The keto diet — when you consume very few carbohydrates and a large amount of fats — can result in heart rhythm disorders in some people. The link between the keto diet and heart arrhythmia has been documented in medical research.
Although a keto diet can be an effective way to lose weight for some people, those considering the diet should also consider its potential effects on their cardiovascular system.
What is the keto diet?
“Keto” is short for “ketogenic,” which means the diet promotes ketosis. Ketosis is a state of the body where higher levels of molecules called ketones are found in your blood or urine.
The body produces ketones when there is low availability of blood sugar (glucose). In this case, the body starts burning fat instead of glucose for energy.
Originally, the diet was promoted as a way to reduce epileptic seizures in children, and it still can be used for this purpose. More recently, it has also been used widely for weight loss.
In the keto diet, people get a very low amount of their daily calories from carbohydrates. Carbohydrates include grains, fruits, and starchy vegetables. Getting the body to create ketones is not easy. It requires eating fewer than 50 grams of carbs per day.
Instead of carbs, a keto diet requires consuming a high amount of fat. This includes unsaturated fats like nuts, avocados, and tofu, but it can also include saturated fats from beef, pork, bacon, and oils like palm oil.
Fruits and vegetables contain carbs, so a limited amount of these food groups are allowed on a keto diet. Berries, leafy greens, broccoli, bell peppers, cucumbers, asparagus, onions, garlic, mushrooms, celery, and summer squashes are allowed in small amounts.
In addition to the concerns about heart arrhythmia, some people in the medical field are concerned about the high levels of saturated fats and the low levels of vitamin-rich vegetables and fruits necessary to maintain a keto diet.
Can it cause arrhythmia?
Atrial fibrillation (AFib) is a common type of heart arrhythmia where the heart beats irregularly, leading to palpitations, fatigue, and in some cases more serious conditions like stroke and heart failure.
A study presented in 2019 analyzed the health records of nearly 14,000 people and tracked their daily intake of 66 different food items.
Those with a low carbohydrate intake (less than 44.8 grams per day) were 18% more likely to develop AFib than those with just a moderate intake of carbohydrates (between 44.8 and 52.4 grams per day).
Two of the potential reasons for this link are inflammation and oxidative stress.
Vegetables, fruits, and grains help the body reduce inflammation. Because people on a keto diet tend to eat fewer of these types of foods, they may have more inflammation in their body — and inflammation is known to be associated with AFib.
Oxidative stress, a condition in which there are too many free radicals and not enough antioxidants to get rid of them, has also been linked to AFib. Consuming more proteins and fats is a known cause of oxidative stress in the body.
It’s important to note that though there is clearly a link between the keto diet and arrhythmia, there has not been enough research to show cause and effect. This means it’s not confirmed that the keto diet actually leads to arrhythmia. Plus, research in more diverse populations is needed.
That said, it’s best to use caution when considering these types of low carbohydrate diets. A healthcare professional can advise you on the best dietary patterns for you.
Treatments for arrhythmia
The first step is to treat the cause of the heart arrhythmia to keep it from getting worse. If a doctor determines that the keto diet may be a contributing factor, they may recommend that you stop the diet.
To manage the arrhythmia, the doctor might prescribe medications. These can include beta blockers, such as metoprolol (Lopressor), and calcium channel blockers, like verapamil (Verelan), to slow the heart rate. Digoxin (Lanoxin) is commonly prescribed to treat AFib.
More invasive treatments may include cardioversion, where an electric shock is used to restore your usual heart rhythm, or cardiac ablation, in which a catheter is used to burn or freeze a portion of the heart where arrhythmias originate.
Alternatives to the keto diet
The 2020–2025 Dietary Guidelines for Americans recommend carbohydrates make up 45%–65% of total daily calorie intake. This is particularly true for active people. That’s because carbohydrates provide energy to all cells in the body, as well as dietary fiber.
This intake should be balanced with fiber-rich foods, such as whole grains, vegetables, fruits, beans, and peas. People who can tolerate dairy products can also get a nutrient-dense source of carbohydrates from cheese, milk, and yogurt.
People who have a more sedentary lifestyle should consider decreasing caloric carbohydrates to maintain a healthy weight. This does not require decreasing them to keto levels. Instead, you can balance carbs with vegetables and low fat proteins.
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Summary
Though more scientific study is needed, a relationship between the keto diet and heart arrhythmia has been noted within the medical field. That’s because getting the body into a state of ketosis requires low levels of carbohydrates, which actually help manage inflammation and oxidative stress.
People concerned about heart arrhythmia should switch to a balanced diet that includes vegetables, low fat proteins, and complex carbohydrates like oats, quinoa, and whole grains.
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