This work was supported by the PronoKal Group® and by grants from the Fondo de Investigacion Sanitaria (PE13/00024 and PI14/01012 research projects) and CIBERobn (CB06/003), Instituto de Salud Carlos III–Subdireccion General de Evaluacion y Fomento de la Investigación; Fondo Europeo de Desarrollo Regional, and the Health Department of the Xunta de Galicia, Spain. D.G.A. is grateful to the Colombian Department of Science, Technology and Innovation – COLCIENCIAS as a recipient of their predoctoral scholarship to support his work. The funding sources had no involvement in the study design, recruitment of patients, study interventions, data collection, or interpretation of the results. A PronoKal representative (I.S.) was involved in the study design and revised the final version of the manuscript, without intervention in the analysis of data, statistical evaluation, or final interpretation of the results of this study.
The ESS is based on questions referring to eight such situations, some known to be very soporific and others less so. The questionnaire is self-administered, and the item scores provide a new method for measuring sleep propensity in eight different real-life situations. Subjects are asked to rate on a scale of 0–3 how likely they would be to doze off or fall asleep in the eight situations, based on their usual, current lifestyle. A distinction is made between dozing off and simply feeling tired. If a subject has not been in some of the situations recently, he or she is asked, nonetheless, to estimate how each might affect him or her [29].
In 1863, William Banting, a formerly obese English undertaker and coffin maker, published "Letter on Corpulence Addressed to the Public", in which he described a diet for weight control giving up bread, butter, milk, sugar, beer, and potatoes.[46] His booklet was widely read, so much so that some people used the term "Banting" for the activity usually called "dieting".[47]
Psychological well-being and hunger and food control are two relevant factors involved in the success of weight-loss therapy in treating obesity. Thus, this study aims to evaluate food and alcohol cravings, physical and sexual activity, sleep, and life quality (QoL) in obese patients following a very low-calorie ketogenic (VLCK) diet, as well as the role of weight lost and ketosis on these parameters. A battery of psychological test was performed in twenty obese patients (12 females, 47.2 ± 10.2 year and BMI of 35.5 ± 4.4) through the course of a 4-month VLCK diet on four subsequent visits: baseline, maximum ketosis, reduced ketosis, and endpoint. Each subject acted as their own control. Relevantly, the dietary-induced changes in body composition (7.7 units of BMI lost, 18 kg of fat mass (1.2 kg of visceral fat mass)) were associated with a statistically significant improvement in food craving scores, physical activity, sleepiness, and female sexual function. Overall, these results also translated in a notable enhancement in QoL of the treated obese patients. Therefore, the rapid and sustained weight and fat mass (FM) loss induced by the VLCK diet is associated with good food control and improvements in the psychological well-being parameters in obese subjects, which could contribute to the long-term success of this therapy.
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 >
You can receive the FULL benefit of the 3-Week Ketogenic Diet without adding any exercise during the 3-weeks you'll be following the plan. If you choose to incorporate at least an hour of metabolic exercise during the week using my personal-trainer guided exercise videos, you'll see up to THREE times the results. Exercise contributes to hormonal balance, blood sugar stability, and lean muscle growth.
In a fantastic online review of the study, Dr. Stephan Guyenet, a nutritional research expert, notes the study's thoroughness and that the results, at face value, support the researchers’ initial hypothesis that a ketogenic diet promoted greater fat loss. Compared with the higher carbohydrate diet, the keto diet coincided with increased energy expenditure, meaning the subjects appeared to burn more calories when their carbohydrate levels were cut, thought they were consuming the same amount of calories as they were on the high carbohydrate diet.

The keto diet works for such a high percentage of people because it targets several key, underlying causes of weight gain — including hormonal imbalances, especially insulin resistance coupled with high blood sugar levels, and the cycle of restricting and “binging” on empty calories due to hunger that so many dieters struggle with. In fact, these are some of the direct benefits of the keto diet.
“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.”
White sugar, honey, and most traditional sugars are out when you’re eating keto because of the high carb counts. While many artificial sweeteners deliver sweetness sans a single carb, that doesn’t mean you should eat them, Crandall says. “We have demonized sugar—rightly so—for causing unneeded insulin spikes,” Crandall says, but “many artificial sweeteners do the exact same thing.” One study found that eating artificial sweeteners may increase cravings—especially for sweet things. This can stymie your weight-loss intentions. Discover how one woman totally kicked her sugar habit by trying the keto diet.
While there are delicious-looking ketogenic recipes and meal plans online, experts like Weaver warn that you’ll want to avoid relying too much on artificial sweeteners and unhealthy foods for your keto diet menu. Make sure your grocery list includes healthy fats like avocados, coconut oil, olive oil. This is what really happens to your body on the keto diet.

10. Crujeiras A.B., Morcillo S., Diaz-Lagares A., Sandoval J., Castellano-Castillo D., Torres E., Hervas D., Moran S., Esteller M., Macias-Gonzalez M., et al. Identification of an episignature of human colorectal cancer associated with obesity by genome-wide DNA methylation analysis. Int. J. Obes. (Lond.) 2018 doi: 10.1038/s41366-018-0065-6. [PubMed] [CrossRef] [Google Scholar]
Certain studies suggest that keto diets may “starve” cancer cells. A highly processed, pro-inflammatory, low-nutrient foods can feed cancer cells causing them to proliferate. What’s the connection between high-sugar consumption and cancer? The regular cells found in our bodies are able to use fat for energy, but it’s believed that cancer cells cannot metabolically shift to use fat rather than glucose. (11)
Check nutritionally-complete low-carb menus with under 50 grams of net carbohydrate per day to see what a ketogenic diet could look like. These menus are, however, going to be too high in protein for some people to remain in ketosis, and some of them may be a little high in carb if you have very poor carb tolerance. Keep in mind that ketogenic diets should always be tailored to the individual.
Excess fat mass (FM), especially visceral fat, is associated with a variety of pathological conditions such as hypertension, dyslipidemia, diabetes, and even cancer (1–4), as well as an increase in overall and cardiovascular mortality (2, 5). Very-low-calorie diets are commonly used as obesity treatments; however, a primary concern in using such diets is the amount of fat-free mass (FFM; i.e., muscular tissue) that is lost together with the FM (6). This could produce so-called sarcopenic obesity, that is, the coexistence of an excess of FM and a decline in FFM that yields a near-normal body weight (7). Sarcopenic obesity constitutes a double impact on the health of patients, because the reduction in muscle mass and muscle strength is also a cause of cardiometabolic disorders, such as myocardial infarction and stroke, and other adverse health outcomes (5, 7–9). For these reasons, it is of primary interest to find weight loss strategies that promote preferential loss of FM and preservation of muscle mass and its functional status (i.e., muscle strength) (10–12).
Most recently, Wilson et al. (27) investigated the effect of a 10-week KD on strength, body composition, blood lipids and hormonal response in resistance trained males, while following a periodized resistance training program. The investigation included a 2-week dietary adaptation period, and a control group, which followed a more traditional macronutrient ratio consisting of 55% CHO, 25% fat and 20% protein (WD). The 10-week dietary intervention was followed by a 1-week CHO re-introduction for the KD group. Average caloric consumption across the 11-week intervention was similar between groups. Blood lipids remained constant and were not significantly different between groups. The KD group did, however, elicit a significant increase in blood triglycerides during week 11, with the re-introduction of CHO. Total testosterone was significantly increased in the KD group, compared to WD, however, free testosterone was not significantly different between groups. While both groups saw increases in lean body mass, the KD group realized gains significantly greater than the WD group. Similarly, the KD group experienced significantly greater decreases in fat mass during the 10-week CHO restriction period. There were no significant differences in measures of strength or power between groups. From this, the authors concluded that the KD favorably impacted body composition, with no negative impact on blood lipids or muscular strength and power.

“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.”
Just to put things in context, I read an old scientific report about a seriously obese man who decided to be without food about a year (under medical supervision) and was given only some necessary micronutrients (vitamins, minerals, etc.) during the entire period. In this case all his energy had to come from adipose tissue (plus gluconeogenesis, I assume) in deep ketosis, and eventually he lost a lot of weight, mostly fat. Even more surprisingly, repeated tests during that year and thereafter demonstrated, that his health was continuously improving and he was actually feeling very well. What would be the downside of this kind of “starvation ketosis”, that will obviously last only until the point where the person has lost all his excessive fat?
“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!”

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. 

Letting your blood sugar drop too low when following low-calorie diets -- often containing 1,000 to 1,200 calories daily for women and 1,200 to 1,600 calories a day for men -- can lead to headaches. Low blood sugar, which happens when too little glucose is in your bloodstream, can occur if you skip meals to reach your weight-loss calorie allotment. To help prevent headaches during weight loss, eat regular meals and snacks every few hours or so.
In spite of the scientific evidence and real-life testimonials, not everyone is recommended to go on the ketosis diet. This highly specialized, extremely meticulous diet plan is suited to a particular dieter profile, and may also be harmful to some without the guidance of a doctor. But if performed correctly, the very low-calorie diet may be the only way for you to experience considerable, life-changing weight reduction.
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). 

Gut health is extremely important for anyone looking to lose weight and increase overall health[*][*]. It is not uncommon for those who shift to a ketogenic diet to have a change in the production of bacteria in their colon (although not necessarily a bad thing – just a change)[*]. To help support this change and increase the healthy bacteria in your gut, try consuming more fermented foods such as sauerkraut, kimchi or kefir and/or supplement with a high-quality probiotic[*][*].

“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.”
You’ll need to focus on titrating your insulin. Given the low amount of carbs in the Keto diet, I suggest you take detailed notes on how your blood sugar reacts to protein and fats. That way you can determine how much insulin to take with food. As for your basal, if you consistently go high/low without any bolus on board it might be a good idea to revisit your basal rates
The liquid diets involved with VLCDs often bring on ketosis, a condition that involves a buildup of ketone bodies in the blood as well as urine. Ketones are a byproduct that is created when your body has to switch to fat as an energy source. It means your store of glycogen, or carbohydrates, has been depleted. One of the consequences of ketosis is a loss of appetite, which helps make it easier to follow a VLCD. Ketosis also causes you to shed excessive amounts of sodium, potassium and water, which can cause dehydration, sluggishness, constipation and gas. However, your body can adjust to changes in your electrolytes.
A ketogenic diet helps control blood sugar levels. It is excellent for managing type 2 diabetes, sometimes even leading to complete reversal of the disease. This has been proven in studies. It makes perfect sense since keto lowers blood-sugar levels, reduces the need of medications and reduces the potentially negative impact of high insulin levels.
Wondering how many carb foods you can eat and still be “in ketosis”? The traditional ketogenic diet, created for those with epilepsy consisted of getting about 75 percent of calories from sources of fat (such as oils or fattier cuts of meat), 5 percent from carbohydrates and 20 percent from protein. For most people a less strict version (what I call a “modified keto diet”) can still help promote weight loss in a safe, and often very fast, way.
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.
My Husband and I started doing Keto July 2018. We got over weight after we got out of the Marine Corps. It has been hard to workout because I became disabled, but my diet was not good. After our friend Amber recommended your site and support group, we found a lot of helpful information to get us started on a successful journey. So far it’s been one month and we have lost 18 pounds each!
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.
Several recent studies indicate that a low-carbohydrate diet is effective at improving glycemia. A few studies have shown that in non-diabetic individuals, low-carbohydrate diets were more effective than higher carbohydrate diets at improving fasting serum glucose [13,14] and insulin [6,14-16], and at improving insulin sensitivity as measured by the homeostasis model [6]. One of these studies also included diabetic patients and noted a comparative improvement in hemoglobin A1c after 6 months (low fat diet: 0.0 ± 1.0%; low carbohydrate diet: -0.6 ± 1.2%, p = 0.06) [6] and 12 months (low fat diet: -0.1 ± 1.6%; low carbohydrate diet: -0.7 ± 1.0%, p = 0.019) duration [5]. In a 5-week crossover feeding study, 8 men with type 2 diabetes had greater improvement in fasting glucose, 24-hour glucose area-under-the-curve (AUC), 24-hour insulin AUC, and glycohemoglobin while on the low-carbohydrate diet than when on a eucaloric low-fat diet [7]. In a 14-day inpatient feeding study, 10 participants with type 2 diabetes experienced improvements in hemoglobin A1c and insulin sensitivity as measured by the euglycemic hyperinsulinemic clamp method [8]. Hemoglobin A1c also improved in an outpatient study of 16 participants who followed a 20% carbohydrate diet for 24 weeks [9].
A recent systemic review and meta-analysis of randomized controlled trials comparing the long-term effects (greater than 1 year) of dietary interventions on weight loss showed no sound evidence for recommending low-fat diets. In fact, low-carbohydrate diets led to significantly greater weight loss compared to low-fat interventions. It was observed that a carbohydrate-restricted diet is better than a low-fat diet for retaining an individual’s BMR. In other words, the quality of calories consumed may affect the number of calories burned. BMR dropped by more than 400 kcal/day on a low-fat diet when compared to a very low-carb diet.
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.”
This is where we have to depart! Sorry to say but you’re on your own. You should have plenty of leftovers that are frozen, ready, and waiting! I know a lot of you out there have trouble with timing and are busy people – so making sure that some nights you make extras to freeze is important. All those leftovers you have in the freezer? Use them up! Create your own meal plan, at first using this as a guide, and then completely doing it yourself. Once you get the hang of it, it’ll be a sinch – I promise you 🙂
I recall reading once that pink grapefruit and eggs for breakfast (or maybe it was the grapefruit 10-15 minutes before eggs) was supposed to launch you into some crazy fat burning mode. Something to do with hormone production, I seem to recall. Can’t say if it’s true or not. I tasted a grapefruit once when I was about 10, and have never desired to repeat that mistake in the 24 years since.
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The ketogenic diet is a medical nutrition therapy that involves participants from various disciplines. Team members include a registered paediatric dietitian who coordinates the diet programme; a paediatric neurologist who is experienced in offering the ketogenic diet; and a registered nurse who is familiar with childhood epilepsy. Additional help may come from a medical social worker who works with the family and a pharmacist who can advise on the carbohydrate content of medicines. Lastly, the parents and other caregivers must be educated in many aspects of the diet for it to be safely implemented.[5]
I’m a type 2 Diabetic who just started Keto 3 days ago. I usually only take a small amt of long acting insulin once a day. Usually glucose is around 130 to 150. However today for first time EVER glucose 97!!!! I took no insulin today and find myself very satisfied having BP coffee and don’t get very hungry on Keto. Hoping my glucose stays low tomorrow as well. Is it ok if I don’t eat as I’m not hungry?
During the ketosis phase of the nutritional intervention, the IWQOL-Lite scores did not change for the sexual life, social anxiety, and work area domains (Table S1). A significant improvement was observed in the physical function and self-esteem scores during this phase. When comparing the visit of reduced ketosis and endpoint with baseline, a significant improvement was found in all domains, except for social anxiety, which did not change throughout the nutritional intervention.
Melinda – I’m afraid there’s no getting around the fact that one of the Keto requirements is to *calculate your macros,* based on the amount of calories you need to consume each day, in order to (a) maintain your current weight level, or (b) lose weight. Go to an online Keto macro calculator – there’s one linked to a good one on this site, further up the thread. They are generally very easy to use. Then stick to your calculated results, with trust and patience. It may be slow, but you will absolutely see results. I did – and I’ve tried absolutely everything. I barely have time to exercise, but I still lost at least a couple of dress sizes, and I feel absolutely amazing – no more brain fog, tons of energy – maybe too much energy! And best of all, I’m no longer miserable about food, because on Keto, everything is delicious! One final thing in the interest of full disclosure – I am an uber-clean-Keto advocate. I put in the work to eat only healthy fats and carbs from healthy sources. I’m pescatarian – no meats except seafood. I also carefully limit my saturated fat intake to 10% of total calories (the recommended daily allowance), to keep my genetically problematic cholesterol level from skyrocketing, as it did when I first began. This is all working well for me so far – I was able to cut 40 points from my abnormally high LDL (bad cholesterol) level within three months, And hope to get it down to normal levels in three more months. You do want to make sure you get your regular physical exams and monitor your blood work whenever you change your nutritional lifestyle. I wish you the best!
The ketogenic diet is not a benign, holistic, or natural treatment for epilepsy; as with any serious medical therapy, complications may result.[28] These are generally less severe and less frequent than with anticonvulsant medication or surgery.[28] Common but easily treatable short-term side effects include constipation, low-grade acidosis, and hypoglycaemia if an initial fast is undertaken. Raised levels of lipids in the blood affect up to 60% of children[38] and cholesterol levels may increase by around 30%.[28] This can be treated by changes to the fat content of the diet, such as from saturated fats towards polyunsaturated fats, and if persistent, by lowering the ketogenic ratio.[38] Supplements are necessary to counter the dietary deficiency of many micronutrients.[18]

Sleep quality was evaluated by determining sleep propensity and quality by means of the PSS and PSQI, respectively. Overall, participants showed a poor sleep condition with a total score >5 au (Table S1). Thus, a significant improvement in sleepiness (PSS) was observed when comparing the visit of reduced ketosis with baseline, a point that coincided with maximum loss of fat mass (Figure 3B). By contrast, no statistically significant effect was observed on sleep quality and duration (PSQI; Figure 3B). Accordingly, plasma levels of dopamine showed no statistically significant changes (data not shown).
“I treat patients with cancer, specializing in breast cancer. I also perform clinical research on the interactions between diet, cancer, and exercise, and advise my patients on the benefits of a healthy lifestyle for helping to prevent and reduce the risk of cancer by promoting a healthy metabolism. These recommendations include a general reduction in carbohydrates, including low-carbohydrate and ketogenic diets, based on the available literature that supports this approach. I also recommend that patients take control of their own health by educating themselves with sources that provide evidence-based recommendations and scientific reviews.”

Weight loss is a common target for disease management, as well as health promotion. The prevalence of obesity remains high among U.S. adults (36.5%) (5), as well as children and adolescents (17%) (6). Importantly, obesity is a significant contributor to increased morbidity and mortality, as well as being a primary driver of increasing medical expenses (4). Despite much effort and cost, there has been little success on this front and obesity remains a public health crisis.
“Our medical practice was featured implementing a low-carbohydrate plan for a patient with type 2 diabetes in the documentary The Magic Pill. We believe food can be used as medicine. Many of our patients with insulin resistance, diabetes, metabolic syndrome, PCOS and more will see excellent results and resolution of chronic disease states with low-carbohydrate diets. Education and understanding as to which dietary strategy is best for the individual is essential in reclaiming one’s health. There is no doubt in my mind that low-carbohydrate planning can be extremely useful and safe for the appropriate clinical scenario.”
Of the 28 participants enrolled in the study, 21 completed the 16 weeks of follow-up. Reasons for discontinuing the study included unable to adhere to study meetings and unable to adhere to the diet; no participant reported discontinuing as a result of adverse effects associated with the intervention. All but one of the 21 participants were men; 62% (n = 13) were Caucasian, 38% (n = 8) were African-American (Table ​(Table1).1). The mean age was 56.0 ± 7.9 years.
Most recently, Wilson et al. (27) investigated the effect of a 10-week KD on strength, body composition, blood lipids and hormonal response in resistance trained males, while following a periodized resistance training program. The investigation included a 2-week dietary adaptation period, and a control group, which followed a more traditional macronutrient ratio consisting of 55% CHO, 25% fat and 20% protein (WD). The 10-week dietary intervention was followed by a 1-week CHO re-introduction for the KD group. Average caloric consumption across the 11-week intervention was similar between groups. Blood lipids remained constant and were not significantly different between groups. The KD group did, however, elicit a significant increase in blood triglycerides during week 11, with the re-introduction of CHO. Total testosterone was significantly increased in the KD group, compared to WD, however, free testosterone was not significantly different between groups. While both groups saw increases in lean body mass, the KD group realized gains significantly greater than the WD group. Similarly, the KD group experienced significantly greater decreases in fat mass during the 10-week CHO restriction period. There were no significant differences in measures of strength or power between groups. From this, the authors concluded that the KD favorably impacted body composition, with no negative impact on blood lipids or muscular strength and power.
“When the low-fat dietary advice I had been preaching for decades didn’t work for me in middle age, I changed to low-carb. After mentorship from Dr. Eric Westman, I introduced low-carb to my patients with astonishing results reversing diseases I had only been “managing”. In fact, more than 90% of patients who come to me on insulin are able to come off. I run a multidisciplinary medical weight loss clinic helping to restore health. This has brought the joy back into medicine for me. Diet Doctor has been an amazing resource to help me and my patients in this journey.”

Over the long-term the KD poses possible risks as well, although the evidence remains unclear on this topic. Consumption of a high fat diet, particularly saturated fat, is associated with increased cardiovascular risk (23) and consumption of saturated fat has been shown to acutely induce insulin resistance and raise blood triglyceride levels (12). Nevertheless, many KD studies have documented improvements in markers of cardiovascular risk, including improvements in vascular function (24) reduction in inflammatory markers (10), and other markers of cardiovascular health (13,20). Methodological issues, such as clear definitions of dietary interventions, may play a significant role in obscuring the underlying principles, however, it is clear that more targeted research is warranted.
“As a family doctor in India, I recommend low-carb and keto diets, with and without intermittent fasting, to all of my patients who have lifestyle-related chronic conditions. I follow the growing, evidence-based science behind these approaches and I have seen the impressive clinical results. I, too, follow a low carb lifestyle and usually do it with intermittent fasting. I have been able to reverse my diabesity and keep my post-menopausal symptoms at bay. I also recommend to my patients that they visit the Diet Doctor website to find trustworthy information and delicious recipes.”

63. Seidelmann S.B., Claggett B., Cheng S., Henglin M., Shah A., Steffen L.M., Folsom A.R., Rimm E.B., Willett W.C., Solomon S.D. Dietary carbohydrate intake and mortality: A prospective cohort study and meta-analysis. Lancet Public Health. 2018;3:e419–e428. doi: 10.1016/S2468-2667(18)30135-X. [PMC free article] [PubMed] [CrossRef] [Google Scholar]

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.
This is because the triglycerides from those fat cells are metabolized for energy while the cholesterol is not. The cholesterol is simply released into the blood where it will remain until removed by the liver, making it appear that our cholesterol has suddenly skyrocketed. Many people are quick to assume that this is due to an increase in dietary fat and cholesterol intake.
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.

The popular belief that high-fat diets cause obesity and several other diseases such as coronary heart disease, diabetes, and cancer has not been observed in recent epidemiological studies. Studies carried out in animals that were fed high-fat diets did not show a specific causal relationship between dietary fat and obesity. On the contrary, very-low-carbohydrate and high-fat diets such as the ketogenic diet have shown to beneficial to weight loss.
“As an interventional pain physician, in addition to cutting-edge techniques I use nutritional strategies to deliver people from a cycle of pain and disability. Chronic pain may result from inflammation and metabolic disarray; it intersects every part of life and is an illness as much as it is a symptom. Obesity and aging are inflammatory processes at the root of many pain-inducing chronic diseases. I suggest anti-inflammatory, low-carb, ketogenic diets and fasting protocols to optimize patients’ health. Diet Doctor is a great resource for patients compliant with this lifestyle.”

There is little doubt that one key to maintaining a healthy weight is exercise. Cardiovascular workouts burn off energy and improve musculature so the body works more efficiently. However, it can be hard to reduce body fat. This is where a ketogenic diet may help. By reducing daily carbohydrates, the body must look for other sources of energy, and it is forced to use fat reserves. Loading up on carbohydrates right before exercise provides energy when you need it.
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The keto diet is known for helping people lose a few pounds very quickly, says Becky Kerkenbush, RD, a clinical dietitian at Watertown Regional Medical Center. Carbs hold on to more water than protein or fat, so when you stop eating them, your body releases all that extra H2O by making you pee more. As a result, the scale might read a few pounds lower, and you may look a bit leaner.

Dietary fiber keeps you full longer and contains prebiotic nutrients that support a healthy gut flora, creating a win-win for weight loss. Getting insufficient dietary fiber (yes, I'm talking to you, all-meat carnivore or cave-man diet folks) adversely shifts your healthy gut flora, which will increase inflammation, insulin resistance, fat deposition around the middle, and weight gain. Leafy green and cruciferous vegetables, avocado, coconut, and berries make great fiber-rich, keto-friendly foods.
Dr. Josh Axe, DNM, DC, CNS, is a doctor of natural medicine, clinical nutritionist and author with a passion to help people get well using food as medicine. He’s the author of the books “Eat Dirt: Why Leaky Gut May Be the Root Cause of Your Health Problems,” “Essential Oils: Ancient Medicine” and the upcoming “Keto Diet: Your 30-Day Plan to Lose Weight, Balance Hormones, Boost Brain Health, and Reverse Disease” (February 2019, published by Little, Brown Spark). He’s a co-founder of Ancient Nutrition, a health company where the mission is to restore health, strength and vitality by providing history’s healthiest whole food nutrients to the modern world.
On a high-fat ketogenic diet, you can easily eat 3,000 calories or more daily with high-calorie foods like cheese and nuts. Sure, your body will shift into ketosis on a high-fat diet, but eating too many calories means your body will utilize dietary fat instead of body fat. A food journal can help you pinpoint high-calorie foods that might sabotage your weight loss. You don't need to be on an old Atkins diet plan to lose weight the keto way.

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.
“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!”
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