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.


Looking for that hearty crunch that’s packed full of flavor? Look no more. Instead of cracking open a box of Ritz or Cheez-Its, go ahead and make your own! You can make crackers from anything including flaxseed meal (featured in The RULED Book), chia seeds, or even almond flour to make your own homemade crunchy snacks with a delicious flavor of your own.
Over the past century, ketogenic diets have also been used as natural remedies to treat and even help reverse neurological disorders and cognitive impairments, including epilepsy, Alzheimer’s symptoms, manic depression and anxiety. Research shows that cutting off glucose levels with a very low-carb diet makes your body produce ketones for fuel. This change can help to reverse neurological disorders and cognitive impairment, including inducing seizure control. The brain is able to use this alternative source of energy instead of the cellular energy pathways that aren’t functioning normally in patients with brain disorders.
Cholesterol serves a number of important roles in the body. First of all, cholesterol is a critical structural element in certain tissues such as our brain and nervous system. In fact, it is estimated that around 25% of our cholesterol can be found in the brain. Just to highlight our failed fat philosophy over the years, higher saturated fat intake and high cholesterol levels are associated with better mental function in old age (1)!
This article originally appeared in Personal Training Quarterly (PTQ)—a quarterly publication for NSCA Members designed specifically for the personal trainer. Discover easy-to-read, research-based articles that take your training knowledge further with Nutrition, Programming, and Personal Business Development columns in each quarterly, electronic issue. Read more articles from PTQ »
The most common and relatively minor short-term side effects of ketogenic diet include a collection of symptoms like nausea, vomiting, headache, fatigue, dizziness, insomnia, difficulty in exercise tolerance, and constipation, sometimes referred to as keto flu. These symptoms resolve in a few days to few weeks. Ensuring adequate fluid and electrolyte intake can help counter some of these symptoms. Long-term adverse effects include hepatic steatosis, hypoproteinemia, kidney stones, and vitamin and mineral deficiencies.
“I recommend low-carb and ketogenic diets to my patients who want to lose weight permanently, particularly those who have weight-related medical conditions such as diabetes, high blood pressure, lower limb joint arthritis, metabolic syndrome, and high triglycerides. Why? Because they work! I visit the Diet Doctor website daily because it’s science-based, reliable, comprehensive, and consumer-friendly. I particularly like the recipes, which are provided with nutritional analysis.”
Bonnie J. Brehm, Randy J. Seeley, Stephen R. Daniels, and David A. D’Alessio, “A Randomized Trial Comparing a Very Low Carbohydrate Diet and a Calorie-Restricted Low Fat Diet on Body Weight and Cardiovascular Risk Factors in Healthy Women,” The Journal of Clinical Endocrinology & Metabolism: Vol 88, No 4; January 14, 2009. http://press.endocrine.org/doi/full/10.1210/jc.2002-021480.
Instead of adding sugar to your coffee, you can put a few drops of stevia in there to sweeten it up. Stevia is a great sweetener and won’t increase your blood sugar levels – so it’s a perfect way to sweeten your morning coffee. If you find stevia to have a bitter aftertaste, erythritol and monk fruit extract are two other keto-friendly sweeteners worth trying.
Fats: When it comes to types of fat to consume, anything goes. It’s recommended that you consume a mixture of saturated and monounsaturated fats. Things like coconut oil, which contains medium-chain triglycerides (MCTs) help keep ketone levels high. So long as you’re keeping your carbs in check, if you want to go as far as swigging bacon grease to get your fat in, you won’t be the first.
I am 50 pounds overweight and I want to track my macros for weight loss. Can I still us the macro calculator for my ideal calories per day? also what other steps do you recommend I do? any information will be helpful since I’m not sure were to start first. my goal is to get down to my wealthy weight which is 185 pounds. I’m 6’0 at 240 pounds currently.

Long-term compliance is low and can be a big issue with a ketogenic diet, but this is the case with any lifestyle change.  Even though the ketogenic diet is significantly superior in the induction of weight loss in otherwise healthy patients with obesity and the induced weight loss is rapid, intense, and sustained until at least 2 year, the understanding of the clinical impacts, safety, tolerability, efficacy, duration of treatment, and prognosis after discontinuation of the diet is challenging and requires further studies to understand the disease-specific mechanisms.
A: The amount of weight you lose is entirely dependent on you. Obviously adding exercise to your regimen will speed up your weight loss. Cutting out things that are common “stall” causes is also a good thing. Artificial sweeteners, dairy, wheat products and by-products (wheat gluten, wheat flours, and anything with an identifiable wheat product in it).
“Real food — that is low-sugar, high-fiber — works for most of the population, but some patients may need a low-carb diet for best results. For those patients, I am totally for low carb. I have certainly had many insulin-resistant patients who didn’t get better until they went on a low-carb diet. I am not remotely concerned about negative effects of low carb. I feel that, aside from patients with familial hypercholesterolemia and type 5 hyperlipidemia, a low-carb diet is entirely safe.”
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The concern regarding the possible loss in muscular mass was addressed by a strict analysis of the FFM component using DXA, MF-BIA, and ADP, and mild but significant reductions in relation to baseline were observed [Fig. 3(A)]. The greatest decrease in FFM occurred at the visit of maximum ketosis (visit C-2), with partial recovery thereafter [Fig. 3(A)]. The FFM losses determined by the different techniques at this point were −4.2 ± 1.8 kg (DXA), −3.1 ± 1.5 kg (MF-BIA), and −3.7 ± 7.6 kg (ADP). At the end of the study (visit C-4), these FFM losses had diminished to −3.7 ± 2.0 kg, −2.4 ± 1.8 kg, and −3.0 ± 8.0 kg, respectively.

A ketogenic diet could be an interesting alternative to treat certain conditions, and may accelerate weight loss. But it is hard to follow and it can be heavy on red meat and other fatty, processed, and salty foods that are notoriously unhealthy. We also do not know much about its long-term effects, probably because it’s so hard to stick with that people can’t eat this way for a long time. It is also important to remember that “yo-yo diets” that lead to rapid weight loss fluctuation are associated with increased mortality. Instead of engaging in the next popular diet that would last only a few weeks to months (for most people that includes a ketogenic diet), try to embrace change that is sustainable over the long term. A balanced, unprocessed diet, rich in very colorful fruits and vegetables, lean meats, fish, whole grains, nuts, seeds, olive oil, and lots of water seems to have the best evidence for a long, healthier, vibrant life.
“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.”
The ketogenic diet is a high-fat, adequate-protein, low-carbohydrate diet that in medicine is used primarily to treat difficult-to-control (refractory) epilepsy in children. The diet forces the body to burn fats rather than carbohydrates. Normally, the carbohydrates contained in food are converted into glucose, which is then transported around the body and is particularly important in fueling brain function. However, if little carbohydrate remains in the diet, the liver converts fat into fatty acids and ketone bodies. The ketone bodies pass into the brain and replace glucose as an energy source. An elevated level of ketone bodies in the blood, a state known as ketosis, leads to a reduction in the frequency of epileptic seizures.[1] Around half of children and young people with epilepsy who have tried some form of this diet saw the number of seizures drop by at least half, and the effect persists even after discontinuing the diet.[2] Some evidence indicates that adults with epilepsy may benefit from the diet, and that a less strict regimen, such as a modified Atkins diet, is similarly effective.[1] Potential side effects may include constipation, high cholesterol, growth slowing, acidosis, and kidney stones.[3]
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.

The importance of dietary CHO is so well ingrained that the concept is taken for granted. In fact, basic macronutrient guidelines are predicated upon the idea that the central nervous system (CNS) requires a minimum of ~130 grams (~520 kcal) per day to function properly (i.e., to maintain optimal cognitive function). As a result, the minimum recommended daily intake of CHO reflects this idea (7). Similarly, most contemporary texts on sports nutrition emphasize the outsized role of CHO in optimizing both athletic performance and recovery (9). Frequently referred to as the “master fuel,” recommendations range from 3 – 12 grams per kilogram of bodyweight, per day. As an example, the recommended daily intake for a 180-lb athlete would be 246 – 982 grams, with a caloric equivalent of 984 – 3,928 calories. In marked contrast, the KD would recommend a maximum of just 50 grams (~ 200 calories) per day for the same individual.
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.
It has been repeatedly found that in the long-term, all diets with the same calorific value perform the same for weight loss, except for the one differentiating factor of how well people can faithfully follow the dietary programme.[27] A study comparing groups taking low-fat, low-carbohydrate and Mediterranean diets found at six months the low-carbohydrate diet still had most people adhering to it, but thereafter the situation reversed: at two years the low-carbohydrate group had the highest incidence of lapses and dropouts.[27] This may be due to the comparatively limited food choice of low-carbohydrate diets.[27]
“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!”
I’ve been following the Keto diet for almost 4 months now. I have lost almost 25 pounds and feel good. I am an active daily walker and have also started doing some strength and conditioning 3-5 days week. I decided to have a physical since I’m being so healthy why not keep up with everything else. All my lab work came back good, and very good except for LDL cholesterol, very high over 200. Immediately the doctor wants to put me on a low dose of medicine. I know I’ve been consuming alot of saturated fats on this diet. I’m confused on what to do now 🙁
Dear Martina, I wasn’t sure how to contact you. I am a final year undergraduate Human Nutrition student. I was also a keto diet follower and your app and blogs were a great help. For my final year project I‘ve chosen to study the present awareness of the ketogenic diet. I would like to ask if you would be interested to present my questionnaire to your followers. I will of course send you the questionnaire personally first for your approval. Please let me know if you are interested. Thank you for your hard work. You are a great help for many of us.
Others consider the keto diet a short-term solution for weight loss. Tyler Drew, a 34-year-old real estate broker from Los Angeles, first read about the diet on Reddit and used it to lose 45 pounds in six months before returning to a traditional diet. While on the keto diet, Drew’s cholesterol levels improved, even though a typical day of eating involved bacon at both breakfast and dinner.
You can have a completely smooth transition into ketosis, or…not. While your body is adapting to using ketones as your new fuel source, you may experience a range of uncomfortable short-term symptoms. These symptoms are referred to as “the keto flu.” Low-sodium levels are often to blame for symptoms keto flu, since the kidneys secrete more sodium when you’re in ketosis, says Volek. A few side effects:
Carrying out a very low-calorie diet plan is one of the quickest and best methods to lose sizable weight. Its principle is founded on decades-long research that proves how a diet that lessens or removes carbohydrates, prioritizes lean proteins and leafy vegetables and allows a tiny amount of good fat can change the way the body's energy system operates. The diet causes ketosis, from where the body is driven by ketones instead of glucose. Through following a menu of a cautious selection of recommended food items, a very low-calorie diet kills food cravings and enables you to feel sufficiently full without excessive food intake.
“I have personally followed a low-carb, keto diet for over 20 years for my own health, and have used it for over 15 years with patients, primarily for weight loss. Recently, I have found the medical version of the ketogenic diet to have antipsychotic effects and mood benefits in patients with chronic mental illness, so I am pioneering the clinical use of the ketogenic diet in psychiatry. I often recommend Diet Doctor to patients, friends, and family as a trustworthy resource for weight loss versions of the diet. For the treatment of serious mental illness, I recommend working with a trained clinician.”
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).
“As a physician I was frustrated and distressed by patients’ worsening health and by the spiraling health care costs caused by diabetes, obesity and other chronic conditions, all linked to the food we eat. We help our patients improve their health and optimize their weight with prescribed lifestyle modification, teaching them the link between unhealthy, refined and processed foods and chronic illness. Our growing database of patients who have lost weight and improved cardio-metabolic markers demonstrates the benefits of low-carbohydrate, whole-food diets. In short, reducing the carbohydrate content of our meals controls hunger, promotes weight loss, and improves health.”
Body composition was first measured by dual-energy X-ray absorptiometry (DXA; GE Healthcare Lunar, Madison, WI, USA). Daily quality control scans were acquired during the study period. No hardware or software changes were made during the trial. Subjects were scanned using standard imaging and positioning protocols, while wearing only light clothing. For this study, the values of bone mineral density, lean body mass, and FM were directly measured by the GE Lunar Body Composition Software option. Some derivative values, such as bone mineral content, regional lean mass, FFM, fat mass percentage (FM%), and visceral fat mass, were also calculated.
Check nutritionally-complete low-carb menus with under 50 grams of net carbohydrate per day to see what a ketogenic diet could look like. These menus are, however, going to be too high in protein for some people to remain in ketosis, and some of them may be a little high in carb if you have very poor carb tolerance. Keep in mind that ketogenic diets should always be tailored to the individual.

Look, the good doctor is right – he only forgot to stress “portion control” which is why many fanatical dieters are so kee-jerk reactive to any discussion – odds are you over ate like a hog before your keto diet, and are weak and insecure in your diet plans. Eat EVERYTHING in small amounts, and you will live long and prosper. The only thing to avoid are processed foods. Cook your meals from scratch using quality ingredients.


Fat is an important energy source; however, it plays a secondary role as an energy substrate, particularly during exercise that exceeds moderate intensity. For example, one of the fundamental concepts of bioenergetics illustrates this point through the axiom “fat burns in a carbohydrate flame;” clearly emphasizing the important role of CHO in energy metabolism. In the absence of adequate CHO availability, as might occur during starvation, near the end of a long endurance event or CHO-restricting diet, the body must turn to an alternate source to maintain energy for all tissues. Under normal dietary conditions there is a steady supply of glucose which the body readily uses as a primary fuel.

The goal of the ketogenic diet is to put your body into ketosis — a state where your body burns fat instead of carbs for fuel. The diet consists of mostly fat (75% of your daily calories, in fact), with moderate consumption of protein (20%) and very few carbs (<5%).  Without access to glucose from carbs, your body doesn’t have all the highs and lows that lead to hunger pangs, energy crashes, and cravings.  The liver instead must convert fatty acids from your diet into ketones for the body and brain to use as fuel. This keeps blood sugar levels stable. Your body also sheds excess weight — fast. But that doesn’t mean it’s unhealthy or unsustainable — provided you do it the right way.
Instead of adding sugar to your coffee, you can put a few drops of stevia in there to sweeten it up. Stevia is a great sweetener and won’t increase your blood sugar levels – so it’s a perfect way to sweeten your morning coffee. If you find stevia to have a bitter aftertaste, erythritol and monk fruit extract are two other keto-friendly sweeteners worth trying.
“I recommend low-carb and keto diets because there’s nothing more fun than empowering people to treat the root of the problem to help regain their health. Diet Doctor offers a great deal of support to me and to my patients because it allows them to digest the information in their own time and, particularly if it’s the first time they hear it, it helps ease their fears to see that there’s a whole world of science supporting the new prescription (food) I am giving them.”
As your body breaks through the carb cycle and enters ketosis (where you rely on ketones, instead of carbs, for energy), you may experience fatigue, mental fogginess, even irritability. My "keto flu" only lasted a day, and once I passed it, I never experienced the symptoms again. I even ate a cookie one day during the diet to celebrate my birthday. I certainly came out of ketosis when I ate that treat, but I didn't experience any repercussions for it. 
Hi Kelly, All packaged foods will have a nutrition label that list the macros per serving, including fat, protein and cabrohydrates. Net carbs, which is what most people look at for low carb and keto, are total carbs (the amount on the label) minus fiber and sugar alcohols, as explained in the article above. I have a low carb food list here that gives you a full list of all the foods you can eat, and the net carbs in each. You can also sign up above to be notified about the meal plans, which are a great way to get started.
Ariel Warren is a Registered Dietitian, Diabetes Educator, graduate from Brigham Young, and was diagnosed with Type 1 at the age of 4 years old. Ariel understands diabetes and enjoys working with clients to improve their blood sugar management, healthy eating, weight loss, fitness, and pregnancy. For coaching from a T1D Dietitian, you can contact Ariel directly, through her website: arielwarren.com.
The good news, however, is that following a well-formulated ketogenic diet should help increase HDL while lowering triglyceride levels. LDL will likely remain the same or potentially increase in order to efficiently transport triglycerides to cells to metabolize for energy. Again, LDL will likely become more of the pattern A type which is a highly beneficial shift.
Excessive ketone bodies can produce a dangerously toxic level of acid in the blood, called ketoacidosis. During ketoacidosis, the kidneys begin to excrete ketone bodies along with body water in the urine, causing some fluid-related weight loss. Ketoacidosis most often occurs in individuals with type 1 diabetes because they do not produce insulin, a hormone that prevents the overproduction of ketones. However in a few rare cases, ketoacidosis has been reported to occur in nondiabetic individuals following a prolonged very low carbohydrate diet. [4,5]
Commonly known as “keto”, a ketogenic diet is a diet typically characterized by a 4:1 ratio of dietary fat to protein and carbohydrate and was originally used in the treatment of childhood epilepsy. It has been theorized that keto diets facilitate greater fat loss in humans as an absence of dietary carbohydrate forces the body to oxidize fat as its primary energy source.
A ketogenic diet may be an option for some people who have had difficulty losing weight with other methods.  The exact ratio of fat, carbohydrate, and protein that is needed to achieve health benefits will vary among individuals due to their genetic makeup and body composition. Therefore, if one chooses to start a ketogenic diet, it is recommended to consult with one’s physician and a dietitian to closely monitor any biochemical changes after starting the regimen, and to create a meal plan that is tailored to one’s existing health conditions and to prevent nutritional deficiencies or other health complications. A dietitian may also provide guidance on reintroducing carbohydrates once weight loss is achieved.
Getting into ketosis is a critical component of the ketogenic diet. You can achieve ketosis by fasting, cutting carbs drastically (typically under 50 grams a day), and/or taking keto supplements, such as BHB (exogenous ketones) and MCT-based meal replacement shakes. After becoming fat-adapted, incorporating intermittent fasting (IF) can help boost weight loss or break weight loss plateaus. The most common method is 16:8 where you go 16 hours without eating, and consume all of your calories during an 8-hour eating window.
Katherine Arvesen, RDN, who in private practice in Plano, Texas, also notes that the study was not randomized and controlled, which is the gold standard for medical research to minimize error and bias. In this study, the patients were their own controls, meaning their results were compared with their own baseline (starting) measurements, not with the results of a control group.
The inclusion criteria were age 18 to 65 years, body mass index (BMI) ≥ 30 kg/m2, stable body weight in the previous 3 months, a desire to lose weight, and a history of failed dietary efforts. The main exclusion criteria were thyroid alteration, diabetes mellitus, obesity induced by other endocrine disorders or by drugs, and participation in any active weight-loss program in the previous 3 months. In addition, those patients with previous bariatric surgery, known or suspected abuse of narcotics or alcohol, severe depression or any other psychiatric disease, severe hepatic insufficiency, any type of renal insufficiency or gouts episodes, nephrolithiasis, neoplasia, previous events of cardiovascular or cerebrovascular disease, uncontrolled hypertension, orthostatic hypotension, and hydroelectrolytic or electrocardiographic alterations were excluded. Females who were pregnant, breastfeeding, or intending to become pregnant and those with child-bearing potential and not using adequate contraceptive methods were also excluded. Apart from obesity and metabolic syndrome, participants were generally healthy individuals. Under these conditions, 20 obese patients were included in this study.
I have been on keto for past 7 months. Triglycerides improved from 117 to 86 and HDL from 53 to 55, VLDL from 23 to 17 compared to last year. My problem is, LDL has been increasing by an average of 20 points every year for past 5 years, it was 130 in 2014, My metabolic panel is normal. Below is my lipid panel done a couple of days ago. Could you please advise me on how to improve my LDL level?
Hi Gigi, Low carb and keto is about the balance of macronutrients eaten (fat, protein and carbs), not specifically meat or lack thereof. Most people on keto do eat meat, though some people do vegetarian keto. Fat is actually necessary for many body processes. There is no issue for the kidneys with a high fat diet, but if you eat too much protein that isn’t great for the kidneys. It’s a common misconception that keto is high protein (it isn’t). Keto is great for diabetics as it naturally helps stabilize insulin. All of this being said, please know I’m not a doctor and you should consult your doctor on any medical questions or before starting any diet. If you have more questions that aren’t medical questions, I recommend our low carb & keto support group here.
Great point – the literature shows that ketogenic macro splits are very protein sparing for weight loss and the body will typically burn fat and glucose and spare lean mass. Dr. Jason Fung makes the analogy that it would be like stacking firewood for the winter and then when winter hits, deciding not to use the firewood and instead use the living room couch!
The ketogenic diet has grown to become extremely popular over the last few years. It’s ideal for those of you that are looking to lose a considerable amount of weight. This diet is essentially a very low carb, high fat diet. While it has many similarities to the Atkins diet when on the keto diet, your body mostly gets its calories from proteins and fat, not from carbohydrates. The video below will give you an idea of what you can expect when moving to a ketosis lifestyle.
Hi Courtney, I’m currently working on a 21-Day Keto Meal Plan. Unfortunately, it’s super time-consuming. And after buying a keto cookbook yesterday and returning it the same day because it wasn’t well researched and the recipes clearly not created specifically for the Keto diet you wouldn’t want me to rush this. I want to make sure the Meal Plan is SPOT on and the recipes complement each other and make eating Keto easy. Give me another month or two and I’ll hopefully have more news on progress. Currently working on a rough sketch but still have to test all recipes and photograph them, too. You definitely don’t need nuts to be able to eat Keto. For now, I recommend to keep it as simple as possible. You can eat my 1-day meal plan 4 days a week and find other recipes you like to build another similar day and then keep switching between mine and the other.
In part, keto diet weight loss is a real thing because high-fat, low-carb diets can both help diminish hunger and boost weight loss through their hormonal effects. As described above, when we eat very little foods that supply us with carbohydrates, we release less insulin. With lower insulin levels, the body doesn’t store extra energy in the form of fat for later use, and instead is able to reach into existing fat stores for energy.
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