From the Guidelines
Frequent bowel movements during the first week of a keto diet are common and typically result from your body adjusting to the significant change in macronutrients. This digestive disturbance, sometimes called "keto diarrhea," often occurs because the high fat content of the diet can temporarily overwhelm your digestive system, particularly your gallbladder and pancreas, which must produce more bile and enzymes to process the increased fat 1. Additionally, many people on keto consume sugar alcohols in low-carb products, which can cause digestive issues, or they may not be getting enough fiber after eliminating many carbohydrate-rich foods.
Some key points to consider when starting a keto diet include:
- The ketogenic diet is a low-carbohydrate, normal protein, high-fat dietary approach designed to induce a metabolic state called ketosis, where the body primarily utilizes fat for energy production 1
- The diet typically leads to a significant reduction in carbohydrate intake, which in turn causes the body to release stored glycogen, and as glycogen is depleted, the body also loses water weight 1
- Monitoring changes in body composition variables, such as fluid changes and skeletal muscle mass, is crucial to understanding short-term shifts in weight and hydration status 1
To manage frequent bowel movements on a keto diet, consider the following:
- Ensure you're staying well-hydrated
- Gradually increase your fat intake rather than making a sudden change
- Incorporate fiber-rich low-carb vegetables
- Limit sugar alcohols
- Consider taking a probiotic supplement If symptoms persist beyond two weeks or are particularly severe, consult with a healthcare provider as this could indicate a more serious issue requiring medical attention.
From the Research
Frequent Bowel Movements on the Keto Diet
- The keto diet has been shown to cause a rapid and sensible weight loss along with favorable biomarker changes, such as a reduction in serum hemoglobin A1c in patients with diabetes mellitus type 2 2.
- However, there is limited evidence directly addressing the issue of frequent bowel movements on the keto diet.
- Some studies have investigated the effects of the keto diet on weight loss, cardiovascular risk factors, and body composition, but have not specifically reported on bowel movement frequency 3, 4.
- Other studies have focused on the therapeutic potential of the keto diet for neurodegenerative diseases and depression, but have not addressed the topic of bowel movements 5, 6.
- Overall, there is a lack of direct evidence to explain why frequent bowel movements may occur on the keto diet, and further research is needed to fully understand this phenomenon.