“A lower-carbohydrate diet and lifestyle has not only changed my personal health for the better, but also the health of my family and my patients. The low-carb ketogenic lifestyle has also transformed my medical practice from a traditional sick-care office to an Integrative Wellness practice that focuses on improving people’s health and preventing illness. I enjoy going into work every day as I now feel I am truly preventing chronic diseases from taking root via proper nutritional counseling. I send virtually all my patients to Diet Doctor for help getting started on their own low-carb journey.”
Ok when you see the % sign it means the daily percentage from a 2000 calorie diet. That one says you should have 300g a day. This is the standard nutrition value in most if not all products. If you want to try a low carb diet ignore that part, at least the number with % on the side. Concentrate on the number with the letter g next to it. That is the grams per serving. To that number substract the amount of fiber it has (also the number with the g next to it not the one with % symbol) That gives you the net carbs for that specific product. The rest is just math with whatever you eat. Good Luck.
^ 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.
Thanks for this inputs. 20 years ago I gain 17 pounds a year for 5 years. I was healthy but my dr told me start diet, any diet just come back in a month I want to see you start loosing… I started Atkins and lost 7 pound in a month. She was checking my progress every six months and checking my condition. I lost 64 pounds in 3 years. Now I started eating out of control. I am eating healthy but too much… I gain 40 pound back after 20 years. Now I will start again my Atkins to take off 30 pounds…
“I encounter many patients who are interested in LCHF and are finding benefit in weight reduction, better diabetes control, improved endurance and energy levels, and improved lipid profiles. There is a great deal of confusion out there about the diet, much of it based on outdated science or an incomplete understanding of the topic. I feel that I owe it to patients to be informed about LCHF so that I can advise them on the risks and benefits it could have for them.”
In many developing countries, the ketogenic diet is expensive because dairy fats and meat are more expensive than grain, fruit and vegetables. The modified Atkins diet has been proposed as a lower-cost alternative for those countries; the slightly more expensive food bill can be offset by a reduction in pharmaceutical costs if the diet is successful. The modified Atkins diet is less complex to explain and prepare and requires less support from a dietitian.[55] 

8. Van Lenten, B. J., Hama, S. Y., De Beer, F. C., Stafforini, D. M., McIntyre, T. M., Prescott, S. M., … Navab, M. (1995). Anti-inflammatory HDL becomes pro-inflammatory during the acute phase response. Loss of protective effect of HDL against LDL oxidation in aortic wall cell cocultures. Journal of Clinical Investigation, 96(6), 2758–2767. PMID: 8675645
Other experts say the long-term accumulation of ketones could be harmful. “Those ketones are emergency fuel sources, and we’re not meant to run on them long-term,” says Kristen Kizer, a registered dietitian at Houston Methodist Hospital. “Ketones are negatively-charged molecules, which means they’re acidic. When you build up ketone bodies in your system, you’re building up acid. One of the ways your body buffers acid is by pulling calcium from your bones.” Kizer also notes that the diet isn't very balanced and involves a very high intake of animal products, which generally do not protect against cancer, diabetes, or other diseases.
Con: Results can vary depending on how much fluid you drink. By drinking more water, you dilute the concentration of ketones in the urine and thus a lower level of ketones will be detected on the strips. The strips don’t show a precise ketone level. Finally, and most importantly, as you become increasingly keto-adapted and your body reabsorbs ketones from the urine, urine strips may become unreliable, even if you’re in ketosis.

Ketosis was determined by measuring ketone bodies, specifically β-hydroxy-butyrate (β-OHB), in capillary blood by using a portable meter (GlucoMen LX Sensor, A. Menarini Diagnostics, Neuss, Germany; sensitivity <0.2 mmol/L). As with anthropometric assessments, all the determinations of capillary ketonemia were made after an overnight fast of 8 to 10 h. These measurements were performed daily by each patient during the entire VLCK diet, and the corresponding values were reviewed on the machine memory by the research team to control adherence. Additionally, β-OHB levels were determined at each visit by the physician in charge of the patient. Glucose, insulin, HbA1C were performed using an automated chemistry analyzer (Dimension EXL with LM Integrated Chemistry System, Siemens Medical Solutions Inc. (Tarrytown, NY, USA). Thyroid-stimulating hormone (TSH), free thyroxine (FT4), and free triiodothyronine (FT3) were measured by chemiluminescence using ADVIA Centaur (Bayer Diagnostics, Tarrytown, NY, USA). The overnight fasting plasma levels of ghrelin and leptin were measured using commercially available ELISA kits (Millipore, Burlington, MA, USA). The fasting plasma levels of dopamine was tested by high pressure liquid chromatography (HPLC; Reference Laboratory, Barcelona, Spain).
According to one hypothesis, low-carb diets have a distinct “metabolic advantage” over diets with higher carbohydrate content when the amount of calories consumed are the same.3 This metabolic advantage is essentially an increase in the expenditure of energy (calories) on the low-carb diet. Factors that may account for this higher rate of calorie burning include:
A lot of people take their macros as a “set in stone” type of thing. You shouldn’t worry about hitting the mark every single day to the dot. If you’re a few calories over some days, a few calories under on others – it’s fine. Everything will even itself out in the end. It’s all about a long term plan that can work for you, and not the other way around.

Cutting back on protein is one of the largest challenges to the diet. Because high levels of protein in the diet can turn into glucose in a process called gluconeogenesis, the keto theory says too much protein in the diet can mean too much glucose, whisking you out of ketosis. That’s why bacon, which has a ton of fat but not a lot of protein is a preferred food over chicken breast, which is high in protein with very little fat.
Julie Hand is a certified holistic health and nutrition counselor (Institute for Integrative Nutrition), personal fitness trainer (National Personal Training Institute), and yoga teacher (Kripalu Center for Yoga & Health). Though she can’t resist trying every science-backed health tip, she also has a penchant for crystals and astrology (don’t judge). You can find her walking the beach (coffee in hand, of course) and practicing the ukulele on weekends.
Because some cancer cells are inefficient in processing ketone bodies for energy, the ketogenic diet has also been suggested as a treatment for cancer.[59][60] A 2018 review looked at the evidence from preclinical and clinical studies of ketogenic diets in cancer therapy. The clinical studies in humans are typically very small, with some providing weak evidence for anti-tumour effect, particularly for glioblastoma, but in other cancers and studies, no anti-tumour effect was seen. Taken together, results from preclinical studies, albeit sometimes contradictory, tend to support an anti-tumor effect rather than a pro-tumor effect of the KD for most solid cancers.[61]
People claiming huge benefits of these supplements – despite the lack of solid scientific support – may sometimes have a financial reason to believe in the supplements. Some of these products are sold under a multi-level marketing arrangement, where sales people are paid based on commission. For example, the company Prüvit sells drinkable ketones, called KETO//OS with a multi-level marketing structure.
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Although fat is the centerpiece of any keto diet, that doesn't mean you should be subsisting on butter-topped steaks, says Kristen Mancinelli, RD, author of The Ketogenic Diet. “A big misconception is that you should just put meat at the center of your plate and add more fat on top,” she says. You also shouldn't be relying on fatty meats to hit your fat quota, she adds.
“The totality of evidence is very clear: A low-carbohydrate dietary approach is the most effective way to manage the insulin resistance syndrome which is that single biggest driver of obesity, type 2 diabetes and cardiovascular disease. Diet Doctor has been instrumental in providing extremely useful, clear and educational material to all who want to implement this dietary approach in to their lives. That’s why I recommend the website to all my at-risk patients.”

Thanks for this inputs. 20 years ago I gain 17 pounds a year for 5 years. I was healthy but my dr told me start diet, any diet just come back in a month I want to see you start loosing… I started Atkins and lost 7 pound in a month. She was checking my progress every six months and checking my condition. I lost 64 pounds in 3 years. Now I started eating out of control. I am eating healthy but too much… I gain 40 pound back after 20 years. Now I will start again my Atkins to take off 30 pounds…
I can maintain 20g daily carbs and lose weight fast if I remain mostly sedentary. I get weak very fast when I try exercise and even though I get all the electrolytes I get muscle burn. I did this for 5 weeks..went from 248 to 217. Am starting a modified diet tomorrow with 1500 total cals/150 g protein/50 g carb. I hope to tolerate exercise better and the extra carbs will basically be burnt on exercise. If I still feel the carb level impedes my biking and walking will add 10 carbs until I feel comfortable exercising.
I am just starting the Keto diet and I eat a banana or a little pineapple in cottage cheese once a day as part of my lunch or a snack will this be bad at the start of my diet or should I cut it out all together? I’m so disappointed that my favorite fruits are high in carbs,especially bananas, once I heard the help with anxiety I have been eating one almost every day and I think it lifts my mood.

The beauty of The 3-Week Ketogenic Diet is that it's completely opposite of the majority of "lose-weight quick" weight loss scams. The 3-Week Ketogenic Diet focuses on FAT LOSS, not weight loss (the difference is explained in the Program Guide). You'll be eating anti-inflammatory foods that promote a healthy, a fast metabolism, and stimulates fat-burning hormones. You'll lose a lot of weight and inches in a short period of time and this time...you'll keep it off.
At the first visit, participants were instructed how to follow the LCKD as individuals or in small groups, with an initial goal of ≤20 g carbohydrate per day. Participants were taught the specific types and amounts of foods they could eat, as well as foods to avoid. Initially, participants were allowed unlimited amounts of meats, poultry, fish, shellfish, and eggs; 2 cups of salad vegetables per day; 1 cup of low-carbohydrate vegetables per day; 4 ounces of hard cheese; and limited amounts of cream, avocado, olives, and lemon juice. Fats and oils were not restricted except that intake of trans fats was to be minimized. Participants were provided a 3-page handout and a handbook [11] detailing these recommendations. Participants prepared or bought all of their own meals and snacks following these guidelines.
“I recommend low-carbohydrate and ketogenic diets to almost all my patients, from the general public to world-class Olympic athletes. A huge variety of benefits can be seen, from improvements in metabolic health and reductions in joint pains to enhanced athletic performance. While a degree of nuance is needed for specific recommendations, based on factors like general health and goals, the general principle is to reduce carbohydrates while ensuring appropriate intake of fat and protein. This addresses the key problem of insulin resistance, which is central to many modern disease states, including cardiovascular disease and type 2 diabetes.”
“As a physician who developed type 1 diabetes in 1998 at the age of 38, I struggled to manage my blood sugar with conventional medical advice. I met Dr. Andreas Eenfeldt at a medical meeting in 2012 and have used Diet Doctor as an excellent source of information for both myself and my patients ever since. The low-carb diet resulted in a marked improvement in my blood sugar control and my entire outlook on life. I provide online coaching to people with diabetes who need individualized attention.”
If you want to try a ketogenic diet, be aware that you'll have to adjust it for your individual metabolism and experiment with the right balance of carbs and calories. While some low-carbohydrate dieters find they are able to break stalls in their weight loss, others find that it is more difficult for them to stay in this state. You may want to consult a registered dietitian to build keto-friendly menus for you that will meet your nutritional needs. Be sure to keep your health care provider informed when you start a new diet, especially if you have ongoing health conditions.
Although the patients underwent a total of 10 visits, the complete body composition analyses were synchronized with the ketone levels in 4 visits (Table 1; Fig. 1). Visit C-1 was the baseline visit, before starting the diet, with no ketosis (0.0 ± 0.1 mmol/L) and a body weight of 95.9 ± 16.3 kg. Visit C-2 was at the time of maximum level of ketosis (1.0 ± 0.6 mmol/L) with a body weight of 84.2 ± 18.0 kg. At visit C-3 (after 89.7 ± 19.1 days of VLCK), patients began the return to a normal diet and showed a reduction in ketone levels (0.7 ± 0.5 mmol/L) and a body weight of 76.6 ± 11.1 kg. Finally, at visit C-4, the patients were out of ketosis (0.2 ± 0.1 mmol/L) and showed a body weight of 75.1 ± 11.8 kg. All weights were statistically different from baseline levels (P < 0.05; Table 1; Fig. 1).
Various mechanisms may explain the variations in body water. For example, glycogen depletion induced by VLCK diets could cause a marked increase in diuresis, given that glycogen is usually stored together with water (39, 40). Water loss might also be associated with ketonuria, because ketone bodies increase the renal sodium and water loss as a result (39, 41). These assumptions seem reasonable considering that the peak water loss coincides with the phase of maximum ketosis. However, the mechanisms explaining the diuresis observed with VLCK and with most hypocaloric diets are not known at present (30). Contrary to previous observations (42, 43), DXA analysis evidenced a maintenance in bone mineral density in the current study.

If you choose to make your sauces and gravies, you should consider investing in guar or xanthan gum. It’s a thickener that’s well known in modern cooking techniques and lends a hand to low carb by thickening otherwise watery sauces. Luckily there are many sauces to choose from that are high fat and low carb. If you’re in need of a sauce then consider making a beurre blanc, hollandaise or simply brown butter to top meats with.
^ 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
Letting your blood sugar drop too low when following low-calorie diets -- often containing 1,000 to 1,200 calories daily for women and 1,200 to 1,600 calories a day for men -- can lead to headaches. Low blood sugar, which happens when too little glucose is in your bloodstream, can occur if you skip meals to reach your weight-loss calorie allotment. To help prevent headaches during weight loss, eat regular meals and snacks every few hours or so.
Ok when you see the % sign it means the daily percentage from a 2000 calorie diet. That one says you should have 300g a day. This is the standard nutrition value in most if not all products. If you want to try a low carb diet ignore that part, at least the number with % on the side. Concentrate on the number with the letter g next to it. That is the grams per serving. To that number substract the amount of fiber it has (also the number with the g next to it not the one with % symbol) That gives you the net carbs for that specific product. The rest is just math with whatever you eat. Good Luck.
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).
“For five years now, I’ve been changing my life and the life of my patients in a rural area of Delaware using the LCHF diet with intermittent fasting. My patients have been achieving not only their weight loss goals, but improving their medical conditions associated with obesity. It is very satisfying to explain the science behind the diet and see their faces light up at the possibility of finally improving their health and reducing their medications and medical costs. Diet Doctor, all this time, has been a valued resource with easy to navigate content and great science.”
The classic ketogenic, or “keto,” diet calls for consuming a low amount of carbs, a high amount of fat, and a moderate amount of protein. But in the current study, participants induced ketosis by getting the majority of their calories from protein, a small amount from fat, and a low amount from carbs. One of the side effects of very low-calorie diets is loss of lean muscle mass, but on the adjusted keto diet in the study, participants preserved lean muscle mass. Researchers attributed the preservation of lean muscle mass to participants’ sustained RMR, and their results support those of a prior study, published in February 2017 in the Journal of Clinical Endocrinology and Metabolism.
Although fat is the centerpiece of any keto diet, that doesn't mean you should be subsisting on butter-topped steaks, says Kristen Mancinelli, RD, author of The Ketogenic Diet. “A big misconception is that you should just put meat at the center of your plate and add more fat on top,” she says. You also shouldn't be relying on fatty meats to hit your fat quota, she adds.
Basically, carbohydrates are the primary source of energy production in body tissues. When the body is deprived of carbohydrates due to reducing intake to less than 50g per day, insulin secretion is significantly reduced and the body enters a catabolic state. Glycogen stores deplete, forcing the body to go through certain metabolic changes. Two metabolic processes come into action when there is low carbohydrate availability in body tissues: gluconeogenesis and ketogenesis.[4][5]
“As an interventional pain physician, in addition to cutting-edge techniques I use nutritional strategies to deliver people from a cycle of pain and disability. Chronic pain may result from inflammation and metabolic disarray; it intersects every part of life and is an illness as much as it is a symptom. Obesity and aging are inflammatory processes at the root of many pain-inducing chronic diseases. I suggest anti-inflammatory, low-carb, ketogenic diets and fasting protocols to optimize patients’ health. Diet Doctor is a great resource for patients compliant with this lifestyle.”
But all those studies were very small, and not all research on the keto diet is as promising. One American Society for Clinical Nutrition study of 20 participants found that those on the diet didn’t lose more weight than those on a non-keto diet. But they did have fouler moods and higher levels of inflammation, which has been linked to a variety of conditions, including heart disease and cancer.
But let’s look a little deeper at that. Though the subjects’ energy expenditure increased in the first two weeks of ketogenic diet, this increase eventually plateaued in the final two weeks and fell back down to the study’s baseline. What’s more, though participants lost weight rapidly in the first few days of going keto as a result of decreased water retention, body fat loss eventually also slowed. Further testing also returned that the participants on the keto diet even started to break down lean tissue for energy – not body fat.
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)
Women were also invited to complete a questionnaire on sexual function (the Female Sexual Function Index—FSFI). The FSFI consists of 19 questions, divided into 6 domains: desire, arousal, lubrication, orgasm, satisfaction, and pain. Each answer is rated on a scale ranging from 0 to 5 or 1 to 5 (0 means no sexual activity in the four preceding weeks) [28]. The total FSFI score, obtained from the sum of the items in each domain multiplied by the domain factor (0.6 for desire, 0.3 for arousal and lubrication, and 0.4 for orgasm, satisfaction, and pain), may range from 2.0 to 36.0. Lower scores indicate poorer sexual function. A total FSFI score less than 26.55 is indicative of sexual dysfunction [28].
“I recommend LCHF nutrition to all my patients to shift their metabolism to a more beneficial state. This nutrition is often enough to reverse diseases like obesity, diabetes and fatty liver disease, improving the health and quality of life of my patients. In my experience, other medical interventions also become much more efficacious. I recommend the Diet Doctor website, due to its panel of experts, to all my patients to make their transition easier.”
1. West, R., Beeri, M. S., Schmeidler, J., Hannigan, C. M., Angelo, G., Grossman, H. T., … Silverman, J. M. (2008). Better memory functioning associated with higher total and low-density lipoprotein cholesterol levels in very elderly subjects without the apolipoprotein e4 allele. The American Journal of Geriatric Psychiatry : Official Journal of the American Association for Geriatric Psychiatry, 16(9), 781–5. PMID: 18757771
Finally, the accuracy of MF-BIA and ADP in the estimation of body composition was studied in relation to DXA. As shown in Table 2, the unadjusted regression coefficients for FM, FM%, and FFM were consistently higher with MF-BIA in comparison with ADP throughout the study. Specifically, regression coefficients for MF-BIA were high (r2 > 0.8) for FM and FFM, whereas those regression coefficients for FM% were slightly lower (r2 > 0.7). However, most of the regression coefficients using ADP were lower (r2 < 0.7) for FM, FM%, and FFM. A similar pattern was observed when adjusting for age and sex. The regression coefficients for both MF-BIA and ADP decreased with weight loss.

I get many questions about intermittent fasting, the health benefits, the weight loss benefits, and the like. People normally use intermittent fasting for both the energy and mental clarity it can offer. But it’s not just good for that. It can offer breakthroughs of plateaus and even benefits in nutrient uptake in exercise. We go more in depth to intermittent fasting in Week 3 and 4, so keep your eyes peeled!

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).
The premise of many popular diets is eating a lower amount of carbohydrates, but most of these diets, including Atkins and Paleo, are also very high in protein. The keto diet plan is different because you only eat a moderate amount of protein. Otherwise, your body would convert protein into glucose and wouldn’t achieve a state of ketosis, where it only uses fat for energy.
Dr. Campos, it is so discouraging to see that you disparage the ketogenic diet based on your assumption that it is very heavy in poor quality processed meats. No diet that relies on processed foods can be viewed as “healthy”. Become better informed by getting up to speed with what Jeff Volek, RD, PhD, calls a “well-formulated ketogenic diet.” Also, learn more about the potential of the diet to slow cancer progression (my specialty). You owe it to your patients who are depending on you for advice. Present them with facts, not opinions.
While you’re focusing on fat, protein, and carbs, you should also make sure you’re getting adequate fiber. “People often assume that they should only eat things like meat and butter on the ketogenic diet,” says Farshad Fani Marvasti, MD, an associate professor and director of Public Health, Prevention, and Health Promotion at the University of Arizona College of Medicine in Phoenix. “You should make sure you are eating enough vegetables because you need the fiber.”
“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.”

There are vegetables that are high in carbs and others low in carbs. The keto diet recommends sticking to the ones low on carbs but encourages you to eat a lot of them. Best vegetables are all green ones to make it easy. And vegetables that grow above the ground (e.g. lettuce) are always better than the ones that grow below the ground (e.g. potatoes)

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