The keto diet can be stringent and hard to stay with, and the typical response from people who follow this diet is that they experience constipation. If you are following a low-carb, high-fat diet and your bowel movements start to decrease, it’s not much of an unexpected event.
The lack of fiber-containing foods in the diet can lead to irregularity. Luckily, it is possible to adhere to the ketogenic diet without the oftentimes overwhelming backsliding.
The ketogenic diet is commonly referred to as ‘keto.’
During the 1920s, it was employed as a medication for kids with epilepsy, nowadays however, it is well-known for its aiding in weight reduction. The number of individuals engaging in the keto diet every year increases annually, and currently 6% of people in the US are on the keto diet.
Consuming fewer carbohydrates and increasing your consumption of fat and protein is a part of the Keto diet. If one strictly follows the plan, the body will produce ketones, using fat as its primary energy source, rather than glucose from carbs.
You should aim to consume macronutrients in a ratio of approximately 55-60% fat, 30-35% protein, and 5-10% carbs.
Defecation that is infrequent, resulting in fecal matter that is difficult to excrete due to it being compact and dried out. Additionally, bowel movements may be less frequent than usual.
Nonetheless, what is considered typical for one individual may be extraordinarily different for someone else. A study conducted in the year 2010 indicated adults typically produce anywhere from three bowel movements every day to three per week, which is an incredibly broad range.
In a recent evaluation of data from 2018, it was acknowledged that due to the lack of a precise definition for constipation, it is hard to ascertain the exact amount of individuals who are suffering from it.
It is thought that 16 percent of grown-ups and 33.5 percent of those over 60 have chronic constipation worldwide.
Despite individuals experiences varying; in general, one can usually tell when it takes extra effort to expel a bowel movement.
There are numerous sources for constipation, for instance, hypothyroidism, pressure level, being idle, taking narcotic pain killers, low liquid consumption, and being sensitive to particular foods.
How Common is Constipation on Keto and Low-Carb Diets
Constipation can occur commonly when people start eating keto and low-carb diets, particularly in the early stages when the body is getting accustomed to utilizing fat instead of glucose for energy.
Even though it depends on the person, it’s not an absolute that people get constipated when they have a very low intake of carbohydrates.
An epilepsy center studied 48 children who were on a ketogenic diet in order to gain control over their seizures. Out of these children, 65% (32) experienced constipation while following the diet.
A parallel investigation at another center resulted in the discovery that only two out of a total of 26 kids (8%) following the modified Atkins diet (MAD) reported having constipation.
Children who consume a ketogenic diet for treatment of their epilepsy generally take in a large amount of fat, with the ratio of three to four parts fat to the amount of the combined protein and carbohydrates. The MAD has a high amount of fat and minimal carbohydrates but permits a relatively sizable amount of protein, with a ratio somewhere between 1:1 and 2:1.
Despite this, people who follow less restrictive low-carb meals might still have difficulty with digestion.
In 2002, forty-one grown-ups with type 2 diabetes were instructed to never surpass twenty-five grams of carbs daily without any limits on healthful fats, protein, and calories.
At the conclusion of the research, twenty-eight (68%) of the test subjects stated that they had some level of constipation throughout the timeframe which lasted 24 weeks.
Is It Truly Constipation
It is significant to note that not having frequent trips to the bathroom does not necessarily indicate constipation.
People often observe that there is less of a need for bowel movements when following a ketogenic diet, especially when their prior diet consisted of large quantities of bran cereal, legumes, and other items that generate large stools due to their high-fiber content.
This means that if you don’t have difficulty with going to the toilet and you don’t experience pain, gas, or difficulty while going, then you are likely not constipated.
This could be the way things remain for you as long as you are having bowel movements at least three times a week.
Keto Constipation Causes
It is vital to make sure to include a lot of foods that provide both soluble and insoluble fiber in the diet (such as vegetables, fruits, grains, and starches) in order to promote regularity of bowel movements. The keto diet lacks most fiber-filled foods, making it more likely for you to suffer from constipation.
Many individuals in the U.S. don’t consume adequate amounts of fiber in their nutrition already, therefore, how can the deficiency of fiber be more significant for those on a keto diet?
The ketogenic diet is low in carbohydrates, allowing for only 50 grams or slightly less than two ounces each day. Instead, it consists mainly of fats and protein. Therefore, you run the risk of under-consuming fiber-rich foods.
Consuming fiber is important. Soluble fiber absorbs liquid and assists in the passage of substances through the digestive system. Incontrovertible fiber, on the contrary, is utilized as a swelling agent.
Lowering the amount of fiber in your diet could also affect the bacteria in your intestines, which helps to break down what you eat. Around half of individuals who follow a ketogenic diet may suffer from constipation due to a deficiency of fiber.
An Increase in Dairy
Those who like dairy products may find that the keto diet suitable for them because it includes cheese, yogurt, and cream, which are high in fat and protein.
Milk sugar, or lactose, is often the source of bowel irregularity and constipation. A number of people find it difficult to process lactose, leading to puffiness, gas, queasiness, and difficulties with going to the toilet.
A recent study comparing the effect of diets consisting of high vs. low amounts of dairy products on the gut microbiome concluded that individuals on the high dairy diet had a decrease in a certain butyrate bacteria, which plays a role in the digestion of fiber and contributing to healthy digestion.
In addition, having a diet that is not well balanced and has a lot of dairy products and not enough fibers may make you feel low in energy.
Reduced Water Intake
It is vital to ingest lots of water as it is necessary for the proper functioning of your body, including keeping your bowels regular. Nonetheless, if you eat fewer fruits and vegetables, you may be inadvertently drinking less water without being aware of it.
Rapidly decreasing carbohydrates in your diet can cause dehydration and a lack of essential electrolytes while following a ketogenic lifestyle.
Because each gram of glycogen, which is sugar that is stored in the body used for energy and is found primarily in carbohydrates, holds a total of three grams of water as well, stored within the muscles.
Be sure to drink enough water throughout the day, and you can use the color of your urine as an indication of whether you’re sufficiently hydrated.
How to Treat It
Sticking to a keto diet can be a major challenge and requires rigorous adherence. To stick with a keto diet and sidestep constipation, try the following:
1. Add More Dietary Fiber
The Academy of Nutrition and Diuretics recommends that females consume 25 grams (0.9 ounces) and males 38 grams (1.2 ounces) of fiber every day. Luckily, there are a variety of keto-friendly, fibrous foods:
- Sliced avocado: 6.7 grams (0.2 ounces) of fiber per 100 grams (3.5 ounces) serving
- A sprinkle of chopped almonds: 3.5 grams (0.1 ounces) of fiber per 28.35 grams (1 ounce) serving
- A cup of cauliflower: 2.2 grams (0.08 ounces) of fiber per 64 grams (2.2 ounces) serving
Studies have shown that exercising regularly can help to maintain regularity. Aerobic exercise, specifically, can help to alleviate constipation by causing the intestines to contract. Taking a swift stroll, jogging at a low-level pace, or participating in an intense physical activity routine can potentially control your bathroom habits.
3. Retrain Your Bowel
Regaining regular defecation can help get rid of problems with constipation and make stool texture better. It may be easy to condition your digestive system by consuming adequate amounts of liquids and developing a set time to use the restroom.
It may be necessary to use a stimulation aid, like a fiber supplement or a suppository, as well. Prior to taking any kind of OTC remedies, it is advisable to consult with your medical practitioner to check whether these substances are suitable for you.
4. Increase Your Water Intake
It is essential to drink enough fluids in order to get rid of toxins from your body. The amount of water you need to consume will be dependent on your gender, size, weight, and whether or not you are pregnant or lactating.
Drink before starting to feel thirsty and use the color of your pee to gauge your hydration levels. The darker it is, the more dehydrated you are.
5. Get Enough Sodium, Potassium and Magnesium
Not having enough electrolytes can be credited with producing the most commonly observed indications of keto flu: exhaustion, lassitude, headache, and moodiness. Nevertheless, sodium and magnesium are essential to ensure your digestive system functions effectively.
A study conducted with 244 women who had constipation showed that those who drank water enhanced with magnesium experienced a considerable alleviation of symptoms in comparison to the group who drank water that only contained a minimal amount of minerals.
Most folks require at least 3-5 grams of salt per day if they are following a very low-carb dietary plan. Some simple strategies to up your sodium intake include seasoning your dishes with salt when you are preparing them or when you are about to eat them, having a cup of broth with salt, and including olives, cheese, and sauerkraut in your meals.
Keto foods that are high in potassium and magnesium include avocado, nuts, meat, fish, leafy greens, and Greek yogurt.
Adding an extra 200-400 mg of magnesium in one’s diet each day could be of assistance. Start your magnesium intake with no more than 200 mg daily of either magnesium oxide or citrate for a laxative effect; otherwise, you may experience loose stools or diarrhea.
6. Include Coconut Oil and MCT Oil in Your Diet
MCTs may have the capacity to spur on bowel movements due to the fact that they are quickly broken down and absorbed into the body. MCT oil has the most intensive laxative ability, but coconut oil has some MCTs as well and can also lead to consistent bowel habits.
Target consuming between 1-2 tablespoons of coconut oil or MCT oil each day, either mixed into foods or in drinks that accompany your meals.
Begin by consuming a small amount of 1 teaspoon a day and then gradually increase the quantity. By taking that approach, it is possible to evade potential gastrointestinal side effects such as abdominal spasms and loose stools.
7. Soak Nuts and Seeds
Despite our tendency to believe that nuts and seeds can be used to cure constipation, given their good content of dietary fiber, it is possible that they may actually be the thing that triggers its occurrence or adds to it in some people.
You might be able to counterbalance this impact by submerging nuts and seeds in water before consuming them. Incorporating the process of soaking and drying out nuts and seeds may assist in the absorption of their nutrients by increasing their capacity for digestion.
Also, make sure you’re not eating too many nuts. Most people who don’t have nut allergies or sensitivities can consume between 30-60 grams (1-2 ounces) of nuts per day without adverse effects.
8. Consume Probiotic Foods or Supplements
Probiotics are helpful microorganisms found either in certain food items or in a supplement form that work to regulate the microorganisms in the intestine, thus aiding in regularity.
Some examples of widely enjoyed fermented dishes are Greek yogurt, kefir, sauerkraut, and the Korean side dish kimchi. A sample of twenty individuals with long-running constipation saw a reduction in the use of laxatives and increased regularity of bowel movements after drinking kefir daily for 28 days.
A benefit can be found in consuming probiotic supplements in addition to eating food.
A study conducted in 2016 which looked at 15 trials concluded that the use of probiotics could reduce the amount of time it takes food to pass through the intestines and decrease the severity of constipation symptoms. It was discovered by researchers that Bifidobacterium lactis was the most efficient strain of bacteria for aiding in regularity.
Some other probiotics that may help with bowel movement regularity are Lactobacillus acidophilus, Lactobacillus reuteri, Lactobacillus plantarum, Lactobacillus rhamnosus, and Bifidobacterium animalis.
There are several supplements designed for constipation that contain these probiotic strains:
When to See a Healthcare Provider
It would be a good idea to consult a medical expert before embarking on a keto diet. If you have begun a course of treatment and are having issues with constipation, be sure to consult your doctor.
Regular abdominal discomfort, puffiness, flatulence, and even a split in the covering of the rectum due to too much pushing are common complaints associated with constipation.
Chronic constipation can also impact your mental health. A study from 2020 of 240 individuals with constipation-focused irritable bowel syndrome (IBS) revealed that nearly one-third of them exhibited indications of depression, particularly in female participants.17
In addition to this, the keto diet may lead to hypotension, formation of kidney stones, irregularity in the bowels, lack of essential nutrients, and increased chances of coronary disease.
Adhering to rigorous dietary plans like a ketogenic program could lead to social seclusion and disturbing eating habits. The ketogenic diet should not be followed if an individual has any medical issues with their pancreas, liver, thyroid, or gallbladder.