61. Thomson C.A., Morrow K.L., Flatt S.W., Wertheim B.C., Perfect M.M., Ravia J.J., Sherwood N.E., Karanja N., Rock C.L. Relationship between sleep quality and quantity and weight loss in women participating in a weight-loss intervention trial. Obesity. 2012;20:1419–1425. doi: 10.1038/oby.2012.62. [PMC free article] [PubMed] [CrossRef] [Google Scholar]
Given this new meta-analysis, it’s safe to say that low-carb and high-carb diets with protein matched have similar effects on energy expenditure and body fatness. However, this doesn’t mean that the insulin theory of obesity is entirely wrong — these results simply suggest that the theory carries much less significance than calorie intake in general.
“I follow and recommend a low-carb or keto lifestyle, with and without intermittent fasting, to all of my patients whether or not they have lifestyle-related chronic conditions. I do this because of the health benefits to anyone who follows them, but also because of the science behind them and the impressive clinical results I have seen in my patients. I have recommended the Diet Doctor website for the past 5-6 years as a first-stop to find completely trustworthy information, delicious recipes, great visuals and excellent videos.”
Since this is my full-time job, donations really help me keep afloat and allow me to post as much to the website as I do. I really appreciate any donation you want to give, but you can change the price yourself. I’ve added in $15 as the suggested price. I think that’s a very fair price considering other websites are charging in the hundreds of dollars, and I’ve seen what they are like on the inside.
Published studies established the metabolic advantage of low-carb diets.4,3,15 A recent pilot study–though flawed and biased against low-carb eating–showed a significant increase in energy expenditure (100-150 calories/day) associated with a ketogenic diet.16 If sustained, this would lead to ~ 10 to 15 pounds of fat lost, or not gained, over a year.
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. Higher quality studies tend to find no meaningful difference in outcome between low-fat and low-carbohydrate dieting. 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.
Ketones are a very effective fuel for the brain—often a more efficient fuel than glucose. Your body is like a hybrid car when it comes to fuel. When you run out of carbohydrates to burn for fuel—say you’re fasting before a surgery or a religious holiday—your body seeks an alternative way to get more fuel. (If your body didn’t do this, you would die after a short fast.) So the body kicks into burning fat, which is the metabolic state of ketosis, or “keto.” Technically, your liver takes long-chain and medium-chain fatty acids from your fat tissue, and produces a major ketone called beta-hydroxybutyrate (BHB). BHB provides more energy per unit oxygen used than glucose, which benefits the brain.
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“I discovered the ketogenic diet in 2017 and since then I have come to truly believe it is the metabolic and nutritional pathway to overall health. Hippocrates once stated, ‘All disease begins in the gut” and I now truly believe the right food can cure. I am now discouraging patients from undergoing bariatric surgery too soon and advising them to try the keto diet first. Diet Doctor gives people the knowledge they need. It is a place where everyone can go to learn and have fun with this nutritional approach.”
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I prescribe nutritional ketosis for my patients with brain and focus issues, such as: epilepsy, attention deficit, brain fog, traumatic brain injury, memory issues, mild cognitive impairment, Parkinson’s disease, and Alzheimer’s disease (including patients with one or two copies of the genes for Alzheimer’s, called ApoE4). Most of my patients on keto say they feel smarter, sharper, and more focused—and some may lose weight (fat) as a result of using ketones as fuel.
I wanted to put it out there that I made this meal plan specifically with women in mind. I took an average of about 150 women and what their macros were. The end result was 1600 calories – broken down into 136g of fat, 74g of protein, and 20g net carbs a day. This is all built around a sedentary lifestyle, like most of us live. If you need to increase or decrease calories, you will need to do that on your own terms.
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.
While body weight decreased significantly (-8.5 kg) in these 21 diabetic participants, the mean weight loss was less compared with what we observed in the LCKD participants of an earlier trial (-12.0 kg) . Given that the diabetic participants had a higher baseline mean weight than the LCKD participants of our previous trial (131 kg vs. 97 kg), this translates into an even more dramatic disparity in percent change in body weight (-6.6% vs. -12.9%). This lesser weight loss might result from several factors. First, in the current study, most of the participants were taking insulin and/or oral hypoglycemic agents that are known to induce weight gain[20,21] Second, these same agents, particularly insulin, inhibit ketosis, which is strived for in the earliest phases of the LCKD; while it remains unclear whether ketones actually play a role in weight loss on the LCKD, previous research in non-diabetic patients has shown a positive correlation between level of ketonuria and weight loss success . Lastly, compared with our previous study the participants in the current study had more comorbid illness, lower socioeconomic status, and a shorter duration of follow-up (16 weeks versus 24 weeks), all of which are associated with reduced success on any weight loss program .
Keto runs counter to many of the low-fat diet fads of the 1980s and 1990s: It actually emphasizes fat. “That is hard to comprehend because we don’t eat anything that’s pure fat, says Kristen Mancinelli, RD, author of The Ketogenic Diet. “We don’t eat a stick of butter or a spoonful of olive oil or even a nice cup of lard. That would be unpleasant, so we really have a hard time wrapping our heads around this concept of the ketogenic diet.”
If you think about it, one of the diets that follow these principles is the low-carb ketogenic diet. It focuses on highly-satiating foods like meat and low-carb vegetables while cutting out all processed, carb-ridden, and highly-palatable foods. By eating in this way, most people experience tremendous amounts of fat loss — not because insulin levels dropped or the body got a metabolic advantage from burning fat, but because keto dieters tend to eat significantly fewer calories than before without realizing it.
This is the first time I heard about Keto diet I need to lose weight because I am a diabetic 2 and high cholesterol and high blood pressure the doctor want me to do but bypass lot of people told me not to everybody was telling me about this new diet keep Keto I want to try it and I made it my goal my weight is 257 on 5 for messaging and I think this is going to be good for me I need a lot of help thank you
“Diabetes and metabolic syndrome are rampant in my community, so I prescribe a very low-carb, high-fat diet to many of my patients. This way of eating has resulted in many successes, such as stopping or reduce my patients’ medications. I have spread the LCHF word by giving lectures to our doctors and nutritionists. As a result, a ketogenic diet nutritionist in our organization now gives classes to patients and our endocrinologist is also on board. I give out Diet Doctor information to almost all my patients and it is truly a big resource in my practice.”
Hi Maya. I LOVE your site!! Interesting, informative with fab recipes and ideas. Hubby and I have just started eating low carb and I have to say, we are not finding it too difficult and I already feel sooo much better!! I find the hardest part is choosing low carb veg, I feel as if we are not eating enough. Any suggestions on how to get more veggies into our diet?
Essential fatty acids (the omegas) provide core functions to the human body, but they are often times out of balance when on a standard diet. On keto, with a little bit of preparation, your omega fatty acids are easily manageable. If you want to know more about essential fatty acids, omegas, and how they interact with our body on a ketogenic diet, you can read more here >
Normal dietary fat contains mostly long-chain triglycerides (LCTs). Medium-chain triglycerides (MCTs) are more ketogenic than LCTs because they generate more ketones per unit of energy when metabolised. Their use allows for a diet with a lower proportion of fat and a greater proportion of protein and carbohydrate, leading to more food choices and larger portion sizes. The original MCT diet developed by Peter Huttenlocher in the 1970s derived 60% of its calories from MCT oil. Consuming that quantity of MCT oil caused abdominal cramps, diarrhea, and vomiting in some children. A figure of 45% is regarded as a balance between achieving good ketosis and minimising gastrointestinal complaints. The classical and modified MCT ketogenic diets are equally effective and differences in tolerability are not statistically significant. The MCT diet is less popular in the United States; MCT oil is more expensive than other dietary fats and is not covered by insurance companies.
The National Academy of Medicine recommends a minimum intake of 130 g of carbohydrate per day. The FAO and WHO similarly recommend that the majority of dietary energy come from carbohydrates. Low-carbohydrate diets are not an option recommended in the 2015-2020 edition of Dietary Guidelines for Americans, which instead recommends a low fat diet.
The keto diet is made up of 75% fat, 20% protein, and 5% carbohydrates. This combination enables your body to enter a state of ketosis, where the body switches from burning carbs for fuel, to burning fat for fuel. Fat, protein, and carbohydrates are called macronutrients – “macros” for short. To achieve a keto macro breakdown of 75% fat, 20% protein, and 5% carbs, you first need to know that:
Changes in the impact of weight on quality of life-lite (IWQOL-Lite). Raw scores (higher scores indicate poorer quality of life on the IWQOL-Lite) were converted into a T-score (0–100), with 100 representing best possible health. Mean ± standard error of changes from baseline are reported for total score. (ƚ) Denotes statistically significant differences through the intervention (p for trend < 0.05) evaluated by means of repeated-measures ANOVA. (*) Denotes statistically significant differences (p < 0.05) from baseline after post-hoc pairwise comparisons employing the Tukey’s adjustment for multiple comparisons.
Food reward regions in the brain programmed much of this physical dependence on processed foods and refined starches. But the body can reverse it. Acute bouts of aerobic exercise have been shown to significantly suppress appetite and hunger while increasing satiety and fullness.6 Exercise in the form of resistance (weight) training can enhance insulin sensitivity,7 which results in reduced insulin secretion.8 Less insulin helps bodies favor fat burning over fat storage.
The one important caveat: Eating keto also ups the risk for diabetic ketoacidosis, a life-threatening condition where fat gets broken down too fast and causes the blood to become acidic. It’s much more common in people with type 1 diabetes, but if you have type two and are eating keto, talk with your doctor about what you should be doing to diminish your risk.
The primary outcome was the change from baseline to week 16 in hemoglobin A1c. Changes in all variables were analyzed by the paired t-test or Wilcoxon signed-ranks test, as appropriate. Linear regression analysis was used to examine predictors of change in hemoglobin A1c. A p value of 0.05 or less was considered statistically significant. Statistical analysis was performed using SAS version 8.02 (SAS Institute, Cary, NC).
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.
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.
Eating too much for your genes/environment. I was guilty of this when I first tried keto in 2015. I made coffee with pastured butter and coconut oil every morning, ate bacon and other fatty meats, and promptly gained weight. Without getting too much in the weeds, you want to aim for a less-caloric ketogenic food plan, not a hypercaloric one like I did. Calories aren’t everything—hormones matter more—but you need to be paying attention and not overeat, which, obviously, can cause you to gain weight.
A cyclic ketogenic diet (or carb-cycling) is a low-carbohydrate diet with intermittent periods of high or moderate carbohydrate consumption. This is a form of the general ketogenic diet that is used as a way to maximize fat loss while maintaining the ability to perform high-intensity exercise. A ketogenic diet limits the number of grams of carbohydrate the dieter may eat, which may be anywhere between 0 and 50g per day. The remainder of the caloric intake must come primarily from fat sources and protein sources in order to maintain ketosis (the condition in which the body burns fats and uses ketones instead of glucose for fuel).
The ketogenic diet has been shown to produce beneficial metabolic changes in the short-term. Along with weight loss, health parameters associated with carrying excess weight have improved, such as insulin resistance, high blood pressure, and elevated cholesterol and triglycerides. [2,7] There is also growing interest in the use of low-carbohydrate diets, including the ketogenic diet, for type 2 diabetes. Several theories exist as to why the ketogenic diet promotes weight loss, though they have not been consistently shown in research: [2,8,9]
Regarding VLCK diets, there is still some distrust in their usage, despite the solid scientific evidence that supports the use of this kind of diet as a useful weight-loss therapy [13,14]. This type of diet is characterized by the restriction of carbohydrates and/or caloric intake to the point of inducing a shift in metabolism and the production of plasma ketone bodies [15,16,17]. However, it was evidenced that a VLCK diet is safe because it does not modify the acid-base equilibrium . In fact, it has been proposed that the ketone body, β-hydroxy-butyrate (β-OHB) has several beneficial effects on metabolism  and psychological functions [20,21]. Nevertheless, a scarcity of studies has evaluated the effect of a VLCK diet combined with physical activity, on potential improvement in the psychological conditions and well-being of treated overweight/obese patients.
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.
Animal proteins (meat, fish, etc.) have very little, if any, carbs. You can consume them in moderate amounts as needed to control hunger. Overall, choose fattier cuts of meat rather than leaner ones. For example, chicken thighs and legs are preferable to chicken breasts because they contain much more fat. We’ve got quick keto diet chicken recipes to help.
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.
Here’s a nutritional list of some of the more commonly consumed vegetables on keto. Keep in mind that the weights are the same of everything listed so that it will impact the skew of the carb counts. For example, in a meal you may have 6 oz. of broccoli in the side, but you would not have 6 oz. worth of berries in the morning. You may mix 6 oz. of berries into a pudding with 4 servings.
“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.”
You want to keep your cheats to none. Be prepared, make sure you’re eating what you need to be satiated (“full”), and make sure you’re satisfied with what you’re eating. If you have to force yourself to eat something, it will never work out in the end. This is just a guideline on how you can eat on a ketogenic diet, so you’re very welcome to change up what kind of foods you eat!
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.
The safest way to try a ketogenic diet is to discuss it first with your (trusted, collaborative, and evidence-based) doctor or other clinician. I urge my patients, readers, and coaching clients to start with a keto calculator (such as Maria Emmerich’s or Martin Ankerl’s). These calculators give you guidelines for macronutrients, i.e., the number of carbs, proteins, and fats to eat to get into ketosis—and adjust the recommendations based on age, activity level, and goals (such as weight loss or maintenance).
Keep up electrolytes. The major electrolytes in our bodies are sodium, potassium and magnesium. Because a low carb diet (especially a keto diet!) reduces the amount of water you store, this can flush out electrolytes and make you feel sick (called “keto flu”). This is temporary, but you can avoid or eliminate it by salting your food liberally, drinking broth (especially bone broth), and eating pickled vegetables. Some people also choose to take supplements for electrolytes, but it’s best to first consult a doctor that understands and supports keto/low carb lifestyles.
Patients were invited to complete a battery of psychological tests to assess performance in the domains of food cravings, quality of life (QoL), daytime sleepiness and sleep quality, sexual functioning, and physical activity through the course of the nutritional intervention. The psychological tests were selected for availability of multiple test versions, well-stablished psychometric properties, and accepted clinical use.