Which of the following is a potential complication of long-term ketosis?

Long-term ketosis, a metabolic state often induced by very low carbohydrate diets, has been associated with various health impacts, among which osteoporosis stands out as a potential complication. When the body is in a state of ketosis, the reliance on fat for energy may lead to alterations in mineral metabolism and vitamin D activity, both crucial for maintaining bone health. Sustained low carbohydrate intake can also affect the absorption and utilization of calcium and magnesium, resulting in diminished bone density over time. This could theoretically contribute to an increased risk of osteoporosis, characterized by weakened bones and higher susceptibility to fractures.

In contrast, while hypertension, weight gain, and increased blood sugar levels can be associated with dietary changes, they are not directly linked to the state of prolonged ketosis in the same way. Ketogenic diets have, in fact, been shown to have a variable effect on blood pressure and often result in weight loss initially, while blood sugar levels tend to stabilize or decrease in ketosis due to lower carbohydrate intake. Understanding these nuances helps in recognizing osteoporosis as a key concern in the context of long-term ketosis.