Keto Diet and Constipation | Causes and Remedies

Keto diet and constipation

A ketogenic diet causes the body to primarily use fat for energy rather than glucose. Ketogenic diet regimens consist of low carbohydrate intake (<5%) with high fat (70-75%) and moderate protein (20-25%). The low carbohydrate content assists with weight loss and glycemic control while the relatively high protein content can increase satiety and thus assist adherence to the diet, reduce food intake, and decrease weight. The ketogenic diet has been used for the treatment of childhood epilepsy since 1920. Nowadays, the keto diet is often used as a quick weight loss diet regimen. Unlike other low carbohydrate diets, a keto diet focuses on fat, which supplies up to 90% of daily calories. Although there is some individual variation, a diet moderate in protein and 60 gm of carbohydrate per day is ketogenic in most people. Some can eat as much as 100 gms per day and remain in ketosis.

 

What are the health benefits of a ketogenic diet?

  • The ketogenic diet is primarily used for weight loss. This diet uses body fat as an energy source. The ketogenic diet efficacy in weight loss is much higher as compared to low-fat and high-carb diets.
  • Many studies have suggested that ketogenic diets have benefits in patients with autism, depression, migraine polycystic ovary syndrome, and type 2 Diabetes Mellitus.
  • The clinical trial shows that a ketogenic diet can provide symptomatic relief in brain disorders including Alzheimer’s disease, Parkinson’s disease and may be protective in traumatic brain injury and stroke.
  • A ketogenic diet helps to boost energy as fat is a more reliable source of energy than carbohydrates.
  • Keto diet also helps to lower blood sugar, as carbohydrate consumption is limited. The ketogenic diet is also very much beneficial in keeping control of diabetes.
  • The ketogenic diet has also been shown to improve mental performance. Studies have shown that fatty acids can have a positive effect on brain function.
  • Studies suggest that the keto diet has been shown to decrease cholesterol and triglycerides levels and prevent coronary artery disease.

 

What are the pitfalls of keto diets?

Despite tremendous health benefits, there are several downfalls with the keto diet. The keto flu is one of the most notorious downsides of the keto diet. Most keto adapters may face symptoms such as dizziness, headache, nausea, and vomiting.

Some long term side effects of the ketogenic diets are:

  • Appetite suppression: An adaptation to the keto diet will decrease their appetite for food. The researcher has also found that high intake of the keto diet slowed digestion, which in turn provides fullness and suppresses appetite.
  • Cholesterol level: A high-fat diet can increase the risk of cardiovascular disease. The studies suggest a short-term increase in cholesterol level.
  • Exercise: A ketogenic diet may not be suitable for those performing high-intensity exercise.
  • Increase in uric acid level: A protein-based diet can increase uric acid levels in the blood and cause a problem like gout.
  • Kidney stone: A study suggests that long-term keto diet adaptation can cause kidney stones.
  • Constipation: A keto diet causes constipation because of the overall lack of fibers in food.
  • Vitamins and mineral deficiencies: A different food restriction can cause lacking one or more vitamins and minerals.

 

Does the keto diet cause constipation?

Constipation is an uncomfortable decrease in bowel movement. A ketogenic diet involves carbohydrate restriction and an increase in intake of high fat and a moderate amount of protein. The keto diet has caused constipation among keto adapters because of the overall lack of fiber in food and increase in absorption of food. The constipation is usually mild and can last from a few days to a few weeks.

According to the National Institute of Diabetes and Digestive and kidney disease. people on the keto diet experience one or more of the following symptoms:

  • Passage of stool less than 3 times a weeks
  • Stool becomes hard and dry or appears in form of lumps
  • Pain and discomfort passing the stool
  • Incomplete evacuation of the bowel
  • Passage of excessive gas
  • Bloody stools

A few reasons for constipation on the keto diet include:

  • Less fiber intake: Usually 300gm of carbohydrate IS recommended per day to get enough of fibers, only 20-50 gm of carbohydrate can be consumed in a keto diet. The fibers prevent constipation by adding bulk to the interesting by adding water. This added bulk and water help to maintain the soft consistency of stool. So, a fiber lacking diet can cause constipation.
  • Food passage occurs too quickly: The body takes some time to adjust from digesting loads of carb to a high amount of fat.
  • Dehydration: Keto diet is known to cause urination, especially at the beginning while adapting to a keto. Dehydration can result in constipation.
  • Loss of electrolytes: A proper bowel function requires a well-balanced electrolyte. A limited carb intake will drop insulin levels and decrease urinary sodium.

Constipation for prolong period can lead to complications including anal fissures, hemorrhoids, and abdominal pain. Constipation for a few days to a week can be expected following a keto diet. Constipation exiting for more than 2 weeks, you should visit your physician for consultation.

 

How to avoid keto constipation?

The tactics to avoid keto constipation are:

  • Eat food containing fiber: food containing a lot of fibers help to maintain regularity in bowel habit. It improves bowel movement consistency and frequency.
  • Stay hydrated: Dehydration can result as a complication of a keto diet. Drinking a lot of water and hydrating foods like cucumber, lettuce, spinach, and kale helps to avoid constipation.
  • Physical activity: Physical activity can help maintain healthy bowel function. A study found out that physical activity has a beneficial effect on bowel habits, although optimal exercise and duration were not mentioned.
  • Include coconut oil and MCT oil in your diet: This oil gets quickly digested and helps to stimulate bowel movements. Adding 1-2 MCT (medium-chain triglycerides) acts as a strong laxative and can promote regularity of the bowel.

 

How to treat Constipation in the keto diet?

For people suffering from infrequent bowel movement despite the application of other interventions, the treatment options are:

  • Over-the-counter laxatives: For constipation that does not go away by modification in diet and other methods, stool softeners such as Colace, or laxatives, such as Dulcolax, should be an option. It is advised to take this medication with a consultation from the physician.
  • Probiotic food and supplement: In a clinical trial, probiotics have been shown to decrease the transition time and decrease constipation symptoms. Probiotics Bifidobacterium lactis are the most beneficial train to maintain the regularity of the bowel.
  • Magnesium supplements: Magnesium acts as a laxative and is one of the most frequently recommended supplements. For a person suffering from constipation in a keto diet, 600 mg of magnesium and increasing up to 1000mg should be taken to relieve constipation.

See Also

9 Juices for Constipation

 

References:

1.Diabetes Metabolic Syndrome and Obesity 2017: Effects of a proposed physical activity and diet control to manage constipation in middle-aged obese women [randomized trial; moderate evidence]

2.Clinical Nutrition ESPEN 2019: Effect of flaxseed or psyllium vs. placebo on the management of constipation, weight, glycemia, and lipids: a randomized trial in constipated patients with type 2 diabetes

3.Frontiers in Nutrition 2017: Coffee with high but not low caffeine content augments fluid and electrolyte excretion at rest

4.Allen L, Benoist B, Dary O, Hurrell R. Guidelines on food fortification with micronutrients. World Health Organization website. http://www.who.int/nutrition/publications/guide_food_fortification_micronutrients.pdf. Published 2006. Accessed August 18, 2015.

5.Mohorko N, Černelič-Bizjak M, Poklar-Vatovec T, Grom G, Kenig S, Petelin A, Jenko-Pražnikar Z. Weight loss, improved physical performance, cognitive function, eating behavior, and metabolic profile in a 12-week ketogenic diet in obese adults. Nutr Res. 2019 Feb;62:64-77. [PubMed