A ketogenic diet also has been shown to improve blood sugar control for patients with type 2 diabetes, at least in the short term. There is even more controversy when we consider the effect on cholesterol levels. A few studies show some patients have increase in cholesterol levels in the beginning, only to see cholesterol fall a few months later. However, there is no long-term research analyzing its effects over time on diabetes and high cholesterol.
Melinda – I’m afraid there’s no getting around the fact that one of the Keto requirements is to *calculate your macros,* based on the amount of calories you need to consume each day, in order to (a) maintain your current weight level, or (b) lose weight. Go to an online Keto macro calculator – there’s one linked to a good one on this site, further up the thread. They are generally very easy to use. Then stick to your calculated results, with trust and patience. It may be slow, but you will absolutely see results. I did – and I’ve tried absolutely everything. I barely have time to exercise, but I still lost at least a couple of dress sizes, and I feel absolutely amazing – no more brain fog, tons of energy – maybe too much energy! And best of all, I’m no longer miserable about food, because on Keto, everything is delicious! One final thing in the interest of full disclosure – I am an uber-clean-Keto advocate. I put in the work to eat only healthy fats and carbs from healthy sources. I’m pescatarian – no meats except seafood. I also carefully limit my saturated fat intake to 10% of total calories (the recommended daily allowance), to keep my genetically problematic cholesterol level from skyrocketing, as it did when I first began. This is all working well for me so far – I was able to cut 40 points from my abnormally high LDL (bad cholesterol) level within three months, And hope to get it down to normal levels in three more months. You do want to make sure you get your regular physical exams and monitor your blood work whenever you change your nutritional lifestyle. I wish you the best!
A low-carbohydrate diet gives slightly better control of glucose metabolism than a low-fat diet in type 2 diabetes.[12][34] A 2018 report on type 2 diabetes by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) found that a low-carbohydrate diet may not be as good as a Mediterranean diet at improving glycemic control, and that although having a healthy body weight is important, "there is no single ratio of carbohydrate, proteins, and fat intake that is optimal for every person with type 2 diabetes".[35]

Before starting, ask yourself what is really realistic for you, Mattinson suggests. Then get your doctor’s okay. You may also work with a local registered dietitian nutritionist to limit potential nutrient deficiencies and talk about vitamin supplementation, as you won’t be eating whole grains, dairy, or fruit, and will eliminate many veggies. “A diet that eliminates entire food groups is a red flag to me. This isn’t something to take lightly or dive into headfirst with no medical supervision,” she says.
–Make healthy breakfast fun with these little low carb blueberry pancake dippers. They're easy enough to make on a weekday morning! This post is sponsored by Wyman's. Do you get into a breakfast rut? You wake up, wander to the kitchen, grab a cup of coffee and think...same old same old. You could have eggs...again. Or you could have a low carb muffin...again. Maybe you have some low carb bread on hand for toast...again. Whatever your breakfast routine, you're sick of it and you want something different. Yep, this happens in my house too, with relative frequency.All Day I Dream About Food
In the 1960s, medium-chain triglycerides (MCTs) were found to produce more ketone bodies per unit of energy than normal dietary fats (which are mostly long-chain triglycerides).[15] MCTs are more efficiently absorbed and are rapidly transported to the liver via the hepatic portal system rather than the lymphatic system.[16] The severe carbohydrate restrictions of the classic ketogenic diet made it difficult for parents to produce palatable meals that their children would tolerate. In 1971, Peter Huttenlocher devised a ketogenic diet where about 60% of the calories came from the MCT oil, and this allowed more protein and up to three times as much carbohydrate as the classic ketogenic diet. The oil was mixed with at least twice its volume of skimmed milk, chilled, and sipped during the meal or incorporated into food. He tested it on 12 children and adolescents with intractable seizures. Most children improved in both seizure control and alertness, results that were similar to the classic ketogenic diet. Gastrointestinal upset was a problem, which led one patient to abandon the diet, but meals were easier to prepare and better accepted by the children.[15] The MCT diet replaced the classic ketogenic diet in many hospitals, though some devised diets that were a combination of the two.[10]
We’re going full on fats with breakfast, just like we did last week. This time we’ll double the amount of ketoproof coffee (or tea) we drink, meaning we double the amount of coconut oil, butter, and heavy cream. It should come to quite a lot of calories, and should definitely keep us full all the way to dinner. Remember to continue drinking water like a fiend to make sure you’re staying hydrated.
A recent randomized, double-blind, placebo-controlled trial found that subjects who received 400 mg garlic powder tablets twice a day lost significantly more fat than the control group. Although there are many confounding variables in this trial, animal studies back up the human findings by providing us with evidence that garlic supplementation can have anti-obesogenic effects (i.e., garlic prevents weight gain) in mice.

Your individual fat adaptation period. Remember your body needs time to become fat-adapted and that time depends on your metabolism. For instance, if you’re coming off a Standard American Diet (SAD) and your adult body has never run on ketones before, your adaptation period might take a little longer. You’ll only experience the true weight loss effects of keto when your body is actually running on ketones.


Here’s encouragement…it’s not all about weight in the beginning. As you ween off of sugar (which is really poison to your body), your body has to start getting rebooted. I had a solid week or more of serious detox. I knew that getting the poison out of my body was going to be significant, and it was. Don’t be discouraged. It’s well worth it to truly rid your gut and body of cancer-causing poison, not to mention your ability to fight disease. The acid level will change. Your arthritis (joints) will improve. Stick with it and don’t give up. Your family is worth it!
Diego Gomez-Arbelaez, Diego Bellido, Ana I. Castro, Lucia Ordoñez-Mayan, Jose Carreira, Cristobal Galban, Miguel A. Martinez-Olmos, Ana B. Crujeiras, Ignacio Sajoux, Felipe F. Casanueva, Body Composition Changes After Very-Low-Calorie Ketogenic Diet in Obesity Evaluated by 3 Standardized Methods, The Journal of Clinical Endocrinology & Metabolism, Volume 102, Issue 2, 1 February 2017, Pages 488–498, https://doi.org/10.1210/jc.2016-2385
In conclusion, to the best of our knowledge, this is the first study that exhaustively assessed food and alcohol cravings and changes in well-being determinants, such as sexual function, physical activity, and sleep abnormalities and QoL, during the weight-reduction process induced by a VLCK diet. The severe weight loss induced by the VLCK diet-PNK method was concomitant with a decrease in food and alcohol cravings, increases in physical activity, reduction of sleep abnormalities, and improvement in sexual functioning. Overall, these psychobiological parameters were translated to an enhancement in general QoL for the dieters. Relevantly, this is the first study able to distinguish the effect of ketosis per se independently of the weight-loss magnitude because the strongest effect was evidenced at highly ketosis-mild weight reduction, rather than at nonketosis-strong (mean 20 kg) weight reduction. Therefore, the results of this study evidenced that the rapid and sustained weight and FM loss induced by VLCK-diet are associated with good food control and improvements in the psychological well-being parameters in obese subjects that could be reinforced by the effect of ketosis. This effect could contribute to long-term success of this therapy and further reinforce the suitability of a VLCK-diet as a viable and valuable treatment option for obesity.
“Our medical practice was featured implementing a low-carbohydrate plan for a patient with type 2 diabetes in the documentary The Magic Pill. We believe food can be used as medicine. Many of our patients with insulin resistance, diabetes, metabolic syndrome, PCOS and more will see excellent results and resolution of chronic disease states with low-carbohydrate diets. Education and understanding as to which dietary strategy is best for the individual is essential in reclaiming one’s health. There is no doubt in my mind that low-carbohydrate planning can be extremely useful and safe for the appropriate clinical scenario.”
“Thanks to nutrition and the low-carb diet, which I fell in love with 21 years ago, I’ve witnessed in my private practice diabetes & metabolic syndrome improving or reversing; women with PCOS conceiving; memory problems getting better; and cancer patients achieving remarkable results. Since I found Diet Doctor, this health company has become my main resource and partner for inspiring and helping patients and family feed themselves to better health. When Diet Doctor asked me to be part of their Spanish team, I did not hesitate because empowering people to revolutionize their health is our common mission.”
Dr. Jockers, thank you so much for this clear and detailed article! I began a keto-style diet around August 2019. By late November, I had fallen from 197 lbs. to under 175 lbs., dropped from 28% to 18% body fat, and anecdotally felt much better in all aspects of my health. All of this occurred exclusively due to diet, I believe– I had almost no exercise routine to speak of, and my desk-based job is pretty sedentary. My family practice doc was surprised and happy with the results as well when I met with him in January… until my blood work came back showing total cholesterol at 257, triglycerides at 236, LDL-C at 162, and HDL at 50.
Our bodies are incredibly adaptive to what you put into it – when you overload it with fats and take away carbohydrates, it will begin to burn ketones as the primary energy source. Optimal ketone levels offer many health, weight loss, physical and mental performance benefits.1There are scientifically-backed studies that show the advantage of a low-carb, ketogenic diet over a low-fat diet. One meta-analysis of low-carbohydrate diets showed a large advantage in weight loss. The New England Journal of Medicine study resulted in almost double the weight loss in a long-term study on ketone inducing diets.
Low-carbohydrate diets or carbohydrate-restricted diets (CRDs) are diets that restrict carbohydrate consumption. Foods high in carbohydrates (e.g., sugar, bread, pasta) are limited or replaced with foods containing a higher percentage of fats and moderate protein (e.g., meat, poultry, fish, shellfish, eggs, cheese, nuts, and seeds) and other foods low in carbohydrates (e.g., most salad vegetables such as spinach, kale, chard and collards), although other vegetables and fruits (especially berries) are often allowed.
The keto diet forces your body to use fat as its main energy supply instead of glucose, a process called ketosis. On the keto diet, you eat so few carbohydrates that your body can't rely on glucose for energy. And since keto meals are loaded with fat, your body switches over to using fat for energy instead of carbohydrates. You get 70 to 80 percent of your calories from fat, 15 to 20 percent from protein and about 5 percent from carbohydrates (for a total of 20 to 30 grams of carbohydrates a day, depending on your height and weight).

It’s been a disaster this calories in, calories out. I mean look at the effect. Since we have adopted that philosophy we have worldwide epidemics of obesity, diabetes, faKy liver and so on… It’s been a disaster and the sooner we forget about it… It’s sort of an attractive concept, you know, what you bring in, what you take out… But unfortunately it doesn’t work.
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.

Ketosis was determined by measuring ketone bodies, specifically B-hydroxybutyrate (B-OHB), in capillary blood using a portable meter (GlucoMen LX Sensor, A. Menarini Diagnostics, Neuss, Germany) before measurements of anthropometric parameters. As with anthropometric assessments, all of the determinations of capillary ketonemia were made after an overnight fast of 8 to 10 hours. These measurements were performed daily by each patient during the entire VLCK diet, and the corresponding values were reviewed on the machine’s memory by the research team for managing adherence. Additionally, B-OHB levels were determined at each complete visit by the physician in charge of the patient. The measurements reported as “low value” (≤ 0.2 mmol/L) by the meter were assumed to be zero for purposes of statistical analyses.

“Through my 31 years in primary care, I have witnessed the growing waistlines and blood sugar levels of my patients. Seeing that the “eat less, move more” advice was failing them, I moved to a low-carb, high-fat approach eight years ago. This has produced great results in my patients. I am able to manage many medical issues without resorting to medications. This new approach has revitalized my practice. I feel like I can finally really help my patients.”
There is nothing inherently difficult about following a ketogenic diet. We have many patients who do this very easily over many years. The metabolic benefits significantly outway any perceived challenges from limiting particular food types. Uptake would be far more widespread if nutrition professionals left their predujical opinions of SFA’s behind. Finally, given the expertise in Ketogenic Diets at Harvard, Dr David Ludwig, for one springs to mind, I am surprised the author did not avail themselves of the local expertise.
Dr. Josh Axe, DNM, DC, CNS, is a doctor of natural medicine, clinical nutritionist and author with a passion to help people get well using food as medicine. He’s the author of the books “Eat Dirt: Why Leaky Gut May Be the Root Cause of Your Health Problems,” “Essential Oils: Ancient Medicine” and the upcoming “Keto Diet: Your 30-Day Plan to Lose Weight, Balance Hormones, Boost Brain Health, and Reverse Disease” (February 2019, published by Little, Brown Spark). He’s a co-founder of Ancient Nutrition, a health company where the mission is to restore health, strength and vitality by providing history’s healthiest whole food nutrients to the modern world.
The ketogenic diet, or keto, relies on using your fat as fuel, instead of glucose from carbohydrates or protein. Simply put, the daily ketogenic diet consists of 75 percent fat, 20 percent of protein, and a teeny allotment of carbohydrates, about 5 percent. This balance of macronutrients is intended to put your body in a state of ketosis, which suppresses the release of insulin and blood glucose levels. The benefits of ketosis to your health are improvements in biomarkers like blood glucose, reduction of blood pressure and decreased appetite due to fullness linked to consumption of fats.
Recently, four studies have re-examined the effect of carbohydrate restriction on type 2 diabetes. One outpatient study enrolled 54 participants with type 2 diabetes (out of 132 total participants) and found that hemoglobin A1c improved to a greater degree over one year with a low-carbohydrate diet compared with a low-fat, calorie-restricted diet [5,6]. Another study enrolled 8 men with type 2 diabetes in a 5-week crossover outpatient feeding study that tested similar diets [7]. The participants had greater improvement in glycohemoglobin while on the low-carbohydrate diet than when on a eucaloric low-fat diet. The third study was an inpatient feeding study in 10 participants with type 2 diabetes [8]. After only 14 days, hemoglobin A1c improved from 7.3% to 6.8%. In the fourth study, 16 participants with type 2 diabetes who followed a 20% carbohydrate diet had improvement of hemoglobin A1c from 8.0% to 6.6% over 24 weeks [9]. Only these latter three studies targeted glycemic control as a goal, and two of these were intensely-monitored efficacy studies in which all food was provided to participants for the duration of the study [7,8]. Three of the studies [6,8,9] mentioned that diabetic medications were adjusted but only one of them provided detailed information regarding these adjustments [9]. This information is critical for patients on medication for diabetes who initiate a low-carbohydrate diet because of the potential for adverse effects resulting from hypoglycemia.
My Husband and I started doing Keto July 2018. We got over weight after we got out of the Marine Corps. It has been hard to workout because I became disabled, but my diet was not good. After our friend Amber recommended your site and support group, we found a lot of helpful information to get us started on a successful journey. So far it’s been one month and we have lost 18 pounds each!
Unfortunately, there’s no long-term data on ketogenic diets versus other diets. In a 2015 Italian study, those on a ketosis diet lost 26 pounds in three months. About half of the participants stayed on the diet for a year but lost little additional weight in the next nine months. People in a 2014 Spanish study who followed a very-low-calorie ketogenic diet lost an average of 44 pounds in a year—but a third of them dropped out, possibly because it was too hard to maintain.
In theory, a ketogenic diet that increases carbohydrate loads for cardio exercise seems perfect. However, the side effects of a ketogenic diet can include dehydration, malnutrition and constipation. According to the Mayo Clinic website, ketogenic plans also can lead to kidney stones. In addition, the ketogenic diet does not give you the nutrition you need to be healthy. Instead, try cutting portion sizes and counting calories; this also can force your body to burn fat while still providing you with balanced nutrition, including proteins, carbohydrates, fiber and fat. As with any diet, you should discuss a ketogenic diet with your doctor.
The ketogenic diet first gained fame through its effectiveness for weight loss. The high-fat, low-carb diet promotes nutritional ketosis–a normal metabolic state marked by moderate levels of ketones in the blood. The idea with carb restriction in terms of weight loss is that it prompts the release of body fat to be burned or converted to ketones for energy (extra dietary fat also contributes to ketone production).
“I’ve studied LCHF nutrition for over 20 years for personal health benefits. In my medical practice, it has become integral to reversing many of modern society’s worst medical concerns including metabolic syndrome, obesity, and diabetes. It can be applied safely and effectively for nearly all of my patients and often results in dramatic restoration of good health.”
The changes in the variables of the study were analyzed through repeated-measures ANOVA (the within-subjects factor included 4 measurements), defining polynomial contrast to explore potential linear, quadratic, and cubic trends (3-order polynomial trends were considered due to the 4-level measurements), and post-hoc pairwise comparisons employing Tukey’s adjustment for multiple comparisons. Effect size for each pairwise comparison was based on Cohen’s-d coefficient, considering poor effect size for |d| > 0.20, medium/moderate for |d| > 0.50, and large/good for |d| > 0.80 [33].
“Our medical practice was featured implementing a low-carbohydrate plan for a patient with type 2 diabetes in the documentary The Magic Pill. We believe food can be used as medicine. Many of our patients with insulin resistance, diabetes, metabolic syndrome, PCOS and more will see excellent results and resolution of chronic disease states with low-carbohydrate diets. Education and understanding as to which dietary strategy is best for the individual is essential in reclaiming one’s health. There is no doubt in my mind that low-carbohydrate planning can be extremely useful and safe for the appropriate clinical scenario.”
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.
A low-carbohydrate diet has been found to reduce endurance capacity for intense exercise efforts, and depleted muscle glycogen following such efforts is only slowly replenished if a low-carbohydrate diet is taken.[38] Inadequate carbohydrate intake during athletic training causes metabolic acidosis, which may be responsible for the impaired performance which has been observed.[38]
The first modern study of fasting as a treatment for epilepsy was in France in 1911.[12] Twenty epilepsy patients of all ages were "detoxified" by consuming a low-calorie vegetarian diet, combined with periods of fasting and purging. Two benefited enormously, but most failed to maintain compliance with the imposed restrictions. The diet improved the patients' mental capabilities, in contrast to their medication, potassium bromide, which dulled the mind.[13]
When you’re on a ketogenic diet, fatty acids are released from your body fat and insulin levels decrease. When insulin levels decrease, your kidneys will excrete more water (you’ll notice an increase in the frequency of trips to the bathroom), sodium and potassium. As a result, your blood pressure can plummet. Dizziness, fatigue and sudden weakness are symptoms of low blood pressure. Leg cramps may also occur from dehydration.
“As a family physician in the most obese state in the USA, I see the devastation of type 2 diabetes and metabolic disease in almost every hospital patient I see. For six years, I have been using education and a low-carb lifestyle to help these patients get healthier, reduce meds, gain energy, and lose belly fat. They learn that this is a sustainable life plan filled with joy and good food. Every day I share the amazing resource of Diet Doctor in my practice. Together as a global community we can put these conditions in remission and prevent them all together.”
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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