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.

“After years of practicing Family & Sports Medicine, I’ve recognized that preventing and addressing my patients’ dietary metabolic issues are the foundation upon which quality medical and musculoskeletal care are built. LCHF principles produced such remarkable results in my patients that I completely redefined my scope of practice and developed a unique Lifestyle Medicine Program that synergistically complements my Sports Medicine & Non-Surgical Orthopedics specialty practice. I truly care for the whole person. Diet Doctor is an exceptional, comprehensive resource for lay persons and clinicians; I recommend it to all my patients and colleagues.”


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 🙁
In fact, once all our our reserved glucose/glycogen runs out after several days on a low-carb, keto diet, our bodies create compounds called ketone bodies (or ketones) from our own stored body fat, as well as from fats in our diet. In addition, researchers have discovered that ketones contain main benefits, such as fat loss, suppressing our appetites, boosting mental clarity and lowering the risk for a number of chronic diseases.
Keto flu is a real thing. Cutting your carbs to the bone and going into a state of ketosis (where your body burns fat for energy) can bring on a cluster of uncomfortable symptoms, such as headaches, fatigue, muscle aches, nausea, and diarrhea. The side effects are the result of your body transitioning to using fat as its primary source of energy instead of carbs, explains Kristen Mancinelli, MS, RDN, author of The Ketogenic Diet. Once it adapts to the new fuel source (usually within a week or two), you’ll start to feel better.

Some previous studies have suggested that very-low-calorie ketogenic (VLCK) diets may be effective tools to manage overweight and obesity (10, 11, 13). VLCK diets are a nutritional intervention that emulate fasting by restricting carbohydrates and fat with a relative increase in protein intake (6). The increased protein content may be partially responsible for the muscle mass preservation (12–14). Importantly, the weight-reducing action of these diets is rapid, and despite the fact that the ketosis state lasts only 60 to 90 days at the start of treatment, the weight reduction remains for up to 2 years (13). Therefore, VLCK diets operate by potent mechanisms to induce weight loss, and various body compartments might be altered. To the best of our knowledge, no studies have exhaustively assessed the changes in body composition associated with this type of diet, and variations in muscle strength have been only assessed in athletes (15).
Because people with type 2 diabetes are at an increased risk for cardiovascular disease, there’s a specific concern that the saturated fat in the diet may drive up LDL, or “bad,” cholesterol levels, and further increase the odds of heart problems. If you have type 2 diabetes, talk to your doctor before attempting a ketogenic diet. They may recommend a different weight-loss diet for you, like a reduced-calorie diet, to manage diabetes. Those with epilepsy should also consult their doctor before using this as part of their treatment plan.
Initially, 23 participants were recruited into the study, but 3 dropped out voluntarily during the first week of the intervention for reasons unrelated to diet, and therefore were excluded from analysis. The 20 patients who completed the study exhibited the following baseline characteristics: mean age, 47.2 ± 10.2 years; BMI, 35.5 ± 4.4; and waist circumference, 109.4 ± 12.8 cm; 12 (60%) were women (Supplemental Table 1). Other baseline characteristics and their corresponding changes during the study are presented in Table 1.

A Cochrane systematic review in 2018 found and analysed eleven randomized controlled trials of ketogenic diet in people with epilepsy for whom drugs failed to control their seizures.[2] Six of the trials compared a group assigned to a ketogenic diet with a group not assigned to one. The other trials compared types of diets or ways of introducing them to make them more tolerable.[2] In the largest trial of the ketogenic diet with a non-diet control[16], nearly 38% of the children and young people had half or fewer seizures with the diet compared 6% with the group not assigned to the diet. Two large trials of the Modified Atkins Diet compared to a non-diet control had similar results, with over 50% of children having half or fewer seizures with the diet compared to around 10% in the control group.[2]


It’s also currently as trendy to the fitness world as kale and açaí are to the pseudo-hipsters who wear beanies, even in the dead-heat of summer. If you haven’t tried keto on for size, maybe give it a go (unless you’re a complete and utter carb bitch, and cramming yourself full of bagels and pancakes just makes your abs really pop - in which case, the rest of us hate you on the inside. Just a little.)

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]
HDL stands for high-density lipoprotein and its primary role in the body is actually to sweep up LDL particles and return them to the liver for recycling. This is because LDL is actually very susceptible to oxidation so it must be cleared from the blood efficiently. This means when LDL is exposed to chronic inflammation, it becomes damaged. The longer LDL remains in the blood stream and the higher your inflammation levels are, the higher your risk of heart disease.
While there are delicious-looking ketogenic recipes and meal plans online, experts like Weaver warn that you’ll want to avoid relying too much on artificial sweeteners and unhealthy foods for your keto diet menu. Make sure your grocery list includes healthy fats like avocados, coconut oil, olive oil. This is what really happens to your body on the keto diet.

.. 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.
A very recent review on nutritional approaches toward preventing and reversing Alzheimer’s disease (AD) was conducted in Christchurch, New Zealand’s Canterbury University. The results were submitted to the journal Nutrition. It’s title: "The ketogenic diet as a potential treatment and prevention strategy for Alzheimer's disease." After analyzing 33 studies researching AD and other neurological disorders handled with a ketogenic diet and supplementing coconut oil, the University of Canterbury review analysis concluded: "In this review, we hypothesize that the ketogenic diet could be an effective treatment and prevention for Alzheimer's disease, but both ketone production and carbohydrate restriction may be needed to achieve this."
"The keto diet is primarily used to help reduce the frequency of epileptic seizures in children. While it also has been tried for weight loss, only short-term results have been studied, and the results have been mixed. We don't know if it works in the long term, nor whether it's safe," warns registered dietitian Kathy McManus, director of the Department of Nutrition at Harvard-affiliated Brigham and Women's Hospital.
Dieter beware: U.S. News & World Report, in its high-profile January cover story on "best diets," calls the DASH and Mediterranean diets tops for health, though these regimens represent the failed nutritional status quo of the last 50 years. It's clear that U.S. News — which employed an expert panel to rate 40 diets on various criteria — merely recapitulated questionable dietary advice that has gone by a succession of names since the 1970s — "low-fat," "DASH," "USDA-style," "plant-based." The basic set of recommendations have remained the same, emphasizing plant foods (grains, cereals, fruits and vegetables) over animal products (eggs, regular dairy, meat), and vegetable oils over natural animal fats such as butter. According to government data, Americans have largely followed these recommendations over the last 50 years, notably increasing their consumption of grains, vegetables and fruits and eating less whole milk, butter, meat and eggs. The outcome? In that time, rates of obesity and Type 2 diabetes have skyrocketed. Something has gone terribly wrong. Why would 25 doctors, dietitians and nutritionists on the U.S. News panel choose a dietary philosophy that has — so far, at least — failed us?
MF-BIA (InBody 720; Biospace, Tokyo, Japan) was also used for determining body composition in terms of FM, FM%, FFM, total body water, intra- and extracellular water, skeletal muscle mass, and ASLM. This noninvasive technology employs 8 contact electrodes, which are positioned on the palm and thumb of each hand and on the front part of the feet and on the heels. In addition, MF-BIA uses the body’s electrical properties and the opposition to the flow of an electric current by different body tissues. The analyzer measured resistance at specific frequencies (1, 5, 50, 250, 500, and 1000 kHz) and reactance at specific frequencies (5, 50, and 250 kHz). The participants were examined while lightly dressed, and the examination took less than 2 minutes and required only a standing position. The validity of this technology has been documented in previous studies (21, 22). Visceral fat area values were also calculated in cm2 by MF-BiA. Importantly, these values are significantly correlated with those generated by computed tomography (22, 23). The calculation of the different body compartments was performed according to the instructions of the manufacturer (Biospace).

You know you’re in ketosis by checking blood ketones with a hand-held ketone meter (a test for beta-hydroxybutyrate). A ketone meter can be purchased online for about $100-120, along with ketone test strips. You prick your finger and use a drop or two of blood to measure ketones. Aim for 0.5-3.0 mm. I use Precision Xtra, which can check for both ketones and glucose in the blood (useful if you’re overweight). Some people measure ketones in the urine or via a breath taste, but I’ve found them to be not as accurate.
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Much of the research into low-carbohydrate dieting has been of poor quality and studies which reported large effects have garnered disproportionate attention in comparison to those which are methodologically sound.[5] Higher quality studies tend to find no meaningful difference in outcome between low-fat and low-carbohydrate dieting.[5] Low-quality meta-analyses have tended to report favourably on the effect of low-carbohydrate diets: a systematic review found that 9 out of 10 meta-analyses with positive conclusions were affected by publication bias.[5]
A typical keto diet is comprised of 80 percent fat, 15 percent protein, and a mere 5 percent of calories from carbohydrates. If you consume 2,000 calories a day, that means just 100 of them are coming from carbs—including healthy carbs like fruits and vegetables. When you eat this way, it triggers ketosis, which means your body has burned through all its carbs and needs to begin burning fat for energy.
1. Aragon AA, Schoenfeld BJ, Wildman R, Kleiner S, VanDusseldorp T, Taylor L, Earnest CP, Arciero PJ, Wilborn C, Kalman DS, Stout JR, Willoughby DS, Campbell B, Arent SM, Bannock L, Smith-Ryan AE, and Antonio J. International Society of Sports Nutritionists Position Stand: Diets and body composition. Journal of the International Society of Sports Nutrition 14:16, 2017.
In steps 4 or 5, the ketogenic phases were ended by the physician in charge of the patient based on the amount of weight lost, and the patient started a low-calorie diet (800–1500 kcal/day). At this point, the patients underwent a progressive incorporation of different food groups and participated in a program of alimentary re-education to guarantee the long-term maintenance of the weight loss. The maintenance diet consisted of an eating plan balanced in carbohydrates, protein, and fat. Depending on the individual, the calories consumed ranged between 1500 and 2000 kcal/day, and the target was to maintain the weight lost and promote a healthy lifestyle.
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