The Keto Diet & Ketosis: Is It Right for You?

If you’ve worked with me before, you’ll know that I’m not a fan of restrictive diets.

That’s not because they never “work,” but because they often come with trade-offs, whether that’s nutritional gaps, added stress around food, or simply being difficult to sustain in real life.

My approach is always to build something that supports your health and fits into your life, long term.

That said, nutrition is rarely black and white. And the ketogenic (keto) approach is a good example of where a more nuanced view is helpful.

What is the Keto Diet?

The ketogenic diet is a very low-carbohydrate, high-fat diet that shifts the body into a state called ketosis.

In ketosis, instead of relying on glucose (from carbohydrates) for energy, your body produces compounds called ketones from fat, which can then be used as an alternative fuel source, particularly by the brain.

This is quite different from how most of us typically eat, where carbohydrates are the primary energy source.

Why Has Keto Become So Popular?

You’ve probably seen keto linked to weight loss, blood sugar control, and improved energy.

Some people do feel better on it, especially in the short term. However, popularity doesn’t always equal suitability.

The question isn’t “does keto work?”, because in certain contexts, it clearly does.

The better question is: who is it appropriate for, and when?

Where Keto May Have Real Therapeutic Value

There are specific situations where a ketogenic approach has strong clinical backing or emerging evidence:

1. Epilepsy

Keto has been used for decades in the management of drug-resistant epilepsy, particularly in children. In this context, it can significantly reduce seizure frequency.

2. Neurological Conditions

There is growing interest in the role of ketosis in conditions like Alzheimer’s disease and other forms of dementia. The brain can use ketones as an alternative fuel, which may be helpful where glucose metabolism is impaired.

3. Mental Health (Emerging Area)

Some early research suggests potential benefits in conditions like depression and other mood disorders. This is still an evolving area, but it highlights how metabolism and brain health are closely linked.

4. Blood Sugar Regulation

For some individuals with insulin resistance or type 2 diabetes, reducing carbohydrate intake can improve blood glucose control, although this doesn’t always require a strict ketogenic approach.

Is Keto Better for Men Than Women?

This is where things become more complex.

In clinical practice, I often see that men tend to tolerate a ketogenic or very low-carbohydrate approach more easily than women.

For women, especially those in their reproductive years or experiencing perimenopause, very low carbohydrate intake can sometimes:

• Disrupt hormonal balance

• Increase stress hormone (cortisol) levels

• Affect sleep and energy

• Impact thyroid function in some cases

That doesn’t mean keto is “bad” for women, but it does mean that it needs to be approached with more care and individualisation.

Women’s bodies are generally more sensitive to energy availability and metabolic stress, which is important to consider.

The Challenges of a Keto Approach

Even when keto is used appropriately, there are some practical and nutritional considerations:

• Restrictive nature – cutting out or heavily limiting foods like fruits, whole grains, and legumes

• Fibre intake is often lower, which can significantly impact gut health

• Social and lifestyle impact – harder to maintain long-term

• Nutrient diversity – risk of missing key vitamins, minerals, and plant compounds

• Nutrigenomics – some people may have genetic tendencies that alter their ability to metabolise fats

When Might I Consider Keto with a Client?

Although it’s not my first-line approach, there are situations where I might consider elements of a ketogenic or lower-carbohydrate strategy:

• As part of a targeted, short-term therapeutic intervention

• When supporting specific neurological conditions

• In carefully selected cases of insulin resistance

• When a client feels significantly better eating this way, and it’s sustainable for them and not detrimental to their overall health.

Even then, the goal is not always “strict keto,” but rather finding the least restrictive approach that still delivers the benefit.

A More Sustainable Perspective

For most people, we can achieve excellent results without going to extremes.

Simple, consistent strategies often go much further:

• Balancing blood sugar with protein, healthy fats, and fibre

• Including a wide variety of plant foods to support gut health

• Eating in a way that supports hormones, energy, and lifestyle

These approaches tend to be more sustainable, and sustainability is what ultimately drives long-term health.

Final Thoughts

The ketogenic diet isn’t inherently good or bad; it’s a tool. And like any tool, its value depends on how, when, and why it’s used.

For some people, in specific situations, it can be incredibly helpful. For others, it may add unnecessary complexity or even create new imbalances. This is the benefit of a personalised approach.

If you’re considering keto, it’s worth looking beyond the headlines and thinking about what your body actually needs, both now and in the long term.