A recent comprehensive analysis of the keto diet in the journal Frontiers in Nutrition finds it may not live up to all its popularity.

The review found that keto diets place certain groups, such as pregnant women and people with kidney disease, at risk of adverse health effects.

The review, “Ketogenic Diets and Chronic Disease: Weighing the Benefits Against the Risks” also found that for most people, the possible long-term risks of the keto diet outweigh its benefits.

Those long-term risks include heart disease, cancer, diabetes and Alzheimer’s disease.

The premise of the diet is to eat red and even processed meat but restrict carbohydrate-rich vegetables, fruits, whole grains and legumes. The diet is low in carbohydrates, modest in protein and high in fat.

The goal is to induce ketosis, or the production of ketone bodies that serve as an alternate energy source. It was originally found to be helpful in reducing seizures in individuals with epilepsy who were resistant to epilepsy medications.

Here are a few key findings of the article:

  • Keto diets may be unsafe for women who are pregnant or want to become pregnant because lower carbohydrate diets are linked to a higher risk of neural tube defects even when women supplement with folic acid.
  • Higher protein keto diets may promote kidney failure in people with kidney disease.
  • Keto diets are likely to raise “bad cholesterol” levels for many who go on the diet.
  • Restricting carbohydrates promotes consumption of cancer-causing foods as well as heart disease, diabetes and Alzheimer’s disease.

The bottom line is a keto diet may help with weight loss in the short-term, but it’s no more effective than other diets that restrict calories.

If you want to lose weight, try a healthy, sustainable eating pattern such as the Mediterranean diet that focuses on fruits, vegetables, legumes, whole grains, exercise, socialization, red wine with food and occasional fish or red meat.


Q: Is it OK to drink flavored water, or should I just drink (plain) water?

A: We need water; it’s essential for a healthy body and mind. If you don’t love “plain” water, the Food & Drug Administration says flavor enhancers are safe.

However, read the label — they may also include thickening and stabilizing agents, artificial colors and flavors, added vitamins, caffeine and natural ingredients like ginseng or B vitamins.

If flavored water helps you drink it, it can be a good choice; just check the label.

Pear and Berry Crisp with Pecan Oat Topping

I think we sometimes forget about the sweet taste of a fresh pear. They’re not as familiar as an apple or orange, but they’re a good grab-and-go snack and are great baked as well.

A medium pear has 100 calories, 6 grams of fiber and 8% of the vitamin C we need in a day.

Here’s a recipe from Today’s Dietitian to remind you how good a pear can be.


  • 3 large ripe pears, peeled, cored and cut into 3/4-inch pieces
  • 1 (12-ounce) bag frozen mixed berries
  • ¼ cup brown sugar, divided
  • 2 tablespoons cornstarch
  • 1 teaspoon ground cinnamon, divided
  • ½ teaspoon ground ginger
  • 1 cup quick-cooking or old-fashioned oats
  • ½ cup roughly chopped pecans
  • Pinch of kosher salt
  • 3 tablespoons extra virgin olive oil
  • Optional topping: plain Greek yogurt or frozen vanilla yogurt


Preheat oven to 375 degrees. Place pears and frozen mixed berries in large bowl and stir gently to combine. Add 2 tablespoons brown sugar, cornstarch, ½ teaspoon cinnamon, and ginger. Stir gently until fruit is evenly coated and cornstarch dissolves.

Place fruit mixture in 8-by-8-inch baking pan and set aside.

To make topping, place oats, pecans, remaining brown sugar and cinnamon, and salt in a medium bowl and stir to combine. Add oil and stir until oat mixture is well coated.

Spread topping evenly over fruit mixture. Bake 30 minutes until topping is golden. Lightly cover with aluminum foil and cook 10-15 minutes more until fruit is tender and mixture is bubbly.

Serve with additional toppings if desired.


Serves 6-8

Per serving: 217 calories; 3 grams protein; 35 grams carbohydrates; 9 grams fat (1 gram saturated); 0 grams cholesterol; 6 grams fiber; 18 grams sugars (8 grams added); 27 milligrams sodium.

Charlyn Fargo Ware is a registered dietitian with SIU School of Medicine in Springfield, Illinois, and the current president of the Illinois Academy of Nutrition and Dietetics. Contact her at charfarg@aol.com, and follow her on Twitter: @NutritionRd. The opinions expressed are her own.