One of the most frequently cited side effects of following the keto diet long term is gut disturbance – in particular constipation – which can see those who are used to having a bowel motion most days only opening their bowels once or twice each week.
Not only can the physical discomfort be an issue, but not eliminating wastes from your body as regularly as you once did is a key marker of your health overall. So, does the keto diet ruin your gut health? And if so, what can you do to help avoid these unpleasant side effects and the potential repercussions long term?
The keto diet causes gut issues for two key reasons
The first is that fibre intake on a keto diet is generally low. Not only is it low, but certain carbohydrate rich foods than are banned on keto including fruits, wholegrain breads and cereals, also offer specific types of fibre that play key roles in keeping you regular.
This means that even if you are eating plenty of vegetables on your keto diet, it may not be enough to get your gut moving.
The second reason is that a high protein diet, too, can specifically be linked to constipation, and while the keto is not technically high protein, it often it becomes so, further causing gut issues.
While we are very aware of the relationship between constipation and keto, less do we know about the impact of this on our gut health long term.
There are multiple health benefits associated with the weight loss often achieved via keto, but the issue is whether a low fibre intake directly impacts gut microflora and therefore impacts digestive health. At worst, hard core keto fans may be altering their gut microflora long term, which leaves them feeling clogged up.
What you can do to improve your gut health on the keto diet
Gut health is important, and if you prefer a keto diet but also want to do what you can to look after your gut, there are a few options.
Firstly, remember that there are several varieties of fruit that are relatively low in carbs but that still contain soluble fibre – all types of berries, kiwi fruits, and even an occasionally stone fruit all contain good amounts of dietary fibre and are a smart daily addition to your keto plan.
Next, consider where you could add both some probiotics and prebiotics into your diet.
Probiotics are the good bacteria, while prebiotic fibres help to feed the probiotics to keep them healthy. Low carb probiotics include kombucha, plain natural yoghurt and probiotic supplements. These will all benefit your gut health while eating keto.
Prebiotic fibres are found in a range of vegetables including leeks, artichokes and onions, and you can also find them in some supplementary yoghurts, which are relatively low in carbs overall.
Finally, but most importantly, keep a close eye on your protein intake on keto. Not only does eating more than 20-25 per cent of your calories from proteins potentially take you out of ketosis, but a diet higher in fats and plenty of low carb vegetables will be one hundred times better for your gut health long term than eating too much meat and dairy. So, keep a close eye on your macros to help strike a balance between keto and gut health.
Susie Burrell is a dietitian and nutritionist. Continue the conversation on Twitter @SusieBDiet.