Ketogenesis results in the production of ketone bodies, a product of fatty acid catabolism performed primarily by the liver, in the absence of adequate CHO availability. Three primary ketone bodies are produced; acetone, acetoacetate and β-hydroxybutyrate. Even though trace amounts of ketones are always present in the blood, it is only during periods of inadequate CHO availability that significant ketone production will occur. This accumulation of ketone bodies in the blood is commonly referred to as ketosis.
For obesity-reduction experts, it is well known that the main obstacle to follow a hypocaloric diet is hunger. In fact, within a few days after undertaking such a calorie-lowered diet, patients suffered a battery of negative effects, such as hunger, sadness, bad humor, and, in some cases, mild depression. All these side effects were absent in the patients following a VLCK diet, thus contributing to the success of these types of treatments. The mechanism that erases hunger and sadness in obese subjects following a VLCK diet are not known, and several authors strongly believe that it is due to the anorexigenic effect of ketosis [42]. As a result, of that rationale, the target of this work was to study the neurocognitive effects of ketosis, using a battery of neurocognitive and QoL tests in the same individuals at three different stages; (a) nonketosis-nonweight reduction (basal), (b) highly ketosis-mild weight reduction (visit 2), and (c) nonketosis-strong (mean 20 kg) weight reduction.
Sexual dysfunction in subjects with obesity has been scarcely studied. Recent studies evidenced a rate of sexual dysfunction in 29–60% of women and 24.8–45% of men with obesity [50]. In the current study, at baseline, the obese men reported a relatively good sexual function based on the EMAS–SFQ. The domains included in this questionnaire correlated with levels of testosterone, and the EMAS-SFQ scores reported in the current study are higher than those previously observed in patients with low levels of testosterone [27]. Accordingly, we did not find significant changes in the sexual function of men during the nutritional intervention. By contrast, women reported a general sexual dysfunction that improved, especially in the maximum ketosis phase, and then during the intervention. More concretely, women exhibited an improvement in excitation, lubrication, and orgasm capacity. Sexual dysfunction is usually related to impairments in parameters related to healthy, body image dissatisfaction, depressive symptoms, and lower levels of romantic relationship satisfaction [51]. Then, it could be hypothesized that the beneficial effects on several parameters of body composition and biochemicals induced by the VLCK diet, PNK method®, could be involved in an improvement in the sexual function of obese women.
“I discovered the ketogenic diet in 2017 and since then I have come to truly believe it is the metabolic and nutritional pathway to overall health. Hippocrates once stated, ‘All disease begins in the gut” and I now truly believe the right food can cure. I am now discouraging patients from undergoing bariatric surgery too soon and advising them to try the keto diet first. Diet Doctor gives people the knowledge they need. It is a place where everyone can go to learn and have fun with this nutritional approach.”
Having tempting, unhealthy foods in your home is one of the biggest reasons for failure when starting any diet. To maximize your chances of success with the keto diet, you need to remove as many triggers as you can. This crucial step will help prevent moments of weakness from ruining all your hard work.If you aren’t living alone, make sure to discuss with your family or housemates before throwing anything out. If some items are simply not yours to throw out, try to compromise and agree on a special location so you can keep them out of sight.
All anthropometric measurements were undertaken after an overnight fast (8 to 10 h), under resting conditions, in duplicate, and performed by well-trained health workers. Participants’ body weights were measured to the nearest 0.1 kg on the same calibrated electronic device (Seca 220 scale, Medical Resources, EPI Inc. (Lewis Center, OH, USA) in underwear and without shoes. BMI was calculated by dividing body weight in kilograms by the square of height in meters; BMI = weight (kg)/height2 (m).
^ 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
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
Carbohydrate: Most of what determines how ketogenic a diet is will depend on how much carbohydrate is eaten, as well the individual's metabolism and activity level. A diet of less than 50 or 60 grams of net (effective) carbohydrate per day is generally ketogenic. Some sources say to consume no more than 20 grams of carbohydrates per day, while others cite up to 50 grams, and many recommend no more than 5 percent of calories from carbs. However, athletes and people with healthy metabolisms may be able to eat 100 or more grams of net carbohydrate in a day and maintain a desired level of ketosis. At the same time, an older sedentary person with Type 2 diabetes may have to eat less than 30 net grams to achieve the same level.

I won't be staying with keto for the long term—I really can't eat that much bacon anymore—but I do expect I'll return to it several times a year. If nothing else, the strict diet works well for me as a reset after a long splurge (hello, holidays!), and my month-long experiment helped me break my dependency on some of my biggest food crutches (sugar, pasta, crackers).

Sexual dysfunction in subjects with obesity has been scarcely studied. Recent studies evidenced a rate of sexual dysfunction in 29–60% of women and 24.8–45% of men with obesity [50]. In the current study, at baseline, the obese men reported a relatively good sexual function based on the EMAS–SFQ. The domains included in this questionnaire correlated with levels of testosterone, and the EMAS-SFQ scores reported in the current study are higher than those previously observed in patients with low levels of testosterone [27]. Accordingly, we did not find significant changes in the sexual function of men during the nutritional intervention. By contrast, women reported a general sexual dysfunction that improved, especially in the maximum ketosis phase, and then during the intervention. More concretely, women exhibited an improvement in excitation, lubrication, and orgasm capacity. Sexual dysfunction is usually related to impairments in parameters related to healthy, body image dissatisfaction, depressive symptoms, and lower levels of romantic relationship satisfaction [51]. Then, it could be hypothesized that the beneficial effects on several parameters of body composition and biochemicals induced by the VLCK diet, PNK method®, could be involved in an improvement in the sexual function of obese women.


Conklin's fasting therapy was adopted by neurologists in mainstream practice. In 1916, a Dr McMurray wrote to the New York Medical Journal claiming to have successfully treated epilepsy patients with a fast, followed by a starch- and sugar-free diet, since 1912. In 1921, prominent endocrinologist Henry Rawle Geyelin reported his experiences to the American Medical Association convention. He had seen Conklin's success first-hand and had attempted to reproduce the results in 36 of his own patients. He achieved similar results despite only having studied the patients for a short time. Further studies in the 1920s indicated that seizures generally returned after the fast. Charles P. Howland, the parent of one of Conklin's successful patients and a wealthy New York corporate lawyer, gave his brother John Elias Howland a gift of $5,000 to study "the ketosis of starvation". As professor of paediatrics at Johns Hopkins Hospital, John E. Howland used the money to fund research undertaken by neurologist Stanley Cobb and his assistant William G. Lennox.[10]
Measuring blood ketones is the most reliable method. There is a home blood test you can use, but the strips can be very expensive. An alternative is to measure ketones in the urine with a dipstick test, which is much more accessible and inexpensive. However, this method is much less reliable and as time goes on and the body adapts to ketosis, it becomes even less reliable.
Boosts energy levels. The sluggishness and lethargy you feel after a heavy carb-filled meal is due to the insulin spike and reactive sharp drop in blood sugars. Eating a high-fat diet provides steady energy and helps you avoid crashes that are associated with eating a high-carb diet. Additionally, since ketones are the brain’s preferred source of energy, a ketogenic diet leaves you feeling more alert and mentally energized without having to supply a steady stream of caloric intake [13].
Recently, many of my patients have been asking about a ketogenic diet. Is a ketogenic diet safe? Would you recommend it? Despite the recent hype, a ketogenic diet is not something new. In medicine, we have been using it for almost 100 years to treat drug-resistant epilepsy, especially in children. In the 1970s, Dr. Atkins popularized his very-low-carbohydrate diet for weight loss that began with a very strict two-week ketogenic phase. Over the years, other fad diets incorporated a similar approach for weight loss.
Thankyou for the breakdown! I’m quite excited to get started. I’m a T1 newly diagnosed (6m) and the hospital educator had me eating 30gm Carbs per meal which saw me a) Nearly vomit every meal as it was too much food b) gain a ridiculous amount of weight! (never really been a big carb eater, but my issue was not eating frequently!) (15+kg gained!) so bring on 2019 with a better relationship with food and a better relationship with myself, knowing how and what works with for my body. blessings xx😘
Ketones are a very effective fuel for the brain—often a more efficient fuel than glucose. Your body is like a hybrid car when it comes to fuel. When you run out of carbohydrates to burn for fuel—say you’re fasting before a surgery or a religious holiday—your body seeks an alternative way to get more fuel. (If your body didn’t do this, you would die after a short fast.) So the body kicks into burning fat, which is the metabolic state of ketosis, or “keto.” Technically, your liver takes long-chain and medium-chain fatty acids from your fat tissue, and produces a major ketone called beta-hydroxybutyrate (BHB). BHB provides more energy per unit oxygen used than glucose, which benefits the brain.
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].
Reduced hunger. Many people experience a marked reduction in hunger on a keto diet. This may be caused by an increased ability of the body to be fueled by its fat stores. Many people feel great when they eat just once or twice a day, and may automatically end up doing a form of intermittent fasting. This saves time and money, while also speeding up weight loss.

.. it can be heavy on red meat and other fatty, processed, and salty foods that are notoriously unhealthy. What is unhealthy about red meat. We should know that acrilamides, pyrroles in burnt meat (and veges) from BBQ and over-heated cooking inflames the colon. According to Clark H R, PhD ND an inflamed part allows easy entry for the cancer nucleus and cancer complex, to start and fuel a malignancy at that location.
The other big factor in deciding to do Keto for 60 days was noticing how I felt doing Trim Healthy Mama (some people call it carb cycling).  When I ate lots of healthy fats, especially in the morning I felt amazing.  My mental focus was amazing and I felt bulletproof.  Often, I would eat an E lunch with carbs and very little fat, which, while perfectly in line with THM guidelines, left me feeling mentally foggy, tired, and lethargic.
During this study, the patients followed the different steps of the method until they reached the target weight or up to a maximum of 4 months of follow-up, although patients remained under medical supervision for the following months. Patients visited the research team every 15 ± 2 days to control adherence and evaluate potential side effects. Complete anthropometric, body composition, biochemical and phycological assessments were performed at four of the visits which were made according to the evolution of each patient through the steps of ketosis and weight loss: Visit 1 (baseline), visit 2 (maximum ketosis), visit 3 (reduced ketosis) and visit 4 (Endpoint).
Obesity is a preventable disease that plagues all the countries of the world, affecting 650 million of its habitants [1,2,3]. In the fight against obesity, a very low-calorie ketogenic (VLCK) diet has consistently been shown to be a useful tool [4,5,6]. Indeed, recent studies from our research group demonstrated that a VLCK diet induces more weight loss than a standard low-calorie diet after 1 and 2 years of follow-up [6]. Among the beneficial effects, the VLCK diet was able to preserve muscle mass, muscle strength [4] and resting metabolic rate [7] and the weight loss was due to fat mass and visceral fat mass [4]. However, obesity is more than an excess body-weight problem [8]. This metabolic disorder is associated with several co-diseases, such as type 2 diabetes, cardiovascular and neurological disorders, and cancer [9,10,11]. Moreover, overweight/obese subjects usually experience a strong desire to eat coupled with a lack of control over eating [12] and suffer from emotional distress and a decrease in quality of life (QoL) and sleep and sexual function [11]. In this regard, few studies have evaluated the effect of weight-loss therapy on the food craving and well-being parameters in overweight/obese subjects.
While you don’t have to be 100% accurate, you can use calorie counting as a starting point. It’s a way to measure how much energy you are actually taking in, and then adjust it to your needs. Obviously, a faster/slower metabolism, activity levels, endocrine problems, etc. will affect the amount of energy you will be expending, and therefore will affect the number of calories you need to take in.
“Your liver produces ketones all the time, but the rate depends on carbohydrate and protein intake,” says Jeff Volek, Ph.D., R.D., a professor of human sciences at Ohio State University. When the majority of your diet is made up of of carbs and protein, ketogenesis slows. Replacing carbs and protein with fat will put your body into ketosis, thus ramping up ketone production. This takes about three days to induce.
When the craving for alcohol was evaluated, no statistically significant changes were observed in the MACS scores through the nutritional intervention, taking all patients together (Table S1). However, when the analysis was performed considering the gender of participants in the study, men experienced a significant decrease in the total score through the study (p = 0.047). This decrease was more notable in the maximum ketosis phase as compared with baseline (−15.14; p = 0.047). Moreover, a statistically significant reduction was observed in the lack of inhibition item (−27.19; p = 0.042).

You’re ok with not so fast results and can remain disciplined.Every weight loss management plan needs an amount of sacrifice as well as a compromise from the dieter. But the ketosis approach may be one of the most challenging because it will change the most sacred of all eating routines among Western cultures: enjoying a full-dish meal. It's certainly no picnic, but the procedure can be done simpler having the right products and program, and the results can be spectacular.
Very low calorie diets are designed to bring on a mild form of ketosis, which means your body shifts from using primarily carbohydrates to fat as an energy source. The relative safety of ketosis is a hotly debated topic. In very low calorie diets, which are medically supervised diets, ketosis is supported for a short period of time to produce rapid weight loss in people who are extremely obese. It's not something you try at home simply because you want to lose a few pounds. Very low calorie diets and ketosis in people who are simply overweight can be dangerous.
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.
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.
There are plant based healthy oils that have been in the food chain for thousands of years, including high-fat foods such as all nuts and seeds, avocados, extra virgin olive oil, sesame seed oil, black cumin seed oil (popular in the Middle East), palm oil sourced from sustainable producers, and the healthiest plant based fat of them all, coconut oil.
Participants were recruited from the Durham Veterans Affairs Medical Center (VAMC) outpatient clinics. Inclusion criteria were age 35–75 years; body mass index (BMI) >25 kg/m2; and fasting serum glucose >125 mg/dL or hemoglobin A1c >6.5% without medications, or treatment with oral hypoglycemic agents (OHA) and/or insulin. Exclusion criteria were evidence of renal insufficiency, liver disease, or unstable cardiovascular disease by history, physical examination, and laboratory tests. All participants provided written informed consent approved by the institutional review board. No monetary incentives were provided.
Very low calorie diets, or VLCDs, are supervised medical programs designed to bring about rapid weight loss in people who are dangerously overweight or morbidly obese. They typically involve you taking specially prepared formulas, usually liquid shakes, to replace all your meals for several weeks to a few months. Because they are meal replacements, they also contain a balance of nutrients to provide you with all the vitamins and minerals you need, but also just enough calories to prevent your body to clinging to fat because it thinks you are starving. By definition, a VLCD involves consuming about 800 calories per day.
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).
Though technically a fruit, avocados offer a rich source of heart-healthy monounsaturated fatty acids (MUFAs). They're also packed with fiber to bolster digestive health. One-half of an avocado contains 161 calories, 2 grams (g) of protein, 15 g of fat, 9 g of total carbs, and 7 g of fiber (bringing it to 2 g of net carbs), notes the U.S. Department of Agriculture (USDA).
Eating out while going keto can be tricky. Planning ahead helps you know where your next snacks and meals will come from, so you aren’t tempted to reach for an easy—high-carb—fix, like fast food. Each week, plan out everything from meals to snacks and if you’re using an app, go ahead and fill in your estimated macronutrients ahead of time. This will help you get an idea of your overall intake, so you can make adjustments to reach your daily goals more easily. Get started by planning to make these 10 keto recipes so good you’ll never know you’re on a diet.
“I discovered the low-carb lifestyle after struggling myself with my obesity for many years. I was unsuccessful losing weight with the traditional low-fat diet plans that I used to recommend to patients. I researched and reviewed the studies of low-carb/keto eating and I lost weight, becoming a much healthier doctor. I am now passing on that experience onto my patients! When I counsel patients not familiar with low-carb living, I refer them to the Diet Doctor site for testimonials, recipes, and much more.”

Beta-hydroxybutyrate (BHB) – Not technically a ketone but a molecule. Its essential role in the ketogenic diet makes it count as the important ketone body. BHB is synthesized by your liver from acetoacetate. BHB is important because it can freely float throughout your body in your blood, crossing many tissues where other molecules can’t. It enters the mitochondria and gets turned into ATP (adenosine triphosphate), the energy currency of your cells. BHB = ATP = energy!
If you do try the diet outside of medical supervision, Kizer says it’s important to test your urine with urinalysis ketone test strips to ensure your ketone levels don’t become dangerously high. Ketone urine test strips are also used by people with diabetes to determine if they’re at risk for ketoacidosis (DKA), a life-threatening complication that occurs when an individual doesn’t have enough insulin in their body. (Healthy ketosis is considered 0.5 to 3.0 mM blood ketones.)
In a 2004 study, overweight and obese adults consumed a low-fat diet and a low-carb diet for one week each. Both diets were designed to reduce each person’s calorie intake by 500 calories per day. However, people lost more weight and body fat after the low-carb week than the low-fat week – even though the men averaged higher calorie intake during the low-carb phase.
What's more, it's especially important to make sure your diet is well-planned when you're eating keto-style, because the foods you can choose from are limited. In addition to checking in with a dietitian if you're able, Stefanski recommends that you "talk to your doctor and make sure she or he is aware that you'll be starting a diet that completely changes how your body metabolizes energy." You might also want to check your most recent bloodwork levels for things such as cholesterol, vitamin D, and other indicators of health because these can change while on keto. That's because for some people, a prolonged keto diet can result in certain nutritional deficiencies or even high cholesterol. But most experts will tell you that the ketogenic diet is not a permanent lifestyle change (as could be the case for something like the 80/20 approach to eating or a Mediterranean eating style).
You’ll need to focus on titrating your insulin. Given the low amount of carbs in the Keto diet, I suggest you take detailed notes on how your blood sugar reacts to protein and fats. That way you can determine how much insulin to take with food. As for your basal, if you consistently go high/low without any bolus on board it might be a good idea to revisit your basal rates
GLUT1 deficiency is the technical term for what some medical practitioners are now calling diabetes 3. It’s the brain cell’s insulin resistance or a deficiency of glucose transport to brain cells. It impairs cellular metabolism in the brain, and is considered a source of Alzheimer’s disease, Multiple sclerosis, and epileptic seizures, among others.
Health experts think that the first law is relevant to why we get fat because they say to themselves and then to us, as the The New York Times did, “Those who consume more calories than they expend in energy will gain weight.” This is true. It has to be. To get fatter and heavier, we have to overeat. We have to consume more calories than we expend. That’s a given. But thermodynamics tells us nothing about why this happens, why we consume more calories than we expend. It only says that if we do, we will get heavier, and if we get heavier, then we did.
×