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keto questions

Your Keto Questions, Answered By A Dietitian

Throughout the past few years, the ketogenic diet has transitioned from a topic known only to biohackers and bodybuilders to a mainstream trend. Yet as the high-fat, super-low-carb diet has spread across the wellness community, so has misinformation about it. There are a whole lot of keto questions out there!

Still on the fence about this fat-fueled diet? We gathered your keto questions on Instagram, and turned to The Vitamin Shoppe nutritionist Brittany Michels, R.D. to provide the answers you need to jump on the keto lifestyle happily and healthfully.

Q: Is it safe for children or elderly people to be on the keto diet?

I’ve witnessed both children and elderly people on keto who have had seemingly great results. However, I want to caution that the keto diet does eliminate nutrients (since you cut back on certain food groups) and must be supplemented.

Some basics to supplement with in order to replenish the nutrients that get depleted on a keto diet include:

If the elderly person or child refuses to take those vital supplements, keto is not right for them. To be safe, consult with your healthcare provider or a registered dietitian before making significant dietary changes for these groups.

Q: What is the best multivitamin to take while on keto?

I bought the Ancient Nutrition Keto Multi Fermented Vitamin and Mineral Formula for my dad while he was on keto. It covers so many keto essentials, so he only needs to pair it with a probiotic, fish oil, fiber, and electrolytes.

Q: Is keto safe long-term?

As long as potentially missing nutrients are supplemented, I believe this diet is safe long-term. I have worked with several clients who have followed keto for several years without adverse outcomes. That said, research will continue to call out any negative effects of following this diet long-term without supplementation and proper nutrition. I recommend signing up for a virtual nutrition consultation with one of our amazing nutritionists to ensure you meet your nutritional needs on a keto diet. And, as always, check in with your healthcare providers before making radical changes to your diet and lifestyle.

Q: Is keto safe for mothers who are breastfeeding?

Though no current evidence has identified any risks to ketones in breast milk, there are mixed opinions on this topic.

Overall, the concerns about going keto while breastfeeding center around inadequate nutrient intake and hydration. Going keto would certainly be risky for breastfeeding mothers who struggle with drinking enough fluids, don’t follow a whole foods keto approach, or are inconsistent with taking daily supplements.

Check with your healthcare provider before adopting a keto diet while breastfeeding.

Q: How will marathon training impact my keto diet plan?

I’ve run a couple of marathons and an ultramarathon while in ketosis. A few perks I experienced: I never hit the notorious “wall,” recovered more quickly than ever, and didn’t need to carry a bunch of carbs while training and racing.

The downside, though—and I’ve heard this may improve the longer you’re in ketosis—is that my mile splits were slightly slower. Not a big deal if time isn’t your goal, but if you’re trying to PR then carb-cycling may support performance.

Q: Is fruit allowed on keto?

A: There are definitely some keto-friendly fruits! Berries, for example, contain about five grams of carbohydrates per third-cup, and may be consumed to fulfill your carbohydrate allowance.

Q: How do you know if keto is right for you?

A: This is a tricky one because there are many factors to consider when determining whether keto is right for you.

A few to think about:

  • Sticking to keto’s very specific macro ranges is essential for getting into (and staying in) ketosis—and the most successful dieters track their food intake (often on apps like Carb Manager or MyFitness Pal). If you’re opposed to tracking your food, keto may not be for you.
  • Food prep is essential on keto—especially if you have a busy schedule. If you enjoy meal prepping (or are willing to try it), the diet could work for you. If you’re more of a grab-and-go type, keto may be a little more difficult.
  • Eating keto requires completely eliminating grains, most fruits, and most starchy vegetables. If that doesn’t sit well with you—or you have a history of disordered eating—keto may not be for you.

Q: What sweeteners are not connected to migraines, but are keto approved?

Some people who are extremely migraine-prone can be triggered by sugar substitutes. If this is the case for you, sticking to whole foods is your best bet for preventing migraines. Many people, however, handle most sugar substitutes well.

Popular keto sugar substitutes include stevia, sugar alcohols (such as erythritol), and monk fruit.

Approach all sugar substitutes with caution until you know how they affect you—and remember to consume keto treats in the same moderation you’d consume regular treats in.

Q: What should I look for when reading condiment or seasoning ingredients?

Many traditional condiments, including ketchup, are made with sugar or high fructose corn syrup, which spike carb content (often beyond keto-friendly levels). Other popular sugar-filled ingredients to look out for: agave nectar, molasses, fruit juice, honey, maple syrup, and brown rice syrup.

Q: Is there such a thing as too much exercise on keto?

Going keto can affect your workouts, particularly anaerobic exercise like weightlifting and HIIT, which are generally powered by sugars in the form of glucose or glycogen. Performing higher-intensity exercises like these can strain a body that’s running on an almost-sugar-free keto diet.

Otherwise, enjoy all the exercise you want—within your means, of course. Just remember those fluids and electrolytes. On keto, we flush water and electrolytes (such as sodium, potassium, and magnesium), so be extra cautious if you’re a heavy sweater.

Q: How can you go back to eating carbs without gaining weight back?

Many keto dieters transition to a typical low-carbohydrate diet after meeting their weight goals.

Though some fluid retention is inevitable when you increase your carb intake, I recommend gradually reintroducing carbohydrates over several weeks. This can help you avoid big jumps in weight, bloating, and changes in appetite and satiety.

Some people choose to increase carb intake by 10 percent per day, while others increase by 10 percent every few days.

Track your food during this transition to ensure you don’t jump up too quickly, stick to whole foods that are high in fiber, and avoid concentrated carbohydrates and added sugars.

Q: How can I figure out my keto macros?

Your individual keto macros depend on your calorie needs, so you need to know your calorie goal to make calculations. Once you know your calorie needs, five percent of them should come from carbs, 20 percent from protein, and 75 percent from fat.

Say you’re eating 1,500 calories per day, for example. To calculate your carb allowance, multiply 1,500 by .05. This is the number of calories from carbs you can consume per day (75 calories). Then, divide that number by four (the number of calories per gram of carbs). This is the number of grams of carbs you can consume per day (19 grams).

Repeat these calculations for protein and fat, noting that while protein also contains four calories per gram, fat contains nine.

If all this manual work isn’t your thing, use a tracking app instead.

Have more nutrition questions for The Vitamin Shoppe nutritionists? Shoot us a DM on our Instagram! 

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