These are all keto related questions that a person looking into the ketogenic diet for the first time will have, and I’ve put together a comprehensive list of answers to these questions and more in my 3 Day Keto Kickstart Plan & Keto frequently asked questions linked to below.  If you’re new to keto I recommend starting there, and if you use that Keto Kickstart meal plan as written, I am confident that you will get into ketosis and be losing weight within 3 days of starting.  I’m excited for you!!!!
“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.”
Option 3: "Make your own keto 'lunchable' with cubes of grilled chicken, a slice of nitrate-free ham, cheese cubes, pickle slices, a hard-boiled egg, a few raw grape tomatoes, raw veggies like cauliflower or broccoli, a few almonds or walnuts, guacamole, and ranch dressing," says Stefanski. (Looking for something meat-free? Here are 29 Vegetarian Keto Recipes for Plant-Based Eaters.)
“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.”
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). 

We know now that plaque formation is a culmination of inflammation at the plaque formation site along with a white blood cell mediated interaction between calcium, cholesterol and other biological substances. In fact, it is thought that cholesterol is actually used by the body as a kind of internal bandage when our arterial lining becomes damaged by inflammation. This means that cholesterol build up in the arteries may actually be a protective mechanism.
The modified Atkins diet reduces seizure frequency by more than 50% in 43% of patients who try it and by more than 90% in 27% of patients.[18] Few adverse effects have been reported, though cholesterol is increased and the diet has not been studied long term.[48] Although based on a smaller data set (126 adults and children from 11 studies over five centres), these results from 2009 compare favourably with the traditional ketogenic diet.[18]

“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.”


Spices have carbs in them, so make sure you are adding them to your counts. Sea salt is preferred over table salt, as it is usually mixed with powdered dextrose. Most pre-made spice mixes will have sugars added to them, so make sure you read the nutrition label beforehand to make sure you know what’s inside. If you have the choice, never include added sugar into your spice blends or food.
Experts agree more research needs to be done to determine which keto diet has the potential to preserve muscle and help increase the chances of sustained weight loss. But similar studies suggest the keto version analyzed in this study may hold promise. For example, a randomized study published in December 2014 in the journal Endocrine found that a very-low-calorie ketogenic diet was more effective at sustaining weight loss and preserving lean muscle mass in obese people than a standard low-calorie diet after one year.
I was a Corpsman (not a corpse-man as some recent somewhat fanatical president would say), and I can tell you many stories of Marines and Sailors who maintained restrictive diets (aka picky eaters). Most obvious was lack of sustaining energy (hypoglycemia) at mile 15 (with 80lbs of gear including a 6.5lb rifle and 200 rnds of ammo, etc.) and depletion of essential vitamins, electrolyte imbalance. They were always the first to collapse and have to hear me scold “see I told you so.” An IV of D5W usually does the trick (D is for dextrose, OMG!)

You're using it for a particular, short-term period.The meal substitute diet can function so quick and so well that you might decide to keep on following it for a longer while. You've acquired the flavor and habit of consuming the yummy meal substitute products that you think you'll stick to the program for a vague period. However, you need to understand that enduring high-calorie deficit in your system may not be good on an extended basis. Take advantage of the diet only as a boost to significant weight reduction or to be a procedure for a huge occasion arriving soon or under strict doctors monitoring.
“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!”

Hello, following a Keto diet with IF but cholesterol ratios not proper. Diet fats come mainly from olive oil, avocado oil, once a week beef, no butter, bacon etc. Had to go back on statins. Goal is stay away from drugs. Is there a doctor/clinic in the Boston area that you can recommend that understands/tests what you explain in this article? Please advise.
(Note that ketosis should not be confused with diabetic ketoacidosis, a dangerous state that occurs primarily in Type 1 and sometimes in Type 2 diabetics, when high levels of ketones build up because there’s not enough insulin to metabolize blood glucose—so the diabetes becomes out of control. This is sometimes due to an infection or other severe stress. But for healthy individuals without Type 1 diabetes, ketones are used as an alternative energy source and rarely poison or acidify the body.)
Eating out while going keto can be tricky. Planning ahead helps you know where your next snacks and meals will come from, so you aren’t tempted to reach for an easy—high-carb—fix, like fast food. Each week, plan out everything from meals to snacks and if you’re using an app, go ahead and fill in your estimated macronutrients ahead of time. This will help you get an idea of your overall intake, so you can make adjustments to reach your daily goals more easily. Get started by planning to make these 10 keto recipes so good you’ll never know you’re on a diet.

Participants completed take-home food records (4 consecutive days, including a weekend) collected at baseline and at weeks 2, 8, and 16 during the study. Participants were given handouts with examples of how to complete the records. A registered dietician analyzed the food records using a nutrition software program (Food Processor SQL, ESHA Research, Inc., Salem, OR).


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
I’ve been following the Keto diet for almost 4 months now. I have lost almost 25 pounds and feel good. I am an active daily walker and have also started doing some strength and conditioning 3-5 days week. I decided to have a physical since I’m being so healthy why not keep up with everything else. All my lab work came back good, and very good except for LDL cholesterol, very high over 200. Immediately the doctor wants to put me on a low dose of medicine. I know I’ve been consuming alot of saturated fats on this diet. I’m confused on what to do now 🙁
Keto is a healthy state for some, but not all. It is most proven for epilepsy and other brain problems like Alzheimer’s, mild cognitive impairment, and Parkinson’s disease. There are more safety concerns for people trying keto for fat loss or performance. In humans, there are reports of adverse reactions to keto, including menstrual irregularities, gut dysbiosis, change in circadian rhythm, hair loss, constipation, mood disorders, and thyroid dysfunction; and in rodents, insulin resistance and nonalcoholic fatty liver.
Adequate food records were available for analysis in a proportion of participants at each of the 4 timepoints (Table ​(Table2).2). Participants completed food records at a mean of 2.5 and a median of 3 timepoints. In general, comparing baseline to subsequent timepoints, mean carbohydrate intake decreased substantially and energy intake decreased moderately while protein and fat intake remained fairly constant.

What's more, it's especially important to make sure your diet is well-planned when you're eating keto-style, because the foods you can choose from are limited. In addition to checking in with a dietitian if you're able, Stefanski recommends that you "talk to your doctor and make sure she or he is aware that you'll be starting a diet that completely changes how your body metabolizes energy." You might also want to check your most recent bloodwork levels for things such as cholesterol, vitamin D, and other indicators of health because these can change while on keto. That's because for some people, a prolonged keto diet can result in certain nutritional deficiencies or even high cholesterol. But most experts will tell you that the ketogenic diet is not a permanent lifestyle change (as could be the case for something like the 80/20 approach to eating or a Mediterranean eating style).


Anecdotally speaking, people do lose weight on the keto diet. Heather Wharton, a 35-year-old business relationship manager from Tampa, Florida, lost 140 pounds since starting the keto diet in January 2016: “I plan on being on the keto diet for the rest of my life,” says Wharton. “My husband and I consider ourselves to be food addicts, and the keto diet is what we use as a form of abstinence from trigger foods that have sugar and other carbohydrates." A typical day of eating for Wharton includes coffee with a protein supplement, a cup of unsweetened cashew milk, cauliflower rice with ground turkey and liquid aminos (a carb-free substitute for soy sauce), spinach, six slices of turkey bacon, six eggs, and a little salsa.

A lot of veggies are carb-heavy—they can’t fit into an ultra-low-carb diet. These include potatoes of course, but also yams, corn, peas, and carrots. The best options for keto dieters include asparagus, bell peppers, Brussels sprouts, leafy greens, and zucchini. “What’s tough for many people to grasp when starting out on a ketogenic diet is that you can’t really eat a lot of [certain] vegetables,” Mancinelli says. “When you’re keeping carbs super low, you have to limit vegetables—which goes counter to everything you know about how to eat healthy and lose weight.”
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.
There are numerous benefits that come with being on keto: from weight loss and increased energy levels to therapeutic medical applications. Most anyone can safely benefit from eating a low-carb, high-fat diet. Below, you’ll find a short list of the benefits you can receive from a ketogenic diet. For a more comprehensive list, you can also read our in-depth article here >
“I encounter many patients who are interested in LCHF and are finding benefit in weight reduction, better diabetes control, improved endurance and energy levels, and improved lipid profiles. There is a great deal of confusion out there about the diet, much of it based on outdated science or an incomplete understanding of the topic. I feel that I owe it to patients to be informed about LCHF so that I can advise them on the risks and benefits it could have for them.”
I also asked a friend to join me as an accountability partner. She had tried the keto diet before with good success, so having a guide for my myriad questions was a big help. It was also nice to have someone to message at 10 p.m. when I really wanted a cookie so she could commiserate with me. (We agreed the cookie would be delicious, and then ate a cheese stick.)
“As a family doctor, I not only lost weight and improved my own health with the low-carb diet, I also inspired colleagues and patients alike to follow this lifestyle and reap its benefits. It has now become a powerful tool I use in my daily practice to help treat and reverse obesity, diabetes, fatty liver, PCOS, and chronic pain. I refer all my English-speaking patients to the Diet Doctor website and I also use it during visits as a counseling tool. Inspired by Diet Doctor, I have created my own website to cater to French-speaking patients!”
“I have been a supporter of a low-carb lifestyle that includes intermittent fasting for myself and my patients for years. I am part of our health systems Medicine Residency program. I teach physicians-in-training and medical staff to utilize low-carb and keto dieting to improve the health of their patients and reduce their need for medications. Diet Doctor is an excellent resource for patients and physicians to help patients help themselves to promote a healthy lifestyle.”
Ok when you see the % sign it means the daily percentage from a 2000 calorie diet. That one says you should have 300g a day. This is the standard nutrition value in most if not all products. If you want to try a low carb diet ignore that part, at least the number with % on the side. Concentrate on the number with the letter g next to it. That is the grams per serving. To that number substract the amount of fiber it has (also the number with the g next to it not the one with % symbol) That gives you the net carbs for that specific product. The rest is just math with whatever you eat. Good Luck. 

Vegan ketogenic diet or vegetarian diet: Yes, both are possible. Instead of animal products, plenty of low-carb, nutrient-dense vegan and/or vegetarian foods are included. Nuts, seeds, low-carb fruits and veggies, leafy greens, healthy fats and fermented foods are all excellent choices on a plant-based keto diet. There’s also a similar plan called ketotarian, which combines keto with vegetarian, vegan and/or pescatarian diets for supposedly greater health benefits.


In steps 4 or 5, the ketogenic phases were ended by the physician in charge of the patient based on the amount of weight lost, and the patient started a low-calorie diet (800–1500 kcal/day). At this point, the patients underwent a progressive incorporation of different food groups and participated in a program of alimentary re-education to guarantee the long-term maintenance of the weight loss. The maintenance diet consisted of an eating plan balanced in carbohydrates, protein, and fat. Depending on the individual, the calories consumed ranged between 1500 and 2000 kcal/day, and the target was to maintain the weight lost and promote a healthy lifestyle.
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).

Some patients constantly graze on "legal" keto foods that can stall fat loss. Intermittent fasting is the answer here: You naturally reduce your caloric intake and give your gut a break. By not eating, you're allowing inflammation to quiet down in your body, which helps with blood sugar balance and weight loss. As an example, some plans combine daily fasting with a ketogenic diet. Have a big dinner, close up the kitchen, and push breakfast as far back the next morning as you can. I talk more about this type of keto diet, which I call a Cyclitarian plan, here.
MCT oil powder is a unique form of dietary fat rapidly absorbed by the body and has a wide range of health benefits. Supplementation with MCT powder can help combat fatigue, suppress appetite[*], enhance thermogenesis (aka ‘fat burning’)[*] and help your body adapt to using ketones for fuel. A recent scientific review showed that MCTs can effectively decrease body weight, total body fat, hip circumference, waist circumference, total subcutaneous fat and visceral fat[*]. Check out this articlefor more information on how to supplement with MCTs.
People suffering from diabetes and taking insulin or oral hypoglycemic agents suffer severe hypoglycemia if the medications are not appropriately adjusted before initiating this diet. The ketogenic diet is contraindicated in patients with pancreatitis, liver failure, disorders of fat metabolism, primary carnitine deficiency, carnitine palmitoyltransferase deficiency, carnitine translocase deficiency, porphyrias, or pyruvate kinase deficiency. People on a ketogenic diet rarely can have a false positive breath alcohol test. Due to ketonemia, acetone in the body can sometimes be reduced to isopropanol by hepatic alcohol dehydrogenase which can give a false positive alcohol breath test result. 
^ St Jeor ST, Howard BV, Prewitt TE, Bovee V, Bazzarre T, Eckel RH (October 2001). "Dietary protein and weight reduction: a statement for healthcare professionals from the Nutrition Committee of the Council on Nutrition, Physical Activity, and Metabolism of the American Heart Association". Circulation. 104 (15): 1869–74. doi:10.1161/circ.104.15.1869 (inactive 15 February 2019). PMID 11591629. These diets are generally associated with higher intakes of total fat, saturated fat, and cholesterol because the protein is provided mainly by animal sources. ... Beneficial effects on blood lipids and insulin resistance are due to the weight loss, not to the change in caloric composition. ... High-protein diets may also be associated with increased risk for coronary heart disease due to intakes of saturated fat, cholesterol, and other associated dietary factors.
Calculate your “macronutrients.” Macronutrients are nutrients which your body needs in large quantities, and they provide energy in the form of calories. Calculating your macronutrient intake will let you see the current levels of your fat consumption. With this information, you can decide how to reduce your carb and protein consumption, and increase your fat consumption.
You may also want to try a cyclical keto diet, or carb cycling. You follow the standard keto diet for 6 days of the week, when you eat less than 50 grams of net carbs a day. But on one day of the week, you increase your carb intake to roughly 150 grams of net carbs. Doing this satisfies any carb cravings you might have, making it easier to sustain keto in the long-run. Learn more about the benefits of carb cycling and weight loss here.
For those looking for something just a little closer to real sugar, you can use Xylitol. It cooks and tastes very similar to sugar, but it has a slight glycemic impact (13 vs. 100 for sugar). It is great, but please keep in mind that it is very toxic to animals and it will raise insulin levels slightly. These are the two most cited reasons for not using Xylitol.
To find out whether you have achieved ketosis, you can test your blood or urine for the presence of ketone bodies. Depending on your diet, your activity level, and your body type, it can take a couple of days to a couple of weeks to reach ketosis. Testing for ketosis is a personal preference. For some, it’s an added inconvenience; for others, it provides added incentive to stay on track.
You can approach keto in a number of different ways. On some keto diets, like dirty keto, it doesn’t matter where your fats, protein, and carbs come from. So dinner could be a bunless cheeseburger with extra bacon. Eating bad fats like low-quality vegetable oils, packaged low-carb snacks, and processed cheese dials up inflammation, making weight loss more challenging.[8]

The keto diet is a high-fat and low-carb (HFLC) diet. I would actually describe it as extremely low-carb—you're allowed to eat just 20 grams in a day. Some people on keto follow a net-carb plan (you can subtract the grams of fiber from a food's total carbs) and you're allowed to eat more carbs in a day. For my 30-day diet and for the sake of simplicity, I stuck with total carbs.


“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.”

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Ketones are generally an efficient source of fuel for your human body. They're created the fatty acids in your liver; a consequence of the breakdown of fatty tissue. These only appear when there's a lack of glucose and sugar. Inside Atkins diet plan, you reduce the amount of glucose and sugar that may be from the bloodstream. Hence, your system produces ketones for fuel. When your system is creating ketones it is known as ketosis.

Ketones are generally an efficient source of fuel for your human body. They're created the fatty acids in your liver; a consequence of the breakdown of fatty tissue. These only appear when there's a lack of glucose and sugar. Inside Atkins diet plan, you reduce the amount of glucose and sugar that may be from the bloodstream. Hence, your system produces ketones for fuel. When your system is creating ketones it is known as ketosis.


a) Why do I need to eat dietary fat during the keto diet if I have plenty of adipose tissue (as is currently the case) that can equally well be used as a source of energy? In your article you simply say that dietary fat is necessary for the keto diet to work, by I can’t see any explanation for that. Eating fat while I already have plenty of it available seems a bit counterintuitive.


Hi Sylvie, thanks for the positive review! To answer your question about spaghetti squash – it could quite frankly go either way. It has about 7g total carbs per serving (1 cup) and 5.5 net carbs which could be considered a bit high for keto but still on the moderate/low range compared to all the other starchy veggies out there. I would just be mindful of this and consume in moderation 🙂

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.


Vegan ketogenic diet or vegetarian diet: Yes, both are possible. Instead of animal products, plenty of low-carb, nutrient-dense vegan and/or vegetarian foods are included. Nuts, seeds, low-carb fruits and veggies, leafy greens, healthy fats and fermented foods are all excellent choices on a plant-based keto diet. There’s also a similar plan called ketotarian, which combines keto with vegetarian, vegan and/or pescatarian diets for supposedly greater health benefits.


On a “strict” (standard) keto diet, fats typically provides about 70 percent to 80 percent of total daily calories, protein about 15 percent to 20 percent, and carbohydrates just around 5 percent. However, a more “moderate” approach to the keto diet is also a good option for many people that can allow for an easier transition into very low-carb eating and more flexibility (more on these types of plans below).
Keep low-carb, high-fat dipping sauces, such as salad dressings and flavored mayonnaise, handy when you’re eating. They’re an easy way to boost your total fat—the second most important nutrient to track after net carb totals—and they add flavor and creamy satisfaction to many proteins and dinners, from grilled pork chops to lamb burgers. Now that you’re an expert on how to make the perfect keto diet menu, check out these unexpected health benefits of the keto diet.
Providing additional support Paoli et al. (17) examined the effect of a modified KD diet (~55% fat, 41% protein, and 4.5% CHO) on performance and body composition in gymnasts. In a crossover design, researchers compared independent 30-day dietary regimens consisting of “normal diet” (WD; 46.8% CHO, 38.5% fat, and 14.7% protein) and modified KD in nine elite male gymnasts. There were no significant changes from pre to post during either dietary intervention for measures of physical performance, indicating the absence of significant dietary CHO did not negatively impact physical ability. The post-KD measurements, however, saw a significant decrease in fat mass (pre: 5.3; post:
a) Why do I need to eat dietary fat during the keto diet if I have plenty of adipose tissue (as is currently the case) that can equally well be used as a source of energy? In your article you simply say that dietary fat is necessary for the keto diet to work, by I can’t see any explanation for that. Eating fat while I already have plenty of it available seems a bit counterintuitive.
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.
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