Nutrition · Kitchener, Waterloo & Cambridge
A ketogenic, or keto, diet is a very-low-carbohydrate way of eating that shifts your body toward burning fat for fuel. It suits some people and not others, and it can change how much diabetes medication a person needs. At CARESPACE a Registered Dietitian or Naturopathic Doctor can help you decide whether to try it, set it up safely and plan what comes after. No referral is needed, and you can book online.
What a ketogenic diet is
Your body normally runs mostly on glucose, which comes from carbohydrates. When you eat very little carbohydrate, usually under 50 grams a day, your body makes ketones from fat and uses those instead. That state is called nutritional ketosis. A low-carbohydrate diet with more than about 50 grams a day is not ketogenic, although it has some of the same effects.
What the evidence says
- Diabetes. Diabetes Canada’s 2020 position statement says a healthy low or very-low-carbohydrate diet can be considered as one eating pattern for adults with type 1 or type 2 diabetes, for weight loss and better blood sugar control. It also says the long-term effects are not yet known.
- Weight. Canada’s adult obesity guideline says there is no one-size-fits-all eating pattern. Cutting calories brings weight down in the short term, under a year, and has not been shown to last beyond that. The guideline’s advice is to choose the pattern you can keep up.
- Keeping it up. Very-low-carbohydrate diets are hard for most people to maintain over the long term.
So keto is one option among several. It is not the right choice for everyone, and it is not better than other approaches for everyone.
Who should talk to their physician first
- If you take insulin or other diabetes medication. Diabetes Canada says people on lower-carbohydrate diets may need their doses reduced or stopped to lower the risk of low blood sugar. Talk to your physician, Nurse Practitioner or pharmacist before you change how you eat, not after.
- If you have another medical condition or take prescription medicine. Ask whether a very-low-carbohydrate diet is suitable for you.
Restrictive ways of eating can also leave you short of some vitamins and minerals. That is one of the things your Registered Dietitian or Naturopathic Doctor watches for.
How CARESPACE helps
- Deciding. Whether keto fits your health, your medicines and your life, or whether another way of eating would get you to the same goal more easily.
- Starting. What to eat, how to shop and cook for it, and what to expect in the first weeks.
- Side effects. In the first week some people get what is often called keto flu: headache, tiredness, weakness and irritability. Constipation and muscle cramps can go on longer. Your practitioner helps you manage these.
- Keeping track. Bloodwork and body composition as you go. A Naturopathic Doctor can order lab tests, and either practitioner can work with results you already have.
- What comes after. A plan for bringing carbohydrates back and holding on to what you have gained.
See our naturopathic medicine team →
What to expect
Your first visit covers your health history, the medicines and supplements you take, what you eat now and what you want to change. You leave with a plan. If keto is not a good fit, your practitioner will say so and suggest something that is.
One team, one plan
Food is one part of it. Your practitioner may bring in a Kinesiologist or personal trainer for exercise, or a Registered Psychotherapist or Registered Social Worker if stress, sleep or your relationship with food is getting in the way. If your goal is weight, read about our weight loss program. If you live with diabetes, read diabetes: who to see and what helps.
Common questions
Will I lose weight on keto?
Many people do in the first months. Over the long term, Canada’s obesity guideline does not single out any eating pattern as the one that works: what matters most is whether you can keep it up. Your practitioner will help you find that out early.
Can I do keto if I have diabetes?
Diabetes Canada says a healthy low or very-low-carbohydrate diet can be considered. Your medication may need to change first, because eating far fewer carbohydrates on the same dose can cause low blood sugar. Talk to the physician or Nurse Practitioner who manages your diabetes before you start.
Do I have to stay on it forever?
No. Most people find very-low-carbohydrate eating hard to maintain for years. Part of the plan is what happens next: how to bring carbohydrates back and what to keep.
Should I see a Registered Dietitian or a Naturopathic Doctor?
Either can guide you. A Naturopathic Doctor can order lab tests. Your receipt is for the service you see, so check which one your extended health plan covers. If you are not sure, call 519-208-2273 and our Central Reception Team will help you choose.
Do I need a referral, and will my plan reimburse it?
No referral is needed. CARESPACE does not bill insurance directly; you pay at your visit and receive a detailed receipt to submit to your extended health plan. Check your plan for annual maximums and any requirements such as a physician’s note.
Sources
- Diabetes Canada. Position statement on low-carbohydrate diets for adults with diabetes: a rapid review. Canadian Journal of Diabetes, 2020;44:295–299.
- Diabetes Canada. Low carbohydrate diets for adults with diabetes: summary. 2020.
- Brown J, Clarke C, Johnson Stoklossa C, Sievenpiper J. Canadian Adult Obesity Clinical Practice Guidelines: medical nutrition therapy in obesity management. Obesity Canada, version 2, 2022.
Ready to book?
Book online with a Registered Dietitian or Naturopathic Doctor, or call 519-208-2273 and our Central Reception Team will match you with the right person and the closest location.