You’re starting keto? Oh but you’ll die!

2019 seems to be the year of ketosis. There are a million different supplements, recipe books, plans, and “gurus” trying to persuade you that keto is the right way to eat. Unfortunately they try and elaborate on their claims by selling you useless garbage that you don’t need, and providing advice that’s just terrible.

Similarly, you will also have your well-meaning non-keto friends telling you how keto will kill you. You will hear the word “ketoacidosis” thrown around like ticker tape. Your family will worry about your poor kidneys. Poor, poor kidneys.

My point is you’re going to get terrible advice from some well-meaning people who know just enough to be dangerous, and some not-so-well-meaning people who are looking to make a buck. Over the course of my 200+ pound weight loss through ketosis, I have done a LOT of studying because I’ve heard a LOT of nonsense. What follows is some of the worst of the keto “advice” you will likely hear, along with why it’s wrong.

Don’t do keto because of ketoacidosis/it will hurt your kidneys/you’ll gain it all back

Drawing on a Post-It of a kidney with a sweat band and a Mom tattoo
Your kidneys are tougher than you think

Best to start with the bad advice trying to dissuade you from keto, since it will be the first thing you’ll likely hear. Ketoacidosis a state where your blood becomes highly acidic due to high levels of ketones AND blood glucose. If you’re in ketosis, your body will preferentially create and burn ketones, but it will still manage glucose. If, however, you’re diabetic and insulin dependent, then you can easily get into ketosis while still having elevated blood glucose. Those ketones not being burned, flowing around your body can make your blood acidic quickly and it can turn deadly.

HOWEVER, if you’re not diabetic, and not reliant on injected insulin, it is nearly impossible for your metabolism to get to a state where this would occur. This is because your body will still produce insulin to deal with glucose while it’s producing and utilizing ketones. One of the most common but still rare situations where this could occur in a body that produces insulin is alcoholic ketoacidosis, where a person isn’t eating so they’re producing ketones, but their body is full of alcohol which it will burn for fuel first. While alcohol persists in the bloodstream, the body can’t regulate or utilize ketones, which will lead to increased acidity. Still dangerous, but incredibly specific, and highly unlikely in most people.

You’ll also hear that all the proteinĀ  you’ll eat on keto will hurt your kidneys, but that’s not accurate, either. Keto isn’t a high-protein diet; it’s a high fat, moderate protein, very low carb diet. Since your liver processes fat, that won’t cause undue strain onĀ  your kidneys, and since protein will be probably the same as your before-keto diet, there shouldn’t be any strain there. Finally, since there’s nothing magic about carbs that helps your kidneys, if you eat less of them there shouldn’t be any issues, either. In fact, persistent high blood sugar – such as in type 2 diabetes – is FAR more detrimental to your kidneys. If anything, keto will HELP them, and even if you upped your protein intake, as long as nothing else is going on behind the scenes health-wise, your kidneys can easily handle more protein.

Finally, there’s the idea that “if you stop eating keto you’ll gain all that weight back!”.

Well, duh? You mean if I go back to eating pizza and drinking beer all the time that I’ll gain weight back? Keto isn’t about a short-term fix to a few extra pounds; it’s a way of eating that is far closer to our ancestral way of eating. This means we typically ate meat and vegetables, which honestly should be the bedrock of everyone’s diet, though you can do vegetarian keto just fine.


You need to “hit” your fat macros for the day

Spoonful of coconut oil balanced on the lid of the jar
“Gotta make sure I eat enough fat so I can lose fat” – me, being terrible at keto circa 2011

If you poke around in keto forums on Facebook or other sites long enough, you’ll find that the ketogenic diet has a broad range of adherents. Some of those people believe that, once you’ve calculated your macronutrient ratios (how much fat/protein/carbs you should be eating), that those are numbers you need to ingest daily. They’ll suggest things like adding fat to your coffee, eating “fat bombs”, or adding butter to every bite of food you take. Writer of Keto Clarity Jimmy Moore advocates that last bit, and I guess it works for him?

The fact of the matter is, however, that you don’t need a certain amount of fat each day if you’re already overweight. Fat should be used for energy and satiation, but you don’t need an excess of it if you’re not hungry. Anyone telling you to add fat to your coffee or to make fat bombs to hit your macros is unfortunately giving you some poor advice.


You should be using ketogenic products

There are a lot of keto products out right, everything from meal replacements to exogenous ketones. While some products have their uses, they’re more for people who are seasoned at eating low carb, and most often who are also weight lifters or athletes. The biggest hurdle going from a standard western diet to a ketogenic one is dialing in your macros and just adjusting to eating vastly differently. Focus on that and then do research on what products might help you, but there’s no reason to buy BHB salts, MCT oil, or anything else like that.


Sugar-free products are compatible with keto

Many companies make a sugar-free chocolate or candy that you’ve probably seen at the grocery store. While they’re technically sugar-free, most are made with maltitol, which is both only slightly better than sugar on the glycemic index (52 for maltitol vs 60 for table sugar), but it’s also used as a laxative. Naturally having one piece here and there might not be a bad thing, but in bulk they’ll cause a stall, cause weight gain, and for some people, it’ll make it feels like there’s a weasel in their intestines.

Stevia blends and monk fruit sweetener are both great alternatives for sweetening keto baking, and both are 0 or very near 0 glycemic impact. Erythritol is also a fine sweetener, but it’s got a weird almost cold aftertaste and it personally gives me wicked heartburn. Better to find it blended with stevia, like the Pyure brand in the link above.


Too much protein will kick you out of ketosis!

You’ll find a persistent boogeyman word within keto communities: gluconeogenesis. Effectively, the term represents a process by which the body produces (genesis) new (neo) glucose by converting protein. While this process does occur, it’s not based on the protein you ingest but rather the glucose your body needs. You see, no matter how much you restrict carbs, your brain still derives the bulk of its energy from glucose – around 60%. It will always convert enough protein to meet its needs if there’s not enough carbohydrate coming in.


You don’t need to exercise to lose weight

Get to the gym, lift weights, walk a lot, run vigorously sometimes.

This is bad advice for a handful of reasons. Studies show that exercise has profound effects on mood, mental health, and just about every bodily system. For these reasons alone you should be getting regular exercise. With that said, fat loss is largely about diet – “you can’t exercise your way out of bad nutrition” is an old adage that holds a lot of truth. Your weight loss will be highly dependent on your adherence to keto, but exercise will help increase that fat burn. In addition, like I said above, it provides a wealth of other benefits. The bottom line is that everyone should exercise.

All carbs are bad!

Once you accept that cauliflower has replaced bread, rice, and potatoes, you can get on with your life.

This is strictly untrue. Most ketogenic plans suggest you start at about 20g of “net” carbs a day, with the net being your total carbs minus your fiber. This is fine if you’re eating mostly veggies for carbs, but when “net” gets fuzzy is when you’re looking at low carb protein bars and the like, where the added fiber might not function the way that natural plant fiber does.

The most ideal situation is one where you’re getting most of your carbs from leafy greens and other non-starchy vegetables. Count ALL your carbs, and aim to stay under 50g a day.


Putting it all together

This isn’t an exhaustive list to be sure but the takeaway from this should be:

  • Eat mostly whole foods, lots of plants, some protein, and plug in the holes with healthy fats
  • Eat only when you’re hungry and don’t try to hit some “goal” of fat grams per day
  • Exercise in ways that motivate you to continue exercising, and try to get some weight training in
  • Don’t worry about eating too much protein
  • Don’t worry about using keto esters, BHB salts, MCT oil, or anything else “targeted” at keto users. Supplements have their place but learn more and get the basics down first.
  • Eat sugar-free products sparingly
  • Unless you have a preexisting condition, you won’t go into ketoacidosis and your kidneys will be fine.


What are some ridiculous pieces of advice you’ve been given about keto, exercise, or losing weight in general? I’d love to hear so we can laugh and laugh.

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