The keto diet is gaining popularity among older adults, but is it safe for them?
Good nutrition is critical to the health and well-being of older adults. Of course, eating well can be a challenge at any age, but seniors often struggle to maintain balanced and nutritious eating habits due to factors such as cognitive disorders, medications affecting appetite, and mobility issues limiting their food choices. Individuals over the age of 65 are at greater risk of being malnourished, which can result from either not eating enough or eating too much. Additionally, many medical conditions are directly influenced by diet, and vice versa, which significantly increases the risk of senior malnutrition.
Within your senior living community, diet and nutrition are likely key concerns. You want to ensure every resident receives nutritious, appetizing food when and how they need it. However, it can be difficult to navigate shifting trends within the diet industry and especially tricky to distinguish diet fads from smart nutrition. In this article, we’ll take a closer look at one of these diets — the keto diet — to determine whether it’s just a trend or truly a healthy lifestyle choice. We’ll analyze whether this is a safe option for your residents and give you ways to easily offer them balanced and customized diets they’ll enjoy.
What Is the Ketogenic Diet?
The ketogenic diet, usually called “keto,” is an eating plan that significantly limits carbohydrates while promoting a diet high in healthy fats and protein. The goal is to put the body into a state of “ketosis,” in which body fat is burned at a rapid rate.
To do that, followers of the keto diet carefully plan meals around their macros or macronutrients, which include the breakdown of grams of carbs, protein, and fat. While the numbers vary pretty widely depending on the source, a recent study indicates that a keto macro breakdown usually looks like this:
Some versions of a ketogenic diet are even more restrictive, limiting carb intake to around 5%. So, what do followers of the keto diet eat?
Allowed Foods on a Keto Diet
- Salmon, sardines, and fatty fish
- Eggs, including the yolk
- Nuts and seeds
- Cheese and dairy products like cream, butter, yogurt, and cottage cheese
- Non-starchy vegetables and leafy greens
- Dark chocolate and cocoa powder
- Fats like olive oil, avocado oil, or coconut oil
Prohibited Foods on a Keto Diet
- Refined carbohydrates and sugars
- White bread
- Pasta
- Sweetened coffee, tea, or soda
- Potatoes and sweet potatoes
- Winter squashes
- Corn and beets
The keto diet has caught on among many groups of people as an effective method to achieve weight loss, but is a keto diet for seniors a good idea?
Potential Benefits for Seniors
The keto diet gained so much popularity because of its health benefits, but do those same benefits also apply to seniors? Here’s how a ketogenic diet can positively impact older adults:
Supports Weight Management
When in ketosis, the body burns fat rapidly, which can lead to weight loss. Seniors may struggle with their weight due to a lack of mobility or other health issues, and a keto diet could be one way to help them drop pounds and feel better.
Boosts Cognitive Function
One study shows that a ketogenic diet can be a brain booster, leading to improvements in learning and memory. This can be a big gain for seniors looking to prevent cognitive decline or those who already have Alzheimer’s disease or dementia.
Reduces Inflammation
The energy many people derive from carbohydrates in a standard diet comes instead from fat in the keto diet. This fat-burning triggers a healing response from the body, which then leads to a reduction in inflammation. This could be a great option for seniors who want a more natural way to manage swelling and pain.
Stabilizes Blood Sugar
By now, we know that simple and refined carbs aren’t the best for our bodies, but keto takes that to the extreme, eliminating almost all carbohydrates in favor of fats and protein. Because most carbs turn into sugar once in our digestive system, the keto diet is an effective way to lower blood sugar levels, making it a good choice for the substantial number of pre-diabetic seniors out there.
Eases Joint Pain
Because it reduces inflammation, a keto diet helps soothe joint pain, a common complaint for many older adults. One study shows that a keto diet can help with gout, which is inflammation within the joints. However, it’s important to stay cautious and consult your healthcare provider, as many keto-friendly foods, such as high-purine foods like red meat, shellfish, and other certain types of fish, can actually trigger gout.
Supports Heart Health
Cardiovascular disease is one of the leading causes of death among seniors, often due to fatty buildup in the arteries. Using a high-fat diet like keto to combat heart disease may seem counterintuitive because ketosis can increase one’s low-density lipoprotein (LDL), commonly referred to as "bad" cholesterol, according to one study. However, the ketogenic diet can also promote weight loss, which can reduce heart stress and improve overall cardiovascular health.
Risks and Considerations
While there are a number of benefits to the keto diet for seniors, there are some serious risk factors that must be taken into account, including:
Nutrient Deficiencies
Because of the dietary restrictions that come with keto, including a limited amount of fruit, dieters might find they lack the recommended daily amount of certain vitamins and minerals, like vitamin K or vitamin B12. Careful management of keto diets is recommended to ensure proper vitamin intake and possible oral vitamin supplementation.
Bone Health
Numerous contradicting studies exist regarding the keto diet and bone health. Overall, most studies find either no impact on the bones or some degree of negative impact. None of the studies find any signs of bone-strengthening or slowing of bone loss. Because of this, it is important to consider how a keto diet may affect seniors with bone diseases such as osteoporosis or those prone to falls and injury.
Medication Interactions
A keto diet is not recommended for some individuals who are being medicated or treated for certain health conditions, including seizure disorders, high blood pressure, and, in some cases, diabetes. In these cases, being in a state of ketosis can render some of these medications ineffective, resulting in potential health and safety risks. Conversely, some medications work against a keto diet, making the diet itself ineffective and keeping the body from entering ketosis. It’s always best to weigh any dietary changes against a resident’s medication schedule to know what will contribute to their overall health.
Kidney Function
Research is still being conducted into how ketogenic diets affect the kidneys. The diet itself, however, can lead to the consumption of foods that may trigger kidney stones and other kidney issues. For those who have a history of kidney problems, it’s best to either manage the diet very carefully or avoid it altogether.
Blood Sugar Fluctuations
Radical carb reduction can be a great way for people to manage their blood sugar, but they must exercise caution, as a keto diet can cause wide fluctuations that may lead to distress. Especially in the beginning, dieters may notice symptoms of “keto flu” — a condition that begins early on in the keto diet and mimics the feeling of an actual flu. For those who struggle to stick to the diet and stay consistent, symptoms of keto flu can return over and over again, a sign that blood sugar is not stabilizing. This can be especially dangerous for those with type 2 diabetes.
Digestive Issues
Keto can have a major impact on your overall gut health. Because fiber intake is limited in a keto diet, many people report issues with constipation, while others experience diarrhea. These unpleasant side effects can be manageable for many people following a keto diet, but for seniors, these issues can lead to other issues like bowel obstructions or dehydration.
Is a Keto Diet Safe for Seniors?
A keto diet can be safe for seniors if managed properly and if their medical background allows it. One significant study that compiled research from many years of keto observation came to the conclusion that a ketogenic diet for seniors can be safe and effective. Most relatively healthy seniors should be able to practice a keto diet without any major risks, and they may see many of the benefits previously mentioned here. However, there are some seniors who should forego a keto diet or undertake it only with proper support and guidance. These include:
- Seniors on medications that are contraindicated for the keto diet
- Those with severe health issues that may be incompatible with keto, such as seizure disorders, kidney disease, heart disease, and unmanaged diabetes
- Those who do not have access to balanced and healthy food options
- Anyone who has exhibited signs of disordered eating
- Seniors with a history of pancreatitis or liver disease
How to Safely Start a Ketogenic Diet
Starting a keto diet should be done under the supervision of a trusted physician or dietician to ensure safety and effectiveness, especially for seniors. As a senior living community, you can also help residents maintain their nutrition goals. Here are some essential tips for helping seniors start a ketogenic diet:
- Provide education. Most seniors begin a keto diet without first undergoing education or training. Work with staff and nutritionists to offer educational courses to residents who are considering it.
- Encourage a slow start. Diving headfirst into a ketogenic diet will do little more than lead to bottoming out their carbs and bringing on the keto flu. Work on a meal plan that slowly reduces carbs and ramps up healthy fats over a few weeks.
- Monitor carefully. Some keto dieters don’t get the minerals, vitamins, and nutrients they need, so it’s important to give them access to foods that provide those critical elements or offer supplements like oral vitamins.
- Stay on top of medications. Because a keto diet can interact negatively with some medications, it’s critical to note any med changes and ensure the new diet is compatible with them.
Alternatives to the Keto Diet
A keto diet for seniors may not always be the best choice for your residents. There are many other types of healthy diets out there that can support weight loss goals and lead to better health. Some keto alternatives include:
Mediterranean Diet
The Mediterranean diet is low in carbs and somewhat high in fat, though it’s not as extreme as keto. The big difference is that the Mediterranean diet promotes more plant-based foods and far less meat, especially red meat. This low-carb diet can be a better choice for seniors with heart disease who want to lower cholesterol levels.
DASH Diet
DASH stands for “dietary approaches to stop hypertension,” and it’s an excellent diet for seniors with high blood pressure. DASH focuses on eating veggies, fruits, and whole grains while reducing sugar intake.
Lazy Keto
Lazy keto, or “dirty keto,” uses the same principles behind the ketogenic diet but forgoes tracking macros and eases up on some of the restrictions. While lazy keto likely won’t result in the same type of weight loss, it’s a gentler approach that is much easier to follow.
Low-Carb High-Fat Diet
The LCHF (low-carbohydrate and high-fat) diet is very similar to lazy keto but not quite the same. It uses the basic principle of carb reduction and higher fat intake but with fewer of the rules of keto. Many people find LCHF to be a more sustainable, flexible option as it focuses on whole, unprocessed foods without strict macro tracking.
Diet trends come and go, but you’ll notice that most of them share a common denominator: carb reduction. Carbs can be hard to give up, but many of these low-carbohydrate diets make it easier for seniors to stay healthy and feel satisfied.
How eMenuChoice Can Help You Track Your Residents' Nutrition Needs
There is no one-size-fits-all for senior diet plans, and keto is just one of the many options. But of course, managing any senior's diet means prioritizing their health, and that’s why having a seamlessly integrated senior software solution like Eldermark NEXT is so important.
Eldermark NEXT: Eldermark NEXT helps you with end-to-end management of your senior living community and provides EHR and eMAR that allow you to monitor each resident’s medical status, medication list, and overall health.
eMenuChoice: From there, you can integrate with eMenuCHOICE, which will help seniors manage their dietary needs, whether keto, Mediterranean, heart-healthy, or allergy/specialty. eMenuCHOICE helps your staff to provide safe and nutritious meals for every resident and equips you with everything you need for easy billing, menu planning, meal delivery, online ordering, and much more.
Find out how Eldermark NEXT and eMenuCHOICE can help residents in your care eat better and feel better. Schedule your free demo today!
