over time. Elevated levels of cortisol lead to more belly fat.
Research has shown that holding excess fat in your abdominal area increases a person’s risk for health conditions including type 2 diabetes and heart disease more than holding fat in other areas of the body.
Although initial weight loss may occur on a keto diet (as would cutting out any entire food group) the long-term impact of elevated cortisol levels from overly restricting carbohydrate intake may actually do more harm than good.
We have been critical of the Keto Diet for multiple reasons, including its negative long-term effects on proper liver function. You can read our broader Keto Diet discussion on this blog post.
To read more about foods to avoid, foods to eat, and how to make easy changes as part of a healthy PCOS diet, download our PCOS Nutrition Guide.