10 Reasons Why the 'Keto Bloat' Won't Leave You Alone and How to Fix It
Martha Carlin
| Apr 11, 2023 |
7 minutes read
This article explores the common issue of bloating while following a keto diet. It identifies several factors that contribute to this discomfort, including dehydration, lack of electrolytes, and an imbalance of gut bacteria. The article suggests practical solutions such as increasing water intake, ensuring a proper balance of electrolytes, and incorporating probiotics to promote a healthy gut. Additionally, it emphasizes the importance of gradual dietary changes and mindful eating practices to alleviate bloating. By understanding these causes and implementing the recommended strategies, individuals can enhance their keto diet experience and improve overall digestive health.
- What is a ketogenic diet?
- How does the keto diet benefit you?
- What is bloating?
- What is keto bloating?
- Possible reasons for feeling keto bloated
- Finding the answer to keto bloating
If you're experiencing bloating while eating keto, you might be going through what is commonly known as keto bloat or keto flu. Feeling bloated can be an uncomfortable and sometimes debilitating condition affecting anyone following the high-fat, very low-carbohydrate keto diet.
For many keto dieters, diligently tracking and tweaking their diet in terms of fat, protein, carbs, dietary fiber - whether it's too much fiber or not enough fiber - sugar alcohol, hydration, and electrolytes, etc. - can help them quickly resolve keto bloating.
To alleviate the symptoms of keto bloat, it's important to identify and address the underlying cause of what's making you feel bloated.
What is a ketogenic diet?
The high-fat, low carbs ketogenic diet is becoming increasingly popular as a way to both lose weight and experience other potential health benefits such as increased energy and mental clarity.
When you're eating a typical carb-rich diet, your body primarily burns glucose and stored glycogen (a form of glucose) as its main energy source but during keto (ketosis), your liver breaks down fat into ketones, as the body's primary source of energy.
How does the keto diet benefit you?
Ketones offer an alternative and efficient fuel source1 to the body and following the ketogenic diet has been associated with potential health benefits2 such as an improved lipid profile, balanced blood sugar levels, tissue healing, cellular repair processes along with potential weight loss benefits.
What is bloating?
Bloating is a common issue and chances are you've experienced it before. Feeling bloated means different things to different people3 and for you, it might mean having a tight and swollen belly, stomach pain, gas, flatulence, feeling too full, or constipation.
Your belly may feel tight and painful if you have excess gas trapped in your gut or even due to excessive water retention in the colon. Bloating might occur for no apparent reason or it could be a symptom of indigestion, irritable bowel syndrome, constipation, food intolerances such as lactose intolerance, electrolyte imbalance, and so on.
What is keto bloating?
Experiencing keto bloating can be a particularly unpleasant introduction to the keto diet. It may involve excess gas production, stomach pain, flatulence, burping, and abdominal distension.
Many keto dieters experience keto bloating when they initially start this journey. Despite the discomfort, those of you looking to "keto adapt" and maintain ketosis need not worry too much as keto bloat tends to fade4 on its own in a few weeks as your microbiome adjusts to the keto diet and provides more support for the digestion of fats. If that isn't the case for you, then it might be time to look into some other possible reasons behind feeling bloated on a keto diet.
Possible reasons for feeling keto bloated
When there's a shift in our dietary habits it might take a while for our digestive systems to adapt and while it's adapting to a new diet, we might feel some digestive tract discomfort. Here are some of the reasons you might be feeling bloated.
A sudden shift in diet and eating too much and too fast
Your body likes routine which means when you suddenly switch to a new diet, your body struggles to adjust to unfamiliar foods and different portion sizes. Also, eating too fast and too much at once can quickly overwhelm your digestive system with the amount of food your stomach needs to process at once.
It generally takes time for your digestive system to break down and digest a meal and when you eat too fast5 for your stomach to process the food, it may pass along improperly processed and undigested food along the digestive tract.
Additionally, eating too quickly may cause you to gulp in more air and swallow improperly chewed food. Improperly chewed food can contribute to bloating as it stays in the digestive tract longer than foods that have been adequately chewed up.
When the digestive system is unable to process the type and amount of food you're eating, the undigested food can go through excessive fermentation in your gut6, which might mean excess gas production which can cause bloating and abdominal pain.
To maintain optimal digestion on a keto diet, it's important not to introduce sudden, large increases in fat and protein intake, instead, start with low doses of healthy fat and protein and work up gradually as needed.
Digestion begins in the mouth where enzymes first begin to break down the food. Chewing each bite thoroughly before swallowing will allow your digestive system the time to release the right mix of digestive enzymes to properly digest your meal before moving it along the digestive tract.
Insufficient digestive enzymes
As you chew your food, your taste buds profile the food you're eating and signal to the rest of your digestive system to make the most of your meal. Digestive enzymes6 are then released to help you break down fats, proteins, and carbohydrates into their simplest forms and release micronutrients from food to make them available for absorption.
In a typical environment, most of the food will be broken down and absorbed before it reaches the large intestine, leaving only complex carbohydrates such as fiber, water, and a few nutrients.
But in case of6 insufficient digestive enzymes, undigested fat, protein, and carbs may reach the large intestine leading to increased bacterial fermentation and gas buildup. Chewing your food thoroughly and slowly as well as taking a keto-friendly digestive enzyme supplement might help you alleviate symptoms of bloating.
Too much MCT oil
Coconut oil-derived MCT (medium chain triglyceride) oil is a calorie-dense oil containing high levels of saturated fatty acids. Once MCTs (medium chain triglycerides) reach the small intestine, they can directly travel to the liver via the hepatic portal and be broken down into ketones for instant energy.
But if you consume more MCT oil than your liver can process at a time, the excess MCTs might end up back in your intestine and lead to digestive upset7. It's best to start slowly and increase your tolerance for MCT oil.
Gut flora imbalance
The gut flora changes and evolves based on the foods we eat, our genetics, and our environment. When you switch to a keto lifestyle, your diet shifts from a high-carb to a high-fat diet.
Any change in your diet8 will cause a shift in the diversity of your gut bacteria, which might lead to a period of digestive discomfort as your gut flora adjusts to the changes in your diet.
Consider introducing probiotic supplements such as BiotiQuest's Sugar Shift which may potentially help you curb sugar cravings but might also help you restore a healthy balance of good bacteria over harmful bacteria in your gut.
Unintentional carb intake
The keto diet is known for its low carbohydrate composition but any unintentional carb intake9 such as dextrose and starch fillers used in zero-labeled sweeteners; thickeners and sweetening agents in condiments such as barbecue sauce can spike your blood sugar and disrupt your body's ability to stay in ketosis.
Marinades and sauces often have ingredients that can affect your net carbohydrate intake. Due to added fillers in artificial sweeteners, many "low-carb" products might have more carbohydrates than expected.
To avoid any unintentional carb consumption, be mindful of ingredient labels and ask questions about menu items when dining out.
Too many sugar alcohols
Many people on the ketogenic diet turn to sugar alcohols as a sugar substitute as sugar alcohols or polyols aren't fully absorbed9 by the body and generally don't rack up your net carbs. But once sugar alcohols reach the large intestine, they might be fermented by the gut bacteria and lead to bloating.
Although sugar alcohols such as xylitol and sorbitol have lower net effective carbs, you should still monitor their consumption since they’ve been associated10 with nutrition depletion. An additional point of conflict with eating even artificially sweetened foods is that it might make it difficult to kick your sugar cravings in the long run.
Food intolerances (including FODMAP)
If you've tried other changes in your diet and still don't know what's behind the keto bloat then it's time to look into FODMAPs. FODMAPs are fermentable oligosaccharides, disaccharides, monosaccharides, and polyols or simply short-chain carbohydrates that some people might be intolerant to.
FODMAPs in keto-friendly foods such as nuts and seeds such as flax seeds, dairy, and high-fiber cruciferous vegetables such as Brussels sprouts might cause bloating11 because of inefficient digestion. An intolerance to these types of carbohydrates can lead to an increase in bacteria that work to break them down, resulting in an uncomfortable buildup of gas.
The best thing you can do if you notice these signs is to try an elimination diet to isolate which foods you may be sensitive to, or seek medical advice so that your doctor can help you identify food allergies or intolerances, and adjust your keto diet accordingly.
Insufficient fiber intake
Your body needs both insoluble and soluble fiber. Fiber intake has been associated12 with benefits such as disease prevention and even longevity. But a high-fat diet tends to be low in dietary fiber intake, as it eliminates the more common sources of fiber since they’re carb-rich.
Insufficient fiber in your diet can slow down digestion13 and cause constipation which can then lead to bloating.
To prevent uncomfortable symptoms of bloating, it is recommended to include foods such as nuts, seeds, avocados, and some non-starchy vegetables like broccoli and cauliflower (best introduced in small amounts to see if they agree with you), foods that are naturally higher in fiber, and essential nutrients but low in carbs.
Lack of Water
Your body loses water through breathing, sweating, and urinating. This is especially true on a high-fat, low-carb keto diet as you tend to urinate a lot more on a keto diet. At the beginning phase of your diet, you lose water weight as your body uses up the last of its glycogen14 (a source of glucose) stores and releases the water that was stored along with glycogen through urine.
At the same time, as you hit ketosis, ketones - water-soluble fatty acids - start circulating in your blood, and since ketones have a diuretic (make you pee) effect, you'll need to urinate more often.
Insufficient water intake may cause your body to hold onto water leading to water retention. The lack of water can cause your digestive system to slow down and you can become constipated15and feel bloated, as there isn't enough water in your body to keep your feces moist and moving.
On the other hand, if you’re consuming too much supplemental fiber16, it can have the unintended effect of drawing too much water into the intestines and lead to a bloated and painful gut due to water retention.
The combination of ketones-related water weight loss, and a low-carb diet leading to an insufficient fiber intake, can easily result in dehydration. Drinking plenty of water is the best way to avoid this issue.
To address insufficient hydration and electrolyte dumping at the start of the keto diet, you might want to try adrenal cocktails. Adrenal cocktails can be made with whole food sources of vitamin C and other trace minerals (sodium, magnesium, potassium, iron, phosphorous and manganese, zinc, selenium, and copper) found in limes, lemons, grapefruit, and/or oranges and add additional ingredients like cream of tartar (an additional source of potassium), Himalayan pink and black salt, as well as coconut water, etc to boost the overall mineral availability of your drink.
Natriuretic effect of leptin and electrolyte imbalance
Leptin is a hormone produced by fat cells that regulates your nutritional behavior (whether you feel satiated or not) and energy balance. For women, leptin also has an impact on estrogen levels and ovulation.
Leptin17 has a natriuretic effect on your body. Natriuresis means to18 expel sodium from the body by increasing urine output. In the initial days of a keto diet, your body loses water and sodium.
Electrolytes are minerals in the body that help to regulate fluid levels and keep the heart, brain, and muscles functioning properly. An imbalance of electrolytes - sodium, calcium, potassium, chloride, phosphate, and magnesium can occur when you become dehydrated, consume too much alcohol or caffeine, don't get enough sleep, or have a medical condition such as diabetes or kidney failure. This unbalanced state19 allows fluids to move between cells and organs, leading to water retention that results in bloating.
While simply drinking more water may not immediately alleviate this issue, rehydrating with electrolyte drinks such as an adrenal cocktail can help you restore electrolyte balance and reduce bloating.
Finding the answer to keto bloating
Shifting from a high carbs diet to consuming a high-fat and very low-carb ketogenic diet is a major change for your body. All of the seemingly different reasons why you might be feeling bloated might come down to pacing and personalizing your keto journey and relearning what works and what to avoid.
Keeping a food journal or using a food tracking app might be the first step in figuring out which aspects of your diet need to be tweaked for some keto bloat relief.
But be mindful, if your bloating persists, speaking with a healthcare professional is recommended.
Want to learn more about keto and probiotics? Here's how you can level up your keto diet with probiotics!
References
- Puchalska, P., & Crawford, P. A. (2017). Multi-dimensional Roles of Ketone Bodies in Fuel Metabolism, Signaling, and Therapeutics. Cell Metabolism, 25(2), 262–284. https://doi.org/10.1016/j.cmet.2016.12.022
- Daria Gołąbek, K., & Regulska-Ilow, B. (2022). Possible Nonneurological Health Benefits of Ketogenic Diet: Review of Scientific Reports over the Past Decade. Journal of Obesity, 2022, 7531518. https://doi.org/10.1155/2022/7531518
- Azpiroz, F., & Malagelada, J. (2005). Abdominal Bloating. Gastroenterology, 129(3), 1060-1078. https://doi.org/10.1053/j.gastro.2005.06.062
- Masood W, Annamaraju P, Khan Suheb MZ, et al. Ketogenic Diet. [Updated 2023 Jun 16]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan. Available from: https://www.ncbi.nlm.nih.gov/books/NBK499830/
- Zhang L, Sizar O, Higginbotham K. Meteorism. [Updated 2022 Oct 17]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK430851/
- Hasler W. L. (2006). Gas and Bloating. Gastroenterology & Hepatology, 2(9), 654–662.
- Harvey, C., Schofield, G. M., Williden, M., & McQuillan, J. A. (2017). The Effect of Medium Chain Triglycerides on Time to Nutritional Ketosis and Symptoms of Keto-Induction in Healthy Adults: A Randomised Controlled Clinical Trial. Journal of Nutrition and Metabolism, 2018(1), 2630565. https://doi.org/10.1155/2018/2630565
- Attaye, I., van Oppenraaij, S., Warmbrunn, M. V., & Nieuwdorp, M. (2021). The Role of the Gut Microbiota on the Beneficial Effects of Ketogenic Diets. Nutrients, 14(1), 191. https://doi.org/10.3390/nu14010191
- Lenhart, A., & Chey, W. D. (2017). A Systematic Review of the Effects of Polyols on Gastrointestinal Health and Irritable Bowel Syndrome. Advances in Nutrition, 8(4), 587-596. https://doi.org/10.3945/an.117.015560
- DiNicolantonio, J. J., & Berger, A. (2016). Added sugars drive nutrient and energy deficit in obesity: A new paradigm. Open Heart, 3(2). https://doi.org/10.1136/openhrt-2016-000469
- Wong, W. M. (2016). Restriction of FODMAP in the management of bloating in irritable bowel syndrome. Singapore Medical Journal, 57(9), 476-484. https://doi.org/10.11622/smedj.2016152
- Park, Y., Subar, A. F., Hollenbeck, A., & Schatzkin, A. (2011). Dietary fiber intake and mortality in the NIH-AARP Diet and Health Study. Archives of Internal Medicine, 171(12), 1061. https://doi.org/10.1001/archinternmed.2011.18
- Forootan, M., Bagheri, N., & Darvishi, M. (2018). Chronic constipation: A review of literature. Medicine, 97(20). https://doi.org/10.1097/MD.0000000000010631
- Kreitzman, S. N., Coxon, A. Y., & Szaz, K. F. (1992). Glycogen storage: Illusions of easy weight loss, excessive weight regain, and distortions in estimates of body composition. The American Journal of Clinical Nutrition, 56(1 Suppl), 292S–293S. https://doi.org/10.1093/ajcn/56.1.292S
- Foley, A., Burgell, R., Barrett, J. S., & Gibson, P. R. (2014). Management Strategies for Abdominal Bloating and Distension. Gastroenterology & Hepatology, 10(9), 561-571. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4991532/
- Ho, S., Mei Tan, C. Y., Mohd Daud, M. A., & Seow-Choen, F. (2012). Stopping or reducing dietary fiber intake reduces constipation and its associated symptoms. World Journal of Gastroenterology: WJG, 18(33), 4593-4596. https://doi.org/10.3748/wjg.v18.i33.4593
- Korczynska, J., Czumaj, A., Chmielewski, M., Swierczynski, J., & Sledzinski, T. (2021). The Causes and Potential Injurious Effects of Elevated Serum Leptin Levels in Chronic Kidney Disease Patients. International Journal of Molecular Sciences, 22(9). https://doi.org/10.3390/ijms22094685
- Haynes, W. G., Sivitz, W. I., Morgan, D. A., Walsh, S. A., & Mark, A. L. (1997). Sympathetic and cardiorenal actions of leptin. Hypertension, 30(3), 619-623. https://doi.org/10.1161/01.HYP.30.3.619
- Harvey, C., Schofield, G. M., Williden, M., & McQuillan, J. A. (2017). The Effect of Medium Chain Triglycerides on Time to Nutritional Ketosis and Symptoms of Keto-Induction in Healthy Adults: A Randomised Controlled Clinical Trial. Journal of Nutrition and Metabolism, 2018(1), 2630565. https://doi.org/10.1155/2018/2630565
With gratitude,
Martha Carlin, is a “Citizen Scientist”,
systems thinker, wife of Parkinson’s warrior, John Carlin, and founder of The BioCollective , a microbiome company expanding
the reach of science and BiotiQuest, the first of it’s kind probiotic line. Since John’s diagnosis in 2002,
Martha began learning the science of agriculture, nutrition, environment, infectious disease, Parkinson’s
pathology and much more. In 2014, when the first research was published showing a connection between the gut
bacteria and the two phenotypes of Parkinson’s, Martha quit her former career as a business turnaround expert
and founded The BioCollective to accelerate the discovery of the impact of gut health on all human disease. Martha was a speaker at the White House 2016 Microbiome Initiative launch, challenging the scientific
community to “think in a broader context”. Her systems thinking background and experience has led to collaborations
across the scientific spectrum from neuroscience to engineering to infectious disease. She is a respected out of the
box problem solver in the microbiome field and brings a unique perspective to helping others understand the
connections from the soil to the food to our guts and our brains.
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