A: The most common ways to track your carbs is through MyFitnessPal and their mobile app. You cannot track net carbs on the app, although you can track your total carb intake and your total fiber intake. To get your net carbs, just subtract your total fiber intake from your total carb intake. I have written an article on How to Track Carbs on MyFitnessPal.
The first signs of ketosis are known as the “keto flu” where headaches, brain fogginess, fatigue, and the like can really rile your body up. Make sure that you’re drinking plenty of waterand eating plenty of salt. The ketogenic diet is a natural diuretic and you’ll be peeing more than normal. Take into account that you’re peeing out electrolytes, and you can guess that you’ll be having a thumping headache in no time. Keeping your salt intake and water intake high enough is very important, allowing your body to re-hydrate and re-supply your electrolytes. Doing this will help with the headaches, if not get rid of them completely.
“I have been applying low carb solutions to metabolic problems since the moment I closed the cover of Good Calories, Bad Calories. I share with my low-carb colleagues the wonderful experience of offering effective advice and seeing real results. In addition to metabolic and hormonal problems, I have more recently focused on flexible low-carb approaches for Alzheimer’s and other neurodegenerative conditions. I greatly enjoy the lively online low-carb community and rely on Diet Doctor as a resource for myself and my patients.”

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.
Despite their low-calorie content, the fiber and water in the shirataki noodles make them very filling. They can even help you stay full between meals because their fiber will slow down the movement of food through your digestive tract. These unique qualities are what make shirataki noodles ideal for anyone who wants to cut their calorie consumption without starving themselves.
Very low calorie diets are not something you should try alone. Consuming over-the-counter meal replacement products is not the same kind of treatment your doctor will provide you. In addition, ketones are not the ideal energy supplier — but rather a "will do" supplier — and this underscores how important it is that VLCDs are short in duration and guided by a qualified health care professional. In addition, many VLCD treatments involve supplementing with prescription medications to help with weight loss, which provides a measure of effectiveness you are not likely to get by going it alone.
Regarding higher-carbohydrate diets, 20 studies reported higher energy expenditure, and this increase in energy expenditure was statistically significant in 14 of those studies. Overall, the evidence suggests that the carbohydrate and fat content of the diet has little impact on energy expenditure. In other words, low-carb diets do not have a significant metabolic advantage like many insulin theory proponents believe.
“I am a physician with type 1 diabetes. I have been using a low-carb, ketogenic diet to treat my own diabetes for the past 16 years. Evidence shows that low-carb diets are safe and effective. With the potential to reverse type 2 diabetes, control type 1 diabetes and even stop, slow down, or reverse complications, a low-carb diet can be life changing. Diet Doctor provides the most accurate and relevant materials for a healthy, easy and fun low-carb experience.”
Importantly, in the current study, an improvement in the indexes of sleep was observed, especially at the point of maximum loss of fat mass (reduced ketosis). Sleep is essential to health and is associated with morbidities and mortality associated with obesity [52,53,54,55,56,57]. A recent study demonstrates that dietary protein intake while dieting to lose weight may improve sleep quality in overweight and obese adults [30]. We were unable to detect statistically significant changes in the sleep quality measured by the PSQI and indirectly corroborated with no changes during the treatment in the plasma levels of dopamine, a brain neurotransmitter synthetized from tryptophan. By contrast, the sleepiness during different real-life situations measured by the ESS was significantly reduced. This result is important because it can be associated with an improvement in the QoL, influencing parameters such as physical functioning, sexual life, and work activity. These parameters were improved after the VLCK diet treatment and contributed to an enhanced global score of quality of life evaluated by the IWQoL-Lite. The strength of this study is its longitudinal design, which allows the evaluation of the time-course of changes of psychological well-being induced by a VLCK diet. The small sample size of this study might be a limitation; however, as each subject underwent 4 evaluations and results compare with themselves, this adds statistical power to the study and a real difference between the experimental points. Moreover, the short follow-up of this study (4 months) increases the relevance of the findings as they were strong enough to be evident so rapidly. Other limitation could be that the results of this study were not comparable with a standard nonketogenic low-calorie diet. This was because this analysis was performed in previous studies [58,59,60,61,62].
Aude, Y., A. S, Agatston, F. Lopez-Jimenez, et al. “The National Cholesterol Education Program Diet vs a Diet Lower in Carbohydrates and Higher in Protein and Monounsaturated Fat: A Randomized Trial.” JAMA Internal Medicine 164, no. 19 (2004): 2141–46. doi: 10.1001/archinte.164.19.2141. jamanetwork.com/journals/jamainternalmedicine/article-abstract/217514.

HDL is still low and stuck on 45 even after hoping strongly with more healthy saturated fats organic bone broth from lamb bones, etc. LDL way up 170 and triglycerides a a record high of 170, Non HDL choleseterol at 203. Kinda surprizd I cannot more that HDL number aftyer all the keto stuff. And unsure why the LDL has exploded since stress has always been with me these last 9 years.
I have been on this Keto diet 2weeks now,have lost almost 8lbs,am strictly following this diet,the food is great,I have the cookbook,I don’t feel starved,nor deprived,am hanging in there,because according to this cookbook,your body doesn’t start to be a fat burning machine until day 30,is this correct?however,my clothes are loose on me,so I feel I am in keytosis as we speak
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).
Proteins and fats promote satiety and help control blood sugar to reduce cravings. Resting metabolic rate increases somewhat, and does not continue to spiral downward as the body sheds excess fat. As you become more keto-adapted, calories burn at a higher clip. Elevated levels of ketones (beta-hydroxybutyrate) even reduce inflammation, whether introduced endogenously through diet or exogenously through HVMN Ketone.23

“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.”
Dr. Campos, it is so discouraging to see that you disparage the ketogenic diet based on your assumption that it is very heavy in poor quality processed meats. No diet that relies on processed foods can be viewed as “healthy”. Become better informed by getting up to speed with what Jeff Volek, RD, PhD, calls a “well-formulated ketogenic diet.” Also, learn more about the potential of the diet to slow cancer progression (my specialty). You owe it to your patients who are depending on you for advice. Present them with facts, not opinions.
Fanatic? Someone with T2D, a disease usually claimed to be progressive and a never ending stream of problems and medications, was REVERSED. That’s something to shout from the rooftops. The drop in medication use alone, but the big pharma companies would prefer that people’s stories of reversing (well, putting it into remission) T2D get called fanatical instead of insightful.
Another difference between older and newer studies is that the type of patients treated with the ketogenic diet has changed over time. When first developed and used, the ketogenic diet was not a treatment of last resort; in contrast, the children in modern studies have already tried and failed a number of anticonvulsant drugs, so may be assumed to have more difficult-to-treat epilepsy. Early and modern studies also differ because the treatment protocol has changed. In older protocols, the diet was initiated with a prolonged fast, designed to lose 5–10% body weight, and heavily restricted the calorie intake. Concerns over child health and growth led to a relaxation of the diet's restrictions.[19] Fluid restriction was once a feature of the diet, but this led to increased risk of constipation and kidney stones, and is no longer considered beneficial.[18]
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.
What is the condition you developed from dieting years ago? And how did you find out what it was? I used diet pills years ago but have stopped using them about 3 years ago. Now I’m finding it extremely hard to lose weight and fear I’ll have to eat hardly any calories (1000 or less which seems like nothing on Keto) to finally lose weight. I’m just curious how you found out about yours.
Although studies have shown that the keto diet can reduce seizures for children with epilepsy, there is no evidence indicating that keto helps with other brain disorders or improves mental cognition, according to Harvard Health Publishing. Some studies show that keto may lower blood sugar for people with type 2 diabetes, but there is not enough long-term research to determine whether it’s safe and effective for diabetics.

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.
In the absence of CHO, however, the body must shift to fat as the primary energy source. In this case, the body catabolizes stored triglycerides, which exist in abundance in even the leanest individual. In effect, the KD provokes a physiological stimulus, i.e., CHO restriction, that mimics starvation. Due to the limited ability to store or produce CHO during periods of starvation, the body thus switches to ketogenesis, the production of ketone bodies as a primary fuel source (3).
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.
There are theoretically no restrictions on where the ketogenic diet might be used, and it can cost less than modern anticonvulsants. However, fasting and dietary changes are affected by religious and cultural issues. A culture where food is often prepared by grandparents or hired help means more people must be educated about the diet. When families dine together, sharing the same meal, it can be difficult to separate the child's meal. In many countries, food labelling is not mandatory so calculating the proportions of fat, protein and carbohydrate is difficult. In some countries, it may be hard to find sugar-free forms of medicines and supplements, to purchase an accurate electronic scale, or to afford MCT oils.[54]
Your dietary needs change dramatically with keto. Sodium becomes a critical nutrient, as do magnesium and potassium. “At least in the initial stages of being on the keto diet, you will urinate more. One of the key electrolytes lost through urination is magnesium,” says Carolyn Dean, MD, ND, a health and nutrition expert and author of The Magnesium Miracle. “Magnesium is an energy mineral, which will help you burn fat and lose weight.”
“I encourage my patients to do fasting coupled with a very-low-carbohydrate, whole-foods diet because of the astounding biochemical and clinical improvements these interventions provide, in terms of managing chronic metabolic illnesses like diabetes, hypertension, and obesity. I invite my patients to go to Diet Doctor because it is a very reliable source of information for people following a low-carbohydrate diet.”

Pattern B LDL, on the other hand, has a much smaller particle size and is much more prone to oxidation. Another thing about pattern B LDL is that it is small enough to enter into the endothelial lining of the artery where it can become oxidized and more likely to form plaque.  There is a high association between these small dense particles and cardiovascular disease.

I’m 50 and have been working out with weights and cardio for over 30 years, 6-7 days per week. I have always had controlled weight in the 180’s for 5′ 9″ due to strength training. I went on a “version” of the Keto diet—per day goals: 35 net carbs/85-95 grams protein/35-40 grams fat. I didn’t want to go all-in with high fats. I weighed 188 at the start and in 6 months dropped 26 lbs to 162, and bodyfat at 9%. My cholesterol levels have mostly been 220 with 50-75 HDL.
A study of 39 obese adults placed on a ketogenic very low-calorie diet for 8 weeks found a mean loss of 13% of their starting weight and significant reductions in fat mass, insulin levels, blood pressure, and waist and hip circumferences. Their levels of ghrelin did not increase while they were in ketosis, which contributed to a decreased appetite. However during the 2-week period when they came off the diet, ghrelin levels and urges to eat significantly increased. [11]

A review of 13 randomized controlled trials (1,415 patients) found that people on the ketogenic diet lost significantly more weight than people on low-fat diets. They also kept the weight off for 12 months or more.9 While the diets in these studies contained no more than 50 grams of carbohydrate (a typical keto diet plan), low-carb diets with more generous amounts of carbohydrate (≥ 120 gm/day) showed similar results (more weight loss with low-carb than low-fat) in a review of 17 randomized controlled trials.10 More recently, type 2 diabetics lost 12% of their body weight after one year in diet-induced ketosis.11


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.
After increasing water intake and replacing electrolytes, it should relieve most all symptoms of Keto Flu. For an average person that is starting a ketogenic diet, eating 20-30g of net carbs a day, the entire adaptation process will take about 4-5 days. My advice is to cut your carbs to fewer than 15g to ensure that you are well on your way into ketosis within one week. If you are experiencing any more keto flu symptoms, double check your electrolyte intake and adjust.
“I discovered the low-carb, ketogenic diet some four years ago and saw huge improvements in my own health. After establishing that it is based on sound scientific principles I felt compelled to offer it to my patients. We recommend the Diet Doctor website as it offers an unbiased, contemporary source of reliable low-carb ketogenic advice. It is easy to use and you can rely on its integrity.”
After initiation, the child regularly visits the hospital outpatient clinic where they are seen by the dietitian and neurologist, and various tests and examinations are performed. These are held every three months for the first year and then every six months thereafter. Infants under one year old are seen more frequently, with the initial visit held after just two to four weeks.[9] A period of minor adjustments is necessary to ensure consistent ketosis is maintained and to better adapt the meal plans to the patient. This fine-tuning is typically done over the telephone with the hospital dietitian[19] and includes changing the number of calories, altering the ketogenic ratio, or adding some MCT or coconut oils to a classic diet.[18] Urinary ketone levels are checked daily to detect whether ketosis has been achieved and to confirm that the patient is following the diet, though the level of ketones does not correlate with an anticonvulsant effect.[19] This is performed using ketone test strips containing nitroprusside, which change colour from buff-pink to maroon in the presence of acetoacetate (one of the three ketone bodies).[45]
This work was supported by the PronoKal Group® and by grants from the Fondo de Investigacion Sanitaria (PE13/00024 and PI14/01012 research projects) and CIBERobn (CB06/003), Instituto de Salud Carlos III–Subdireccion General de Evaluacion y Fomento de la Investigación; Fondo Europeo de Desarrollo Regional, and the Health Department of the Xunta de Galicia, Spain. D.G.A. is grateful to the Colombian Department of Science, Technology and Innovation – COLCIENCIAS as a recipient of their predoctoral scholarship to support his work. The funding sources had no involvement in the study design, recruitment of patients, study interventions, data collection, or interpretation of the results. A PronoKal representative (I.S.) was involved in the study design and revised the final version of the manuscript, without intervention in the analysis of data, statistical evaluation, or final interpretation of the results of this study.
But what about body fat? Hall and Guo investigated 20 controlled feeding studies that reported changes in body fatness on equal-calorie diets differing in fat and carbohydrate content. They found that each diet has similar effects on body fatness, which makes sense when you consider the finding that neither diet provides a significant metabolic advantage.   (Yet higher-carbohydrate diets seem to cause a slightly more substantial loss of body fat per calorie — a 16 gram per day difference.)
Protein: When people first reduce carbohydrates in their diets, it doesn't seem as though the amount of protein they eat is as important to ketosis as it often becomes later on. For example, people on the Atkins diet often eat fairly large amounts of protein in the early stages and remain in ketosis. However, over time, some (perhaps most) people need to be more careful about the amount of protein they eat as (anecdotally) the bodies of many people seem to "get better" at converting protein into glucose (gluconeogenesis). At that point, each individual needs to experiment to see if too much protein is throwing them out of ketosis and adjust as necessary.
I don't know what you've read, but you will not lose weight on any diet if you're consuming more calories than you burn. You must eat less calories than you burn for your body to start dipping into it's fat stores for energy. The point of keto is two-fold. One, a high fat diet makes your body more efficient at using stored fat for energy by the production of keytones. That way you can maintain a calorie deficit without loosing energy. Secondly, it makes it easier to maintain a calorie deficit because fat and protein are more filling than carbs.

Great information and questions! I finish eating before 6 and don’t have anything until noon or sometimes later, the next day! I do drink water and plain herbal tea. I take Omega 3’s, 2 Tbsps. of cold pressed virgin olive oil with lemon in water, in the morning! Around noon I have my BP coffee with butter and coconut cream. Primarily eggs, avocado, chicken, stir fry’s, nuts (mostly almonds), etc.


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:
In spite of the scientific evidence and real-life testimonials, not everyone is recommended to go on the ketosis diet. This highly specialized, extremely meticulous diet plan is suited to a particular dieter profile, and may also be harmful to some without the guidance of a doctor. But if performed correctly, the very low-calorie diet may be the only way for you to experience considerable, life-changing weight reduction.
^ Davies MJ, D'Alessio DA, Fradkin J, Kernan WN, Mathieu C, Mingrone G, et al. (2018). "Management of Hyperglycemia in Type 2 Diabetes, 2018. A Consensus Report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD)". Diabetes Care. 41 (12): 2669–2701. doi:10.2337/dci18-0033. PMC 6245208. PMID 30291106. Low-carbohydrate, low glycemic index, and high-protein diets, and the Dietary Approaches to Stop Hypertension (DASH) diet all improve glycemic control, but the effect of the Mediterranean eating pattern appears to be the greatest
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