Hi, I had a gastric bypass 8yrs ago. I’m doing the keto diet with my 16yr old son to help him lose weight and I’ve also put on 20lbs back that I’m trying to get rid off. So far we’ve lost 6lbs in 4weeks. Since I can only eat a little portion at a time and it’s hard to consume the 75% fats to get into a Ketosis stage, although I’m trying really hard but it’s impossible. Can you recommend ways to booster my fat intakes pls. Or other ways to get in to Ketosis. Thank you for all this info you’ve shared by the way.


It is possible to combine the results of several small studies to produce evidence that is stronger than that available from each study alone—a statistical method known as meta-analysis. One of four such analyses, conducted in 2006, looked at 19 studies on a total of 1,084 patients.[23] It concluded that a third achieved an excellent reduction in seizure frequency and half the patients achieved a good reduction.[18]
Purnell JQ, Hokanson JE, Marcovina SM, Steffes MW, Cleary PA, Brunzell JD. Effect of excessive weight gain with intensive therapy of type 1 diabetes on lipid levels and blood pressure: results from the DCCT. Diabetes Control and Complications Trial. JAMA. 1998;280:140–146. doi: 10.1001/jama.280.2.140. [PMC free article] [PubMed] [CrossRef] [Google Scholar]
Of the many benefits of a keto diet, weight loss is often considered No. 1., as it can often be substantial and happen quickly (especially for those who start out very overweight or obese). The 2013 study published in the British Journal of Nutrition found that those following a keto diet “achieved better long-term body weight and cardiovascular risk factor management when compared with individuals assigned to a conventional low-fat diet (i.e. a restricted-energy diet with less than 30 percent of energy from fat).” (2)
Although most people report a waning of cravings while in ketosis, some people may crave carbohydrates during ketosis for psychological reasons. During a hypocaloric ketogenic diet, the carb cravings may combine with hunger pangs, making matters worse.[2] (However, it is noteworthy that most people report having no hunger pangs on a ketogenic diet, due to its higher fat and protein contents, which help to increase a sense of fullness).[1]
Hi Mel, Assuming that your ranch dressing doesn’t have sugar added, you don’t need to worry too much about limiting it, but within reason. This is my homemade ranch dressing recipe, which has 0.9g net carbs per 2-tbsp serving. It would be hard to find a store bought one with much less than that, even though some round anything less than 1g down to 0g, which isn’t truly accurate. Also, keep in mind that if weight loss is your goal, some people find that too much dairy can cause a stall. Finally, make sure you aren’t using all your “available” carbs on ranch dressing – have it with some low carb veggies!
Moreover, two recent meta-analyses sought to investigate the effect of LCD on weight loss and cardiovascular disease risk. Sackner-Bernstein et al. (19) compared LCD to LF, among overweight and obese men and women. The authors found a significantly greater effect of weight loss in the LCD vs. the LF diets (-8.2 kg vs. -5.9 kg). The impact of diet on cardiovascular risk factors was split, with LCD resulting in significantly greater improvements in HDL cholesterol and triglycerides, while the LF resulted in significantly greater improvements in LDL and total cholesterol. From this the authors concluded that LCD were a viable alternative to LF diets and recommended “dietary recommendations for weight loss should be revisited to consider this additional evidence of the benefits of [low] CHO diets.” A significant limitation of this meta-analysis, however, was the authors’ definition of low-carbohydrate as a daily CHO consumption less than 120 grams. This value, while well below the standard recommendation of daily CHO consumption, still far exceeds the strict recommendation of KD (≤50 g/day), therefore the results of this meta-analysis must be approached with caution.
All anthropometric measurements were undertaken after an overnight fast (8 to 10 hours), 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; Seca North America, Chino, CA), in underwear and without shoes. BMI was calculated by dividing body weight by the height squared [BMI = weight (kg)/height2 (m)]. Waist circumference was recorded with a standard flexible nonelastic metric tape at the middle point between the lower edge of the ribs and the iliac anterior spine. This measurement was made at the end of a normal expiration while the subject stood upright.

Cyclical ketogenic diet (CKD): If you find it difficult to stick to a very low-carb diet every day, especially for months on end, you might want to consider a carb-cycling diet instead. Carb cycling increases carbohydrate intake (and sometimes calories in general) only at the right time and in the right amounts, usually about 1–2 times per week (such as on weekends).

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.
In order to transition and remain in this state, aiming for about 30–50 net grams is typically the recommended amount of total carbs to start with. This is considered a more moderate or flexible approach but can be less overwhelming to begin with. Once you’re more accustomed to “eating keto,” you can choose to lower carbs even more if you’d like (perhaps only from time to time), down to about 20 grams of net carbs daily. This is considered the standard, “strict” amount that many keto dieters aim to adhere to for best results, but remember that everyone is a bit different.
A Cochrane systematic review in 2018 found and analysed eleven randomized controlled trials of ketogenic diet in people with epilepsy for whom drugs failed to control their seizures.[2] Six of the trials compared a group assigned to a ketogenic diet with a group not assigned to one. The other trials compared types of diets or ways of introducing them to make them more tolerable.[2] In the largest trial of the ketogenic diet with a non-diet control[16], nearly 38% of the children and young people had half or fewer seizures with the diet compared 6% with the group not assigned to the diet. Two large trials of the Modified Atkins Diet compared to a non-diet control had similar results, with over 50% of children having half or fewer seizures with the diet compared to around 10% in the control group.[2]

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]
Protein can turn into carbohydrates via a metabolic process called gluconeogenesis (making new carbs) and will do in people at varying degrees. Protein turning into carbohydrates means you’re not in ketosis. However, this is generally an overblown statement that only happens at the extreme cases when you are drinking a lot of liquid protein shakes. 
In the 1990s, Atkins published an update from his 1972 book, Dr. Atkins New Diet Revolution, and other doctors began to publish books based on the same principles. This has been said to be the beginning of what the mass media call the "low carb craze" in the United States.[59] During the late 1990s and early 2000s, low-carbohydrate diets became some of the most popular diets in the US. By some accounts, up to 18% of the population was using one type of low-carbohydrate diet or another at the peak of their popularity.[60] Food manufacturers and restaurant chains like Krispy Kreme noted the trend, as it affected their businesses.[61] Parts of the mainstream medical community have denounced low-carbohydrate diets as being dangerous to health, such as the AHA in 2001[62] and the American Kidney Fund in 2002[63] Low-carbohydrate advocates did some adjustments of their own, increasingly advocating controlling fat and eliminating trans fat.[64]
The average person's diet contain about 55% carbohydrates, 30% fat, and 15% protein. On the keto diet, you eat a whole lot more fat, and a lot less carbs: 80% of the diet is comprised of fat, 15% is protein, and a mere 5% of calories come from carbohydrates. For someone on a 1,500-calorie diet, that translates to 19 grams of carbohydrates per day, which is less than what you find in one medium-sized apple.
The ketogenic diet is a high-fat, adequate-protein, low-carbohydrate diet that in medicine is used primarily to treat difficult-to-control (refractory) epilepsy in children. The diet forces the body to burn fats rather than carbohydrates. Normally, the carbohydrates contained in food are converted into glucose, which is then transported around the body and is particularly important in fueling brain function. However, if little carbohydrate remains in the diet, the liver converts fat into fatty acids and ketone bodies. The ketone bodies pass into the brain and replace glucose as an energy source. An elevated level of ketone bodies in the blood, a state known as ketosis, leads to a reduction in the frequency of epileptic seizures.[1] Around half of children and young people with epilepsy who have tried some form of this diet saw the number of seizures drop by at least half, and the effect persists even after discontinuing the diet.[2] Some evidence indicates that adults with epilepsy may benefit from the diet, and that a less strict regimen, such as a modified Atkins diet, is similarly effective.[1] Potential side effects may include constipation, high cholesterol, growth slowing, acidosis, and kidney stones.[3]
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Several studies have investigated the potential of LCD or KD on weight loss. For example, Brinkworth et al. (2) compared one year of low-fat (LF) vs. LCD diet in adults with abdominal obesity. Subjects were randomly assigned and diets were isocaloric, with moderate energy restriction. Both groups realized significant weight loss, however, there was no significant difference between groups, suggesting that a LCD was equally effective as a LF diet.
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).
“At the Duke Diet and Fitness Center, our residential clients can choose from three levels of carb intake that happen to be aligned with the Diet Doctor’s levels of liberal low-carb, moderate low-carb and keto low-carb. The alignment is not by chance, however. It’s because we have separately come to the same conclusions after carefully and objectively reviewing the evidence and gathering information from experienced clinicians and patients. The Diet Doctor website is very unique in that regard, and a great resource for our patients!”

I have also been doing 16:8, but not everyday. If You eat too few calories for too long you may lower your basic metabolic rate which you don’t really want to do. I eat something around 10 or 11 in the morning such as 3 deviled eggs, then a decent size meal at about 12:30 and my last meal at about 6. This seems to work well for me. I also use my fitness pal( free app), which is awesome and tracks all your macro ratios. It is important to keep it as Keto as you can. 70%fat, 5%carb, and 25% protein. I found at first that I just wasn’t eating enough fat, and my protein levels were too high. I think most people run into that same trap at first. Good luck!


The data are presented as mean (standard deviation). All statistical analyses were carried out using Stata statistical software, version 12.0 (Stata, College Station, TX). A P < 0.05 was considered statistically significant. Changes in the different variables of interest from baseline and throughout the study visits were analyzed following a repeated measures design. A repeated measures analysis of variance test was used to evaluate differences between different measurement times, followed by post hoc analysis with Tukey’s adjustment for multiple comparisons. In addition, linear regression analyses were used to evaluate the accuracy of MF-BIA and ADP in comparison with DXA, because DXA is considered the reference technique in the estimation of body composition in clinical research (26). Finally, the Bland-Altman approach was also used to assess the accuracy of MF-BIA and ADP against DXA in the estimation of FM%.
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:
The Johns Hopkins Hospital protocol for initiating the ketogenic diet has been widely adopted.[43] It involves a consultation with the patient and their caregivers and, later, a short hospital admission.[19] Because of the risk of complications during ketogenic diet initiation, most centres begin the diet under close medical supervision in the hospital.[9]
Moreover, two recent meta-analyses sought to investigate the effect of LCD on weight loss and cardiovascular disease risk. Sackner-Bernstein et al. (19) compared LCD to LF, among overweight and obese men and women. The authors found a significantly greater effect of weight loss in the LCD vs. the LF diets (-8.2 kg vs. -5.9 kg). The impact of diet on cardiovascular risk factors was split, with LCD resulting in significantly greater improvements in HDL cholesterol and triglycerides, while the LF resulted in significantly greater improvements in LDL and total cholesterol. From this the authors concluded that LCD were a viable alternative to LF diets and recommended “dietary recommendations for weight loss should be revisited to consider this additional evidence of the benefits of [low] CHO diets.” A significant limitation of this meta-analysis, however, was the authors’ definition of low-carbohydrate as a daily CHO consumption less than 120 grams. This value, while well below the standard recommendation of daily CHO consumption, still far exceeds the strict recommendation of KD (≤50 g/day), therefore the results of this meta-analysis must be approached with caution.

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.
At the first visit, participants were instructed how to follow the LCKD as individuals or in small groups, with an initial goal of ≤20 g carbohydrate per day. Participants were taught the specific types and amounts of foods they could eat, as well as foods to avoid. Initially, participants were allowed unlimited amounts of meats, poultry, fish, shellfish, and eggs; 2 cups of salad vegetables per day; 1 cup of low-carbohydrate vegetables per day; 4 ounces of hard cheese; and limited amounts of cream, avocado, olives, and lemon juice. Fats and oils were not restricted except that intake of trans fats was to be minimized. Participants were provided a 3-page handout and a handbook [11] detailing these recommendations. Participants prepared or bought all of their own meals and snacks following these guidelines.

Thanks for this inputs. 20 years ago I gain 17 pounds a year for 5 years. I was healthy but my dr told me start diet, any diet just come back in a month I want to see you start loosing… I started Atkins and lost 7 pound in a month. She was checking my progress every six months and checking my condition. I lost 64 pounds in 3 years. Now I started eating out of control. I am eating healthy but too much… I gain 40 pound back after 20 years. Now I will start again my Atkins to take off 30 pounds…
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.
Long-term compliance is low and can be a big issue with a ketogenic diet, but this is the case with any lifestyle change.  Even though the ketogenic diet is significantly superior in the induction of weight loss in otherwise healthy patients with obesity and the induced weight loss is rapid, intense, and sustained until at least 2 year, the understanding of the clinical impacts, safety, tolerability, efficacy, duration of treatment, and prognosis after discontinuation of the diet is challenging and requires further studies to understand the disease-specific mechanisms.

Remember, the point of the ketogenic diet is to enter ketosis by limiting your carbohydrate intake to about 5% of your total calorie needs and consuming about 75% of your calories in the form of fats. Vegetables and fruits naturally contain carbohydrates, and the ones included in the list above are lower in carbohydrates while not skimping on nutrients.

Low-calorie diets leading to rapid weight loss can cause headaches -- especially if your carbohydrate intake is too low. A study published in 2011 in the "Nutrition Journal" reports that symptoms of ketosis, which occurs when there is a buildup of metabolic byproducts called ketones in the body after breaking down fat instead of carbs as fuel -- include headaches, bad breath, weakness and constipation. To reduce your chance of getting a headache during weight loss, eat at least 130 grams of carbohydrates -- which is the recommended dietary allowance, or RDA -- daily and avoid losing more than 2 pounds per week.


Most carbs you consume are broken down into sugar that enters the bloodstream. When you rein in carbohydrates on the keto diet, you have lower levels of blood glucose (high blood glucose can lead to diabetes). A study in the journal Nutrition reveals that a ketogenic diet improves blood glucose levels in type 2 diabetics more significantly than a low-calorie diet and can also decrease the dosage of your diabetes meds.
Regarding VLCK diets, there is still some distrust in their usage, despite the solid scientific evidence that supports the use of this kind of diet as a useful weight-loss therapy [13,14]. This type of diet is characterized by the restriction of carbohydrates and/or caloric intake to the point of inducing a shift in metabolism and the production of plasma ketone bodies [15,16,17]. However, it was evidenced that a VLCK diet is safe because it does not modify the acid-base equilibrium [18]. In fact, it has been proposed that the ketone body, β-hydroxy-butyrate (β-OHB) has several beneficial effects on metabolism [19] and psychological functions [20,21]. Nevertheless, a scarcity of studies has evaluated the effect of a VLCK diet combined with physical activity, on potential improvement in the psychological conditions and well-being of treated overweight/obese patients.
The PSQI questionnaire is a clinical sleep-behavior questionnaire that has been validated for use in patients with insomnia, cancer, Parkinson’s disease, and the general population [30]. The questionnaire is designed to assess indexes of sleep during the preceding month and contains 19 questions that use Likert scales from 0–3. All questions are categorized into the following 7 subvariables: duration of sleep, sleep disturbance, sleep latency, day dysfunction because of sleepiness, sleep efficiency, subjective sleep quality, and use of a sleeping medication. Each of these 7 variables is scored between 0 and 3 arbitrary units (au), which generates a summed total score of 0–21 au. This total score is termed the global sleep score (GSS) with >5 au associated with a poor sleep condition and ≤5 au associated with a good sleep condition.

Gluconeogenesis is the endogenous production of glucose in the body, especially in the liver primarily from lactic acid, glycerol, and the amino acids alanine and glutamine. When glucose availability drops further, the endogenous production of glucose is not able to keep up with the needs of the body and ketogenesis begins in order to provide an alternate source of energy in the form of ketone bodies. Ketone bodies replace glucose as a primary source of energy. During ketogenesis due to low blood glucose feedback, stimulus for insulin secretion is also low, which sharply reduces the stimulus for fat and glucose storage. Other hormonal changes may contribute to the increased breakdown of fats that result in fatty acids. Fatty acids are metabolized to acetoacetate which is later converted to beta-hydroxybutyrate and acetone. These are the basic ketone bodies that accumulate in the body as a ketogenic diet is sustained. This metabolic state is referred to as "nutritional ketosis." As long as the body is deprived of carbohydrates, metabolism remains in the ketotic state. The nutritional ketosis state is considered quite safe, as ketone bodies are produced in small concentrations without any alterations in blood pH. It greatly differs from ketoacidosis, a life-threatening condition where ketone bodies are produced in extremely larger concentrations, altering blood ph to acidotic a state.
"Obese. That's what the doc said. He said if I didn't change I'd be Morbidly Obese. So stopped eating big macs and started out by walking. But it wasn't really enough to undo the damage. Then I found on Shark Tank. So I found it online and ordered it. I figured, it was worth a shot. I'm glad I did. It jumpstarted my weight loss! I started shedding the weight. I'm down 60 pounds after just 9 months! Thank you - you really saved my life!"
Some negative side effects of a long-term ketogenic diet have been suggested, including increased risk of kidney stones and osteoporosis, and increased blood levels of uric acid (a risk factor for gout). Possible nutrient deficiencies may arise if a variety of recommended foods on the ketogenic diet are not included. It is important to not solely focus on eating high-fat foods, but to include a daily variety of the allowed meats, fish, vegetables, fruits, nuts, and seeds to ensure adequate intakes of fiber, B vitamins, and minerals (iron, magnesium, zinc)—nutrients typically found in foods like whole grains that are restricted from the diet. Because whole food groups are excluded, assistance from a registered dietitian may be beneficial in creating a ketogenic diet that minimizes nutrient deficiencies.
Keto flu symptoms and side effects can include feeling tired, having difficulty sleeping, digestive issues like constipation, weakness during workouts, being moody, losing libido and having bad breath. Fortunately, these side effects don’t affect everyone and often only last for 1–2 weeks. (And yes, you CAN build muscle on keto.) Overall, symptoms go away as your body adjusts to being in ketosis.
I have been keto for 1,5 month, lost up to 20 pounds and felt it was overall easy to do. passed the keto flu :  20gr net carbs, 70 % fat and max 20% protein from fish and eggs mainly  ... I drink 3 ltrs of water in which I add lite salt, lemon and some green like parsley ... my blood markers are super healthy except for cholesterol but it was when I was overdoing the dairy which I barely eat anymore ..
A ketogenic diet could be an interesting alternative to treat certain conditions, and may accelerate weight loss. But it is hard to follow and it can be heavy on red meat and other fatty, processed, and salty foods that are notoriously unhealthy. We also do not know much about its long-term effects, probably because it’s so hard to stick with that people can’t eat this way for a long time. It is also important to remember that “yo-yo diets” that lead to rapid weight loss fluctuation are associated with increased mortality. Instead of engaging in the next popular diet that would last only a few weeks to months (for most people that includes a ketogenic diet), try to embrace change that is sustainable over the long term. A balanced, unprocessed diet, rich in very colorful fruits and vegetables, lean meats, fish, whole grains, nuts, seeds, olive oil, and lots of water seems to have the best evidence for a long, healthier, vibrant life.
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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]
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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