The ketogenic diet has a lot of benefits. It's low-carb, so it can help you beat sugar cravings, cut out a lot of unhealthy processed ingredients from your diet, and lose weight. One question many of you, dear readers, are concerned about is fertility. Does the Keto diet affect your fertility, either positively or negatively?
After all, your diet is hugely impactful on fertility. Eating the wrong things can reduce your fertility, hinder ovulation or implantation, and even lead to birth defects or miscarriages. Many of the "wrong things", though, are things like medications, alcohol, and smoking. Where does food fall into the spectrum?
Defining the Ketogenic Diet
Before we can discuss the impact of the ketogenic diet on fertility, we first need to have a unified understanding of what the keto diet is. Some people consider it any low-carb diet. Some consider it to be any diet that induces ketosis. Some consider it a diet that is free from all carbs.
There are many variations on the low-carb diet. Atkins is a famous version, heavily promoted via television and other advertising channels, where they sell you healthy meals with a focus on low carbs.
By most definitions, the keto diet is a diet that cuts out carbohydrates almost entirely. The diet itself is high in dietary fats, with moderate levels of protein, and low levels of carbs. The generally-recommended goal is under 50 grams of carbohydrates per day. That's about three slices of bread or two bananas; more than you might think, but less than you typically consume.
Carbohydrates are sneaky. When you think of carbs, you probably think of things like bread and crackers. What many people don't realize is that sugar is a carbohydrate. Anything sweet, including candies and fruits, are full of carbs.
Now, carbs themselves aren't bad for you. Carbohydrates are easily digested and easily used as energy by the body. It's part of why fruits are so good for most people. Sure, they're packed with natural sugar in the form of fructose, but your body can use that sugar very efficiently.
The problem is, in our modern society, we're not foraging for fruits. We live much more stagnant lifestyles than we did millennia ago, and our bodies have not evolved for that change in dietary intake. See, our bodies evolved to store energy for times of famine and lack. Any energy you consume that you don't burn through resting metabolic processes or through exercise is then converted into fat and stored throughout the body. It's like a battery, storing a charge for you to burn later when you're not able to access food and need to burn energy to survive.
For the vast majority of our population, we don't lack access to food. Thus, all that extra energy is stored and never released. More and more fat builds up, and that's how we end up with obesity.
This is where the ketogenic diet comes in. Fat and protein are harder to break down for energy and give less energy per gram, than carbohydrates. When you limit carbs, your body is forced to draw on these other, less efficient, energy sources. This forces it to burn stored energy and store less energy, in the bodily process known as ketosis.
Known Benefits of the Keto Diet
The keto diet has been used for decades in controlled situations. It was invented to treat epilepsy in children and has been proven quite effective at it.
With the initial popularity of diets like Atkins for weight loss, the more extreme keto diet has been picked up in a much more broad saturation in our culture. While it's primarily used as a weight loss diet, it has a bunch of fringe benefits, including:
- Potential reduction in acne.
- Reversal of insulin resistance and type II diabetes.
- Reversal of metabolic syndrome.
- Lowered risk of heart disease.
- Potential effects on PCOS.
- Potential mitigation or minimization of dementia disorders.
Many of these are still being studied, and the full extent of those effects is unknown. It's possible that a ketogenic diet could reverse the early stages of diabetes, but whether it's temporary or permanent is unknown. A lot of studies are still being conducted.
If you're familiar with the issues facing pregnancy, you may see a few hints at why the keto diet could be beneficial here. So, let's talk about that directly.
Ketogenic Diets and Fertility
First, let's start with the anecdotal evidence. Reddit, for example, is full of people who have started up the keto diet and soon after gotten pregnant. Of course, very few people post the opposite, so it's difficult to tell whether or not the effects are prominent or just based on bias.
While the keto diet is still being studied for a variety of health issues, fertility is one of them. Several studies have been performed, but nothing that fits the rigors of true scientific study. No double-blind studies solely focused on fertility have been performed. Other studies that have, incidentally, looked at fertility and pregnancy have existed, however, so we can look at those.
Luckily, we don't have to do the legwork. Someone else already has, in 2017 literature review entitled "The Effect of Low Carbohydrate Diets on Fertility Hormones and Outcomes in Overweight and Obese Women: A Systematic Review". Whew! What a mouthful. You can find it here.
At first glance, the results look promising. Here, we'll quote it directly:
"Results: Seven studies fulfilled the inclusion criteria and were included in the evidence synthesis. Interventions were diverse and included a combination of low carbohydrate diets with energy deficit or other co-treatments. Study quality was rated as positive for six studies, suggesting a low risk of bias, with one study rated as neutral. Of the six studies which reported changes in reproductive hormones, five reported significant improvements post-intervention."
You can read what the inclusion criteria were in the review itself.
So, it seems like several studies have shown that a keto diet can improve fertility, so why are we being cautious about it? Well, there are several caveats to this literature review.
- It's not studying keto diets specifically, but all low-carb diets. This review can include studies of keto, Atkins, and everything in between, so long as it's restricting carbohydrate intake. Specifically, the review states they looked for studies where carbohydrate intake was under 45% of total energy intake.
- The studies do not isolate low-carb diets as the only factor. The studies may have also included overall energy restriction and other co-factors including additional fertility treatments alongside the diet itself.
- It's not a study itself, it's simply a review of other studies. While the criteria for choosing a study is rigorous, it does mean there are very few actual studies out there.
In short, as you might expect, more study is needed to find out whether or not a ketogenic diet in isolation is enough to boost fertility, or if there are other factors that account for the changes.
Secondary Benefits of the Keto Diet on Fertility
One thing you might recognize here is that the ketogenic diet, even if it doesn't have a direct impact on fertility, might have an indirect effect. Indeed, that's likely where most of the benefits come from, and is what a lot of scientists consider most likely right now.
The number one benefit of the ketogenic diet, when followed properly, is that you lose weight. Ketosis itself is the bodily process of transitioning from burning carbohydrates for energy to burning stored fat for energy, and it happens when you fast as well as when you eat a low carb diet. Weight loss is much easier when you're not stuffing yourself full of carbs.
In fact, while keto might not have been studied with regards to fertility, obesity has. Obesity is one of the leading causes of female infertility and is responsible for a huge amount of fertility issues. It's even a factor in the failure of IVF! Obesity is a hugely impactful factor.
Obesity also causes a variety of other issues. Some cancers can occur more frequently because of obesity. Heart disease and cardiovascular problems can be caused by or exacerbated by obesity. Diabetes is predominantly caused by obesity. Most of these problems, in themselves, make it harder to conceive successfully. Addressing them, and the obesity that causes them makes it easier to conceive.
Obesity also affects bodily hormones, and hormones are a critical part of pregnancy. Imbalanced hormones can prevent or alter conception and can cause miscarriages. There's a reason many forms of birth control are hormonal in nature, after all. It doesn't take much to put your body outside of the range where pregnancy is impossible.
There's a bit of an evolutionary reason for this. Humans aren't born ready to go like many animals are. It takes years before a child can begin to fend for itself, and even longer to come to maturity to face the dangers of the world. If your body isn't in a healthy enough state, it indicates some kind of environmental pressure or danger. Bringing a child into the world in that state – in pre-history, anyways – likely meant the death of the mother and the child. Thus, our bodies evolved to inhibit life-threatening pregnancies when the environment isn't suited for it.
The point is, cutting out carbohydrates and eating more fat isn't necessarily going to have a direct impact on fertility. Losing weight to bring yourself into a healthy range, balance your hormones, and reduce blood sugar issues, on the other hand, is much more likely to have an impact on fertility.
Now after reading about keto so far, it might not sound like your cup of tea and that's ok! You might be interested in other alternative options that could help a little more directly with your fertility and those exist! Be sure to check out our women's fertility kit for a more stress-free experience in regulating your hormones!
Risks and Downsides to Keto
So, are there any risks or downsides to trying the keto diet, when you're trying to conceive? The answer is sort of.
Detractors of the keto diet will point out that rapid weight loss can itself be unhealthy. Rapidly losing weight can throw the body out of balance, and can lead to the dissolution of muscle mass as well as stored fat. It can throw your hormones and other bodily systems even further out of balance. Plus, there's the risk of rebounding if you fall off the diet.
The keto diet can help you lose weight, but to do it safely, you need to do it slowly and deliberately, with an aim to build habits and keep the weight off.
Keto also cuts out some otherwise quite healthy foods, most notably fruits and vegetables. This means you end up potentially suffering from several nutritional deficiencies, including low levels of potassium, selenium, magnesium, vitamin B, vitamin C, and fiber. All of this can be supplemented easily enough, but you need to be aware of the lack and address it before it becomes a problem.
There's also the dreaded "keto flu" effect. Detoxing from sugar and loading your body up with dietary fats induces dramatic changes to your body. While eventually, they can sort themselves out into something healthier than where you started, in the first few days or weeks of keto, you might just feel awful. Keto flu symptoms range from low energy and brain fog to headaches, insomnia, constipation, and dizziness. These all make it very difficult to continue with the diet long enough for it to have a positive effect.
On top of all of this, ketosis is very sensitive. If you have a snack or a "cheat day", you'll pull your body right back out of it, and setback much of your progress.
At the end of the day, if you're overweight, a keto diet can help you lose weight and bring yourself to an overall healthier state to try to conceive. If you're otherwise healthy, consider talking to a fertility doctor; you might have other fertility issues that a keto diet won't touch. Finally, we recommend keeping a doctor on call while trying keto, to keep an eye on any ongoing health concerns, nutritional deficiencies, hormonal levels, and other systems. With proper observation, you can avoid the worst side effects, and make getting pregnant that much easier.