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As the ketogenic diet surges in popularity, a wave of dietary supplements has followed in its wake. Some products claim to suppress appetite, boost ketones, fuel mental performance, and enhance other benefits of ketosis. Other products aim to minimize the potential risks of the ketogenic diet and ensure adequate nutrient intakes.
In a practice paper on the use of the ketogenic diet in epilepsy, the Academy of Nutrition and Dietetics included a summary of supplements to accompany the diet. Here, we explore the rationale and science behind some of these supplements, as well as the controversial use of exogenous ketone salts.
Electrolytes and Trace Minerals
Ketones are osmotically active and can
have a diuretic effect. Patients following a ketogenic diet will lose
electrolytes in the urine, especially as the body initially adjusts to the
diet. Dehydration and electrolyte imbalances might contribute to dry mouth,
headaches, or other unwanted effects commonly referred to as the “keto-flu.”
Patients on a ketogenic diet can also lose minerals in the urine. And the diet’s restriction of grains, beans, and root vegetables could contribute to lower intakes of some minerals, such as magnesium, iron, and selenium.
That’s why a multivitamin with minerals is the first way to reduce the risk of nutrient deficiencies during a ketogenic diet. Sea salt or iodized table salt can also provide electrolytes and trace minerals.
Some electrolyte supplements are purposely formulated to accompany the ketogenic diet to help maintain electrolyte balance, especially at the beginning stages of the diet, until the body adjusts. These products typically include at least sodium, chloride, magnesium, and potassium and ideally other trace minerals as well.
Fiber, Probiotics, and Digestive Enzymes
The ketogenic diet eliminates all grains and is inherently low in fiber. Because fiber serves as a fuel for the microbes of the intestinal tract, the ketogenic diet leads to changes in the gut microbiome. Supplementing the diet with a fiber powder is a reasonable way to support the microbiome and healthy bowel function.
In a review article published in 2019 in the journal Genes, European researchers
summarized nine studies that documented how the ketogenic diet changes the composition of the gut microbiome. The authors concluded by recommending strategies to support gut health during a ketogenic diet, which included supplementation with prebiotics or probiotics.*
Because fiber serves as a fuel for the microbes of the intestinal tract, the ketogenic diet leads to changes in the gut microbiome. Supplementing the diet with a fiber powder is a reasonable way to support the microbiome and healthy bowel function.*