“As a family physician in the most obese state in the USA, I see the devastation of type 2 diabetes and metabolic disease in almost every hospital patient I see. For six years, I have been using education and a low-carb lifestyle to help these patients get healthier, reduce meds, gain energy, and lose belly fat. They learn that this is a sustainable life plan filled with joy and good food. Every day I share the amazing resource of Diet Doctor in my practice. Together as a global community we can put these conditions in remission and prevent them all together.”
Makes social gatherings harder. Dining out at restaurants will require more planning and research due to hidden carbs on restaurant menus. Attending birthday parties, weddings, and other social events will require more self-discipline. If you want to drink alcohol, you’ll have to limit yourself to one or two low-carb drinks. This means dry wines (the dryer the better!) and unflavored clear liquors, such as vodka, gin, and tequila. There are a surprisingly number of keto-friendly alcoholic beverages that won’t knock you out of ketosis. For dessert, dark chocolate (at least 70% cocoa) is okay in moderate amounts. Stick to keto-friendly chocolates that are naturally sweetened with zero-calorie sweeteners such as stevia and erythritol. You can have sugar-free candies on occasion, just be aware that the sugar alcohols may cause digestive discomfort if you have too much.

The understanding of “What is a Keto Diet” has become blurred thanks to the proliferation of Keto Diet “experts”. Many of these “experts” recommend several variants of Keto Diet and lifestyles which they claim can be modified to any walk of life. However, in most instances what they are actually recommending are Low-Carb lifestyle programs. These are neither weight loss programs, nor Ketogenic. With that said, there’s nothing wrong with adopting a Low-Carb lifestyle, but if your goal is weight loss, then changing your eating lifestyle should come after you’ve achieved your weight loss goals.
“As a board certified physician practicing internal and obesity medicine, I reclaimed my health and lost over 150 pounds by ignoring conventional medical advice. I now focus on diabetes, hypertension and lipid management through lifestyle and dietary modifications whenever possible. As well as seeing patients in my clinic, I provide remote consultations via tele-medicine software and equipment, utilizing remotely-tracked bio-impedance scales, blood pressure cuffs and continuous glucose monitoring devices.”
“The growing scientific evidence is robust that the low-carb, ketogenic diet is safe and effective, especially for the management and reversal of type 2 diabetes and for weight loss. I believe that millions of people in the world might have their health improve by adopting this way of eating. Together with the growing team at Diet Doctor we aim to make low carb simple and to empower people, everywhere, to revolutionize their health. Having so many respected low-carb doctors join this page helps spread the word about this potentially life-changing way of eating.”

There are so many tricks, shortcuts, and gimmicks out there on achieving optimal ketosis – I’d suggest you don’t bother with any of that. Optimal ketosis can be accomplished through dietary nutrition alone (aka just eating food). You shouldn’t need a magic pill to do it. Just stay strict, remain vigilant, and be focused on recording what you eat (to make sure your carb and protein intake are correct).


Many unhealthy foods easily meet keto’s low-carb, high-fat criteria. However, that doesn’t mean you can or should eat them freely. “A huge benefit to following the keto diet is that the vast majority of processed food is removed with the removal of grains,” Santo says. “Unfortunately, poor-quality dairy, meat, and veggies may fill the gap.” Look for healthier sources of protein and fat, such as grass-fed meats, and limit processed dairy (think cheese singles) as much as possible.
–These easy low carb blender pancakes will brighten your morning with the sunny taste of lemons and mixed berries. A fabulous gluten-free breakfast treat. My kids all seem to have one track minds, just like their old mum. Turns out that they dream about food as much as I do. Maybe it's a hereditary trait, passed on through the genes of food-obsessed people. Or maybe it's taught when they are really young and impressionable, watching as their mother thinks and schemes and daydreams about her next meal. However it's passed on, my kids all surely have caught that bug.All Day I Dream About Food

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.

Keto runs counter to many of the low-fat diet fads of the 1980s and 1990s: It actually emphasizes fat. “That is hard to comprehend because we don’t eat anything that’s pure fat, says Kristen Mancinelli, RD, author of The Ketogenic Diet. “We don’t eat a stick of butter or a spoonful of olive oil or even a nice cup of lard. That would be unpleasant, so we really have a hard time wrapping our heads around this concept of the ketogenic diet.”
We have a super supportive group of “squeakers” over on Facebook who love helping newbies with questions and cheering on everyone’s weight loss progress and Non Scale Victories (NSV’s). Join us over there and see the radical results the SCKC is having on so many people!  And stay tuned for my new book Squeaky Clean Keto – which will include over 120 new SCKC and Whole 30 friendly recipes, and at least 4 weeks of new meal plans!
Leftovers will be another thing we will take into consideration. Not only is it easier on you, but why put yourself through the hassle to cook the same food more than once? Breakfast is something I normally do leftover style, where I don’t have to worry about it in the morning and I certainly don’t have to stress about it. Grab some food out the fridge, pre-made for me, and head out the door. It doesn’t get much easier than that, does it?

Another difference between older and newer studies is that the type of patients treated with the ketogenic diet has changed over time. When first developed and used, the ketogenic diet was not a treatment of last resort; in contrast, the children in modern studies have already tried and failed a number of anticonvulsant drugs, so may be assumed to have more difficult-to-treat epilepsy. Early and modern studies also differ because the treatment protocol has changed. In older protocols, the diet was initiated with a prolonged fast, designed to lose 5–10% body weight, and heavily restricted the calorie intake. Concerns over child health and growth led to a relaxation of the diet's restrictions.[19] Fluid restriction was once a feature of the diet, but this led to increased risk of constipation and kidney stones, and is no longer considered beneficial.[18]


A one-ounce (28-gram) serving of olives contains 2 grams of total carbs and 1 gram of fiber. This works out to a net carb count of 1 gram for 7–10 olives, depending on their size. If you don’t like olives or don’t want the net carbs they contain, then olive oil is a great option as well. Although you won’t get all of the benefits of olives by consuming olive oil, you will still get plenty of healthy fats and health-promoting compounds.

I have been on a low carb keto diet for more than a year. As T2DM my A1C dropped from 9% to 5.4% & I discontinued meds. All my lipids improved even with ample healthy saturated fat. More than a year now so I wonder why this would be a short term improvement when its obvious that I will not go back to a high A1C and taking 3 diabetes medications including sulphonylureas. It is clear from this article that you lack the necessary experience that would be gained from wholeheartedly trying the diet or monitoring patients doing it properly like me. I would be probably be facing my first amputation if I believed the negativity in your article. So for people with diabetes who may be dissuaded by your article. Ignore it and take back your health by restricting carbs (<25 g a day) or as low as you reasonably can below 130g while being satisfied that you are getting adequate nutrition.

To drill down further, there are some genetic enzyme defects that cause problems with ketosis. Here are a few of note: carnitine deficiency (primary), carnitine palmitoyltransferase (CPT) I or II deficiency, carnitine translocase deficiency, beta-oxidation defects—mitochondrial 3-hydroxy-3-methylglutaryl-CoA synthase (mHMGS) deficiency, medium-chain acyl dehydrogenase deficiency (MCAD).


For those looking for something just a little closer to real sugar, you can use Xylitol. It cooks and tastes very similar to sugar, but it has a slight glycemic impact (13 vs. 100 for sugar). It is great, but please keep in mind that it is very toxic to animals and it will raise insulin levels slightly. These are the two most cited reasons for not using Xylitol.
Getting adequate amounts of vitamins is extremely important to support healthy weight loss and overall wellness. Taking a multivitamin with synthetic ingredients has been shown to be ineffective and a complete waste of money[*]. Alternatively, consuming a high-quality greens powder made from real, nutritious whole foods rich in vitamins, minerals, antioxidants, fiber and phytonutrients is a much better way to optimize health and longevity. Check out this article for more information on supplementing with a high quality, effective greens powder.
The American Academy of Family Physicians defines low-carbohydrate diets as diets that restrict carbohydrate intake to 20 to 60 grams per day, typically less than 20% of caloric intake.[2] A 2016 review of low-carbohydrate diets classified diets with 50g of carbohydrate per day (less than 10% of total calories) as "very low" and diets with 40% of calories from carbohydrates as "mild" low-carbohydrate diets.[18] In a 2015 review Richard D. Feinman and colleagues proposed that a very low carbohydrate diet had less that 10% caloric intake from carbohydrate, a low carbohydrate diet less than 26%, a medium carbohydrate diet less than 45%, and a high carbohydrate diet more than 45%.[16]
“As a psychiatrist who practices traditional and holistic (integrative) psychiatry, I find my patients are always looking for non-pharmacological ways to improve both their psychological and physical health. Diet Doctor has proven to be an excellent and reliable resource to help my patients develop and maintain healthy lifestyle choices with low-carb and ketogenic diets. My patients are thrilled with the extensive variety of recipe options that are easy to prepare as well as the informative videos on relevant health issues. I am equally thrilled with the positive benefits in my patients’ mood, anxiety, and cognitive clarity.”
Dieters and healthy eaters are programmed to get vegetables at every meal in order to reach their daily plant quota, but Mancinelli says the cumulative total can blow through your daily net carbs. “They have vegetables in their breakfast omelet, big salads, snack on celery and carrot sticks, and have big sides of leafy greens in place of rice at dinner,” she says. “The carbs in all those vegetables add up. A few carbs here and there with cheese, nuts, and seeds, and you can really miss the mark for ketosis.” Start smart by cooking with these low-carb vegetables. 

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.
Sleep enough – for most people at least seven hours per night on average – and keep stress under control. Sleep deprivation and stress hormones raise blood sugar levels, slowing ketosis and weight loss a bit. Plus they might make it harder to stick to a keto diet, and resist temptations. So while handling sleep and stress will not get you into ketosis on it’s own, it’s still worth thinking about.
Prior to the advent of exogenous insulin for the treatment of diabetes mellitus in the 1920's, the mainstay of therapy was dietary modification. Diet recommendations in that era were aimed at controlling glycemia (actually, glycosuria) and were dramatically different from current low-fat, high-carbohydrate dietary recommendations for patients with diabetes [1,2]. For example, the Dr. Elliot Joslin Diabetic Diet in 1923 consisted of "meats, poultry, game, fish, clear soups, gelatin, eggs, butter, olive oil, coffee, tea" and contained approximately 5% of energy from carbohydrates, 20% from protein, and 75% from fat [3]. A similar diet was advocated by Dr. Frederick Allen of the same era [4].
Something that makes the keto diet different from other low-carb diets is that it does not “protein-load.” Protein is not as big a part of the keto diet as fat is. Reason being: In small amounts, the body can change protein to glucose, which means if you eat too much of it, especially while in the beginning stages, it will slow down your body’s transition into ketosis.
Changes in food craving during the very low-calorie-ketogenic diet treatment. (A) Food craving trait and state. (B) Food craving inventory. Data represent mean ± standard error of changes from baseline. (ƚ) Denotes statistically significant differences through the intervention (p for trend < 0.05) evaluated by means of repeated-measures ANOVA. (*) Denotes statistically significant differences (p < 0.05) from baseline after post-hoc pairwise comparisons employing the Tukey’s adjustment for multiple comparisons.
It seems obvious that the type of food consumed can affect energy expenditure and fat loss. Staying away from processed foods made with refined starches and added sugar is, “the road map to reducing the obesity epidemic in the United States,” said Dr. Dariush Mozaffarian, a cardiologist and dean of the Friedman School of Nutrition Science and Policy at Tufts University.
It seems strange that a diet that calls for more fat can raise “good” cholesterol and lower “bad” cholesterol, but ketogenic diets are linked to just that. It may be because the lower levels of insulin that result from these diets can stop your body from making more cholesterol. That means you’re less likely to have high blood pressure, hardened arteries, heart failure, and other heart conditions. It's unclear, however; how long these effects last.

The IWQOL-Lite, a shorter form of the original questionnaire, assesses the impact of weight on quality of life in individuals exploring treatments for weight loss. The IWQOL-Lite includes 31 statements that start with “Because of my weight…” with response options to each statement ranging from (1) “Never true” to (5) “Always true” that measure the impact of weight on 5 domains (i.e., physical function, self-esteem, sexual life, public distress, and work life). A score is calculated for each domain for each patient who answers at least 50% of the questions in any given domain. A total score is calculated if patients have responded to at least 26 out of the 31 questions. The total score is the sum of the raw scores of the 5 subscales. Raw scores (higher scores indicate poorer quality of life on the IWQOL-Lite) are converted into a T-score (0–100), with 100 representing the best possible health. Mean and standard deviations are reported for each domain [32].
The PSQI questionnaire is a clinical sleep-behavior questionnaire that has been validated for use in patients with insomnia, cancer, Parkinson’s disease, and the general population [30]. The questionnaire is designed to assess indexes of sleep during the preceding month and contains 19 questions that use Likert scales from 0–3. All questions are categorized into the following 7 subvariables: duration of sleep, sleep disturbance, sleep latency, day dysfunction because of sleepiness, sleep efficiency, subjective sleep quality, and use of a sleeping medication. Each of these 7 variables is scored between 0 and 3 arbitrary units (au), which generates a summed total score of 0–21 au. This total score is termed the global sleep score (GSS) with >5 au associated with a poor sleep condition and ≤5 au associated with a good sleep condition.
In theory, a ketogenic diet that increases carbohydrate loads for cardio exercise seems perfect. However, the side effects of a ketogenic diet can include dehydration, malnutrition and constipation. According to the Mayo Clinic website, ketogenic plans also can lead to kidney stones. In addition, the ketogenic diet does not give you the nutrition you need to be healthy. Instead, try cutting portion sizes and counting calories; this also can force your body to burn fat while still providing you with balanced nutrition, including proteins, carbohydrates, fiber and fat. As with any diet, you should discuss a ketogenic diet with your doctor.

For breakfast, we are going to change it up a bit. Here’s where we introduce ketoproof coffee. Now, don’t get me wrong – I know some of you won’t like it. If you’re not a fan of coffee, then try it with tea. If you’re not a fan of the taste (which is very rare), then try making a mixture of the ingredients by themselves and eating it like that. So, why ketoproof coffee?
I wanted to put it out there that I made this meal plan specifically with women in mind. I took an average of about 150 women and what their macros were. The end result was 1600 calories – broken down into 136g of fat, 74g of protein, and 20g net carbs a day. This is all built around a sedentary lifestyle, like most of us live. If you need to increase or decrease calories, you will need to do that on your own terms. 

Once you click the “Add to Cart” button that is right above, you will be taken to the secure checkout page. Just enter your information and then you will be given an instant access to the entire 3-Week Ketogenic Diet. You can view all the materials, the list, and the guides right on your computer, tablet, or smart phone. You could also download everything and print out as many copies as you would like. 
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.
Hi, I had a gastric bypass 8yrs ago. I’m doing the keto diet with my 16yr old son to help him lose weight and I’ve also put on 20lbs back that I’m trying to get rid off. So far we’ve lost 6lbs in 4weeks. Since I can only eat a little portion at a time and it’s hard to consume the 75% fats to get into a Ketosis stage, although I’m trying really hard but it’s impossible. Can you recommend ways to booster my fat intakes pls. Or other ways to get in to Ketosis. Thank you for all this info you’ve shared by the way.
Melinda – I’m afraid there’s no getting around the fact that one of the Keto requirements is to *calculate your macros,* based on the amount of calories you need to consume each day, in order to (a) maintain your current weight level, or (b) lose weight. Go to an online Keto macro calculator – there’s one linked to a good one on this site, further up the thread. They are generally very easy to use. Then stick to your calculated results, with trust and patience. It may be slow, but you will absolutely see results. I did – and I’ve tried absolutely everything. I barely have time to exercise, but I still lost at least a couple of dress sizes, and I feel absolutely amazing – no more brain fog, tons of energy – maybe too much energy! And best of all, I’m no longer miserable about food, because on Keto, everything is delicious! One final thing in the interest of full disclosure – I am an uber-clean-Keto advocate. I put in the work to eat only healthy fats and carbs from healthy sources. I’m pescatarian – no meats except seafood. I also carefully limit my saturated fat intake to 10% of total calories (the recommended daily allowance), to keep my genetically problematic cholesterol level from skyrocketing, as it did when I first began. This is all working well for me so far – I was able to cut 40 points from my abnormally high LDL (bad cholesterol) level within three months, And hope to get it down to normal levels in three more months. You do want to make sure you get your regular physical exams and monitor your blood work whenever you change your nutritional lifestyle. I wish you the best!
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After initiation, the child regularly visits the hospital outpatient clinic where they are seen by the dietitian and neurologist, and various tests and examinations are performed. These are held every three months for the first year and then every six months thereafter. Infants under one year old are seen more frequently, with the initial visit held after just two to four weeks.[9] A period of minor adjustments is necessary to ensure consistent ketosis is maintained and to better adapt the meal plans to the patient. This fine-tuning is typically done over the telephone with the hospital dietitian[19] and includes changing the number of calories, altering the ketogenic ratio, or adding some MCT or coconut oils to a classic diet.[18] Urinary ketone levels are checked daily to detect whether ketosis has been achieved and to confirm that the patient is following the diet, though the level of ketones does not correlate with an anticonvulsant effect.[19] This is performed using ketone test strips containing nitroprusside, which change colour from buff-pink to maroon in the presence of acetoacetate (one of the three ketone bodies).[45]
Over the long-term the KD poses possible risks as well, although the evidence remains unclear on this topic. Consumption of a high fat diet, particularly saturated fat, is associated with increased cardiovascular risk (23) and consumption of saturated fat has been shown to acutely induce insulin resistance and raise blood triglyceride levels (12). Nevertheless, many KD studies have documented improvements in markers of cardiovascular risk, including improvements in vascular function (24) reduction in inflammatory markers (10), and other markers of cardiovascular health (13,20). Methodological issues, such as clear definitions of dietary interventions, may play a significant role in obscuring the underlying principles, however, it is clear that more targeted research is warranted.
Use fat as a lever.  We’ve been taught to fear fat, but don’t! Both keto and low carb are high fat diets. Fat is our source of energy as well as satiety. The key to understand, though, is that fat is a lever on a low carb or keto diet. Carbs and protein stay constant, and fat is the one you increase or decrease (push the lever up or down) to gain or lose weight, respectively. So if your goal is weight loss, eat enough fat to be satisfied, but there’s no need to “get your fats in” once you’re satisfied.
The results of the Bland-Altman approach in regard to the FM% are shown in Fig. 4. MF-BIA underestimates the FM% during all visits, although with increasing body fat there is a trend toward better agreement [Fig. 4(A)]. This negative slope was significant in visits C2 (P = 0.015), C3 (P = 0.003), and C4 (P = 0.005). Importantly, MF-BIA had a consistent variability of about 5% in determining FM% when compared with DXA. However, the concordance between DXA and ADP is shown in Fig. 4(B). In visits C1 (P = 0.005), C2 (P = 0.010), and C3 (P = 0.004) significant negative slopes were observed, indicating underestimation of ADP at lower levels of FM%, but ADP seemed to overestimate FM% with increasing body fat. During visit C-4, a similar pattern was observed, although the slope did not reach statistical significance (P = 0.093). During all visits there was a high variability in the FM% determined by ADP, reaching values of up to 20% in comparison with DXA.
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