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)

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.


“Real food — that is low-sugar, high-fiber — works for most of the population, but some patients may need a low-carb diet for best results. For those patients, I am totally for low carb. I have certainly had many insulin-resistant patients who didn’t get better until they went on a low-carb diet. I am not remotely concerned about negative effects of low carb. I feel that, aside from patients with familial hypercholesterolemia and type 5 hyperlipidemia, a low-carb diet is entirely safe.”

35. Crujeiras A.B., Gomez-Arbelaez D., Zulet M.A., Carreira M.C., Sajoux I., de Luis D., Castro A.I., Baltar J., Baamonde I., Sueiro A., et al. Plasma FGF21 levels in obese patients undergoing energy-restricted diets or bariatric surgery: A marker of metabolic stress? Int. J. Obes. (Lond.) 2017;41:1570–1578. doi: 10.1038/ijo.2017.138. [PubMed] [CrossRef] [Google Scholar]


“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.”
“I started a low-carb, high-fat diet for myself in an attempt to treat my own health problems. Since then, I have seen significant health benefits not only in myself but also in many of my patients using a LCHF/ketogenic approach. Diet Doctor gives a simple but very effective evidence-based resource that I confidently recommend to all my patients. And the recipes are great!”
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.
A popular keto supplement are exogenous ketones (popularly called “keto diet pills”) that may help you achieve results earlier as well as remain in that state. (Don’t confuse exogenous ketones with raspberry ketones, as the latter don’t raise ketone levels in the body or mimic endogenous ketones, so you wouldn’t use raspberry ketones in your regimen.)

Many unhealthy foods easily meet keto’s low-carb, high-fat criteria. However, that doesn’t mean you can or should eat them freely. “A huge benefit to following the keto diet is that the vast majority of processed food is removed with the removal of grains,” Santo says. “Unfortunately, poor-quality dairy, meat, and veggies may fill the gap.” Look for healthier sources of protein and fat, such as grass-fed meats, and limit processed dairy (think cheese singles) as much as possible.


When following a low carbohydrate diet, for the first few days, there is an adaptation period during which most people report feeling run-down or tired. Some people report feeling irritable, out of sorts, and unable to make decisions. For most people, these feelings disappear after the adaptation period, however, and are replaced with feelings of calm and balance and more consistent energy.[1]
This was a great read. I aim to restrict carbs always because I believe most are why the American population is obese. I would very much like to hear more about carb restriction excluding the discussion on processed meats and processed high salt content foods because I consume neither. I also don’t consume dairy or eggs. So can you provide some substance.
A popular keto supplement are exogenous ketones (popularly called “keto diet pills”) that may help you achieve results earlier as well as remain in that state. (Don’t confuse exogenous ketones with raspberry ketones, as the latter don’t raise ketone levels in the body or mimic endogenous ketones, so you wouldn’t use raspberry ketones in your regimen.)
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!
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.
“At the Norwood Surgery in the North of England we have been offering a low-carb option for our patients with type 2 diabetes since 2013. We feel this makes perfect sense in a condition which could be seen as one where sugar is acting as a ‘metabolic poison’, remembering that starchy carbs like bread rice or breakfast cereals digest down into surprising amounts of sugar, as predicted for us by the glycemic index.”
“As a full-spectrum family physician since 2004, luckily I stumbled on the wonderful low-carb community two years ago after my amazing wife was forced to make dietary changes after surgery. I’ve never looked back! After transforming my own health, with help from resources like Diet Doctor, Jimmy Moore, and Dr. Jason Fung, I’ve committed to bettering the lives of my patients with intensive dietary management through LCHF and intermittent fasting. Empowering patients to make these lifestyle changes has truly brought back the joy of medicine for me. I am so thankful to all who have inspired me along the way.” 

Christopher D. Gardner, PhD; Alexandre Kiazand, MD; Sofiya Alhassan, PhD; Soowon Kim, PhD; Randall S. Stafford, MD, PhD; Raymond R. Balise, PhD; Helena C. Kraemer, PhD; Abby C. King, PhD, “Comparison of the Atkins, Zone, Ornish, and LEARN Diets for Change in Weight and Related Risk Factors Among Overweight Premenopausal Women,” JAMA. 2007;297(9):969-977. http://jama.jamanetwork.com/art icle.aspx?articleid=205916.
On a second note, some individuals find they like to eat a little fruit along with protein before their final workout on Friday night as this will help restore their liver glycogen levels and give them the energy they need to push through that workout. Plus, by refilling the liver glycogen you will help put your body into a slightly more anabolic state so you don't see as much energy breakdown.
In a 2004 study, overweight and obese adults consumed a low-fat diet and a low-carb diet for one week each. Both diets were designed to reduce each person’s calorie intake by 500 calories per day. However, people lost more weight and body fat after the low-carb week than the low-fat week – even though the men averaged higher calorie intake during the low-carb phase.
This is a diet that requires a fair amount of attention to macronutrient quantities in order to work. Unlike the Atkins diet, which only restricts carbs, the ketogenic diet also restricts protein based on your activity level, so that extra protein doesn’t get converted into glucose. When people first go on nutritional ketosis, they sometimes focus on getting their carbs super low (i.e., less than 20 grams per day), and that can cause hormone and mood problems, especially in women. They make up the difference with too much protein, which then converts into sugar. So if you over-restrict carbs and eat too much protein, ketosis may not work. It’s not just a certain amount of carbs you want to target, but the right combination of fat, carbs, and protein for YOU.
Dear Martina, I wasn’t sure how to contact you. I am a final year undergraduate Human Nutrition student. I was also a keto diet follower and your app and blogs were a great help. For my final year project I‘ve chosen to study the present awareness of the ketogenic diet. I would like to ask if you would be interested to present my questionnaire to your followers. I will of course send you the questionnaire personally first for your approval. Please let me know if you are interested. Thank you for your hard work. You are a great help for many of us.
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.
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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.
I actually went on a ketogenic diet last year to see if it would help my migraines. I have a history of chronic migraines which would usually last 3 days, sometimes longer. Triptans help a lot but I don’t like having to take them. I stayed in ketosis for about 8 months and experienced a significant reduction in migraines, from feeling some type of headache (mild o r severe) almost everyday to 1 or 2x per month while in ketosis. Although I’m very healthy otherwise, I do think my migraines may have something to do with blood sugar fluctuations (despite previously eating a whole foods diet and no refined carbs), and keto totally stabilized this. I eventually came off of Keto because I’m not really a meat lover. When I came off, but remained low carb, my migraines stayed under control for the most part. When I increase carbs, they do return.
This week we’re getting stricter with our fasting. We had a full week of intermittent fasting and now we’re going to skip breakfast and lunch. Water is our BEST friend here! Don’t forget that you can drink coffee, tea, flavored water, and the like to get your liquids in. Keep drinking to make sure you’re not thinking about your stomach. It MIGHT start growling, just ignore it – your body will adjust with time.
1. West, R., Beeri, M. S., Schmeidler, J., Hannigan, C. M., Angelo, G., Grossman, H. T., … Silverman, J. M. (2008). Better memory functioning associated with higher total and low-density lipoprotein cholesterol levels in very elderly subjects without the apolipoprotein e4 allele. The American Journal of Geriatric Psychiatry : Official Journal of the American Association for Geriatric Psychiatry, 16(9), 781–5. PMID: 18757771
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].
“After struggling with weight my entire life, I was pointed in the direction of a low-carb diet by a group of other physicians — and it changed my life. As a family physician, it became clear to me how many of my patients could benefit from this lifestyle in so many ways. I spent time training with other doctors who had been practicing nutritional medicine with their patients for years, and learned how best to help my own patients. This is my passion, and being able to help change patients lives in this way is incredibly rewarding.”
Advocates for the diet recommend that it be seriously considered after two medications have failed, as the chance of other drugs succeeding is only 10%.[9][31][32] The diet can be considered earlier for some epilepsy and genetic syndromes where it has shown particular usefulness. These include Dravet syndrome, infantile spasms, myoclonic-astatic epilepsy, and tuberous sclerosis complex.[9][33]
“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.”

Mustering the willpower to push aside the bread basket at your favourite restaurant does not make you a keto aficionado. The ketogenic diet is different from other low carb diets in that your glucose levels have to be so low that you have to moderate even the amount of protein that you consume. With 40% of calories coming from protein, protein will convert to glucose once consumed, which is not keto friendly. 
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]
In part, keto diet weight loss is a real thing because high-fat, low-carb diets can both help diminish hunger and boost weight loss through their hormonal effects. As described above, when we eat very little foods that supply us with carbohydrates, we release less insulin. With lower insulin levels, the body doesn’t store extra energy in the form of fat for later use, and instead is able to reach into existing fat stores for energy. 
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