What is the ketogenic diet exactly? The classic ketogenic diet is a very low-carb diet plan that was originally designed in the 1920s for patients with epilepsy by researchers working at Johns Hopkins Medical Center. Researchers found that fasting — avoiding consumption of all foods for a brief period of time (such as with intermittent fasting), including those that provide carbohydrates — helped reduce the amount of seizures patients suffered, in addition to having other positive effects on body fat, blood sugar, cholesterol and hunger levels. (1)
Remember, the point of the ketogenic diet is to enter ketosis by limiting your carbohydrate intake to about 5% of your total calorie needs and consuming about 75% of your calories in the form of fats. Vegetables and fruits naturally contain carbohydrates, and the ones included in the list above are lower in carbohydrates while not skimping on nutrients.
Everyone has to find their nutritional sweet spot for producing enough ketones and staying in ketosis, but “the core principle of the diet is to keep carbohydrate intake low enough, so your body continues producing ketones at elevated levels,” says Volek. “Your body adapts to this alternative fuel and becomes very efficient at breaking down and burning fat.”
“I started a low-carb, high-fat diet for myself in an attempt to treat my own health problems. Since then, I have seen significant health benefits not only in myself but also in many of my patients using a LCHF/ketogenic approach. Diet Doctor gives a simple but very effective evidence-based resource that I confidently recommend to all my patients. And the recipes are great!”
A ketogenic diet helps control blood sugar levels. It is excellent for managing type 2 diabetes, sometimes even leading to complete reversal of the disease. This has been proven in studies. It makes perfect sense since keto lowers blood-sugar levels, reduces the need of medications and reduces the potentially negative impact of high insulin levels.
I have been on the Keto diet for approximately 2 months. I have lost 18 lbs, but have about 20 more to lose. I definitely notice certain foods, even tho they are Keto friendly stall my weight loss. I am feeling a lot better about myself already and don’t see a reason why I won’t be able to stick with this diet. However, I am stressing about what I will eat on Thanksgiving being that my family does not follow my same eating habits.
In fact, once all our our reserved glucose/glycogen runs out after several days on a low-carb, keto diet, our bodies create compounds called ketone bodies (or ketones) from our own stored body fat, as well as from fats in our diet. In addition, researchers have discovered that ketones contain main benefits, such as fat loss, suppressing our appetites, boosting mental clarity and lowering the risk for a number of chronic diseases.
Most people will choose to begin their carb-up on Friday night and end it before bed on Saturday. This is usually most convenient as it's when you are off of work and can relax and enjoy the process. If you aren't overly concerned with fat loss and are just using this diet as a way to maintain blood sugar levels, you can likely eat whatever carbohydrate foods you like during this period. If you are worried about fat gain though, then you need the math. 

Before starting, ask yourself what is really realistic for you, Mattinson suggests. Then get your doctor’s okay. You may also work with a local registered dietitian nutritionist to limit potential nutrient deficiencies and talk about vitamin supplementation, as you won’t be eating whole grains, dairy, or fruit, and will eliminate many veggies. “A diet that eliminates entire food groups is a red flag to me. This isn’t something to take lightly or dive into headfirst with no medical supervision,” she says.
We know now that plaque formation is a culmination of inflammation at the plaque formation site along with a white blood cell mediated interaction between calcium, cholesterol and other biological substances. In fact, it is thought that cholesterol is actually used by the body as a kind of internal bandage when our arterial lining becomes damaged by inflammation. This means that cholesterol build up in the arteries may actually be a protective mechanism.
Yes, you'll lose weight but only because you're consuming fewer calories. There's no real magic to the keto diet. The weight-loss equation remains the same: You lose weight when you consume fewer calories than you use each day. You're not burning more fat than other diets, or at a faster rate. On the keto diet, you eat high-fat meals with protein, which keeps you feeling full for longer and cuts down on your overall eating throughout the day.

Your dietary needs change dramatically with keto. Sodium becomes a critical nutrient, as do magnesium and potassium. “At least in the initial stages of being on the keto diet, you will urinate more. One of the key electrolytes lost through urination is magnesium,” says Carolyn Dean, MD, ND, a health and nutrition expert and author of The Magnesium Miracle. “Magnesium is an energy mineral, which will help you burn fat and lose weight.”


The keto diet is so restrictive, it's difficult to sustain over time. Only people who are truly devoted can maintain that level of diligence when it comes to meal planning, nutrient tracking and eating out. So after losing the weight, most people go back to their old eating habits. Unfortunately, the vast majority of people who try fad diets end up gaining the weight back because they haven't really found a new way to live.
Thank you for your wonderful informational website.  I've been following ketogenics since Sept 2017 and I've now lost 31 pounds on Keto, but also lost an additional 10 pounds prior to changing to low carb, no sugar ketogenics.  It has been a long time since I've not lived to eat.  It seemed that prior to my weight loss I was always hungry and ate for no good reason.  Now all has changed.  I do not eat processed foods at all only green veggies.  Thanks for all the recipes and "how to" information.
Frederick F. Samaha, M.D., Nayyar Iqbal, M.D., Prakash Seshadri, M.D., Kathryn L. Chicano, C.R.N.P., Denise A. Daily, R.D., Joyce McGrory, C.R.N.P., Terrence Williams, B.S., Monica Williams, B.S., Edward J. Gracely, Ph.D., and Linda Stern, M.D., “A Low-Carbohydrate as Compared with a Low-Fat Diet in Severe Obesity,” N Engl J Med 2003; 348:2074-2081. http://www.nejm.org/doi/full/10.1056/NEJMoa022637.
I was low carb mostly do to a gluten intolerance, and I began losing a lot of weight. I decided to try the Keto diet since I still had a lot further to go. Started at 210 lb and initially lost 30 lb. After going Keto I got down to 160 lb within a short amount of time.(Short compared to how long I had struggled to lose fat years prior on other diets.)
The ketogenic diet is indicated as an adjunctive (additional) treatment in children and young people with drug-resistant epilepsy.[26][27] It is approved by national clinical guidelines in Scotland,[27] England, and Wales[26] and reimbursed by nearly all US insurance companies.[28] Children with a focal lesion (a single point of brain abnormality causing the epilepsy) who would make suitable candidates for surgery are more likely to become seizure-free with surgery than with the ketogenic diet.[9][29] About a third of epilepsy centres that offer the ketogenic diet also offer a dietary therapy to adults. Some clinicians consider the two less restrictive dietary variants—the low glycaemic index treatment and the modified Atkins diet—to be more appropriate for adolescents and adults.[9] A liquid form of the ketogenic diet is particularly easy to prepare for, and well tolerated by, infants on formula and children who are tube-fed.[5][30]
A related clinical diet for drug-resistant epilepsy is called the medium-chain triglyceride ketogenic diet, in which MCT oil is extensively used because it’s more ketogenic than long-chain triglycerides. (13) Another dietary therapy for epilepsy called Low Glycemic Index Treatment (LGIT) was developed in 2002 as an alternative to the keto diet. LGIT monitors the total amount of carbohydrates consumed daily, and focuses on carbohydrates that have a low glycemic index.) (14)

One area where food tracking can be especially helpful, though, is ensuring that you're hitting the right ratios of macronutrients—protein, carbs, and fat. "The most researched version of the ketogenic diet derives 70 percent of calories from healthy fats, 20 percent from protein, and only 10 percent from carbs," explains Charles Passler, D.C., nutritionist, and founder of Pure Change. "In the ideal world, each keto meal and snack should have that same (70/20/10) ratio of macronutrients, but studies have shown that you'll still achieve great results even if each meal varies slightly from that ratio, just as long as you don't exceed 50 grams per day of carbs, or eat those carbs in one sitting," says Passler. In order to achieve these ratios without a preset meal plan from a dietitian or doctor, some food tracking is probably going to be necessary. But once you get the hang of things, you may not need it anymore.
Thank you, Dr. Jockers. I really appreciate your reply. I was wondering if insulin resistance would make my cholesterol go up on the ketogenic diet from a total of 220 before I went on it to 378 after being on it for six months. I have always been in a healthy weight range for my height, but I have always been extremely hungry most of the time. I really got on the ketogenic diet hoping that this would be regulated after being on it for some time, but it hasn’t helped that much. Would this signify that insulin resistance may be the culprit for my sudden rise in cholesterol even though I am following the ketogenic diet perfectly?

Nurse practitioners (NP) are advanced practice registered nurses that manage acute and chronic medical conditions, both physical and mental, through history and physical exam and the ordering of diagnostic tests and medical treatments. NPs are qualified to diagnose medical problems, order treatments, perform advanced procedures, prescribe medications, and make referrals for a wide range of acute and chronic medical conditions within their scope of practice. Their education includes a Bachelor of Science in Nursing (BSN) or other undergraduate degree, and requires a license as a registered nurse (RN) and experience as an RN in a health care setting. They must graduate from an accredited graduate (MSN) or doctoral (DNP) program and achieve a board certification.
Hey Patricia, you definitely want to fill up on fat and make that the majority of your calories. Fat is very satiating so you will probably get fuller, faster compared to when you would eat carbs. However, if you are eating an excessive amount of fat (past your satiety level) than it has to go somewhere and anything in extreme excess will be most likely be stored in your body as body fat. I recommend eating to satiety and if you are not seeing results, you may have to track your consumption for a few weeks so you have a better idea of how much you’re consuming and what works best for your goals. Our macro calculator can help get you started with that if you’d like: https://perfectketo.com/keto-macro-calculator/
^ St Jeor ST, Howard BV, Prewitt TE, Bovee V, Bazzarre T, Eckel RH (October 2001). "Dietary protein and weight reduction: a statement for healthcare professionals from the Nutrition Committee of the Council on Nutrition, Physical Activity, and Metabolism of the American Heart Association". Circulation. 104 (15): 1869–74. doi:10.1161/circ.104.15.1869 (inactive 15 February 2019). PMID 11591629. These diets are generally associated with higher intakes of total fat, saturated fat, and cholesterol because the protein is provided mainly by animal sources. ... Beneficial effects on blood lipids and insulin resistance are due to the weight loss, not to the change in caloric composition. ... High-protein diets may also be associated with increased risk for coronary heart disease due to intakes of saturated fat, cholesterol, and other associated dietary factors.
“I am a family physician and co-author of the book The Diabetes Diet. I have been advocating a low-carb diet for patients for the last 16 years — for weight loss weight, cardiac risk reduction, and better blood sugar control in type 1 and 2 diabetes. The diet enables patients with type 1 diabetes to reduce their insulin needs, while patients with type 2 diabetes on insulin may be able to eliminate the drug completely. I leave the choice as to whether the diet needs to be ketogenic or not up to patients, depending on their motivation and goals.”

Carrie, I highly recommend a support group. I personally know a woman “Amanda Rose” who recently lost half her body weight through the Keto Diet and intermittent fasting. You should totally join her Facebook Group. It’s called “Eat Like a Bear” and you can find it by entering the group’s name in the Facebook search bar. She is so amazing and so supportive for people struggling to lose the weight.
While in ketosis, your body effectively uses fat for fuel. In general, the daily intake of net carbs required to enter ketosis could vary from 20 to 100 grams per day. Most people, who have experienced ketosis, claim to have reached that state at about 20-50 grams of net carbs per day. I'd suggest you start at 20-30 grams and see how you can adjust it for your needs.
Twenty calories a day times the 365 days in a year comes to a little more than seven thousand calories stored as fat every year—two pounds of excess fat. If it were true that our adiposity is determined by calories-in/calories-out, then this is one implication: you only need to overeat, on average, by twenty calories a day to gain fifty extra pounds of fat in twenty years. You need only to rein yourself in by this amount—undereat by twenty calories a day—to undo it. Twenty calories is less than a single bite of a McDonald’s hamburger or a croissant. It’s less than two ounces of Coke or Pepsi or the typical beer. Less than three potato chips. Maybe three small bites of an apple. In short, not very much at all. Twenty calories is less than 1 percent of the daily caloric intake that the U.S. National Academy of Sciences has recommended for a middle-aged woman whose idea of regular physical activity is cooking and sewing; it’s less than half a percent of the daily quota of calories recommended for an equally sedentary middle-aged man. That it’s such an insignificant amount is what makes it so telling about the calories-in/calories-out idea.

I did the Atkins diet almost 20 years ago and lost weight like I had a disease! Since then I’ve put on all that was lost plus more. I’m suffering with high blood pressure (medicated control) and am at risk for diabetes. Being a truck driver lends itself to an unhealthy eating routine. I started the Keto diet a few weeks ago. Preparing my meals and reheating them in my truck. Losing weight slowly and bp is coming down nicely. I’ve noticed that these two diets look very familiar and is, to me, difficult to tell apart. Either work for weightloss and clear head. I’ve incorporated chia seeds into my routine and they help curb hunger through long boring miles. WATER WATER WATER Any high protein diet requires you to hypersaturate your system to aid your bodies flush of extra proteins.


Too many "legal" high-calorie foods can sabotage your keto diet. So can lots of other things. One way to pinpoint those potential glitches is through a food journal. One study found people who tracked everything they ate lost twice the amount of weight as those who didn't track what they ate. A food journal also keeps you honest and compliant with your keto plan.
A low-carbohydrate diet gives slightly better control of glucose metabolism than a low-fat diet in type 2 diabetes.[12][34] A 2018 report on type 2 diabetes by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) found that a low-carbohydrate diet may not be as good as a Mediterranean diet at improving glycemic control, and that although having a healthy body weight is important, "there is no single ratio of carbohydrate, proteins, and fat intake that is optimal for every person with type 2 diabetes".[35]
And good news for coffee addicts: you can still have your morning cup of joe. You’ll just need to adjust what you stir into it. Switch out flavored creamer for the real deal—full-fat heavy whipping cream, which has only 1 gram of carbs per tablespoon. If you want to give your java a jolt of sweet, stir in a low-carb sweetener that uses sugar alcohols. But if you can skip the sweet, even better. In time, you’ll retrain your palate to not crave a sugary start to the day. This is what everyone gets wrong about the keto diet.
The safest way to try a ketogenic diet is to discuss it first with your (trusted, collaborative, and evidence-based) doctor or other clinician. I urge my patients, readers, and coaching clients to start with a keto calculator (such as Maria Emmerich’s or Martin Ankerl’s). These calculators give you guidelines for macronutrients, i.e., the number of carbs, proteins, and fats to eat to get into ketosis—and adjust the recommendations based on age, activity level, and goals (such as weight loss or maintenance).
“At the Duke Diet and Fitness Center, our residential clients can choose from three levels of carb intake that happen to be aligned with the Diet Doctor’s levels of liberal low-carb, moderate low-carb and keto low-carb. The alignment is not by chance, however. It’s because we have separately come to the same conclusions after carefully and objectively reviewing the evidence and gathering information from experienced clinicians and patients. The Diet Doctor website is very unique in that regard, and a great resource for our patients!”

Whitmire recommends these because they offer omega-3 fatty acids. “Getting more of these fats will improve the ratio of omega-6s to 3s you consume, which some research suggests optimizes health,” she says. For example, an article published in September 2016 in the journal Open Heart cited research that linked consuming more omega-3s and fewer omega-6s (which are high in Western diets) to a lower risk of insulin resistance — the hallmark of type 2 diabetes — and obesity, among other protective health benefits. The USDA says 1 oz of chia seeds has 138 calories, 5 g of protein, 9 g of fat, 12 g of carbs, and a whopping 10 g of fiber (so only 2 net carbs). And also according to the USDA, 1 tbsp of ground flaxseed has 37 calories, 1 g of protein, 3 g of fat, 2 g of carbs, and 2 g of fiber (basically 0 net carbs). Just be sure to buy ground flaxseed so your body can absorb their omega-3s.

Positive science on ketosis coupled with personal successes passed by word-of-mouth have driven more people to explore the ketogenic diet, says Volek. More recently, the keto diet hints at having a promising therapeutic role in cancer, Alzheimer’s, Parkinson’s and polycystic ovary syndrome (PCOS). Research is still early in many areas, but Volek suspects there will more definitive answers on the wider scope of the diet’s benefits within the next decade.


The statistical analysis was carried out with Stata15 for Windows. The estimated sample size was based on a repeated-measures ANOVA design with a 4-level within-subject factor, taking into account weight loss after treatment and defining the next parameters: a potential correlation of ρ = 0.30 between measurements, maximum error variance σ = 300 (this value is based on the results published for the type of measures analyzed in the study), default power of 1-β = 80%, alpha level α = 5%, and delta of at least δ = 0.772 (it corresponds to an effect size between the baseline and final measurement of at least 15 kg). The sample size estimated a minimum of n = 20 participants.

Several recent studies indicate that a low-carbohydrate diet is effective at improving glycemia. A few studies have shown that in non-diabetic individuals, low-carbohydrate diets were more effective than higher carbohydrate diets at improving fasting serum glucose [13,14] and insulin [6,14-16], and at improving insulin sensitivity as measured by the homeostasis model [6]. One of these studies also included diabetic patients and noted a comparative improvement in hemoglobin A1c after 6 months (low fat diet: 0.0 ± 1.0%; low carbohydrate diet: -0.6 ± 1.2%, p = 0.06) [6] and 12 months (low fat diet: -0.1 ± 1.6%; low carbohydrate diet: -0.7 ± 1.0%, p = 0.019) duration [5]. In a 5-week crossover feeding study, 8 men with type 2 diabetes had greater improvement in fasting glucose, 24-hour glucose area-under-the-curve (AUC), 24-hour insulin AUC, and glycohemoglobin while on the low-carbohydrate diet than when on a eucaloric low-fat diet [7]. In a 14-day inpatient feeding study, 10 participants with type 2 diabetes experienced improvements in hemoglobin A1c and insulin sensitivity as measured by the euglycemic hyperinsulinemic clamp method [8]. Hemoglobin A1c also improved in an outpatient study of 16 participants who followed a 20% carbohydrate diet for 24 weeks [9].


This website is helpful I gained ten pounds just by snacking. I on the Keto diet with 15 carbs a day I stopped all snacking, stopped staying up late because it screws up cortisol / hormones which causes weight gain so I started going to bed at 9:30 on the dot. I typically eat one meal a day a green salad with either, chicken or prawns and simple homemade dressing . Sometimes I do a big glass of a low carb, a chocolate mocha protein drink with a nut milk and ice blended this does the trick. I never eat after 4:00. I have coffee with a little butter and drink lots of water I use Ketostix every other day to see if I’m still in ketosis. I did get foot cramps and increased sea salt intake and it stopped. I love fasting and going to yoga I feel clearer, lighter and just happier. Just keep with a program and you will see light at the end of the tunnel. Some people have great success with zero carbs. I have never tried it but read about it.

An interesting effect on sexual function was induced by the nutritional intervention (Table S1; Figure 4). The EMAS-SF questionnaire reported no statistically significant changes for sexual activity in men (Figure 4A). However, the FSFI questionnaire for sexual activity in women evidenced that excitation (p = 0.043) and lubrication (p = 0.013) improved with statistical significance throughout the study. Moreover, from baseline to maximum ketosis, a statistically significant increase was observed in the score for the orgasmic domain (Figure 4B; 0.95; p = 0.034). Based on the FSFI mean total score, women included in this study showed sexual dysfunction (total score = 9.55) at baseline. This total score was improved at maximum of ketosis (total score = 10.48) and at the end of the nutritional intervention (total score = 9.8).
19. Soejima E., Ohki T., Kurita Y., Yuan X., Tanaka K., Kakino S., Hara K., Nakayama H., Tajiri Y., Yamada K. Protective effect of 3-hydroxybutyrate against endoplasmic reticulum stress-associated vascular endothelial cell damage induced by low glucose exposure. PLoS ONE. 2018;13:e0191147. doi: 10.1371/journal.pone.0191147. [PMC free article] [PubMed] [CrossRef] [Google Scholar]

This is the first time I heard about Keto diet I need to lose weight because I am a diabetic 2 and high cholesterol and high blood pressure the doctor want me to do but bypass lot of people told me not to everybody was telling me about this new diet keep Keto I want to try it and I made it my goal my weight is 257 on 5 for messaging and I think this is going to be good for me I need a lot of help thank you
Ketogenic diets focus on high amounts of fat in the diet, including saturated fats, along with very restricted amounts of carbohydrates, in order to create ketones that bypass insulin resistance in brain cells and energize their metabolic functions in lieu of glucose. This has proven efficacious for other central nervous systems problems in addition to Alzheimer’s and epilepsy.
Specific fiber goals for every day will depend on your overall intake, current weight, and weight-loss intentions. Thankfully, some high-fat, low-carb foods are also loaded with fiber. These include nuts and seeds, avocado, and squash. “I see so many clients go for high protein, high saturated fat, and no carb,” says Sunny Brigham, MS, CNS, a board-certified nutrition specialist with a private clinic in North Texas. “They become constipated because they aren’t getting enough fiber.” And that’s just one of the 11 hidden dangers of the keto diet.
By design, the nutritional intervention induced an important reduction in BMI and fat mass, especially visceral fat mass through the study visits synchronized with the ketone levels in four visits (Figure 1). Thus, at the end of the nutritional intervention, the patients were out of ketosis (0.2 ± 0.1 mmol/L) with a total of 7.7 units of BMI lost (Figure 1). Most of the initial body composition loss was in the form of total fat mass (Figure 1). Relevantly, from the total fat mass, visceral fat mass, the most physiological and clinically relevant fat depot, was significantly reduced after the VLCK diet (−1.2 ± 0.7 kg; p < 0.05).
Here are a few of the most common side effects that I come across when people first start keto. Frequently the issues relate to dehydration or lack of micronutrients (vitamins) in the body. Make sure that you’re drinking enough water (close to a gallon a day) and eating foods with good sources of micronutrients. To read more on micronutrients, click here >

Hi Maya. I LOVE your site!! Interesting, informative with fab recipes and ideas. Hubby and I have just started eating low carb and I have to say, we are not finding it too difficult and I already feel sooo much better!! I find the hardest part is choosing low carb veg, I feel as if we are not eating enough. Any suggestions on how to get more veggies into our diet?
The biggest shifts in your daily habits will be how you food shop and how you cook, and recipes that are ketogenic need to be followed rather than just low-carb. You will require the healthy fats in order to get into ketosis and have enough energy without the carbs. And you will be considerably more energetic and healthier when cooking your own keto-friendly food rather than buying supposedly keto foods off the shelf.

Because visceral fat is physiologically and clinically more relevant than total FM, special emphasis was placed on its analysis. The VLCK diet led to a significant reduction in visceral fat that can be seen in assessment by either new DXA software (−1.2 ± 0.7 kg) or by MF-BIA [−60.8 ± 20.7 cm2; Fig. 2(B) and 2(C)]. Therefore, when evaluated by different methods, the VLCK diet induced a significant body weight reduction by targeting total FM and visceral FM [Fig. 2(A–C)].


This work was supported by the PronoKal Group® and by grants from the Fondo de Investigacion Sanitaria (PE13/00024 and PI14/01012 research projects) and CIBERobn (CB06/003), Instituto de Salud Carlos III–Subdireccion General de Evaluacion y Fomento de la Investigación; Fondo Europeo de Desarrollo Regional, and the Health Department of the Xunta de Galicia, Spain. D.G.A. is grateful to the Colombian Department of Science, Technology and Innovation – COLCIENCIAS as a recipient of their predoctoral scholarship to support his work. The funding sources had no involvement in the study design, recruitment of patients, study interventions, data collection, or interpretation of the results. A PronoKal representative (I.S.) was involved in the study design and revised the final version of the manuscript, without intervention in the analysis of data, statistical evaluation, or final interpretation of the results of this study.
In general, cholesterol is traditionally misunderstood. I am going to show why high cholesterol is not inherently bad, and how to lookout for some real warning signs that you are in an inflammatory state. Knowing how cholesterol works in the body and how to interpret your cholesterol numbers will empower you to move forward on your ketogenic journey with confidence.
These affect your brain and spine, as well as the nerves that link them together. Epilepsy is one, but others may be helped by a ketogenic diet as well, including Alzheimer’s disease, Parkinson’s disease, and sleep disorders. Scientists aren’t sure why, but it may be that the ketones your body makes when it breaks down fat for energy help protect your brain cells from damage.
I prescribe nutritional ketosis for my patients with brain and focus issues, such as: epilepsy, attention deficit, brain fog, traumatic brain injury, memory issues, mild cognitive impairment, Parkinson’s disease, and Alzheimer’s disease (including patients with one or two copies of the genes for Alzheimer’s, called ApoE4). Most of my patients on keto say they feel smarter, sharper, and more focused—and some may lose weight (fat) as a result of using ketones as fuel.
Most recently, Wilson et al. (27) investigated the effect of a 10-week KD on strength, body composition, blood lipids and hormonal response in resistance trained males, while following a periodized resistance training program. The investigation included a 2-week dietary adaptation period, and a control group, which followed a more traditional macronutrient ratio consisting of 55% CHO, 25% fat and 20% protein (WD). The 10-week dietary intervention was followed by a 1-week CHO re-introduction for the KD group. Average caloric consumption across the 11-week intervention was similar between groups. Blood lipids remained constant and were not significantly different between groups. The KD group did, however, elicit a significant increase in blood triglycerides during week 11, with the re-introduction of CHO. Total testosterone was significantly increased in the KD group, compared to WD, however, free testosterone was not significantly different between groups. While both groups saw increases in lean body mass, the KD group realized gains significantly greater than the WD group. Similarly, the KD group experienced significantly greater decreases in fat mass during the 10-week CHO restriction period. There were no significant differences in measures of strength or power between groups. From this, the authors concluded that the KD favorably impacted body composition, with no negative impact on blood lipids or muscular strength and power.
Just to put things in context, I read an old scientific report about a seriously obese man who decided to be without food about a year (under medical supervision) and was given only some necessary micronutrients (vitamins, minerals, etc.) during the entire period. In this case all his energy had to come from adipose tissue (plus gluconeogenesis, I assume) in deep ketosis, and eventually he lost a lot of weight, mostly fat. Even more surprisingly, repeated tests during that year and thereafter demonstrated, that his health was continuously improving and he was actually feeling very well. What would be the downside of this kind of “starvation ketosis”, that will obviously last only until the point where the person has lost all his excessive fat?
I believe you’re “breaking your fast” by having Olive oil in the morning. Anything over 5 calories will cause an insulin spike. I’ve been intermittent fasting (IF) 16:8 for 4 months and have just recently moved to try ketosis. I’m exercising in a fasted state. I lost 7kg of fat. Can’t comment on how effective Keto is yet, my understanding is it’s excellent for optimal fat burning.

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The ketone bodies are possibly anticonvulsant; in animal models, acetoacetate and acetone protect against seizures. The ketogenic diet results in adaptive changes to brain energy metabolism that increase the energy reserves; ketone bodies are a more efficient fuel than glucose, and the number of mitochondria is increased. This may help the neurons to remain stable in the face of increased energy demand during a seizure, and may confer a neuroprotective effect.[56]
Hi Cyn, The numbers are general guidelines but will vary depending on many factors, such as activity level, insulin resistance, weight and more. There is no single magic number, just conventional recommendations that are a good starting point. I will have a macro calculator coming soon that will help determine what is best for each person, but even then it’s an approximation. The only way to know for sure is to test. If keto is your goal, it’s usually best to start lower and then see if you can stay in ketosis when increasing.
White sugar, honey, and most traditional sugars are out when you’re eating keto because of the high carb counts. While many artificial sweeteners deliver sweetness sans a single carb, that doesn’t mean you should eat them, Crandall says. “We have demonized sugar—rightly so—for causing unneeded insulin spikes,” Crandall says, but “many artificial sweeteners do the exact same thing.” One study found that eating artificial sweeteners may increase cravings—especially for sweet things. This can stymie your weight-loss intentions. Discover how one woman totally kicked her sugar habit by trying the keto diet.
A keto diet works for almost anyone since you can be vegan or vegetarian and still achieve ketogenesis. As a rule of thumb, focus on foods that are naturally high in fat and avoid highly processed foods that are labeled with trans-fats as much as possible. Eat fruits that are low on the glycemic index but are still rich in fiber and, eat other foods like avocados (also for the fat) and berries. Additionally, eat lots of green, yellow and red vegetables.
Minerals/Electrolytes: Adopting a ketogenic diet will change the way your body uses (and loses) certain minerals. Not replacing these minerals can lead to symptoms of the “keto flu” such as lightheadedness, headaches, constipation, muscle cramps and fatigue. Refer to this article for tips on how to replace common minerals such as sodium, potassium, magnesium and calcium.
Too many "legal" high-calorie foods can sabotage your keto diet. So can lots of other things. One way to pinpoint those potential glitches is through a food journal. One study found people who tracked everything they ate lost twice the amount of weight as those who didn't track what they ate. A food journal also keeps you honest and compliant with your keto plan.
MF-BIA (InBody 720; Biospace, Tokyo, Japan) was also used for determining body composition in terms of FM, FM%, FFM, total body water, intra- and extracellular water, skeletal muscle mass, and ASLM. This noninvasive technology employs 8 contact electrodes, which are positioned on the palm and thumb of each hand and on the front part of the feet and on the heels. In addition, MF-BIA uses the body’s electrical properties and the opposition to the flow of an electric current by different body tissues. The analyzer measured resistance at specific frequencies (1, 5, 50, 250, 500, and 1000 kHz) and reactance at specific frequencies (5, 50, and 250 kHz). The participants were examined while lightly dressed, and the examination took less than 2 minutes and required only a standing position. The validity of this technology has been documented in previous studies (21, 22). Visceral fat area values were also calculated in cm2 by MF-BiA. Importantly, these values are significantly correlated with those generated by computed tomography (22, 23). The calculation of the different body compartments was performed according to the instructions of the manufacturer (Biospace).
Carbohydrates have been linked to this skin condition, so cutting down on them may help. And the drop in insulin that a ketogenic diet can trigger may also help stop acne breakouts. (Insulin can cause your body to make other hormones that bring on outbreaks.) Still, more research is needed to determine exactly how much effect, if any, the diet actually has on acne. 
In 1863, William Banting, a formerly obese English undertaker and coffin maker, published "Letter on Corpulence Addressed to the Public", in which he described a diet for weight control giving up bread, butter, milk, sugar, beer, and potatoes.[46] His booklet was widely read, so much so that some people used the term "Banting" for the activity usually called "dieting".[47]
^ Davies MJ, D'Alessio DA, Fradkin J, Kernan WN, Mathieu C, Mingrone G, et al. (2018). "Management of Hyperglycemia in Type 2 Diabetes, 2018. A Consensus Report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD)". Diabetes Care. 41 (12): 2669–2701. doi:10.2337/dci18-0033. PMC 6245208. PMID 30291106. Low-carbohydrate, low glycemic index, and high-protein diets, and the Dietary Approaches to Stop Hypertension (DASH) diet all improve glycemic control, but the effect of the Mediterranean eating pattern appears to be the greatest
When in the hospital, glucose levels are checked several times daily and the patient is monitored for signs of symptomatic ketosis (which can be treated with a small quantity of orange juice). Lack of energy and lethargy are common, but disappear within two weeks.[17] The parents attend classes over the first three full days, which cover nutrition, managing the diet, preparing meals, avoiding sugar, and handling illness.[19] The level of parental education and commitment required is higher than with medication.[44]

Is there a possible middle ? Where I can still lose weight, eat low carb but without having to be paranoid about electrolytes  and feeling like I'm possessed by the spirit of keto doom ? Can I up my carbs to say 50 - I don't need rice, bread and stuff I do great with just veg and protein ... but Im supposed to feel great in keto ... though I really love the benefits I hate how it makes me feel 🤔  Would love your feedback !

^ Jump up to: a b c d e f g h i j k l m n o p q r s Kossoff EH, Zupec-Kania BA, Amark PE, Ballaban-Gil KR, Bergqvist AG, Blackford R, et al. Optimal clinical management of children receiving the ketogenic diet: recommendations of the International Ketogenic Diet Study Group. Epilepsia. 2009 Feb;50(2):304–17. doi:10.1111/j.1528-1167.2008.01765.x. PMID 18823325

Our bodies are incredibly adaptive to what you put into it – when you overload it with fats and take away carbohydrates, it will begin to burn ketones as the primary energy source. Optimal ketone levels offer many health, weight loss, physical and mental performance benefits.1There are scientifically-backed studies that show the advantage of a low-carb, ketogenic diet over a low-fat diet. One meta-analysis of low-carbohydrate diets showed a large advantage in weight loss. The New England Journal of Medicine study resulted in almost double the weight loss in a long-term study on ketone inducing diets.
“After a decade of watching patients with chronic disease get sicker with traditional medical advice, discovering the effectiveness of low-carb was a breath of fresh air! My practice now focuses entirely on patients wishing to follow low-carbohydrate and ketogenic diet treatment for diabetes, hypertension, sleep apnea, and other weight-related concerns. I also use ketogenic diets for the treatment of weight-loss surgery patients who regain weight. Diet Doctor is a terrific resource for patients and for the medical students I teach in my Obesity Medicine clerkship; it has nutritionally and scientifically sound information on ketogenic lifestyles and great recipes.”

Short-term results for the LGIT indicate that at one month approximately half of the patients experience a greater than 50% reduction in seizure frequency, with overall figures approaching that of the ketogenic diet. The data (coming from one centre's experience with 76 children up to the year 2009) also indicate fewer side effects than the ketogenic diet and that it is better tolerated, with more palatable meals.[18][50]
You've selected an efficient, well-designed meal substitute system. The technology of meal substitute demands continuous and careful monitoring from experts. It can be unsafe to do this on your own, although it won't be practical to get your own personal doctor either. The best solution is to join a meal substitute program that offers an extensive solution-from providing advised items, to helping your acquire healthier habits, to aiding your persistence for a fit, energetic and healthier lifestyle.
Animal proteins (meat, fish, etc.) have very little, if any, carbs. You can consume them in moderate amounts as needed to control hunger. Overall, choose fattier cuts of meat rather than leaner ones. For example, chicken thighs and legs are preferable to chicken breasts because they contain much more fat. We’ve got quick keto diet chicken recipes to help.
Dinner: In a small sauce pan bring 2-3 cups of water to the boil. Cook a large egg in rolling boil for 5 minutes, then transfer to ice bath (a bowl with cold water and ice cubes in it). Wash and spin dry butter lettuce, top with sliced avocado and hemp seed. Serve soft boiled egg with cherry tomatoes, butter lettuce salad and mayonnaise as dressing.
Diego Gomez-Arbelaez, Diego Bellido, Ana I. Castro, Lucia Ordoñez-Mayan, Jose Carreira, Cristobal Galban, Miguel A. Martinez-Olmos, Ana B. Crujeiras, Ignacio Sajoux, Felipe F. Casanueva, Body Composition Changes After Very-Low-Calorie Ketogenic Diet in Obesity Evaluated by 3 Standardized Methods, The Journal of Clinical Endocrinology & Metabolism, Volume 102, Issue 2, 1 February 2017, Pages 488–498, https://doi.org/10.1210/jc.2016-2385
On a “strict” (standard) keto diet, fats typically provides about 70 percent to 80 percent of total daily calories, protein about 15 percent to 20 percent, and carbohydrates just around 5 percent. However, a more “moderate” approach to the keto diet is also a good option for many people that can allow for an easier transition into very low-carb eating and more flexibility (more on these types of plans below).
“After a decade of watching patients with chronic disease get sicker with traditional medical advice, discovering the effectiveness of low-carb was a breath of fresh air! My practice now focuses entirely on patients wishing to follow low-carbohydrate and ketogenic diet treatment for diabetes, hypertension, sleep apnea, and other weight-related concerns. I also use ketogenic diets for the treatment of weight-loss surgery patients who regain weight. Diet Doctor is a terrific resource for patients and for the medical students I teach in my Obesity Medicine clerkship; it has nutritionally and scientifically sound information on ketogenic lifestyles and great recipes.”
Achieving optimal ketosis hinges on finding the right balance of macronutrients (or “macros” in keto-speak); these are the elements in your diet that account for the majority of your calories, a.k.a. energy—namely, fat, protein, and carbohydrates. By the way, it’s often “net grams” of carbohydrates that are counted toward your daily intake; “net” deducts the amount of fiber in a food from its carbohydrate total.

“As an emergency medicine and weight-loss physician, I strive to support my patients’ long-term success in weight-loss and wellness. After losing 30 pounds myself using a low-carb, healthy-fat diet and intermittent fasting, I now feel compelled to share this lifestyle with others. In the ER, patients present with concerns and complications stemming from their dietary choices; I use this as an opportunity to educate them on dietary and lifestyle changes. In my weight-loss clinic, I recommend a personalized low-carb and intermittent fasting plan. The Diet Doctor website is an easy, effective, informative resource that complements my patient care.”
Anecdotally speaking, people do lose weight on the keto diet. Heather Wharton, a 35-year-old business relationship manager from Tampa, Florida, lost 140 pounds since starting the keto diet in January 2016: “I plan on being on the keto diet for the rest of my life,” says Wharton. “My husband and I consider ourselves to be food addicts, and the keto diet is what we use as a form of abstinence from trigger foods that have sugar and other carbohydrates." A typical day of eating for Wharton includes coffee with a protein supplement, a cup of unsweetened cashew milk, cauliflower rice with ground turkey and liquid aminos (a carb-free substitute for soy sauce), spinach, six slices of turkey bacon, six eggs, and a little salsa.
I’ve used the Atkins diet for almost 3 months now. Averaging 3/4 pounds a week loss. Never hungry and sometimes replace a meal with an Atkins shake (I make my own: One shake over ice, add 1/4 cup of heavy cream, one Splenda pack, stir and enjoy. Tastes like a milkshake! Carbs, 1 or 2. SECRET TO THE ATKINs DIET- YOU MUST drink your water! I also trim most of the fat off my meat and seldom eat bacon. Dairy – low/0 carb cheeses, mayo, some sour cream. I make wonderful veggie quiche (no crust) and a bread pudding quiche that everyone steals! Salad dressing is a breeze with mayo, mustard and Splenda. Zero carb (maybe 1/2 gram) & tastes like honey mustard. And, boy, if you could have one of my egg-batter, ham & cheese sandwiches. . .it’s to die for! I keep a bowl of steamed veggies in the fridge. Dipping in dressing makes a great snack. Atkin’s bars are a delicious way to get your sweets.I cut them up and nibble during the day. They also sell low carb breads now, very expensive, but the cost makes up for what I’m NOT buying to eat. Weight keeps dropping off, I feel great AND, every time I think of having a bowl of ice cream, I run to the closet and look at all the pretty clothes that soon I can wear again. Then I ‘strip’ and look in the mirror! Yikes! YOU TELL ME WHAT’S BETTER: being ‘fat’ or looking great? I was a model before gaining weight (due mostly to illness) and every pound I lose is totally worth it. I DON’T CARE WHAT ‘THEY’ SAY . . . ‘fat’ isn’t pretty, or acceptable. It’s your road to an early death and every organ in your body is suffering and struggling everyday. Lastly –
I’m discouraged to see that nowhere in the article nor in the comments is there a mention of a diet’s best fit to genetics. Consider if someone is an APOE E2 carrier and/or has certain polymorphisms of the APO5 gene. These are quite rare in Okinawa but much more prevalent in the USA (12% of the population). According to a number of well-designed studies, these genetic characteristics point to a higher fat, lower carbohydrate diet as beneficial and even a “moderate” carb diet as problematic.
The safest way to try a ketogenic diet is to discuss it first with your (trusted, collaborative, and evidence-based) doctor or other clinician. I urge my patients, readers, and coaching clients to start with a keto calculator (such as Maria Emmerich’s or Martin Ankerl’s). These calculators give you guidelines for macronutrients, i.e., the number of carbs, proteins, and fats to eat to get into ketosis—and adjust the recommendations based on age, activity level, and goals (such as weight loss or maintenance).
No diet plan fits all and not everybody can follow a very low-carb diet. Even Dr Volek and Dr Phinney noted that there is not enough evidence that a very low-carb diet (such as less than 20 g net carbs) is beneficial for those with preexisting thyroid or adrenal conditions. Dr. Broda Barnes, who spent over 50 years on thyroid research, suggested in his book “Hypothyroidism: The Unsuspected Illness”, that the minimum amount of carbohydrate intake for patients with hypothyroidism should be at least 30 grams of net carbs.
Tallon, these suggestions are meant to be taken one at a time. If you’ve hit a plateau or are struggling with weight loss, you can try to cut back on your protein. If that doesn’t provide results than maybe that wasn’t the culprit..now try cutting back on dairy, see what happens with that. It’s all about finding what works for you. If you cut out everything at once, you’ll never know which one was causing the issue. Hope that makes sense.
We are brazilian, living in Brazil. My daughter, Isabel, 21y. o., born in 1996, has syndrome of deficiency of Glut1. She was diagnosed around her first year of life. At that time her baby bottle, her begining diet meal, was 50ml water plus 50ml oil plus vitamin. Since then, which means, for 20 years, she is under this diet. For almost 18 years under 4:1 proportion. At this right moment 3:1. The only problem she had since started the diet were kidney stones in 2002. Nothing else. Grateful to the diet she doesn’t take any kind of medicine to avoid seizures. Her health is perfect, no colesterol at all. We are at your will for any issues related to her health.
Blood specimens were obtained at weeks 0, 8, and 16 after the participant had fasted overnight. The following serum tests were performed in the hospital laboratory using standardized methods: complete blood count, chemistry panel, lipid panel, thyroid-stimulating hormone, and uric acid. A non-fasting specimen was also drawn at weeks 4 and 12 to monitor electrolytes and kidney function.
The following measurements were made every other week: anthropometric and vital sign measurements; urine testing for ketones; and assessment for hypoglycemic episodes and other symptomatic side effects. Weight was measured on a standardized digital scale while the participant was wearing light clothes and shoes were removed. Skinfold thickness was measured at 4 sites – the average of 2 measurements at each site was entered into an equation to calculate percent body fat [12]. Waist circumference was measured at the midpoint between the inferior rib and the iliac crest using an inelastic tape; 2 measurements were averaged in the analysis. Blood pressure and heart rate were measured after the participant had been seated quietly without talking for 3 minutes. Certified laboratory technicians assessed urine ketones from a fresh specimen using the following semi-quantitative scale: none, trace (up to 0.9 mmol/L [5 mg/dL]), small (0.9–6.9 mmol/L [5–40 mg/dL]), moderate (6.9–13.8 mmol/L [40–80 mg/dL]), large80 (13.8–27.5 mmol/L [80–160 mg/dL]), large160 (>27.5 mmol/L [160 mg/dL]). Hypoglycemic episodes and symptomatic side effects were assessed by direct questioning of the participant and by self-administered questionnaires.
I actually went on a ketogenic diet last year to see if it would help my migraines. I have a history of chronic migraines which would usually last 3 days, sometimes longer. Triptans help a lot but I don’t like having to take them. I stayed in ketosis for about 8 months and experienced a significant reduction in migraines, from feeling some type of headache (mild o r severe) almost everyday to 1 or 2x per month while in ketosis. Although I’m very healthy otherwise, I do think my migraines may have something to do with blood sugar fluctuations (despite previously eating a whole foods diet and no refined carbs), and keto totally stabilized this. I eventually came off of Keto because I’m not really a meat lover. When I came off, but remained low carb, my migraines stayed under control for the most part. When I increase carbs, they do return.
It's not the easiest plan to follow, but the theory of ketosis as a possible prevention against disease is gaining attention from cancer specialists. Tumor immunologist Dr. Patrick Hwu, one of the leading cancer specialists in the U.S., has followed the keto diet for four years, although he prefers to call it the fat-burning metabolism diet, or fat-burning diet. More research is needed to prove its benefits, but Hwu, the head of cancer medicine at MD Anderson in Houston, believes in it after seeing improvements in his own health.
We’re going full on fats with breakfast, just like we did last week. This time we’ll double the amount of ketoproof coffee (or tea) we drink, meaning we double the amount of coconut oil, butter, and heavy cream. It should come to quite a lot of calories, and should definitely keep us full all the way to dinner. Remember to continue drinking water like a fiend to make sure you’re staying hydrated.
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