In general, you want to eat the minimum amount of protein to preserve lean body mass and not overtax your kidneys. If you eat too much protein, the excess converts to glucose through a process called gluconeogenesis. You don’t want that to occur in ketosis. Instead, eat anti-inflammatory protein—at the minimum amount to preserve or build lean body mass. My favorite sources are wild-caught fish, grass-fed and -finished beef and wild meats (elk, bison, etc.), pasture-raised poultry, nuts, and seeds. Make sure fish has more selenium (which helps protect the brain) than mercury, to mitigate heavy metal toxicity. Good sources that have a safe selenium/mercury ratio include: tuna, opah, wahoo, spearfish, swordfish.
I have great respect for Harvard Medical School. I notice that they support their readers posting comments and I am most appreciative of the article and all the many thoughtful comments by the readers. The readers seem to have the most expertise here and I hope that the doctor who wrote the article will think long and hard about the comments by readers. After 35 years of clinical practice in mental health, I notice that all issues of emotion involve medical issues, nutrition, and the gut bacteria. I would say that these issues and all of the executive brain functions seem to improve with ketogenic principles. For those that apply it in a flexible and smart manner, it appears to improve every area of their lives. I strongly encourage the author of the article to take one class via The Institute for Functional Medicine. If he is open to more learning he can take more classes and get certified. I’m sure a fine doctor, he will be an even better doctor and personally healthier, if he gets more training. Are we all open to new learning(especially us healthcare providers)?
You work out for a few months and get in shape and fall back to the old habits because you were not conditioned mentally, only physically. Physical fitness is only a part of journey, fitness is over 75% percent mental. Gyms, nutritionists, and personal trainers give most people a temporary Band-Aid but never address the actual issue. The 3-Week Ketogenic Diet includes secret mindset strategies to make your journey so much easier.
The ketogenic diet, or even just a higher-fat, low-carb diet, has now gained massive support as a modern-day healing strategy. In fact, our ideas about fats and cholesterol seem to have been almost completely reversed in recent years. That being said, many people see their cholesterol go up after beginning more of a ketogenic lifestyle. Some people get concerned when this happens, so in this article, I am going to address the phenomena of high cholesterol on a ketogenic diet.

In 1967, Irwin Stillman published The Doctor's Quick Weight Loss Diet. The "Stillman diet" is a high-protein, low-carbohydrate, and low-fat diet. It is regarded as one of the first low-carbohydrate diets to become popular in the United States.[52] Other low-carbohydrate diets in the 1960s included the Air Force diet[53] and the Drinking Man's Diet.[54] Austrian physician Wolfgang Lutz published his book Leben Ohne Brot (Life Without Bread) in 1967.[55] However, it was not well known in the English-speaking world.


As the popularity of the Keto Diet has exploded in recent years the true nature of Ketogenic weight loss has gotten blurred. So what is Keto? Very simply Keto refers to Ketosis, the state into which your body enters when it shifts to burning fat for energy instead of carbohydrates. As carbohydrates and sugar intake is restricted, your body begins to break down its fat stores to use as a source of energy. Therefore, the very basics of a Ketogenic Diet are:
Too many "legal" high-calorie foods can sabotage your keto diet. So can lots of other things. One way to pinpoint those potential glitches is through a food journal. One study found people who tracked everything they ate lost twice the amount of weight as those who didn't track what they ate. A food journal also keeps you honest and compliant with your keto plan.
“In my psychiatric practice, the high rate of obesity and metabolic disorders among my patients prompted me to develop an integrative therapeutic response, especially to address frequent patterns of impulsivity/compulsivity, low energy/lethargy, mood instability, mental fog, poor concentration and cognitive deterioration. A real-food, low-carb, healthy-fat, often ketogenic lifestyle, combined with intermittent fasting, stress management, rest, and movement — and appropriate pharmacotherapy as needed — results in improved general health, cognitive function, mood management, and quality of life. Diet Doctor, especially the new Spanish site, is a great tool for my patients.”
Although the KD has shown promise as an alternative dietary strategy for weight management, it should be approached with caution. Acutely, the KD causes physiological changes which may manifest as the “keto flu,” a set of symptoms which commonly includes headache, nausea, gastrointestinal upset and fatigue. A recent study by Urbain et al. (22) illustrates this point, as they state, “Consistent with other studies, our subjects complained about headache, gastrointestinal symptoms, and general weakness mainly during the 1-week metabolic adaptation phase to a KD.” While these symptoms typically resolve within the first one to two weeks, this may present an unpleasant barrier for many individuals to overcome.
“Your liver produces ketones all the time, but the rate depends on carbohydrate and protein intake,” says Jeff Volek, Ph.D., R.D., a professor of human sciences at Ohio State University. When the majority of your diet is made up of of carbs and protein, ketogenesis slows. Replacing carbs and protein with fat will put your body into ketosis, thus ramping up ketone production. This takes about three days to induce.
“The cleaner, the better when it comes to the keto diet,” says Jadin. Focus on “whole” and “unprocessed.” Also, strive for a mix of saturated and unsaturated fats for balance. Note: Tipping the scale toward too much protein is a common pitfall many people make on the keto diet. Mind your protein intake, since too much can kick you out of ketosis, says Jadin.

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]
Well, I am going to give this another try. I have great difficulty in eating greens , or drinking them, also I am not fond of fats, years and years of low fat diets have totally screwed my metabolism,and taste buds. I will read this page every day to keep my mind focused. Start tomorrow when I get up …… I work nights which can cause me problems as well. When I tried this diet before, I got terrible cramp, now I realise I wasn’t drinking enough water. Anyway.here goes.
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.
Collagen is a type of protein that has been shown to suppress appetite[*], provide fullness compared to other proteins like whey, casein, or soy[*], help retain muscle mass[*] and even help to reduce the appearance of cellulite due to it’s ability to improve skin elasticity and thickness[*]. Refer to this article for more information on the benefits of collagen and the best way to supplement it in your diet.

Leftovers will be another thing we will take into consideration. Not only is it easier on you, but why put yourself through the hassle to cook the same food more than once? Breakfast is something I normally do leftover style, where I don’t have to worry about it in the morning and I certainly don’t have to stress about it. Grab some food out the fridge, pre-made for me, and head out the door. It doesn’t get much easier than that, does it?
Your individual fat adaptation period. Remember your body needs time to become fat-adapted and that time depends on your metabolism. For instance, if you’re coming off a Standard American Diet (SAD) and your adult body has never run on ketones before, your adaptation period might take a little longer. You’ll only experience the true weight loss effects of keto when your body is actually running on ketones.
There are three sources of fuel your body uses for energy: carbohydrates, proteins and fats. Carbohydrates are broken down into glucose, or blood sugar, and are your body's primary fuel source. When carbohydrates aren't available, your body relies on fat for energy. Protein is the main building block for muscles and tissues. In a pinch, protein can also be converted to glucose and used for energy.
But what does the science say? Results are mixed. In one Spanish study of 20 obese adults, participants were put on a low-calorie keto diet and lost an average of 40 pounds over four months. Another small experiment had a similar outcome. In a six-month Experimental & Clinical Cardiology study of 83 obese adults, those on the keto diet lost an average of 33 pounds, while lowering their bad (LDL) cholesterol levels and increasing their good (HDL) cholesterol.
A ketogenic diet — which is very low in net carbohydrates and high in healthy fats — is key for boosting mitochondrial function. Healthy fats also play an important role in maintaining your body's electrical system. When your body is able to burn fat for fuel, your liver creates water-soluble fats called ketones that burn far more efficiently than carbs, thereby creating fewer reactive oxygen species (ROS) and secondary free radicals. Ketones also decrease inflammation, improve glucose metabolism and aid the building of muscle mass. The benefits of a cyclical ketogenic diet are detailed in my latest bestselling book, "Fat for Fuel." While the book was peer-reviewed by over a dozen health experts and scientists, a new large-scale international study (known as the international Prospective Urban Rural Epidemiology, or PURE, study) adds further weight to the premise that high intakes of healthy fats — especially saturated fats — boost health and longevity.

“Each person’s journey is different, and therefore each person deserves a highly-specialized and individualized treatment plan to help them reach their optimal health. I recommend low-carb and ketogenic lifestyles to my patients and find ways to make them reasonable and sustainable for each person. Diet Doctor is a wonderful resource for my patients and provides wonderful recipes and invaluable information.”


All anthropometric measurements were undertaken after an overnight fast (8 to 10 h), under resting conditions, in duplicate, and performed by well-trained health workers. Participants’ body weights were measured to the nearest 0.1 kg on the same calibrated electronic device (Seca 220 scale, Medical Resources, EPI Inc. (Lewis Center, OH, USA) in underwear and without shoes. BMI was calculated by dividing body weight in kilograms by the square of height in meters; BMI = weight (kg)/height2 (m).
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.
Vegetables: This isn’t a diet that allows you to eat veggies to your heart’s content. Most of your vegetables should come from leafy greens like lettuce, spinach, and bok choy. You can also fit in some asparagus, cauliflower, and broccoli. As a rule of thumb if it’s a colour other than green, avoid it. Here's a full list of vegetables to eat on a Keto diet.
“As an American board-certified endocrinologist who moved back to Mumbai, I saw India’s diabetes epidemic and dogma through a different lens. Low carb plus intermittent fasting has proven very effective in the reversal of insulin resistance, fatty liver, PCOS, reduced fertility, obesity, metabolic syndrome, hypertension and even early diabetic neuropathy and nephropathy. I conduct Diabetes Self-Management classes every month while looking at the whole lifestyle: stress, sleep, exercise, mindfulness, self-care and nutrition. This works even in India’s predominantly vegetarian culture! I often refer patients to DietDoctor for low-carb recipes and FAQ’s.”
With funding from the Laura and John Arnold Foundation, in 2012 Taubes co-founded the Nutrition Science Initiative (NuSI), with the aim of raising over $200 million to undertake a "Manhattan Project for nutrition" and validate the hypothesis.[29][30] Intermediate results, published in the American Journal of Clinical Nutrition did not provide convincing evidence of any advantage to a low-carbohydrate diet as compared to diets of other composition – ultimately a very low-calorie, ketogenic diet (of 5% carbohydrate) "was not associated with significant loss of fat mass" compared to a non-specialized diet with the same calories; there was no useful "metabolic advantage".[6][8] In 2017 Kevin Hall, a NIH researcher hired to assist with the project, wrote that the carbohydrate-insulin hypothesis had been falsified by experiment.[28][8] Hall wrote "the rise in obesity prevalence may be primarily due to increased consumption of refined carbohydrates, but the mechanisms are likely to be quite different from those proposed by the carbohydrate–insulin model".[8]

Instead of making your own cereal, you can always have a low-carb alternative. Try out chia seed pudding, flax granola sprinkled into coconut or almond milk, salted caramel pork rind cereal, or just mix together toasted nuts that are crushed and crispy. It’s quite easy to find a crunchy alternative to cereal (or just a low-carb replacement in general) so keep on the lookout and experiment for yourself to see which you like best.

The weight-loss program has five steps and adheres to the most recent guidelines of the 2015 EFSA on total carbohydrate intake [22]. The first three steps consist of a VLCK diet (600–800 kcal/day), low in carbohydrates (<50 g daily from vegetables), and lipids (only 10 g of olive oil per day). The amount of high biological-value proteins ranged between 0.8 and 1.2 g per each kg of ideal body weight to ensure that patients were meeting their minimum body requirements and to prevent the loss of lean mass. In step 1, the patients ate high-biological-value protein preparations five times a day and vegetables with low glycemic indexes. In step 2, one of the protein servings was substituted with a natural protein (e.g., meat or fish) either at lunch or at dinner. In step 3, a second serving of low-fat natural protein was substituted for the second serving of biological protein preparation. Throughout these ketogenic phases, supplements of vitamins and minerals, such as K, Na, Mg, Ca, and omega-3 fatty acids, were provided in accordance with international recommendations [23]. These three steps were maintained until the patient lost the target amount of weight, ideally 80%. Hence, the ketogenic steps were variable in time depending on the individual and the weight-loss target. The total ketosis state lasted for 60–90 days only.
I have been on a keto diet for over a year. I lost 60 pounds and got off five different meds and a shot in the stomach for the last 25 years. Fasting sugar under 150 was considered good control. A1C was usually around 7. Now sugars are rarely over 80 and A1C is 5.4. THEN I PLATEAUED AND EVEN GAINED BACK 10 pounds. Little did I know I have been shooting myself in the foot. It didn't help that I quit a job that required seven miles of vigorous walking each day, but I begin my day with a big glass of half and half. I didn't realize I was adding 16-20g hidden carbs over my 25g allotment. I am switching to making my own with heavy whip cream and almond milk. That drops carb count to 6.4g per cup.
Here’s the tricky part: There’s no definite answer for how much protein you’d have to eat before you run into trouble. “It really depends on how much protein a person is consuming versus how much they need, as well as the health of their kidneys at baseline,” Hultin says. That’s why it can be helpful to speak with a nutritionist or doctor who can help you tailor your diet before going keto.

One downside to a ketogenic diet for weight loss is the difficulty maintaining it. “Studies show that weight loss results from being on a low-carb diet for more than 12 months tend to be the same as being on a normal, healthy diet,” says Mattinson. While you may be eating more satiating fats (like peanut butter, regular butter, or avocado), you’re also way more limited in what’s allowed on the diet, which can make everyday situations, like eating dinner with family or going out with friends, far more difficult. Because people often find it tough to sustain, it’s easy to rely on it as a short-term diet rather than a long-term lifestyle.

If you can't see any ketones, be patient. It typically takes 2-3 days for your body to deplete glycogen stores, so don't expect to be in ketosis after just a day of low-carb. Remember, ketosis is a favourable condition and an indication that your body uses fat for fuel but you can lose weight even without being in ketosis. A diet high in fat, adequate in protein and low in carbohydrates is naturally sating, making you less hungry and, therefore, helps you lose weight.


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.
“As a full-spectrum family physician since 2004, luckily I stumbled on the wonderful low-carb community two years ago after my amazing wife was forced to make dietary changes after surgery. I’ve never looked back! After transforming my own health, with help from resources like Diet Doctor, Jimmy Moore, and Dr. Jason Fung, I’ve committed to bettering the lives of my patients with intensive dietary management through LCHF and intermittent fasting. Empowering patients to make these lifestyle changes has truly brought back the joy of medicine for me. I am so thankful to all who have inspired me along the way.”
Just because you're getting headaches doesn't mean your diet is the culprit. Berkeley University Health Services reports that headaches may also be a sign of muscle tightening in your neck triggered by fatigue, depression or emotional stress. However, if you're experiencing chronic headaches, you're not losing more than 2 pounds weekly and you're drinking plenty of water, it may be time to talk with your doctor. Although headaches can occur while dieting, chronic headaches that don't subside may be a sign of a more serious medical condition.
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).

You've selected an efficient, well-designed meal substitute system. The technology of meal substitute demands continuous and careful monitoring from experts. It can be unsafe to do this on your own, although it won't be practical to get your own personal doctor either. The best solution is to join a meal substitute program that offers an extensive solution-from providing advised items, to helping your acquire healthier habits, to aiding your persistence for a fit, energetic and healthier lifestyle.

“Real food — that is low-sugar, high-fiber — works for most of the population, but some patients may need a low-carb diet for best results. For those patients, I am totally for low carb. I have certainly had many insulin-resistant patients who didn’t get better until they went on a low-carb diet. I am not remotely concerned about negative effects of low carb. I feel that, aside from patients with familial hypercholesterolemia and type 5 hyperlipidemia, a low-carb diet is entirely safe.”
Eat fats with all your meals. Fats are the cornerstone of the ketogenic diet, and will encourage your body to burn fatty ketones for fuel. Typically, calories from fat should comprise 80 – 90% of your meals.[10] (However, you cannot eat unlimited fats on a ketogenic diet; the calories can still add up and cause weight gain.[11]) Examples of fatty foods include:
“A lot of folks find that batch cooking once or twice a week saves a tremendous amount of time and keeps you from spending every evening in the kitchen,” Weaver says. “When keto meal planning, you want to follow general good meal planning practices, like shopping for the week’s food all at once, which helps to save money, and prepping your vegetables when you get home. These 10 keto recipes are so good you’ll forget you’re on a diet.
Although the KD has shown promise as an alternative dietary strategy for weight management, it should be approached with caution. Acutely, the KD causes physiological changes which may manifest as the “keto flu,” a set of symptoms which commonly includes headache, nausea, gastrointestinal upset and fatigue. A recent study by Urbain et al. (22) illustrates this point, as they state, “Consistent with other studies, our subjects complained about headache, gastrointestinal symptoms, and general weakness mainly during the 1-week metabolic adaptation phase to a KD.” While these symptoms typically resolve within the first one to two weeks, this may present an unpleasant barrier for many individuals to overcome.
Dr. Campos, it is unfortunate that you retain the medical community’s negative stance on the ketogenic diet, probably picked up in medical school when you studied ketoacidosis, in the midst of an obesity and type II diabetes epidemic that is growing every year, especially among populations who will never see the Harvard Health Letter. The medical community has failed in reversing this trend, especially among children, and the public is picking up the tab, in the form of higher health insurance premiums to treat chronic metabolic diseases which doctors cannot cure. The ketogenic diet does not bid its adherents to eat unhealthy processed meats, and the green leafy vegetables that it emphasizes are important in a number of nutritional deficiencies. People lose weight on the ketogenic diet, they lose their craving for sugar, they feel more satiety, they may become less depressed, their insulin receptors sensitivity is improved, and these are all the good outcomes you fail to mention. There is a growing body of research which demonstrates the neuroprotective effects of the ketogenic diet to slow cancer progression, as well as diseases like Parkinson’s and Alzheimer’s, for which there are no effective medical treatments. Please respect your patients by providing them with evidence-based medical outcomes, not opinions.

The weight-loss program has five steps and adheres to the most recent guidelines of the 2015 EFSA on total carbohydrate intake [22]. The first three steps consist of a VLCK diet (600–800 kcal/day), low in carbohydrates (<50 g daily from vegetables), and lipids (only 10 g of olive oil per day). The amount of high biological-value proteins ranged between 0.8 and 1.2 g per each kg of ideal body weight to ensure that patients were meeting their minimum body requirements and to prevent the loss of lean mass. In step 1, the patients ate high-biological-value protein preparations five times a day and vegetables with low glycemic indexes. In step 2, one of the protein servings was substituted with a natural protein (e.g., meat or fish) either at lunch or at dinner. In step 3, a second serving of low-fat natural protein was substituted for the second serving of biological protein preparation. Throughout these ketogenic phases, supplements of vitamins and minerals, such as K, Na, Mg, Ca, and omega-3 fatty acids, were provided in accordance with international recommendations [23]. These three steps were maintained until the patient lost the target amount of weight, ideally 80%. Hence, the ketogenic steps were variable in time depending on the individual and the weight-loss target. The total ketosis state lasted for 60–90 days only.
If you can't see any ketones, be patient. It typically takes 2-3 days for your body to deplete glycogen stores, so don't expect to be in ketosis after just a day of low-carb. Remember, ketosis is a favourable condition and an indication that your body uses fat for fuel but you can lose weight even without being in ketosis. A diet high in fat, adequate in protein and low in carbohydrates is naturally sating, making you less hungry and, therefore, helps you lose weight.
“Basic human physiology supports the use of a low-carb diet for the management of diabetes and related metabolic conditions, both in daily life and in my practice of hospital medicine, where glycemic control is vitally important. I use Diet Doctor as a resource to stay up-to-date with other low-carb professionals, and I confidently refer my patients to this trusted resource for its wealth of information relevant to their metabolic health.”
On a ketogenic diet, your entire body switches its fuel supply to run mostly on fat, burning fat 24-7. When insulin levels become very low, fat burning can increase dramatically. It becomes easier to access your fat stores to burn them off. This is great if you’re trying to lose weight, but there are also other less obvious benefits, such as less hunger and a steady supply of energy. This may help keep you alert and focused.

There are vegetables that are high in carbs and others low in carbs. The keto diet recommends sticking to the ones low on carbs but encourages you to eat a lot of them. Best vegetables are all green ones to make it easy. And vegetables that grow above the ground (e.g. lettuce) are always better than the ones that grow below the ground (e.g. potatoes)
Adding heavy cream or half-and-half to your coffee is one way to get an additional source of fat into your day, says Keatley. Just realize that it is a source of saturated fat — and, given the small serving size, it’s easy to go overboard. According to the USDA, 1 tbsp has 51 calories, 5 g of fat (3.5 g saturated fat), and is just shy of ½ g of carbohydrate.
If this all sounds like way too much work, consider intermittent fasting. It is a simpler way to achieve cyclic ketosis and has many of the same benefits. Anecdotally, it has worked better for me for weight loss than nutritional ketosis, and has many of the same health benefits. I prefer a 16/8 or 18/6 protocol, where you confine your eating (with no change in calories) to a 6- to 8-hour window, then fast overnight. For instance, I finish eating by 6 p.m., then eat again at noon the next day. For weight loss, I recommend following this protocol two to seven days per week. [Stay tuned for more on goop.]
If you like more veggies in your Keto Diet and are also concerned with a low calorie keto meal plan, then the IBIH 5 Day Keto Soup Diet may be for you!  Featured in Woman’s Day magazine twice already, this Keto Soup Diet is is also Whole 30 friendly, so it’s super healthy and very effective.  Be prepared for some detox symptoms, as this Keto Soup Diet Meal Plan does not include grains, dairy, sweeteners, or alcohol – which means it works very very well, but can cause headaches in the first couple of days.  We have an exclusive Keto Soup Diet Facebook Group for this plan too – so feel free to join to get the support and help you need to succeed and tell everyone about your amazing results!
I enjoyed reading your article. I have recently started a keto diet in hopes of loosing some weight and helping my son who struggles with weight.  He’s done pretty well and lost about 7 lbs the first week- we are on week 3 and he hasn’t lost any more, I haven’t lost a thing.  It’s been very frustrating as I am trying my best- family of 6 is not easy!  Any encouragement or advice would be greatly appreciated.  
Short-term results for the LGIT indicate that at one month approximately half of the patients experience a greater than 50% reduction in seizure frequency, with overall figures approaching that of the ketogenic diet. The data (coming from one centre's experience with 76 children up to the year 2009) also indicate fewer side effects than the ketogenic diet and that it is better tolerated, with more palatable meals.[18][50]
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. 

2. Choose the amount of protein based on your activity level. For instance, I weigh about 130 pounds and exercise (spin, hike, yoga, weight training) about six or more hours per week. Applying the keto calculator, if I want to lose weight, I should eat 20 grams of carbs, 67 grams of protein, and the rest in fat (about 119 grams). Here are my typical proteins in a day. (If you exercise more than me, you’ll need more.)

Despite the efforts to decrease weight loss, obesity prevalence is increasing worldwide [36]. The obesogenic environment and the unsuccessful effect of current treatments are consistently contributing to an increase in obesity prevalence. Obesity is promoted by several factors, including genetic, environmental, metabolic, and behavioral factors [8,11,37]. These same factors are involved in the unsuccessful effect of many weight-loss therapies [38]. Apart from the biochemical and genetic factors, in the literature, obesity has consistently been related with a poorer quality of life [39] and lower self-esteem and lower life satisfaction [40]. Additionally, food addiction was proposed as a plausible causal factor contributing to obesity and weight regain after a weight-loss therapy, at least in the same individuals [41]. Therefore, it is important to control these factors to attain success in weight-loss therapy. In this context, a VLCK diet has previously been shown to induce severe body-weight loss that has been maintained for at least 2 years after dieting [6]. This nutritional weight-loss method resulted in the beneficial effects of decreasing body fat mass by preserving body muscle mass and strength [4] and maintaining the resting metabolic rate [7]. Thus, the new open question was whether the beneficial effects of this nutritional method on body composition and energy metabolism are associated with a modulation in the psychobiological phenomena of obese patients.
Achieving ketosis is a pretty straightforward, but it can seem complicated and confusing with all of the information out there.4If you want to learn more about ketosis and the scientific process around it, you can visit a very in-depth discussion about on Dr. Peter Attia’s website. Here’s the bottom line on what you need to do, ordered in levels of importance:
An important strength of this study was the use of 3 different techniques for determining body composition in different settings, i.e., obesity and no ketosis, marked reduction in body weight with high ketosis, and finally, substantial reduction in body weight without ketosis. The tight control of adherence by daily measurement of B-OHB is another relevant strength of this work. A potential limitation of our study could be the sample size; however, because each subject underwent 4 evaluations, enabling each individual subject’s own results to be compared, this adds statistical power to the study and a real difference between the experimental points. 

A well-formulated ketogenic diet, besides limiting carbohydrates, also limits protein intake moderately to less than 1g/lb body weight, unless individuals are performing heavy exercise involving weight training when the protein intake can be increased to 1.5g/lb body weight. This is to prevent the endogenous production of glucose in the body via gluconeogenesis. However, it does not restrict fat or overall daily calories. People on a ketogenic diet initially experience rapid weight loss up to 10 lbs in 2 weeks or less. This diet has a diuretic effect, and some early weight loss is due to water weight loss followed by a fat loss. Interestingly with this diet plan, lean body muscle is largely spared. As a nutritional ketosis state sustains, hunger pangs subside, and an overall reduction in caloric intake helps to further weight loss.
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).

I have been on a low carb keto diet for more than a year. As T2DM my A1C dropped from 9% to 5.4% & I discontinued meds. All my lipids improved even with ample healthy saturated fat. More than a year now so I wonder why this would be a short term improvement when its obvious that I will not go back to a high A1C and taking 3 diabetes medications including sulphonylureas. It is clear from this article that you lack the necessary experience that would be gained from wholeheartedly trying the diet or monitoring patients doing it properly like me. I would be probably be facing my first amputation if I believed the negativity in your article. So for people with diabetes who may be dissuaded by your article. Ignore it and take back your health by restricting carbs (<25 g a day) or as low as you reasonably can below 130g while being satisfied that you are getting adequate nutrition.


In 1921, Rollin Turner Woodyatt reviewed the research on diet and diabetes. He reported that three water-soluble compounds, β-hydroxybutyrate, acetoacetate, and acetone (known collectively as ketone bodies), were produced by the liver in otherwise healthy people when they were starved or if they consumed a very low-carbohydrate, high-fat diet.[10] Dr. Russell Morse Wilder, at the Mayo Clinic, built on this research and coined the term "ketogenic diet" to describe a diet that produced a high level of ketone bodies in the blood (ketonemia) through an excess of fat and lack of carbohydrate. Wilder hoped to obtain the benefits of fasting in a dietary therapy that could be maintained indefinitely. His trial on a few epilepsy patients in 1921 was the first use of the ketogenic diet as a treatment for epilepsy.[10]
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