Evidence Based

Keto While Pregnant: Is It Safe Or Are There Risks?

Susan Adeosun, MD

Published at 01:15

Kathy Shattler, MS, RDN

Medical reviewer

Keto diets while pregnant may be risky. Photo: Prostock-studio/shutterstock

Pregnancy is a sensitive time for the expectant mother. Both she and the healthcare system are often heightened in their focus on maternal health and well-being. It is also an important period when a pregnant woman’s diet needs to be health-focused. 

Pregnant women have increased nutritional needs, particularly for carbohydrates, which are important for fetal development and preventing complications. The ketogenic diet is currently popular for its potential health benefits, and you might have heard it can help manage your weight gain.

Pregnant women often have concerns about the safety and long-term effects of adopting the keto diet. Below, we examine the safety of several ketogenic practices and look at the foundations of the ketogenic diet, as well as any possible drawbacks.

Pregnancy Nutrition

  • Women need more nutrition, especially carbohydrates when they are pregnant.
  • A keto diet might prevent pregnant women from getting enough nutrients. This can be harmful for both the mother and the baby.
  • Pregnant women considering a keto diet should consult with healthcare providers to ensure they are meeting all nutritional requirements and to discuss potential risks.
  • A balanced diet rich in a variety of nutrients is generally recommended for pregnant women to support both their health and the baby’s development.
  • There is not enough data to determine the safe use of keto diets during pregnancy.

What Is a Keto Diet?

What Is a Keto Diet
What Is a Keto Diet? Photo: Tatevosian Yana/Shutterstock

The keto diet, also referred to as the ketogenic diet, is a diet plan that focuses on limiting carbohydrates and opting for high-fat food so the body enters a state of ketosis. Ketosis is when fat replaces carbohydrates as the body’s main fuel.

This diet’s key principles are:

  • Low carbohydrates: Consuming only 20-50 grams of carbohydrates per day.
  • High fat: About 70-80% of daily calories come from fats.
  • Moderate protein: Protein intake is moderate, making up about 20-25% of daily calories.

When carbohydrate intake is significantly reduced, the body depletes its stored glucose (glycogen) and starts breaking down fat into ketones in the liver to use as the primary energy source.

Risks Of Keto During Pregnancy

Nutrient Deficiencies

Pregnant women need many nutrients to have a healthy pregnancy. However, because the keto diet is restrictive, they may not get adequate nutrients, like omega-3 fatty acids, vitamin D, folate, calcium, iron, fiber, and magnesium.

Folate deficiency, for instance, increases the risk of neural tube defects, while inadequate calcium and vitamin D can impact fetal bone development and maternal bone health.

Constipation

On a keto diet, fruit, vegetable, and whole grain consumption is lower, so there is a lower fiber intake. This can affect stool bulk and lead to constipation. It can be very uncomfortable and even cause complications during pregnancy.

Additionally, the keto diet can cause something called keto flu. It causes a range of symptoms that result from the body’s adaptation to a new energy source: ketones instead of glucose. For pregnant women, these symptoms can pose additional concerns. They can increase pregnancy-related nausea and fatigue.

Ketoacidosis

For some pregnant women, the reason for starting a keto diet is to manage weight. However, extended fasting paired with a ketogenic diet has been linked to the development of ketoacidosis, a severe medical condition. Ketoacidosis is a medical condition characterized by high levels of ketones in the blood, which makes it more acidic. Pregnant women are more vulnerable to this complication because of their heightened likelihood of entering ketosis and experiencing dehydration.

Are Keto Diets Safe During Pregnancy?

The keto diet can pose risks during pregnancy. The purpose of using the keto diet is to lose weight, and one does not want to lose weight during pregnancy.

For one, carbohydrates provide glucose, a primary energy source for the developing fetus, especially for brain development. When this is reduced significantly, there might be concerns about proper development. An old animal study showed that pregnant mice fed a keto diet gave birth to baby mice with smaller brains than typical.

Several studies on mice suggest that ketone exposure, through a ketogenic diet or other means, can lead to alterations in embryo development. However, further research is needed to determine the relevance of these findings to human pregnancy. At present, there is simply not enough data.

Potential Benefit of The Keto Diet

Nonetheless, there are some points on the bright side:

Managing Epilepsy

A study in 2017 suggested that the keto diet might help control epileptic symptoms in pregnant women. Having uncontrolled seizures while pregnant can cause injury, pre-term labor, and developmental issues, so this potential benefit would be significant. But it may also be worth noting that the baby in the study had congenital deformities of the ears.

Treating Diabetes

Another potential benefit of the keto diet is in the event of diabetes. A 2014 study demonstrated that a ketogenic diet can help manage or prevent certain types of diabetes. However, during pregnancy, you don’t need to adopt a keto diet to reduce your risk of gestational diabetes. 

Anxiety And Depression

A study discovered that when mice offspring were fed a keto diet, their sociability improved and their depression-like symptoms decreased. This means, potentially, keto exposure is positive for neurodevelopment. However, it’s also important to remember that this study was conducted on mice.

Conclusion

Before going keto while pregnant, be sure to reach out to a healthcare professional. They can help you decide if keto is right for you and also let you about the risks involved. Research shows there might be a chance of nutrient deficiencies, birth defects, or anxiety and depression.

Instead of going straight on a diet, it is better to simply eat a healthy diet filled with carbs, rich in healthy fats, proteins, fiber, fresh fruits, and vegetables, which is a safer and more balanced approach. Going keto while pregnant might seem fantastic, but to know if it is truly appropriate, you should reach out to a healthcare professional.

Frequently Asked Questions

What is ketosis?

Ketosis is a metabolic state where the body burns fat for fuel instead of carbohydrates, producing ketones as a byproduct. This occurs when carb intake is significantly reduced, forcing the body to use fat for energy.

Can I eat fruits on the keto diet?

Most fruits are high in carbs and should be avoided. However, small portions of low-carb fruits like berries (strawberries, raspberries, blackberries) are allowed in moderation.

What are the common side effects of the keto diet?

Initial side effects, known as keto flu, include headache, fatigue, irritability, and nausea. These typically subside within a week as the body adjusts to ketosis. Staying hydrated and maintaining electrolyte balance can help.

Is the keto diet safe for everyone?

The keto diet is not suitable for everyone, especially those with kidney issues, liver conditions, or pancreatitis. Pregnant or breastfeeding women and individuals on certain medications should consult a healthcare professional before starting the diet.

Is the keto diet safe during pregnancy?

The keto diet’s safety during pregnancy is uncertain. It’s crucial to consult a healthcare professional before starting the diet, as nutritional needs during pregnancy are specific and critical for both mother and baby’s health.

Dr. Susan Aeosun has over five years of experience in public health and preventative medicine. She’s a firm believer in Dutch philosopher Desiderius Erasmus’s phrase, “Prevention is better than cure.” With her expertise and a strong love for writing, Susan has published several health articles on blogs, websites, and peer-reviewed journals.

Resources

MANA adheres to strict sourcing guidelines, avoids most tertiary sources, and uses only professional resources updated to contain accurate and current information. We majorly rely on peer-reviewed studies, academic research from reputable medical associations. For more information regarding our editorial process, please refer to the provided resources.

  1. O’Neill, B. and Raggi, P. (2020). The ketogenic diet: Pros and cons. Atherosclerosis, [online] 292, pp.119–126. doi:https://doi.org/10.1016/j.atherosclerosis.2019.11.021.
  2. Sussman, D., Matthijs van Eede, Wong, M.D., Susan Lee Adamson and Henkelman, M. (2013). Effects of a ketogenic diet during pregnancy on embryonic growth in the mouse. BMC pregnancy and childbirth, [online] 13(1). doi:https://doi.org/10.1186/1471-2393-13-109.
  3. Sussman, D., Germann, J. and Henkelman, M. (2014). Gestational ketogenic diet programs brain structure and susceptibility to depression & anxiety in the adult mouse offspring. Brain and behavior, [online] 5(2). doi:https://doi.org/10.1002/brb3.300.
  4. van, Williams, T.J., Henry-Barron, B.J., Olieman, J.F., Duvekot, J.J., Vermeulen, M.J., Natalja Bannink, Williams, M., Neuteboom, R.F., Kossoff, E.H., Catsman-Berrevoets, C.E. and Cervenka, M.C. (2017). Ketogenic diet therapy for epilepsy during pregnancy: A case series. Seizure, [online] 45, pp.198–201. doi:https://doi.org/10.1016/j.seizure.2016.12.019.
  5. Marzena Rugiel, Zuzanna Setkowicz-Janeczko, Kosiek, W., Rauk, Z., Kamil Kawon and Chwiej, J. (2023). Does Ketogenic Diet Used in Pregnancy Affect the Nervous System Development in Offspring?─FTIR Microspectroscopy Study. ACS chemical neuroscience, [online] 14(15), pp.2775–2791. doi:https://doi.org/10.1021/acschemneuro.3c00331.
  6. Khan KM;Jialal I (2023). Folic Acid Deficiency. [online] Available at: https://pubmed.ncbi.nlm.nih.gov/30570998/ [Accessed 14 Jun. 2024].
  7. Hyde, N.K., Brennan-Olsen, S.L., Bennett, K., Moloney, D.J. and Pasco, J.A. (2016). Maternal Nutrition During Pregnancy: Intake of Nutrients Important for Bone Health. Maternal and child health journal, [online] 21(4), pp.845–851. doi:https://doi.org/10.1007/s10995-016-2178-7.
  8. Bostock, S., Kirkby, K.C., Taylor, B.V. and Hawrelak, J.A. (2020). Consumer Reports of ‘Keto Flu’ Associated With the Ketogenic Diet. Frontiers in nutrition, [online] 7. doi:https://doi.org/10.3389/fnut.2020.00020.
  9. Mahajan, A., Donovan, L.E., Vallee, R. and Yamamoto, J.M. (2019). Evidenced-Based Nutrition for Gestational Diabetes Mellitus. Current diabetes report, [online] 19(10). doi:https://doi.org/10.1007/s11892-019-1208-4.
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