Is diarrhea common in ketosis?

A well-formulated ketogenic diet is a key component for effective diabetes reversal. When done right, diarrhea is not a common side effect of this nutritional plan. If it occurs, it is likely due to well-intentioned but incorrect food choices.

virtahealth.com - What do I do if I get diarrhea on a ketogenic diet? - Virta Health

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‍There are three common errors made with a poorly-formulated low carbohydrate diet that can cause stomach and intestinal upset and diarrhea: sugar alcohols, too much protein, and the wrong source of dietary fats. A well-formulated ketogenic diet is a key component for effective diabetes reversal. When done right, diarrhea is not a common side effect of this nutritional plan. If it occurs, it is likely due to well-intentioned but incorrect food choices. But while sorting this out, it is important that you stay hydrated and replenish your electrolytes! It is also important to note that there are many causes of diarrhea independent of a ketogenic diet, so contact your doctor if your diarrhea causes severe symptoms or lasts longer than a week. You may need to take a closer look at what you are eating.

Ask yourself a few questions:

1. Are you a frequent consumer of sugar free beverages, candies, protein/diet bars, and sugar substitutes? These can cause diarrhea. Sugar free and low carb products frequently contain sugar alcohols to give them a sweet taste while avoiding table sugar (sucrose). These sugar alcohols (xylitol, sorbitol, mannitol, maltitol, lactitol, and isomalt) have been known to cause gastrointestinal distress (Makinen, 2016). Of these, sorbitol is the least tolerated, but all of them can cause gas, nausea, and diarrhea if consumed above one’s level of tolerance. Thus, eating fewer products containing sugar alcohols may help with your diarrhea.

This video explains the connection between sugar alcohols and gastrointestinal distress:

2. Are you eating low carb, low fat, and high protein? Too much protein can lead to diarrhea. Remember, a well-formulated ketogenic diet is low carb, high fat, and moderate protein. When cutting carbs, it can be tempting to increase your protein without increasing your fat, but the resulting high protein diet can lead to diarrhea (Speth, 1983). It is important to keep protein at about 10-20% of your daily energy need and add ‘good fat’ for satiety. More on what constitutes 'good fats' below. Read more on how much protein you need on a ketogenic diet 3. Are you choosing the right sources of dietary fat? Some oils can cause diarrhea. While a little bit of omega-6 and omega-3 essential fats are required from our diet, more is not better. In particular, our digestive systems have a limited tolerance for vegetable and seed oils high in omega-6 fats. Early in our human research, we found out that feeding our patients a high fat diet made with soybean, corn, safflower, or sunflower oils promptly made them feel nauseated and caused diarrhea. Given that a well-formulated ketogenic diet eaten to maintain body weight provides 70-80% of one’s daily energy intake as fat, the majority of this fat intake needs to come from mono-unsaturated and saturated sources such as olive oil, high oleic versions of safflower and sunflower, coconut oil, lard, butter, cream, and high fat cheese.

Here are some fats and oils that we recommend:

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How many carbs can you eat and stay in ketosis?

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What does weight loss feel like?

Weight loss doesn't just make your body feel good. It boosts your mood and mental health. In a study of obese older adults, 3 months after a significant weight loss, they reported less tension, depression, anger, and fatigue. And it went both ways.

webmd.com - What Happens When You Lose a Lot of Weight - WebMD

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Harvard Medical School: "Losing weight and belly fat improves sleep.”

JAMA: “Longitudinal study of moderate weight change and sleep-disordered breathing.”

PLoS Biology: "Inflammation arising from obesity reduces taste bud abundance and inhibits renewal.” Current Opinion in Gastroenterology: “Bariatric surgery and taste: novel mechanisms of weight loss.” Obesity Facts: “Diet-Induced Weight Loss Alters Functional Brain Responses during an Episodic Memory Task.”

Obesity: “Sexual functioning and obesity: a review.”

International Journal of Impotence Research: “Improvements in Sexual Quality of Life after Moderate Weight Loss.” Centers for Disease Control and Prevention: “The Health Effects of Overweight and Obesity.”

National Cancer Institute: “Obesity and Cancer.”

Johns Hopkins Medicine: “Body Contouring After Weight-Loss Surgery.”

Ohio State Medical Center: “How to lose weight without tanking your metabolism.”

Current Biology: “Meal Timing Regulates the Human Circadian System.”

Randomized Controlled Trial: "High caloric intake at breakfast vs. dinner differentially influences weight loss of overweight and obese women.” International Journal of Obesity: “Association of body temperature with obesity. The CoLaus study.” The Japanese Journal of Physiology: “Effects of diets on cold tolerance and metabolic responses to cold in fasted rats.”

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