These are all keto related questions that a person looking into the ketogenic diet for the first time will have, and I’ve put together a comprehensive list of answers to these questions and more in my 3 Day Keto Kickstart Plan & Keto frequently asked questions linked to below.  If you’re new to keto I recommend starting there, and if you use that Keto Kickstart meal plan as written, I am confident that you will get into ketosis and be losing weight within 3 days of starting.  I’m excited for you!!!!
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.
For patients who benefit, half achieve a seizure reduction within five days (if the diet starts with an initial fast of one to two days), three-quarters achieve a reduction within two weeks, and 90% achieve a reduction within 23 days. If the diet does not begin with a fast, the time for half of the patients to achieve an improvement is longer (two weeks), but the long-term seizure reduction rates are unaffected.[44] Parents are encouraged to persist with the diet for at least three months before any final consideration is made regarding efficacy.[9]
27. O’Connor D.B., Corona G., Forti G., Tajar A., Lee D.M., Finn J.D., Bartfai G., Boonen S., Casanueva F.F., Giwercman A., et al. Assessment of sexual health in aging men in Europe: Development and validation of the european male ageing study sexual function questionnaire. J. Sex. Med. 2008;5:1374–1385. doi: 10.1111/j.1743-6109.2008.00781.x. [PubMed] [CrossRef] [Google Scholar]
Cutting back on protein is one of the largest challenges to the diet. Because high levels of protein in the diet can turn into glucose in a process called gluconeogenesis, the keto theory says too much protein in the diet can mean too much glucose, whisking you out of ketosis. That’s why bacon, which has a ton of fat but not a lot of protein is a preferred food over chicken breast, which is high in protein with very little fat.
Determining the diet that best suits you is a very individual choice, so it's hard to make a general recommendation for one type of diet. You can lose weight through a variety of eating styles, whether you choose a low-carb, low-fat, keto or Mediterranean diet, or another one. But in general, eating lots of fruits and vegetables, lean proteins and whole grains is going to help you lose weight and achieve a healthy lifestyle.
What is the ketogenic diet exactly? The classic ketogenic diet is a very low-carb diet plan that was originally designed in the 1920s for patients with epilepsy by researchers working at Johns Hopkins Medical Center. Researchers found that fasting — avoiding consumption of all foods for a brief period of time (such as with intermittent fasting), including those that provide carbohydrates — helped reduce the amount of seizures patients suffered, in addition to having other positive effects on body fat, blood sugar, cholesterol and hunger levels. (1)

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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]
This week we’re introducing a slight fast. We’re going to get full on fats in the morning and fast all the way until dinner time. Not only are there a myriad of health benefits to this, it’s also easier on our eating schedule (and cooking schedule). I suggest eating (rather, drinking) your breakfast at 7am and then eating dinner at 7pm. Keeping 12 hours between your 2 meals. This will help put your body into a fasted state.
Instead of getting that store-bought can of frosting that’s filled with sugar, food coloring, and trans fats, make your own! Cream cheese and butter come together perfectly to create a rich and creamy frosting that makes all of your cakes taste better. If you want an example of a great cream cheese frosting (with added fruit compote), check out our Low Carb Spice Cakes with Cream Cheese Frosting.
“I really believe that the more informed you are about the benefits of a healthy bite versus the chain reaction that you’re going to put into effect in your body when you take that bite — you just suddenly don’t want to make that choice for yourself anymore. It’s beyond willpower at that point; it’s become a desire to do something good for yourself.” — Christie Brinkley

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.
Carrie, I highly recommend a support group. I personally know a woman “Amanda Rose” who recently lost half her body weight through the Keto Diet and intermittent fasting. You should totally join her Facebook Group. It’s called “Eat Like a Bear” and you can find it by entering the group’s name in the Facebook search bar. She is so amazing and so supportive for people struggling to lose the weight.
For breakfast, we are going to change it up a bit. Here’s where we introduce ketoproof coffee. Now, don’t get me wrong – I know some of you won’t like it. If you’re not a fan of coffee, then try it with tea. If you’re not a fan of the taste (which is very rare), then try making a mixture of the ingredients by themselves and eating it like that. So, why ketoproof coffee?

I also asked a friend to join me as an accountability partner. She had tried the keto diet before with good success, so having a guide for my myriad questions was a big help. It was also nice to have someone to message at 10 p.m. when I really wanted a cookie so she could commiserate with me. (We agreed the cookie would be delicious, and then ate a cheese stick.)
Maintain adequate protein intake. Too little protein and you lose muscle mass and starve the few parts of your body that can’t use ketones as an energy source, like portions of your red blood cells, kidneys and brain. Too much protein and you inhibit ketone production. Make sure you consume enough protein to support your vital functions, but not too much that protein becomes your alternate glycogen source.
While keto diets minimize sugar and other food sensitivities, they often allow full-fat dairy such as yogurt that, for some people, can stall fat loss. And some packaged keto-friendly foods (yes, there's a whole industry of keto-friendly cookies, candy, and other junk food!) can contain gluten, artificial sweeteners, and other reactive ingredients. These foods and additives cause dysbiosis (an imbalance between good and bad bugs), leaky gut syndrome, and increase insulin resistance, which raises blood sugar levels—stalling weight loss. Read your labels carefully: Food sensitivities can be sneaky and hide in foods that you would never suspect, like mustard.

In regard to serum measurements, the mean fasting glucose decreased by 17% from 9.08 ± 4.09 mmol/L at baseline to 7.57 ± 2.63 mmol/L at week 16 (p = 0.04) (Table ​(Table4).4). Serum sodium and chloride levels increased significantly, but only by 1% and 3%, respectively. Uric acid level decreased by 10% (p = 0.01). Serum triglyceride decreased 42% from 2.69 ± 2.87 mmol/L to 1.57 ± 1.38 mmol/L (p = 0.001). Increases occurred in both high-density lipoprotein (HDL) cholesterol (8%) and low-density lipoprotein (LDL) cholesterol (10%) but these changes were of borderline statistical significance (p = 0.08 and p = 0.1, respectively). The following blood tests did not change significantly: total cholesterol, potassium, bicarbonate, urea nitrogen, creatinine, calcium, thyroid-stimulating hormone, and hemoglobin.
Ariel Warren is a Registered Dietitian, Diabetes Educator, graduate from Brigham Young, and was diagnosed with Type 1 at the age of 4 years old. Ariel understands diabetes and enjoys working with clients to improve their blood sugar management, healthy eating, weight loss, fitness, and pregnancy. For coaching from a T1D Dietitian, you can contact Ariel directly, through her website: arielwarren.com.
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).
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.”
In theory, a ketogenic diet that increases carbohydrate loads for cardio exercise seems perfect. However, the side effects of a ketogenic diet can include dehydration, malnutrition and constipation. According to the Mayo Clinic website, ketogenic plans also can lead to kidney stones. In addition, the ketogenic diet does not give you the nutrition you need to be healthy. Instead, try cutting portion sizes and counting calories; this also can force your body to burn fat while still providing you with balanced nutrition, including proteins, carbohydrates, fiber and fat. As with any diet, you should discuss a ketogenic diet with your doctor.
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.
Prolonged ketosis and large buildups of ketones can be dangerous, but VLCDs intentionally bring on mild ketosis. At a certain level, ketosis brings on desirable changes that facilitate safe weight loss and keep important body processes working properly while getting so few calories. When your body is using fat for energy, you may be losing weight, but your brain can be starving because it primarily uses glucose, or carbohydrates, for energy. However, ketones can cross the blood-brain barrier and supply most of your brain's energy needs, according to Wim Saris, a researcher writing in the November 2001 "Obesity Research" journal. Without ketones fulfilling this role, your body will begin to break down amino acids, your protein building blocks, into blood sugar. This can cause you to lose lean muscle mass while on the VLCD.
“As an emergency medicine and weight-loss physician, I strive to support my patients’ long-term success in weight-loss and wellness. After losing 30 pounds myself using a low-carb, healthy-fat diet and intermittent fasting, I now feel compelled to share this lifestyle with others. In the ER, patients present with concerns and complications stemming from their dietary choices; I use this as an opportunity to educate them on dietary and lifestyle changes. In my weight-loss clinic, I recommend a personalized low-carb and intermittent fasting plan. The Diet Doctor website is an easy, effective, informative resource that complements my patient care.”
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!

Rami co-founded Tasteaholics with Vicky at the start of 2015 to master the art of creating extremely delicious food while researching the truth behind nutrition, dieting and overall health. You can usually find him marketing, coding or coming up with the next crazy idea because he can’t sit still for too long. His favorite book is The 4-Hour Workweek and artist is Infected Mushroom.
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!
Lazy keto diet: Last but not least, the Lazy keto diet often gets confused with dirty keto … but they’re different, as the “lazy” refers to simply not carefully tracking the fat and protein macros (or calories, for that matter). Meanwhile, the one aspect that remains strict? Not eating over 20 net carb grams per day. Some people find this version less intimidating to start with or end with … but I will caution that your results will be less impressive.
Twenty calories a day times the 365 days in a year comes to a little more than seven thousand calories stored as fat every year—two pounds of excess fat. If it were true that our adiposity is determined by calories-in/calories-out, then this is one implication: you only need to overeat, on average, by twenty calories a day to gain fifty extra pounds of fat in twenty years. You need only to rein yourself in by this amount—undereat by twenty calories a day—to undo it. Twenty calories is less than a single bite of a McDonald’s hamburger or a croissant. It’s less than two ounces of Coke or Pepsi or the typical beer. Less than three potato chips. Maybe three small bites of an apple. In short, not very much at all. Twenty calories is less than 1 percent of the daily caloric intake that the U.S. National Academy of Sciences has recommended for a middle-aged woman whose idea of regular physical activity is cooking and sewing; it’s less than half a percent of the daily quota of calories recommended for an equally sedentary middle-aged man. That it’s such an insignificant amount is what makes it so telling about the calories-in/calories-out idea.
Thanks for this article. I just started a Keto diet so found it appropriate to my current lifestyle. Though I don’t believe your bottom line is strong enough since you simply stating that the diet is “hard to follow” and food is “notoriously unhealthy” without evidence going deeper into why those “notoriously unhealthy” foods are worse than keeping carbohydrate-heavy food that are addictive and give the body a quick sugar high for energy. I believe “hard to follow” is your opinion only, since acceptable Keto foods are found at all restaurants easily and also all grocery stores. All the foods you mention: “rich in very colorful fruits and vegetables, lean meats, fish, whole grains, nuts, seeds, olive oil, and lots of water” are all Keto-friendly. Many people have been on a Keto-diet for years. A healthy lifestyle is a healthy mindset change and making right choices – it’s not going to be easy.
There is evidence that the quality, rather than the quantity, of carbohydrate in a diet is important for health, and that high-fiber slow-digesting carbohydrate-rich foods are healthful while highly-refined and sugary foods are less so.[4] People choosing diet for health conditions should have their diet tailored to their individual requirements.[19] For people with metabolic conditions, in general a diet with approximately 40-50% high-quality carbohydrate is compatible with what is scientifically established to be a healthy diet.[19]
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!

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.
By design, the nutritional intervention induced an important reduction in BMI and fat mass, especially visceral fat mass through the study visits synchronized with the ketone levels in four visits (Figure 1). Thus, at the end of the nutritional intervention, the patients were out of ketosis (0.2 ± 0.1 mmol/L) with a total of 7.7 units of BMI lost (Figure 1). Most of the initial body composition loss was in the form of total fat mass (Figure 1). Relevantly, from the total fat mass, visceral fat mass, the most physiological and clinically relevant fat depot, was significantly reduced after the VLCK diet (−1.2 ± 0.7 kg; p < 0.05).
“As a nephrologist, I have seen many patients with end-stage kidney failure resulting from diabetes and obesity. I decided to switch my career towards wellness, integrative medicine and obesity management. I now provide guidance for ketogenic and low-carb diets along with fasting to all patients in my clinic and via telehealth consultations. It is very rewarding to see their health improve and their medications reduced or eliminated. I refer all my patients to Diet Doctor on the first visit and I teach them also to use the recipes on the site. Thank you for providing an unbiased educational platform!”
It starts with limiting carbohydrate intake to just 20–30 net grams per day. “Net carbs” describes the amount of carbs remaining once dietary fiber is taken into account. Because fiber is indigestible once consumed, simply don’t count grams of fiber toward their daily carb allotment. So that means subtracting grams of fiber from total carb games, to give you the total net carbs.

A low-carbohydrate diet has been found to reduce endurance capacity for intense exercise efforts, and depleted muscle glycogen following such efforts is only slowly replenished if a low-carbohydrate diet is taken.[38] Inadequate carbohydrate intake during athletic training causes metabolic acidosis, which may be responsible for the impaired performance which has been observed.[38]
“I am a hospitalist/primary care doctor and also a specialist in obesity. As I see it, nutrition and other lifestyle factors are at the root of most of the diseases I treat. My own health issues corrected with LCHF. I went on to recommend LCHF to my patients, who have since experienced a wide variety of improved outcomes. Face-to-face time with patients is frustratingly short so simply writing “DietDoctor.com” on slip of paper and handing it to patients is a great way to set them in the direction of trustworthy diet information.”
Most people will choose to begin their carb-up on Friday night and end it before bed on Saturday. This is usually most convenient as it's when you are off of work and can relax and enjoy the process. If you aren't overly concerned with fat loss and are just using this diet as a way to maintain blood sugar levels, you can likely eat whatever carbohydrate foods you like during this period. If you are worried about fat gain though, then you need the math.
If you want to try a ketogenic diet, be aware that you'll have to adjust it for your individual metabolism and experiment with the right balance of carbs and calories. While some low-carbohydrate dieters find they are able to break stalls in their weight loss, others find that it is more difficult for them to stay in this state. You may want to consult a registered dietitian to build keto-friendly menus for you that will meet your nutritional needs. Be sure to keep your health care provider informed when you start a new diet, especially if you have ongoing health conditions.
Plagued by pimples? You may start to notice a difference in your skin on the keto diet, especially if you were a former sugar addict. Consuming lots of empty carbs is linked to worse acne—in part because these foods trigger inflammation and signal the release of hormones that up the production of pore-clogging oils, according to a review published in the Journal of the Academy of Nutrition and Dietetics. Some findings suggest that curbing your carb intake could help solve these problems, improving your skin as a result.
“I’ve studied LCHF nutrition for over 20 years for personal health benefits. In my medical practice, it has become integral to reversing many of modern society’s worst medical concerns including metabolic syndrome, obesity, and diabetes. It can be applied safely and effectively for nearly all of my patients and often results in dramatic restoration of good health.”
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 one-ounce (28-gram) serving of olives contains 2 grams of total carbs and 1 gram of fiber. This works out to a net carb count of 1 gram for 7–10 olives, depending on their size. If you don’t like olives or don’t want the net carbs they contain, then olive oil is a great option as well. Although you won’t get all of the benefits of olives by consuming olive oil, you will still get plenty of healthy fats and health-promoting compounds.

This work was supported by grants from the Fondo de Investigacion Sanitaria, (PI14/01012 and PI17/01167) research projects and CIBERobn (CB06/003), from the Instituto de Salud Carlos III (ISCIII), Fondo Europeo de Desarrollo Regional (FEDER) Spanish. DGA is grateful to the Colombian Department of Science, Technology and Innovation—COLCIENCIAS as a recipient of their pre-doctoral scholarship to support his work. Ana B Crujeiras is funded by a research contract “Miguel Servet” (CP17/00088) from the ISCIII.
Cardiovascular workouts increase the heart rate for extended periods. If you are on the ketogenic diet, you might have difficulty finding energy reserves for cardio exercise. This is why the targeted keto diet can be effective. Right before working out, you load up on high-carbohydrate foods, which provide fuel to burn while exercising. During inactivity, your body burns fat. In periods of high intensity, such as aerobics, the body finds fuel from carbohydrates that can sustain the movement.
The weight loss program has 5 steps (Supplemental Fig. 1) and adheres to the most recent (2015) European Food Safety Authority guidelines on total carbohydrate intake (17). The first 3 steps consist of a VLCK diet (600 to 800 kcal/d), which is low in carbohydrates [< 50 g (26 to 30 g) per day from vegetables] and lipids (only 10 g of olive oil per day). The amount of high-biological-value proteins range from 0.8 to 1.2 g per kg of ideal body weight to ensure minimal body requirements are met and to prevent the loss of lean mass. In step 1, the patients consumed high-biological-value protein preparations 5 times per day, and vegetables with low glycemic indexes. In step 2, 1 of the protein servings was replaced by 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 replaced the second serving of biological protein. Throughout the 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 (18). These first 3 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 most common and relatively minor short-term side effects of ketogenic diet include a collection of symptoms like nausea, vomiting, headache, fatigue, dizziness, insomnia, difficulty in exercise tolerance, and constipation, sometimes referred to as keto flu. These symptoms resolve in a few days to few weeks. Ensuring adequate fluid and electrolyte intake can help counter some of these symptoms. Long-term adverse effects include hepatic steatosis, hypoproteinemia, kidney stones, and vitamin and mineral deficiencies.
“I recommend low-carb and keto diets because there’s nothing more fun than empowering people to treat the root of the problem to help regain their health. Diet Doctor offers a great deal of support to me and to my patients because it allows them to digest the information in their own time and, particularly if it’s the first time they hear it, it helps ease their fears to see that there’s a whole world of science supporting the new prescription (food) I am giving them.”

Proponents of the ketogenic diet say the problem with a high-carbohydrate diet is that it induces high insulin levels and keeps the body burning sugar and carbs instead of fat. In contrast, on a low-carb diet, the body learns to burn fat preferentially. When this happens, acids known as ketones are released from fat into the body, while insulin levels go down. Ketosis can occur after several days on a low-carb diet.

Hi Maya. I LOVE your site!! Interesting, informative with fab recipes and ideas. Hubby and I have just started eating low carb and I have to say, we are not finding it too difficult and I already feel sooo much better!! I find the hardest part is choosing low carb veg, I feel as if we are not eating enough. Any suggestions on how to get more veggies into our diet?
If you talk to keto aficionados, you’ll find many save leftovers from dinner for the next day’s lunch. Cook once, eat twice—your keto diet menu for lunch is solved. If you don’t like leftovers or if you’re craving something different for lunch, the mid-day meal can be as simple as a scoop of chicken salad. Or, hit the salad bar at a local grocery store and top a bowl of greens with some good-fat goodies. You can also try one of these simple keto lunches:
“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!”
“The low-carb, high-fat diet has re-energized my clinical interest in the treatment of diabetes, obesity, and other chronic conditions relating to insulin resistance. Guiding my patients on their journey to reclaiming their health, wellness, and vitality with the prescription of real food brings me the utmost joy. Witnessing the transformative impact of this lifestyle has given me hope for the future health of our patients and communities.”
In summary, the LCKD had positive effects on body weight, waist measurement, serum triglycerides, and glycemic control in a cohort of 21 participants with type 2 diabetes. Most impressive is that improvement in hemoglobin A1c was observed despite a small sample size and short duration of follow-up, and this improvement in glycemic control occurred while diabetes medications were reduced substantially in many participants. Future research must further examine the optimal medication adjustments, particularly for diabetes and diuretic agents, in order to avoid possible complications of hypoglycemia and dehydration. Because the LCKD can be very effective at lowering blood glucose, patients on diabetes medication who use this diet should be under close medical supervision or capable of adjusting their medication.
But it has its share of critics as well. The keto diet is sometimes referred to as “the bacon and butter diet” because it calls for 75% of daily calories to come from fat. Keto followers are gobbling up bacon, steak, sausage, and chicken (skin and all). They’re adding butter to their morning coffee. They’re drowning their salads with ranch dressing.
Physical activity was determined by means of the International Physical Activity Questionnaire (IPAQ), which is used worldwide to indirectly evaluate an individual’s volumes of sedentary behavior and moderate to vigorous physical activity throughout the last seven-day week [26]. It is readily available, very cost-effective, and can generate large data sets. The IPAQ comprises a set of 4 questionnaires. In this study, the short form of the IPAQ was employed (7 items). This measure assesses the types of intensity of physical activity and sitting time that people do as part of their daily lives, which is used to estimate total physical activity in metabolic equivalent task minutes per week (MET-min/week) and time spent sitting [26].
In one week my husband lost 1.5 kg because of Keto diet and recipes. Thank you for the insights and tips. I would like to have a complete recipe for meals everyday and hoping by subscribing I will receive try my mail. I will keep u posted. It takes 2 to tango. The one who wants to diet must be cooperative with the plan and execution while the other person who is preparing the food must be patient to the dieting person. Its not easy to change meals so patience is required
“I discovered the low-carb, ketogenic diet some four years ago and saw huge improvements in my own health. After establishing that it is based on sound scientific principles I felt compelled to offer it to my patients. We recommend the Diet Doctor website as it offers an unbiased, contemporary source of reliable low-carb ketogenic advice. It is easy to use and you can rely on its integrity.”
Bonnie J. Brehm, Randy J. Seeley, Stephen R. Daniels, and David A. D’Alessio, “A Randomized Trial Comparing a Very Low Carbohydrate Diet and a Calorie-Restricted Low Fat Diet on Body Weight and Cardiovascular Risk Factors in Healthy Women,” The Journal of Clinical Endocrinology & Metabolism: Vol 88, No 4; January 14, 2009. http://press.endocrine.org/doi/full/10.1210/jc.2002-021480.
The ketogenic diet has been studied in at least 14 rodent animal models of seizures. It is protective in many of these models and has a different protection profile than any known anticonvulsant. Conversely, fenofibrate, not used clinically as an antiepileptic, exhibits experimental anticonvulsant properties in adult rats comparable to the ketogenic diet.[58] This, together with studies showing its efficacy in patients who have failed to achieve seizure control on half a dozen drugs, suggests a unique mechanism of action.[56]
While you’re focusing on fat, protein, and carbs, you should also make sure you’re getting adequate fiber. “People often assume that they should only eat things like meat and butter on the ketogenic diet,” says Farshad Fani Marvasti, MD, an associate professor and director of Public Health, Prevention, and Health Promotion at the University of Arizona College of Medicine in Phoenix. “You should make sure you are eating enough vegetables because you need the fiber.”
There are numerous benefits that come with being on keto: from weight loss and increased energy levels to therapeutic medical applications. Most anyone can safely benefit from eating a low-carb, high-fat diet. Below, you’ll find a short list of the benefits you can receive from a ketogenic diet. For a more comprehensive list, you can also read our in-depth article here >
What is the keto diet? Rather than relying on counting calories, limiting portion sizes, resorting to extreme exercise or requiring lots of willpower, this low-carb diet takes an entirely different approach to weight loss and health improvements. It works because it changes the very “fuel source” that the body uses to stay energized: namely, from burning glucose (or sugar) to dietary fat, courtesy of keto diet recipes and the keto diet food list items, including high-fat, low-carb foods.
A keto diet has shown to improve triglyceride levels and cholesterol levels most associated with arterial buildup. More specifically low-carb, high-fat diets show a dramatic increase in HDL and decrease in LDL particle concentration compared to low-fat diets.3A study in the long-term effects of a ketogenic diet shows a significant reduction in cholesterol levels, body weight, and blood glucose. Read more on keto and cholesterol >
“A lower-carbohydrate diet and lifestyle has not only changed my personal health for the better, but also the health of my family and my patients. The low-carb ketogenic lifestyle has also transformed my medical practice from a traditional sick-care office to an Integrative Wellness practice that focuses on improving people’s health and preventing illness. I enjoy going into work every day as I now feel I am truly preventing chronic diseases from taking root via proper nutritional counseling. I send virtually all my patients to Diet Doctor for help getting started on their own low-carb journey.”

I’ve used the Atkins diet for almost 3 months now. Averaging 3/4 pounds a week loss. Never hungry and sometimes replace a meal with an Atkins shake (I make my own: One shake over ice, add 1/4 cup of heavy cream, one Splenda pack, stir and enjoy. Tastes like a milkshake! Carbs, 1 or 2. SECRET TO THE ATKINs DIET- YOU MUST drink your water! I also trim most of the fat off my meat and seldom eat bacon. Dairy – low/0 carb cheeses, mayo, some sour cream. I make wonderful veggie quiche (no crust) and a bread pudding quiche that everyone steals! Salad dressing is a breeze with mayo, mustard and Splenda. Zero carb (maybe 1/2 gram) & tastes like honey mustard. And, boy, if you could have one of my egg-batter, ham & cheese sandwiches. . .it’s to die for! I keep a bowl of steamed veggies in the fridge. Dipping in dressing makes a great snack. Atkin’s bars are a delicious way to get your sweets.I cut them up and nibble during the day. They also sell low carb breads now, very expensive, but the cost makes up for what I’m NOT buying to eat. Weight keeps dropping off, I feel great AND, every time I think of having a bowl of ice cream, I run to the closet and look at all the pretty clothes that soon I can wear again. Then I ‘strip’ and look in the mirror! Yikes! YOU TELL ME WHAT’S BETTER: being ‘fat’ or looking great? I was a model before gaining weight (due mostly to illness) and every pound I lose is totally worth it. I DON’T CARE WHAT ‘THEY’ SAY . . . ‘fat’ isn’t pretty, or acceptable. It’s your road to an early death and every organ in your body is suffering and struggling everyday. Lastly –
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).
HDL is still low and stuck on 45 even after hoping strongly with more healthy saturated fats organic bone broth from lamb bones, etc. LDL way up 170 and triglycerides a a record high of 170, Non HDL choleseterol at 203. Kinda surprizd I cannot more that HDL number aftyer all the keto stuff. And unsure why the LDL has exploded since stress has always been with me these last 9 years.
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.
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.

It’s a habit to enjoy a brie cheese for desert instead of a piece of chocolate cake but each are favored deserts in France. I’m personally more satisfied after a 350 calorie sized wedge of brie than the same number of calories of cake.. which will give me sugar crash and .. really I’d like two slices of cake(I’ve got a sweet tooth that once I get going it wants to keep being fed)
Typically you want to stay away from any brands that use filler ingredients like maltodextrin and dextrose, or high glycemic sweeteners like maltitol. Many low-carb products that claim low net carbs usually use these sugar alcohols. Many candies that are “sugar-free” also use these sweeteners. Avoid them where possible. These specific sweeteners respond in our body in a similar way sugar does.
Nurse practitioners (NP) are advanced practice registered nurses that manage acute and chronic medical conditions, both physical and mental, through history and physical exam and the ordering of diagnostic tests and medical treatments. NPs are qualified to diagnose medical problems, order treatments, perform advanced procedures, prescribe medications, and make referrals for a wide range of acute and chronic medical conditions within their scope of practice. Their education includes a Bachelor of Science in Nursing (BSN) or other undergraduate degree, and requires a license as a registered nurse (RN) and experience as an RN in a health care setting. They must graduate from an accredited graduate (MSN) or doctoral (DNP) program and achieve a board certification.
“I’m a family physician and obesity medicine specialist who has been tailoring ketogenic diets for my patients since 2004. I love and live the ketogenic lifestyle. My staff and I have helped reverse hundreds of cases of diabetes and metabolic syndrome over the last 15 years with this simple, effective, long-term lifestyle change. Diet Doctor has been a “go-to” website for thousands of my patients over the years as my patients and I have made this life-saving and health-changing journey.”
A recent 2018 online survey of type 1 diabetics or their parents and caregivers has opened the door for others to use the ketogenic high-fat, low-carbohydrate, moderate protein diet to ease the burden of insulin injections and improve the day-to-day life of type 1 diabetics, potentially leading to remission. This was a breakthrough study, as the ketogenic diet has proven itself with diabetes type 2 sufferers, but there has been little looked into with keto for diabetes 1 patients. This study's focus was on serious carb production. Its title is Management of Type 1 Diabetes With a Very Low–Carbohydrate Diet, and it was published by Pediatrics, the "official journal" of the AAP (American Academy of Pediatrics). Dr. Lewis First, chief editor of Pediatrics, provided an article listing the top 10 items published by Pediatrics during 2018. This study was at the top of the list as the most popular article in Pediatrics for 2018.
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.
You’re ok with not so fast results and can remain disciplined.Every weight loss management plan needs an amount of sacrifice as well as a compromise from the dieter. But the ketosis approach may be one of the most challenging because it will change the most sacred of all eating routines among Western cultures: enjoying a full-dish meal. It's certainly no picnic, but the procedure can be done simpler having the right products and program, and the results can be spectacular. 

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.
All of the patients followed a VLCK diet according to a commercial weight loss program (PNK Method), which includes lifestyle and behavioral modification support. The intervention included an evaluation by the specialist physician conducting the study and assessment by an expert dietician. All patients underwent a structured program of physical exercise with external supervision (16). This method is based on high-biological-value protein preparations obtained from cow milk, soya, avian eggs, green peas, and cereals. Each preparation contained 15 g protein, 4 g carbohydrates, 3 g fat, and 50 mg docosahexaenoic acid, and provided 90 to 100 kcal (16).
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