The Cost Of Keto

For years, keto was seen as the gold standard for diets.

It made sense: lower insulin, stabilize blood sugar, burn fat efficiently.

But new research suggests that long-term ketosis might not be as safe (or effective) as we once believed.

A 2024 review in Current Problems in Cardiology concluded that while keto can help with weight loss initially…

It “does not fulfill the criteria of a healthy diet.”

Over time, participants on a ketogenic plan:

• Lost more lean muscle mass

• Showed no meaningful advantage in body composition

…compared to balanced diets.

That detail matters.

Muscle is not just tissue—it’s a metabolic organ.

Losing it over time makes the body weaker and more insulin-resistant.

The Cortisol Problem

Your body has a built-in metabolic switch called the Randle cycle.

It decides whether you burn glucose or fat for energy…

But not both efficiently at the same time.

When carbohydrate intake is chronically low, your body compensates by producing glucose from cortisol through gluconeogenesis.

That process keeps blood sugar stable—but at a cost.

Elevated cortisol breaks down muscle tissue to release amino acids, fuels inflammation, and suppresses immune function.

What’s marketed as “fat adaptation” is often chronic stress adaptation.

Why Glucose Still Matters

Your brain and mitochondria are designed to run primarily on glucose.

When deprived of it, they down-regulate energy production.

That’s why people on long-term keto often report fatigue, cold extremities, sleep issues, and reduced exercise capacity.

Reintroducing carbohydrates—especially from ripe fruit, fruit juice, and clean starches—can improve mitochondrial output, stabilize hormones, and even lower fasting blood sugar despite higher calorie intake.

Finding Balance

A large meta-analysis of over 421,000 people found that:

• Diets with moderate carbohydrate intake were associated with the lowest cardiovascular mortality risk

• Both very high and very low carbohydrate patterns showed less favorable outcomes

The key takeaway:

Moderation improves metabolic flexibility.

Extremes create biological stress.

The goal isn’t to swing from one extreme to another.

It’s to create balance that supports energy and longevity:

• Fat: 15–30% of total calories (favor saturated fats like butter, ghee, and coconut oil).

• Protein: Around 15% for most people, or roughly 0.8 g per pound of lean body mass.

• Carbohydrates: The rest, ideally from ripe fruits, white rice, and pulp-free fruit juices as your gut microbiome adjusts.

This approach supports the Randle cycle, maintains lean muscle, and fuels the mitochondria without the stress burden of chronic ketosis.

Your body isn’t designed to run on restriction.

It’s designed to run on rhythm—and balance.

Until next time,

Kashif Khan

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