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).
A keto diet has shown to improve triglyceride levels and cholesterol levels most associated with arterial buildup. More specifically low-carb, high-fat diets show a dramatic increase in HDL and decrease in LDL particle concentration compared to low-fat diets.3A study in the long-term effects of a ketogenic diet shows a significant reduction in cholesterol levels, body weight, and blood glucose. Read more on keto and cholesterol >
The reason why low-carb diets work, according to this theory, is that the lowered levels of insulin (caused by restricting carbs) allow for the body to begin metabolizing fat and increase energy expenditure.   Some proponents of the theory think that the reason restricting carbohydrates works is because of a “metabolic advantage” (i.e., a person on a low carb diet burns more calories than a person eating a diet higher in carbohydrate).
The opposing viewpoint maintains that calories still count, but the type of food consumed has a trickle-down effect on the amount of energy expended, and what foods the body craves. It takes way more energy to process and store protein than it does carbohydrate or fat–this is called the thermic effect of food. Essentially, one burns more energy digesting protein because it requires more energy for the body to process. In one study, twice as much energy was expended after meals on a high-protein diet versus a high carbohydrate, low-fat diet.1
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.
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!
To drill down further, there are some genetic enzyme defects that cause problems with ketosis. Here are a few of note: carnitine deficiency (primary), carnitine palmitoyltransferase (CPT) I or II deficiency, carnitine translocase deficiency, beta-oxidation defects—mitochondrial 3-hydroxy-3-methylglutaryl-CoA synthase (mHMGS) deficiency, medium-chain acyl dehydrogenase deficiency (MCAD).
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.

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.


“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.”
If you’re a newbie planning your weekly keto diet menu, make the meals as easy as possible. A keto breakfast, for example, can take advantage of many classic breakfast foods, including eggs, bacon, sausage, and ham. Eggs are real winners in the keto world. They’re extremely versatile, easy to cook, and have just half a gram of carbs but 6 g of protein and 5 g of fat.
“I am an anesthesiologist who managed to lose weight and reverse my pre-diabetes a few years back. I now advocate the low-carb diet and lifestyle to all patients, colleagues and friends. Diet Doctor is a comprehensive one-stop resource which I highly recommend. Almost every patient I anesthetize has metabolic issues, and the situation is difficult as the diet in India is primarily carbohydrate based. I have successfully helped friends and patients reverse their type 2 diabetes.”

I understand your point, and thanks for the reply. I suppose I'm wondering this because when I go through foods (meats in particular, it seems) in the database on MFP, the keto-friendly foods seem to be high in calories. So, I'm wondering if it will be difficult to keep a calorie ceiling of around 1200-1500 per day. My guess would be I'll have to emphasize vegetables moreso than meat in my diet to maintain that level.
Don’t be surprised if you find yourself parched while you’re on the keto diet. Excreting all that extra water will likely cause a spike in thirst—so make it a point to drink up, Mancinelli advises. There’s no hard and fast recommendation for how much water you should be having on a keto diet. But in general, aim to drink enough so your urine is clear or pale yellow. If it’s any darker, bump your intake.
“I have been recommending low-carb and ketogenic diets to my family practice and consultation patients since early 2017. Diet Doctor is an incredibly valuable resource for my patients; counseling low-carb would be much more difficult without all the great information available. My orthopaedic pre-habilitation, diabetes, mood disorder, Alzheimer’s, PCOS, cancer, and obese patients all benefit from low-carb. Low-carb has brought back the joy in family medicine!”

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.


–As with most of our recipes, you can alter them to fit your tastes. Don’t like cheddar? Use mozzarella, or feta, or even brie! Feel free to use turkey bacon, salami or perhaps even mushrooms for a vegetarian spin. These Bacon Egg & Cheese Cups are so versatile!And, since we know people are going to ask – yes, you can make 1 giant Bacon, Egg & Cheese Cup in the form of a pie! Just lay that bacon along the bottom of your pan, prebake it a bit in the oven and assemble one giant cup! Use a pie pan, cheesecake pan or small casserole dish (note: depending on your bakeware, you may need to double the ingredients)!Tasteaholics
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.
You can usually use a mix of multiple flours to get a realistic texture in baking recipes. Combining flours and experimenting with your baking can lead to much lower net carb counts in recipes. We think these lemon poppyseed muffins (a mix of almond flour and flaxseed meal) make a great texture when combined with the fats from the heavy cream and butter.

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.


For the second four weeks, they were fed a very-low-carbohydrate, low-sugar ketogenic diet. Five percent of their total calories came from carbohydrate (36g per day), and 2% of their total calories came from sugar. 15% percent of the calories came from protein. The keto diet totaled 2,738 calories per day. Note that the caloric intakes were kept close to identical, meaning fat loss could only be attributed to the source of the food rather than its caloric content.
This style of Ketogenic Diet, the temporary reduction in fats, carbohydrates and sugars is the heart of the Ideal Protein Protocol. Ideal Protein a medically developed, step-by-step, personalized Ketogenic Weight Loss Diet available today. By temporarily restricting fat intake, the Ideal Protein dieter burns through fat stores more rapidly, resulting in safe, efficient weight loss. Because the Ideal Protein Protocol is a Keto Diet focused on weight loss and weight maintenance, for most people it will be the safest and most credible entry point into living a low carbohydrate lifestyle. Not only is the Ideal Protein Protocol a supervised Ketogenic weight loss program, we teach our dieters how to develop and maintain a healthier relationship with food after they have graduated from Ketosis. This makes maintaining your new healthier weight easier and safer following your weight loss, because living in a state of Ketosis should only be temporary.
“As a reproductive endocrinologist, I have been studying nutrition and fertility for over 15 years. I advise all my patients, both women and men, to adopt a low-carb ketogenic diet both prior to pregnancy to improve their fertility and during pregnancy to improve fetal and maternal health. This way of eating has been shown repeatedly in my practice to improve all measures of health for women and men. We refer all our patients to Diet Doctor which in our opinion is the best online resource for our patients to find all the information, recipes and meal plans they need to be successful.”
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.
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.
The only draw back you will see is for those who do have high activities or are involved in lots of sprinting type exercise. Although a few will find they feel fine, even have more energy on a high fat/moderate protein diet, most of the time carbohydrates are the best source of fuel for these activities. That isn't that big of a problem though, it just means that that person should instead look into doing a TKD instead of a CKD.
While in ketosis, your body effectively uses fat for fuel. In general, the daily intake of net carbs required to enter ketosis could vary from 20 to 100 grams per day. Most people, who have experienced ketosis, claim to have reached that state at about 20-50 grams of net carbs per day. I'd suggest you start at 20-30 grams and see how you can adjust it for your needs.
Some negative side effects of a long-term ketogenic diet have been suggested, including increased risk of kidney stones and osteoporosis, and increased blood levels of uric acid (a risk factor for gout). Possible nutrient deficiencies may arise if a variety of recommended foods on the ketogenic diet are not included. It is important to not solely focus on eating high-fat foods, but to include a daily variety of the allowed meats, fish, vegetables, fruits, nuts, and seeds to ensure adequate intakes of fiber, B vitamins, and minerals (iron, magnesium, zinc)—nutrients typically found in foods like whole grains that are restricted from the diet. Because whole food groups are excluded, assistance from a registered dietitian may be beneficial in creating a ketogenic diet that minimizes nutrient deficiencies.
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.
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.
“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.”
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.
Sleep enough – for most people at least seven hours per night on average – and keep stress under control. Sleep deprivation and stress hormones raise blood sugar levels, slowing ketosis and weight loss a bit. Plus they might make it harder to stick to a keto diet, and resist temptations. So while handling sleep and stress will not get you into ketosis on it’s own, it’s still worth thinking about.

Because some cancer cells are inefficient in processing ketone bodies for energy, the ketogenic diet has also been suggested as a treatment for cancer.[59][60] A 2018 review looked at the evidence from preclinical and clinical studies of ketogenic diets in cancer therapy. The clinical studies in humans are typically very small, with some providing weak evidence for anti-tumour effect, particularly for glioblastoma, but in other cancers and studies, no anti-tumour effect was seen. Taken together, results from preclinical studies, albeit sometimes contradictory, tend to support an anti-tumor effect rather than a pro-tumor effect of the KD for most solid cancers.[61]


The keto diet works by eliminating carbohydrates from the your daily intake and keeping the body’s carbohydrate stores almost empty, therefore preventing too much insulin from being released following food consumption and creating normal blood sugar levels. This can help reverse “insulin resistance,” which is the underlying problem contributing to diabetes symptoms. In studies, low-carb diets have shown benefits for improving blood pressure, postprandial glycemia and insulin secretion. (7)
Participants returned every other week for 16 weeks for further diet counseling and medication adjustment. When a participant neared half the weight loss goal or experienced cravings, he or she was advised to increase carbohydrate intake by approximately 5 g per day each week as long as weight loss continued. Participants could choose 5 g carbohydrate portions from one of the following foods each week: salad vegetables, low-carbohydrate vegetables, hard or soft cheese, nuts, or low-carbohydrate snacks. Diabetes medication adjustment was based on twice daily glucometer readings and hypoglycemic episodes, while diuretic and other anti-hypertensive medication adjustments were based on orthostatic symptoms, blood pressure, and lower extremity edema.
It is possible to combine the results of several small studies to produce evidence that is stronger than that available from each study alone—a statistical method known as meta-analysis. One of four such analyses, conducted in 2006, looked at 19 studies on a total of 1,084 patients.[23] It concluded that a third achieved an excellent reduction in seizure frequency and half the patients achieved a good reduction.[18]
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.
Recently, many of my patients have been asking about a ketogenic diet. Is a ketogenic diet safe? Would you recommend it? Despite the recent hype, a ketogenic diet is not something new. In medicine, we have been using it for almost 100 years to treat drug-resistant epilepsy, especially in children. In the 1970s, Dr. Atkins popularized his very-low-carbohydrate diet for weight loss that began with a very strict two-week ketogenic phase. Over the years, other fad diets incorporated a similar approach for weight loss.
All of the patients followed a VLCK diet according to a commercial weight loss program (PNK Method), which includes lifestyle and behavioral modification support. The intervention included an evaluation by the specialist physician conducting the study and assessment by an expert dietician. All patients underwent a structured program of physical exercise with external supervision (16). This method is based on high-biological-value protein preparations obtained from cow milk, soya, avian eggs, green peas, and cereals. Each preparation contained 15 g protein, 4 g carbohydrates, 3 g fat, and 50 mg docosahexaenoic acid, and provided 90 to 100 kcal (16). 

Which leads us to your personality. You need to be VERY strong willed to follow this diet. It follows very strict rules and you need to be able to commit to this. It makes it hard to eat out with friends or eat with friends in general. It’s hard to find food that fits this diet in common restaurants, but and this takes us to the next point, your health goals might be more important.
“As a physician, I see daily the tremendous impact that our pandemic of chronic nutritional disease is having on people and the health care system, despite our best conventional efforts over the last 40 years. I now focus my time and energy on counseling, supporting and guiding patients on the power of real food as medicine. Using the core principles of low-carb, high-fat eating and intermittent fasting, we see great improvements in diabetes, obesity, metabolic syndrome, polycystic ovary syndrome, NAFLD and many more chronic diseases. Diet Doctor is a great resource for my patients to help them in their journey.”
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.
Carbohydrate: Most of what determines how ketogenic a diet is will depend on how much carbohydrate is eaten, as well the individual's metabolism and activity level. A diet of less than 50 or 60 grams of net (effective) carbohydrate per day is generally ketogenic. Some sources say to consume no more than 20 grams of carbohydrates per day, while others cite up to 50 grams, and many recommend no more than 5 percent of calories from carbs. However, athletes and people with healthy metabolisms may be able to eat 100 or more grams of net carbohydrate in a day and maintain a desired level of ketosis. At the same time, an older sedentary person with Type 2 diabetes may have to eat less than 30 net grams to achieve the same level.
All of the patients followed a VLCK diet according to a commercial weight loss program (PNK Method), which includes lifestyle and behavioral modification support. The intervention included an evaluation by the specialist physician conducting the study and assessment by an expert dietician. All patients underwent a structured program of physical exercise with external supervision (16). This method is based on high-biological-value protein preparations obtained from cow milk, soya, avian eggs, green peas, and cereals. Each preparation contained 15 g protein, 4 g carbohydrates, 3 g fat, and 50 mg docosahexaenoic acid, and provided 90 to 100 kcal (16).
The insulin theory of obesity, in short, declares that the primary cause of obesity is higher carbohydrate diets because these diets increase insulin secretion more than any other diet. When insulin levels are high, fat storage will increase significantly and “starve” muscles and organs of energy.   This causes increased hunger and overeating that results in obesity. 
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