Tons of People Do Intermittent Fasting And Keto At The Same Time—But Is That A Good Idea?

Photo credit: vasiliybudarin - Getty Images
Photo credit: vasiliybudarin - Getty Images

From Women's Health

At this point, you probably know all about the keto diet. Even if you’re not currently on it, you probably know someone who's tried it, or maybe you've dabbled in the high-fat, low-carb diet just to see what all the fuss is about. And if you’re super into diet trends, you might even know about intermittent fasting (IF), a method of eating that requires you to fast for a set number of uninterrupted hours per day.

But here’s one trend you may not know a lot about: doing IF and keto at the same time. Whoa. As if one diet wasn’t hard enough, are there really people out there tackling two diets at once?

Yup. And keto proponents claim good reasons for doing it, too—some of which could be legit. “Practicing IF while on the keto diet may help the body reach ketosis faster,” says registered dietitian Danielle Schaub, who is also the culinary and nutrition manager for Territory Foods. “Because both IF and the keto diet are based on the beneficial shift toward burning body fat instead of carbs for energy, similar health goals can be accomplished by both.”

Now for the burning questions: How do you actually do IF and keto together, and does it help you lose more weight? Do you end up with double the side effects? And, finally, is it really a good idea? Here's everything you need to know about combining keto and intermittent fasting.

First, what exactly is keto?

Keto is a high fat, low-carb diet often mistaken for a high protein diet because so many of its popular recipes include bacon and other types of animal products, but the focus really is on fat.

The goal of the keto diet is to eat meals that are 60 to 75 percent fat, 15 to 30 percent protein, and 5 to 10 percent carbohydrates. Doing so puts you into a state of ketosis, where you can burn ketones from fat instead of glucose from carbs, speeding up your metabolism and increasing the potential for weight loss (according to proponents of the diet). Between burning fat during ketosis, and losing water weight that you'd normally hold onto to store carbs for energy, you may drop quite a few pounds on keto.

Normal staples of a keto diet include healthy fats (good news: tons of avocado), meat, and dairy products. Foods that are off limits are any kind of pasta or bread, starchy veggies like potatoes, beans, and anything that contains sugar, including many cocktails.

There are some variations on the standard keto diet, and some of them include sneaking some carbs in. The cyclic keto diet involves eating keto five or six days out of the week, and then eating a small amount of carbs on the other day or two to replenish energy stores (this is popular with athletes). There's also the targeted keto diet, common in athletes as well, in which you basically carb load less than an hour before strenuous exercise for a burst of energy—the object is that you'll burn off the carbs before they're stored as fat in the body.

Some people even do a vegetarian version of keto, chowing down on healthy fat sources like olive or coconut oil, nuts and seeds, avocados, and dairy products (while avoiding greasy cheeseburgers and sirloin steaks). Others who eat vegan choose a vegan keto diet, which is high in healthy fats but omits all animal products. On vegan keto, you can have small amounts of beans and legumes, but it's tricky to stick to because your other options are limited.

And what's the deal with intermittent fasting?

IF is a pattern of eating where you restrict foods and sweetened beverages for an uninterrupted period of time every day (in many cases 16 hours) and then eat only during the remaining hours (often the eating window is 8).

“You can pick your windows but we encourage people to eat when the sun is up and fast when the sun is down,” says registered dietitian Amy Shapiro, founder of Real Nutrition. “During fasting hours you can drink water, black coffee or plain tea, but nothing that provides calories or requires any sort of digestion or shift in hormones.”

The theory behind IF is that depriving your body of calories for an extended period of time forces it into a temporary state of starvation and slowed metabolism. This makes your fat cells burn glucose for energy and can lead to improved weight loss results. One plus is that you don't necessarily need to cut out any foods to stick with IF. It's really the slashing of calories in general that's said to boost weight loss, and experts say there's not one IF schedule that works better for losing weight over another—you can choose whichever one works best with your lifestyle.

There are several different ways to schedule your fasting times, but the 16:8 version (fasting for 16 hours, eating for eight hours) is the most commonly used. For people who are newer to IF, the 14:10 schedule might be easier to stick to, because you have a 10-hour eating window and only a 14-hour fast.

Another popular schedule is the 5:2 method, which involves eating as you would normally for five days out of the week and cutting back your food intake to about 500 calories two days of the week. It's a similar concept to alternate-day fasting: fasting every other day by consuming little to no calories, and eating as you regularly would for the remainder of the days. Figuring out an IF schedule you like will involve some trial and error, of course.

Also something to note: IF is not recommended for people with a history of disordered eating, since it can get into pretty restrictive territory.

How can you combine keto and intermittent fasting?

It’s actually not that hard if you’ve already got a good handle on keto, since that diet has a stronger learning curve in terms of what’s allowed. Technically IF isn’t even a “diet” in the traditional sense, says Brigid Titgemeier, RDN, a functional medicine dietitian and the founder of BeingBrigid.

“Intermittent fasting can be paired with any kind of diet because it simply refers to the number of hours that you fast,” she explains. “Combining keto with intermittent fasting means adhering to the parameters of a ketogenic diet and eating within a condensed window of time.”

If you do choose to combine the two, it's a good idea to ease into it. Aja Gyimah, MHSc, RD, owner of Compete Nutrition, suggests starting with an easier IF schedule to begin with, like a 12- or 10-hour eating window (with a 12- or 14-hour fasting window, which you can customize based on your schedule), and work your way up to a longer fast, especially if you're an avid snacker throughout the day, she adds.

What does a day of following keto and IF look like?

Here's an eating schedule that Gyimah proposes that's both keto and IF-compliant. It's based on a 12-hour eating window (and 12-hour overnight fast), and 20 to 25 grams of carbs per day. And remember to drink water, tea, or coffee with all of your meals to stay hydrated, she says.

  • 7 a.m.: Breakfast stuffed peppers with cheese

  • 10 a.m.: 4 ounces plain Greek yogurt with ? cup berries

  • 12 p.m.: Tuna salad-stuffed avocado boats (tuna salad with peppers, celery, and mayo spooned into two avocado halves)

  • 3 p.m.: Sliced, raw vegetables and 2 tablespoons tzatziki

  • 5:30 p.m.: Steak, cauliflower rice, and roasted vegetables

  • 7 p.m.: 1-2 cups of popcorn

For a slightly more challenging IF schedule, Gyimah suggests a 10-hour eating window (plus a 14-hour fast) that involves about 30 grams of carbs per day. Again, you need liquids, particularly water, with all meals to be adequately hydrated.

  • 8 a.m.: Scrambled eggs with feta cheese, sliced avocado, and a salad with pepitas, peppers, and a 1/2 cup of raspberries

  • 12 p.m.: Roasted chicken, collard greens, sliced cucumber, and celery with 1 tablespoon hummus

  • 2 p.m.: Handful of assorted nuts and ? cup mixed berries

  • 6 p.m.: 4-6 ounces salmon, roasted asparagus, cauliflower rice

If you're going for an even longer fast, Titgemeier lays out the following schedule for eating within the parameters of both diets, assuming an eight-hour eating window and 16-hour fast between 6 p.m. and 10 a.m.

  • 7 a.m.: Green tea or black coffee

  • 10 a.m.: Keto macadamia bread topped with ricotta cheese and sauerkraut

  • 12 p.m.: 4-6 ounces of wild salmon served with a bed of sautéed greens and ? avocado

  • 3 p.m.: Grainless granola with unsweetened almond yogurt

  • 5:30 p.m.: Shrimp bowl with 4-6 ounces of shrimp, cauliflower rice and sunflower seeds

  • 7 p.m.: Herbal tea

Can combining keto and intermittent fasting help me lose weight?

There’s some solid consensus among the RDs: combining keto with IF does help you reach ketosis faster, which may lead to additional weight loss.

“IF paired with keto intensifies the effects of the ketogenic diet, since they both increase the ketones in the blood,” says Titgemeier. Since the time it takes to enter into ketosis differs from person to person (leaving you suffering from the keto flu in the meantime), anything that can make that happen sooner is appealing to keto dieters...even if it means piling yet another diet on top of the one they’re already doing.

Additionally, Shapiro says that grouping your meals into a smaller window may allow your body to burn its energy stores instead of continuing to build them up—something which could cause more fat loss than if you did only keto or IF. “Eating heavy meals and then letting your body digest will allow for weight loss and hormone balance as well as time for our bodies to use the nutrients we are ingesting for energy,” she explains.

What are the health benefits of combining keto and intermittent fasting?

The main benefit to combining keto and IF really is weight loss, because you're majorly cutting back on calories. It could be potentially beneficial for people with type 2 diabetes to lose weight as well. But there isn't much research out there yet on other prominent health benefits of combining the keto diet with IF.

"However, if you are consuming plenty of vegetables, healthy fats from nuts and seeds, and good-quality protein, that will help you maintain healthy eating habits throughout your diet," Gyimah says. When you get into that routine of packing veggies, a.k.a. antioxidants, lots of protein, and good fats into your diet, it may support lean muscle mass while you lose weight, she adds. Plus, the fiber and antioxidants from those foods can only help your gut health and your immune system as well.

Who should try combining intermittent fasting and keto?

If you're looking to shed pounds quickly, the IF and keto combo could be the right one for you. It may depend on what pre-existing health conditions you have.

"Individuals with type 2 diabetes may benefit from ketogenic diet and IF as it may aid with weight loss and potentially allow you to reduce your medications," says Gyimah. People who've been diagnosed with prediabetes may also see similar benefits, including dropping pounds and reducing insulin, Gyimah adds.

However, if you have type 1 diabetes, keto might not be safe. People with type 1 who try this diet may be susceptible to a condition called diabetic ketoacidosis, Gyimah says, which basically means the buildup of ketones in their bodies can be dangerous. Regardless of what health conditions you have, it's best to check in with your healthcare provider before starting any dietary changes, especially keto or IF.

Are there any side effects to combining keto and intermittent fasting?

WH has previously reported on the many gag-inducing side effects of going keto (constipation and diarrhea and hair loss, oh my!), and the potential downsides of IF, which include low blood sugar, fatigue, nausea, and being just plain hangry all the time.

So do you end up with double the side effects when you combine the diets? In theory, yes. Putting the two together doesn’t do anything to counteract the side effects of either diet, so you could wind up with the undesirable combination of nausea and constipation (or hair loss and hanger, or...well, you get the idea).

More importantly, though, the biggest downside to pairing keto with IF is the sheer level of commitment involved—and the high potential for failure.

“It’s very difficult to maintain such a narrow way of eating,” says Schaub. “Eating an extremely high-fat, low-carb diet itself is difficult to do while maintaining a social life and flexibility in your schedule; layer in a restricted eating window of eight hours, and the ability to sustain it becomes that much tougher.”

The one plus side? Schaub does say that IF could become less uncomfortable when coupled with keto: “The ketogenic diet is very satiating—eating fat leads to less hunger overall, which makes restricting your eating window significantly easier.”

Finally, while IF is a more natural way of eating, keto is decidedly stricter/not for everyone (and definitely not for kids, pregnant women, people with a disordered history of eating, high-intensity athletes, or people with certain health conditions).

“Consult a dietitian or other healthcare practitioner if you are considering following a ketogenic diet paired with intermittent fasting,” says Titgemeier. “You may want to start with intermittent fasting first to see how you feel before going full force with both intermittent fasting and keto.”

If I had to choose one, is keto better than intermittent fasting (or vice versa)?

It depends on your nutrition goals, says Shapiro, but she doesn’t recommend keto for the majority of people because of its restrictive nature (though there are some people with health conditions, like epilepsy, who may benefit from a ketogenic diet).

IF, though, is a different story: “I recommend 12- to 14-hour IF for most individuals because it helps to break mindless eating patterns, encourages balanced meals, and allows for proper digestion, better sleep, and [better] hormone balance,” Shapiro explains.

Schaub agrees, saying that “in general, intermittent fasting is safer and more in line with a natural way of eating, [and it] can be practiced for long periods of time.”

In other words, IF is a more flexible way of eating that often fits organically into a person’s lifestyle (which also makes it easier to stick with long-term). Keto, on the other hand, may be too restrictive to be sustainable—or healthy. Because it’s a medical diet, it carries risks of nutritional deficiencies as well as liver and kidney problems, per Harvard Health.

The bottom line: There may be additional weight-loss benefits to doing both the keto and intermittent fasting diets together instead of alone. But it may be hard to stick with both long enough to reap any benefits.

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