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Understanding the Long Term Effects of Ketosis and The Keto Diet

Published on: August 19, 2019

Understanding the Long Term Effects of Ketosis and The Keto Diet

Previous Article: An In-Depth Look at The Ketosis Metabolism: What Happens Inside Your Body

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Next Article: How Long Does It Take To Get Into Ketosis

Ketosis is a popular and proven way to lose weight and attain several health benefits, as demonstrated by a growing number of studies. In case you don’t know what ketosis is, it is a metabolic state where your body’s ketone levels increase. Ketosis happens when your body utilizes its stored fat in the form of ketones for energy instead of glucose, which is usually the case for most people [1].

In this guide, we’re going to talk about the possible long-term outcomes of being in ketosis. What are its positive and negative effects? Here’s what you should know.

How Long Should a Person Stay in Ketosis?

It’s no secret that most people plan to remain in ketosis through a ketogenic diet only for a certain period. While short-term ketosis seems to be the goal for the majority, we also like to know if it’s sustainable over the long term.

People can stay in ketosis as long as they keep their blood ketone levels within an optimal range (0.5-3.0 mM). To achieve this acceptable range, they need to significantly reduce their carbohydrate consumption to less than 50 grams per day [2].

But here’s the reality: Most people end up exiting and re-entering ketosis from time to time. There are many possible reasons for this.

One is that they revert to old eating patterns. Another is personal preference in which the person simply chooses to indulge in highly palatable, carbohydrate-rich foods during social gatherings or vacations.


Health Benefits of Long Term Ketosis

Before we tackle the benefits of being in ketosis long-term, we want you to keep in mind that ketosis is not a cure-all tool.

However, several studies tell us that ketosis can control the progression of certain health conditions. Signs and symptoms of a disease, for example, Type 2 Diabetes, usually come back if a person does not maintain long-term behavioral change [3]. Here are some significant positive effects of following the keto diet long term:

1. Significantly reduced body weight

Obesity is a global issue. It is associated with several health problems such as certain types of cancer, high blood pressure, and stroke [4, 5].

While people try different interventions to reduce their weight such as reducing their calorie and fat intake as well as exercise, study shows that these methods fail to show sustained long-term effects [4].


A 2004 study on a long-term ketogenic diet showed that within 24 weeks or about 6 months of treatment, the patients’ weight and body mass decreased remarkably. Nutritional ketosis results in weight loss as it suppresses your hunger. It regulates your calorie intake and mimics the effect of starvation on your body [4].

Another study, conducted in 2013, revealed that ketosis maintains secretion of cholecystokinin (CCK) [6]. If you don’t know what CCK is, it is a peptide hormone in the gastrointestinal system that makes you feel full and regulates appetite [7].


2. Improved glycemic control (HbA1c)

HbA1c stands for glycated hemoglobin, and it represents your average blood glucose levels over a 3-month period. Achieving good blood glucose control is especially crucial for people with diabetes [8]. However, non-diabetics should also check their HbA1c to know whether they are at risk.

Reducing your carbohydrate consumption to 30-50 grams per day leads to a significant reduction in your HbA1c values over a 6-month period, as presented by a 2018 study [8]. Nutritional ketosis reduces your HbA1c and makes you more sensitive to insulin [3].

3. Protection for the brain

You probably already know that ketones serve as an alternative fuel to your brain to keep it from starving, when glucose supply is low. This is important with brain glucose hypometabolism, which is characteristic of Alzheimer’s Disease (AD) [9, 10].

It is also interesting to note that ketones serve as a major fuel and as the main substrate for brain lipid synthesis in developing infants [9, 10].

The effect of nutritional ketosis on brain metabolism is believed to be responsible for brain protection [11]. Ketone bodies act as anti-seizure agents. Evidence shows that they block seizures at the synaptic level [12].

Parkinson’s disease animal models, when infused with the ketone body beta-hydroxybutyrate, showed that their dopaminergic neurons were able to receive partial protection against the toxic effects of MPTP [12].

Risk Associated with Long Term Ketosis

Provided that you follow a well-formulated ketogenic diet with the supervision of a physician who understands keto, nutritional ketosis will not put your health at risk. Long-term risks are usually present among those who lack adequate knowledge and consume a poorly formulated diet [13].

1. Micronutrient deficiencies

Early into ketosis, you will experience the need to urinate more often. In medical terms, this is called diuresis. Diuresis happens because the kidneys filter ketone bodies as anions (negatively charged particles), increasing distal sodium (a positively charged particle) delivery to the lumen [14]. In this manner, your body’s sodium level decreases.


Another way that you experience vitamin or mineral deficiencies is when you cut out most carbohydrate-rich foods from your diet such as bread, vegetables, and fruits.

These foods contain a substantial amount of vitamins and minerals such as A, C, E, B vitamins as well as the electrolytes potassium, magnesium, zinc, and calcium.

Micronutrients are essential as they play a role in metabolism by acting as cofactors and coenzymes. Some of them also have antioxidant properties such as vitamins A and E [15].

ketosis long term

2. Processed “keto” foods increase the risk for health problems

One of the characteristics of a well-defined ketogenic diet is the consumption of mostly whole and unprocessed foods. Health problems occur when you follow a low-carb, high-fat diet and yet you eat highly processed foods that are labeled as “ketogenic”.

Even if they are, these foods could contain extra calories, hidden sugars, hydrogenated oils, flavoring agents, and emulsifiers. When extra calories add up, extra weight gain occurs, which puts a person at risk for serious health conditions [16].

Processed meats like hot dogs, salami, and all types of ham contain nitrite and nitrate which also happen to be carcinogenic compounds. It means that these compounds can cause cancer [17].


Nutritional ketosis offers a multitude of health benefits that last for as long as a person maintains optimal ketone levels. Someone who intends to achieve nutritional ketosis should do it in a way that follows proper formulation and with the help of a medical professional who is well-versed in the keto diet.


  • One can stay in ketosis for as long as they desire; however, it can be quite restrictive which is why a lot of people tend to dip in and out of ketosis - what we would call cycling.
  • The health benefits of maintaining ketosis long-term include good blood glucose control, significantly reduced body weight, and brain protection against disease.
  • Nutritional ketosis can only create health problems if one is not careful with his or her micronutrient needs (which increase as carbohydrates are restricted) and ignores food quality.


  1. Masood W, Uppaluri KR. Ketogenic Diet. Last update: 2019 March 21 -
  2. Phinney S, Virta Team. How do I get into nutritional ketosis?
  3. Virta Health. Reversing Type 2 Diabetes.
  4. Dashti HM et... View all references

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