Constipation is the rule–as virtual elimination of dietary carbohydrates also means virtual elimination of prebiotic fibers that nourish bowel flora. Over time, this leads to metabolic distortions including a drop in HDL cholesterol, rise in triglycerides, rise in small LDL particles that lead to heart disease, rise in insulin resistance and blood sugar, rise in blood pressure, even if these parameters initially improved on the diet. This is also due to dysbiosis and lack of prebiotic fibers. While this has not yet been tracked in children, in adults we can expect that these distortions in bowel flora will, over time, also lead to heightened inflammation (bowel and elsewhere), diverticular disease (.e.g., diverticulitis), and colorectal cancer. Yes: prolonged ketosis can add substantially to risk for colon cancer. Other peculiar gastrointestinal complications of prolonged ketosis have also been observed, such as protein-losing enteropathies.
If you’re wondering why iron is at risk on a meat-based diet, hear me out. Many grain foods provide a considerable amount of iron, because wholegrains naturally contain iron in their inner layer called the ‘germ’. Another reason is that some grain products can have iron added to them during manufacturing. So, once you cut grains out, your iron status could suffer, which can lead to unpleasant symptoms like tiredness and lethargy. It can even compromise your immune system.