The primary outcome was the change from baseline to week 16 in hemoglobin A1c. Changes in all variables were analyzed by the paired t-test or Wilcoxon signed-ranks test, as appropriate. Linear regression analysis was used to examine predictors of change in hemoglobin A1c. A p value of 0.05 or less was considered statistically significant. Statistical analysis was performed using SAS version 8.02 (SAS Institute, Cary, NC).
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I am a stage four kidney disease patient. I am also a type one diabetic. I have had diabetes for 37 years. My Internist suggested the Keto diet for me, but there are so many if the foods on the Keto diet that I’m not able to eat because of my kidneys functioning at 22%. How do I reconcile this diet plan to work with my kidney disease? I’m not allowed any dairy, because of my high potassium. Is almond milk ok to drink? I’m not allowed avocados, mushrooms, spinach, tomatoes, greens, (beet or chard). No bacon, or pork. No melons, bananas, oranges, peaches, pears, some apples, pineapple. I can have berries of all kinds. will this still work for me?
When ketone bodies accumulate in the blood, this is called ketosis. Healthy individuals naturally experience mild ketosis during periods of fasting (e.g., sleeping overnight) and very strenuous exercise. Proponents of the ketogenic diet state that if the diet is carefully followed, blood levels of ketones should not reach a harmful level (known as “ketoacidosis”) as the brain will use ketones for fuel, and healthy individuals will typically produce enough insulin to prevent excessive ketones from forming. [2] How soon ketosis happens and the number of ketone bodies that accumulate in the blood is variable from person to person and depends on factors such as body fat percentage and resting metabolic rate. [3]

As ingested CHO is broken down by the stomach and absorbed through the small intestine, rising blood sugar creates a feedback loop which results in secretion of insulin. The primary role of insulin is to “dispose” of excess blood sugar by signaling tissues to “uptake” more glucose from the circulating supply. In this manner insulin serves a prominent role in glucose regulation. This concept also provides the basis for the glycemic index, a concept which attempts to quantify the impact CHO foods have on blood sugar response. For example, foods rich in simple CHO (i.e., “sugars”), which are absorbed quickly, trigger a rapid rise in blood sugar (and subsequently insulin response), whereas foods rich in complex CHO, such as fiber-rich legumes, exert a relatively blunted response on blood glucose.


In addition, on the day the diet was initiated, diabetes medications were reduced – generally, insulin doses were halved, and sulfonylurea doses were halved or discontinued. Due to the possible diuretic effects of the diet soon after initiation, diuretic medications were discontinued if of low dosage (up to 25 mg of hydrochlorothiazide or 20 mg of furosemide) or halved if of higher dosage. Participants were also instructed to take a standard multivitamin and drink 6–8 glasses of water daily, and were encouraged to exercise aerobically for 30 minutes at least three times per week.
Our highly processed and high fat with high carbs diets and sedentary ways are going to kill off many of our kids. A study just done says this generation will probably be less healthy and die earlier than their parents. I did Atkins years ago and did splendidly. I went back to my foolish habits and suffered. I’m on a ketogenic diet which has already reaped many benefits in this 65 year old body. Better mood, less joint pain, less fatigue, and more energy. Loving it.
One thing many people love about keto diet meal plans is that tracking your food is optional. "One of the biggest benefits of the ketogenic diet is that there's no need to meticulously track your calories like you may in other diets," notes Dr. Josh Axe, D.N.M., C.N.S., D.C., founder of DrAxe.com, best-selling author of Eat Dirt, and cofounder of Ancient Nutrition. "Because you're filling up on fat and protein, you're more likely to feel satisfied and energized all day long, which causes you to naturally eat less." This isn't to say that food tracking on keto is discouraged. "Some people may find calorie counting a useful tool to be more mindful and aware of what they're eating, but it's not necessary on the ketogenic diet," says Dr. Axe, but there's no need to get too stressed about hitting a certain caloric goal, especially if you're not trying to lose weight. (Related: The #1 Reason to Stop Counting Calories)
You want to keep your cheats to none. Be prepared, make sure you’re eating what you need to be satiated (“full”), and make sure you’re satisfied with what you’re eating. If you have to force yourself to eat something, it will never work out in the end. This is just a guideline on how you can eat on a ketogenic diet, so you’re very welcome to change up what kind of foods you eat!
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]

Pattern B LDL, on the other hand, has a much smaller particle size and is much more prone to oxidation. Another thing about pattern B LDL is that it is small enough to enter into the endothelial lining of the artery where it can become oxidized and more likely to form plaque.  There is a high association between these small dense particles and cardiovascular disease.

The classic ketogenic diet is not a balanced diet and only contains tiny portions of fresh fruit and vegetables, fortified cereals, and calcium-rich foods. In particular, the B vitamins, calcium, and vitamin D must be artificially supplemented. This is achieved by taking two sugar-free supplements designed for the patient's age: a multivitamin with minerals and calcium with vitamin D.[18] A typical day of food for a child on a 4:1 ratio, 1,500 kcal (6,300 kJ) ketogenic diet comprises three small meals and three small snacks:[28]

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 ketogenic diet, you’re generally eating a diet that’s high in fat (roughly 70 percent of your total calories come from fat), moderate in protein (about 20 percent of your calories), and low in carbohydrate (about 5 percent of calories). By limiting carbohydrates (to usually less than 45 grams for the average person), your body lacks the glucose (from carbs) that it normally uses for energy, so it eventually switches over to burning fat as its primary fuel source instead; through a metabolic process called ketosis, the liver converts the fat into fragments of fatty acids called ketones, which power the brain and other organs and tissues.
The ketogenic diet has been shown to produce beneficial metabolic changes in the short-term. Along with weight loss, health parameters associated with carrying excess weight have improved, such as insulin resistance, high blood pressure, and elevated cholesterol and triglycerides. [2,7] There is also growing interest in the use of low-carbohydrate diets, including the ketogenic diet, for type 2 diabetes. Several theories exist as to why the ketogenic diet promotes weight loss, though they have not been consistently shown in research: [2,8,9]
I recently applied for life insurance after following the ketogenic diet for about six months. I was initially quoted the lowest rate based on the fact that I have no health issues whatsoever. However, my cholesterol readings were very high so they came back and said that I had elevated total cholesterol readings of 378 which alarmed me. They have now doubled my life insurance rates because of it. Even though my total cholesterol was high everything else seems good according to this article. LDL – 272, HDL – 92, Triclycerides – 70. This all translates to an LDL/HDL ratio of slightly under 3:1 and a Triglyceride/HDL ratio of close to 1:1. I don’t know if I should be concerned that my total is well over the 300 that is sited in this article. Does anyone know?
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
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 >

Cholesterol serves a number of important roles in the body. First of all, cholesterol is a critical structural element in certain tissues such as our brain and nervous system. In fact, it is estimated that around 25% of our cholesterol can be found in the brain. Just to highlight our failed fat philosophy over the years, higher saturated fat intake and high cholesterol levels are associated with better mental function in old age (1)!


Very low calorie diets are not something you should try alone. Consuming over-the-counter meal replacement products is not the same kind of treatment your doctor will provide you. In addition, ketones are not the ideal energy supplier — but rather a "will do" supplier — and this underscores how important it is that VLCDs are short in duration and guided by a qualified health care professional. In addition, many VLCD treatments involve supplementing with prescription medications to help with weight loss, which provides a measure of effectiveness you are not likely to get by going it alone.
Hi I’m new to Keto. I have been reading about it, and understanding what to eat and what not to eat. My problem is I’m not sure if I’m doing it correctly. I’m constantly hungry whereas information reads that I will never be hungry. I use fats as required along with topping up with vegetables in my meals yet this does not fill me up. I haven’t experienced the Keto flu and I’ve even put on weight! I have been doing this for about 3 weeks now. Any ideas where I am going wrong.
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! 

Hi Gigi, Low carb and keto is about the balance of macronutrients eaten (fat, protein and carbs), not specifically meat or lack thereof. Most people on keto do eat meat, though some people do vegetarian keto. Fat is actually necessary for many body processes. There is no issue for the kidneys with a high fat diet, but if you eat too much protein that isn’t great for the kidneys. It’s a common misconception that keto is high protein (it isn’t). Keto is great for diabetics as it naturally helps stabilize insulin. All of this being said, please know I’m not a doctor and you should consult your doctor on any medical questions or before starting any diet. If you have more questions that aren’t medical questions, I recommend our low carb & keto support group here.
“I encourage my patients to do fasting coupled with a very-low-carbohydrate, whole-foods diet because of the astounding biochemical and clinical improvements these interventions provide, in terms of managing chronic metabolic illnesses like diabetes, hypertension, and obesity. I invite my patients to go to Diet Doctor because it is a very reliable source of information for people following a low-carbohydrate diet.”
GLUT1 deficiency is the technical term for what some medical practitioners are now calling diabetes 3. It’s the brain cell’s insulin resistance or a deficiency of glucose transport to brain cells. It impairs cellular metabolism in the brain, and is considered a source of Alzheimer’s disease, Multiple sclerosis, and epileptic seizures, among others.
It’s been a disaster this calories in, calories out. I mean look at the effect. Since we have adopted that philosophy we have worldwide epidemics of obesity, diabetes, faKy liver and so on… It’s been a disaster and the sooner we forget about it… It’s sort of an attractive concept, you know, what you bring in, what you take out… But unfortunately it doesn’t work.
Leftovers will be another thing we will take into consideration. Not only is it easier on you, but why put yourself through the hassle to cook the same food more than once? Breakfast is something I normally do leftover style, where I don’t have to worry about it in the morning and I certainly don’t have to stress about it. Grab some food out the fridge, pre-made for me, and head out the door. It doesn’t get much easier than that, does it?

Protein is generally considered the most satiating macronutrient, but it’s mostly used for cell repair, maintenance and growth. Thus protein intake is mostly important in order to fill your body’s protein needs. Protein is not very effective as a fuel (i.e. as calories). Excess protein has to first be converted to glucose in the liver, in order to be used as fuel. Eating protein in excess of your body’s needs is not necessarily a good thing, and it can reduce the effect of a strict low-carb diet. Learn more


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.”
Eating too much for your genes/environment. I was guilty of this when I first tried keto in 2015. I made coffee with pastured butter and coconut oil every morning, ate bacon and other fatty meats, and promptly gained weight. Without getting too much in the weeds, you want to aim for a less-caloric ketogenic food plan, not a hypercaloric one like I did. Calories aren’t everything—hormones matter more—but you need to be paying attention and not overeat, which, obviously, can cause you to gain weight.

“Eggs have a lot of vitamins like vitamin A, B complex, D, K, E, calcium, and zinc,” says Ryan Weaver, a personal trainer and keto enthusiast. “That’s why eggs are an excellent choice for breakfast when you follow the keto diet. To avoid getting bored, you can try different ways of preparing the eggs—boiled, fried, or baked. Also, you can combine the eggs with different foods like bacon, ham, cheddar cheese, butter, mayonnaise, so you get a different recipe each day although using the same main ingredient.”
Previous studies have shown that ketogenic diets preferably reduce the total FM in obese patients (10–13). However, the precise distribution of these losses has not been determined. In this study we confirmed that the diet reduces total FM and specifically visceral adipose tissue, which has a greater impact in predicting cardiometabolic complications associated with obesity than does the total volume of body adiposity (2, 31).
“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.”
For the second four weeks, they were fed a very-low-carbohydrate, low-sugar ketogenic diet. Five percent of their total calories came from carbohydrate (36g per day), and 2% of their total calories came from sugar. 15% percent of the calories came from protein. The keto diet totaled 2,738 calories per day. Note that the caloric intakes were kept close to identical, meaning fat loss could only be attributed to the source of the food rather than its caloric content.
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.
d) Or does the entire question revert back to a classic calorie counting exercise? In this case, I’ll eat the minimum amount of protein that is needed to prevent my muscles from being cannibalized (for energy) and for the rest, I’ll limit my dietary fat intake per day to a level, where its energy + energy currently obtained from adipose tissue match my total energy need? (I’ll leave gluconeogenesis out of this equation for simplicity.) If this is the case, I’ll lose adipose tissue, i.e. lose weight, but the interesting question still remains: How much energy can my body extract from the adipose tissue at its best? How can I maximize the share of energy coming from adipose tissue instead of dietary fat?
Eating a keto diet can have some short-term health perks. But in the long run, it also has the potential to create some serious health problems. That’s why many experts say you shouldn’t attempt it on your own. “In general, if a person follows a ketogenic diet, they should only do so for a brief time and under close medical supervision,” says Hultin.
Dr. Josh Axe, DNM, DC, CNS, is a doctor of natural medicine, clinical nutritionist and author with a passion to help people get well using food as medicine. He’s the author of the books “Eat Dirt: Why Leaky Gut May Be the Root Cause of Your Health Problems,” “Essential Oils: Ancient Medicine” and the upcoming “Keto Diet: Your 30-Day Plan to Lose Weight, Balance Hormones, Boost Brain Health, and Reverse Disease” (February 2019, published by Little, Brown Spark). He’s a co-founder of Ancient Nutrition, a health company where the mission is to restore health, strength and vitality by providing history’s healthiest whole food nutrients to the modern world. 

Given this new meta-analysis, it’s safe to say that low-carb and high-carb diets with protein matched have similar effects on energy expenditure and body fatness. However, this doesn’t mean that the insulin theory of obesity is entirely wrong — these results simply suggest that the theory carries much less significance than calorie intake in general.
“I recommend low-carbohydrate, high-fat (ketogenic) diets to almost all my patients to improve their quality of life. The LCHF diet reduces inflammation, promotes weight loss, and improves blood biomarkers without prescription agents. The result is improved sleep, sharper mental clarity, more energy throughout the day, and healthier relationships to food. Most patients suffer “fat phobia” but fat does not make you fat! Sugar does! We teach patients to eat lots of healthy fats and cycle in and out of ketosis. We refer everyone to Diet Doctor as a great resource, especially for the carb contents of various food and drinks.”

“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.”
About 20% of children on the ketogenic diet achieve freedom from seizures, and many are able to reduce the use of anticonvulsant drugs or eliminate them altogether.[18] Commonly, at around two years on the diet, or after six months of being seizure-free, the diet may be gradually discontinued over two or three months. This is done by lowering the ketogenic ratio until urinary ketosis is no longer detected, and then lifting all calorie restrictions.[46] This timing and method of discontinuation mimics that of anticonvulsant drug therapy in children, where the child has become seizure-free. When the diet is required to treat certain metabolic diseases, the duration will be longer. The total diet duration is up to the treating ketogenic diet team and parents; durations up to 12 years have been studied and found beneficial.[9]
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!
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!!!!
“I encounter many patients who are interested in LCHF and are finding benefit in weight reduction, better diabetes control, improved endurance and energy levels, and improved lipid profiles. There is a great deal of confusion out there about the diet, much of it based on outdated science or an incomplete understanding of the topic. I feel that I owe it to patients to be informed about LCHF so that I can advise them on the risks and benefits it could have for them.”
In 1967, Irwin Stillman published The Doctor's Quick Weight Loss Diet. The "Stillman diet" is a high-protein, low-carbohydrate, and low-fat diet. It is regarded as one of the first low-carbohydrate diets to become popular in the United States.[52] Other low-carbohydrate diets in the 1960s included the Air Force diet[53] and the Drinking Man's Diet.[54] Austrian physician Wolfgang Lutz published his book Leben Ohne Brot (Life Without Bread) in 1967.[55] However, it was not well known in the English-speaking world.
On a ketogenic diet, you’re generally eating a diet that’s high in fat (roughly 70 percent of your total calories come from fat), moderate in protein (about 20 percent of your calories), and low in carbohydrate (about 5 percent of calories). By limiting carbohydrates (to usually less than 45 grams for the average person), your body lacks the glucose (from carbs) that it normally uses for energy, so it eventually switches over to burning fat as its primary fuel source instead; through a metabolic process called ketosis, the liver converts the fat into fragments of fatty acids called ketones, which power the brain and other organs and tissues.
A study with an intent-to-treat prospective design was published in 1998 by a team from the Johns Hopkins Hospital[20] and followed-up by a report published in 2001.[21] As with most studies of the ketogenic diet, no control group (patients who did not receive the treatment) was used. The study enrolled 150 children. After three months, 83% of them were still on the diet, 26% had experienced a good reduction in seizures, 31% had had an excellent reduction, and 3% were seizure-free.[Note 7] At 12 months, 55% were still on the diet, 23% had a good response, 20% had an excellent response, and 7% were seizure-free. Those who had discontinued the diet by this stage did so because it was ineffective, too restrictive, or due to illness, and most of those who remained were benefiting from it. The percentage of those still on the diet at two, three, and four years was 39%, 20%, and 12%, respectively. During this period, the most common reason for discontinuing the diet was because the children had become seizure-free or significantly better. At four years, 16% of the original 150 children had a good reduction in seizure frequency, 14% had an excellent reduction, and 13% were seizure-free, though these figures include many who were no longer on the diet. Those remaining on the diet after this duration were typically not seizure-free, but had had an excellent response.[21][22]
Eliminating several food groups and the potential for unpleasant symptoms may make compliance difficult. An emphasis on foods high in saturated fat also counters recommendations from the Dietary Guidelines for Americans and the American Heart Association and may have adverse effects on blood LDL cholesterol. However, it is possible to modify the diet to emphasize foods low in saturated fat such as olive oil, avocado, nuts, seeds, and fatty fish.
“The growing scientific evidence is robust that the low-carb, ketogenic diet is safe and effective, especially for the management and reversal of type 2 diabetes and for weight loss. I believe that millions of people in the world might have their health improve by adopting this way of eating. Together with the growing team at Diet Doctor we aim to make low carb simple and to empower people, everywhere, to revolutionize their health. Having so many respected low-carb doctors join this page helps spread the word about this potentially life-changing way of eating.”

“I am determined to shatter the chiding “eat less, exercise more” obesity medicine paradigm. Obesity is not a personal failure, but a chronic health condition unfolding in our country and around the world. It is a result of the “carboholic” society we live in. Through a holistic approach, I arm patients with knowledge, tools, and skills to manage their weight as well as their overall health.”

I’m following the ketogenic diet and I find it very easy, pleasant and varied. I can even say that my diet today is more varied than the previous one. I do not intend to leave this diet and I cannot really see why. My initial focus was not to lose weight, I’ve always been lean, but to feel better, well disposed. And I got it! I am very pleased, I have read a lot about it (including scientific literature) and I have influenced other people who need to lose weight or improve some aspects of their health. But from the beginning I went on my own way, without the help of a nutritionist because I did not want to suffer the influence of others’ ideas.

Carbohydrates have been linked to this skin condition, so cutting down on them may help. And the drop in insulin that a ketogenic diet can trigger may also help stop acne breakouts. (Insulin can cause your body to make other hormones that bring on outbreaks.) Still, more research is needed to determine exactly how much effect, if any, the diet actually has on acne. 
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.)
1. Reduce carbs. How much? The short answer is to eat 20 to 25 grams each day for weight loss, and 25 to 30 for weight maintenance. (You must use a nutrition calculator for macronutrients to get it right because thinking in terms of grams is not intuitive, and nutritional ketosis is less likely to be successful if you try to “eyeball” the amounts.) The long answer is: it depends. I encourage people to limit carbs until they are in ketosis, as confirmed with a blood ketone meter (see below), and then try increasing the amount of carbs by 5 grams to see if they stay in ketosis.
I have been on this Keto diet 2weeks now,have lost almost 8lbs,am strictly following this diet,the food is great,I have the cookbook,I don’t feel starved,nor deprived,am hanging in there,because according to this cookbook,your body doesn’t start to be a fat burning machine until day 30,is this correct?however,my clothes are loose on me,so I feel I am in keytosis as we speak
“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.”
There are plant based healthy oils that have been in the food chain for thousands of years, including high-fat foods such as all nuts and seeds, avocados, extra virgin olive oil, sesame seed oil, black cumin seed oil (popular in the Middle East), palm oil sourced from sustainable producers, and the healthiest plant based fat of them all, coconut oil.
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 cyclic ketogenic diet (or carb-cycling) is a low-carbohydrate diet with intermittent periods of high or moderate carbohydrate consumption. This is a form of the general ketogenic diet that is used as a way to maximize fat loss while maintaining the ability to perform high-intensity exercise. A ketogenic diet limits the number of grams of carbohydrate the dieter may eat, which may be anywhere between 0 and 50g per day. The remainder of the caloric intake must come primarily from fat sources and protein sources in order to maintain ketosis (the condition in which the body burns fats and uses ketones instead of glucose for fuel).
Long-term use of the ketogenic diet in children increases the risk of slowed or stunted growth, bone fractures, and kidney stones.[18] The diet reduces levels of insulin-like growth factor 1, which is important for childhood growth. Like many anticonvulsant drugs, the ketogenic diet has an adverse effect on bone health. Many factors may be involved such as acidosis and suppressed growth hormone.[38] About one in 20 children on the ketogenic diet develop kidney stones (compared with one in several thousand for the general population). A class of anticonvulsants known as carbonic anhydrase inhibitors (topiramate, zonisamide) are known to increase the risk of kidney stones, but the combination of these anticonvulsants and the ketogenic diet does not appear to elevate the risk above that of the diet alone.[39] The stones are treatable and do not justify discontinuation of the diet.[39] Johns Hopkins Hospital now gives oral potassium citrate supplements to all ketogenic diet patients, resulting in one-seventh of the incidence of kidney stones.[40] However, this empiric usage has not been tested in a prospective controlled trial.[9] Kidney stone formation (nephrolithiasis) is associated with the diet for four reasons:[39]

The end result of the “ketone diet” is staying fueled off of circulating high ketones (which are also sometimes called ketone bodies) — which is what’s responsible for altering your metabolism in a way that some people like to say turns you into a “fat-burning machine.” Both in terms of how it feels physically and mentally, along with the impact it has on the body, being in ketosis is very different than a “glycolytic state,” where blood glucose (sugar) serves as the body’s energy source.
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?
The modern obesity epidemic appears to be an unprecedented phenomenon, and it coincides with an ever-increased focus on counting calories. Correlation is not causation, so it would obviously be wrong to say that obesity is caused by counting calories. However, counting calories appears to be, at best, an imperfect aid to weight control. So what is really going on?
Thankyou for the breakdown! I’m quite excited to get started. I’m a T1 newly diagnosed (6m) and the hospital educator had me eating 30gm Carbs per meal which saw me a) Nearly vomit every meal as it was too much food b) gain a ridiculous amount of weight! (never really been a big carb eater, but my issue was not eating frequently!) (15+kg gained!) so bring on 2019 with a better relationship with food and a better relationship with myself, knowing how and what works with for my body. blessings xx😘

To drill down further, there are some genetic enzyme defects that cause problems with ketosis. Here are a few of note: carnitine deficiency (primary), carnitine palmitoyltransferase (CPT) I or II deficiency, carnitine translocase deficiency, beta-oxidation defects—mitochondrial 3-hydroxy-3-methylglutaryl-CoA synthase (mHMGS) deficiency, medium-chain acyl dehydrogenase deficiency (MCAD).


Positive science on ketosis coupled with personal successes passed by word-of-mouth have driven more people to explore the ketogenic diet, says Volek. More recently, the keto diet hints at having a promising therapeutic role in cancer, Alzheimer’s, Parkinson’s and polycystic ovary syndrome (PCOS). Research is still early in many areas, but Volek suspects there will more definitive answers on the wider scope of the diet’s benefits within the next decade.
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]
Psyllium husk powder is what you’ll need, and you can find it on Amazon. Flaxseed Meal is another ingredient you can use to provide a slightly chewy texture. Although I feel that it’s not as good as psyllium (as it gives a slightly gelled texture), many people have used it successfully in place of psyllium. Make sure you grab a pack or 3 from Amazon. It’s super cheap and lasts a long time!
“Your liver produces ketones all the time, but the rate depends on carbohydrate and protein intake,” says Jeff Volek, Ph.D., R.D., a professor of human sciences at Ohio State University. When the majority of your diet is made up of of carbs and protein, ketogenesis slows. Replacing carbs and protein with fat will put your body into ketosis, thus ramping up ketone production. This takes about three days to induce.

“The biggest mistake people make is that they neglect to do any substantial research into the keto diet,” says Stephanie Lincoln, founder and CEO of Fire Team Whiskey Health and Fitness. “They hear about a new fad diet or know someone who has tried it, they do a Google search, read about 10 sentences, then start the plan.” Lincoln recommends taking more time to prepare yourself. Otherwise, the diet may be a total failure. “Basing your behaviors on ‘what I heard,’ or a few sentences read on a random article online is not smart for any health-related question,” Lincoln says. “Do some real research. Read a book or two on the subject.” Here are more things you need to know before starting the keto diet.
First, a little background: Eric Westman, MD, director of the Duke Lifestyle Medical Clinic, explained to Health in a previous interview that in order to successfully follow the keto diet, you need to eat moderate amounts of protein, reduce your carb intake, and increase fats. When you reduce your carb consumption, your body turns to stored fat as its new fuel source—a process called ketosis. To stay in ketosis, followers of the keto diet must limit their carbs to 50 grams a day, Dr. Westman says.

Some fruits may contain relatively high concentrations of sugar, most are largely water and not particularly calorie-dense. Thus, in absolute terms, even sweet fruits and berries do not represent a significant source of carbohydrates in their natural form, and also typically contain a good deal of fiber which attenuates the absorption of sugar in the gut.[20]
Yes, you'll lose weight but only because you're consuming fewer calories. There's no real magic to the keto diet. The weight-loss equation remains the same: You lose weight when you consume fewer calories than you use each day. You're not burning more fat than other diets, or at a faster rate. On the keto diet, you eat high-fat meals with protein, which keeps you feeling full for longer and cuts down on your overall eating throughout the day.
In the mid-1990s, Hollywood producer Jim Abrahams, whose son's severe epilepsy was effectively controlled by the diet, created the Charlie Foundation to promote it. Publicity included an appearance on NBC's Dateline programme and ...First Do No Harm (1997), a made-for-television film starring Meryl Streep. The foundation sponsored a multicentre research study, the results of which—announced in 1996—marked the beginning of renewed scientific interest in the diet.[1]
Short-term results for the LGIT indicate that at one month approximately half of the patients experience a greater than 50% reduction in seizure frequency, with overall figures approaching that of the ketogenic diet. The data (coming from one centre's experience with 76 children up to the year 2009) also indicate fewer side effects than the ketogenic diet and that it is better tolerated, with more palatable meals.[18][50]

So I have tried many things to loose weight and nothing worked, including this. This was a while ago. Then I decided I was not going to eat breakfast anymore, because in order to loose weight, you need to be a little bit hungry. So anyways, I have been doing intermittent fasting (eating at noon and dinner 6-8) and the first day was hard for me but I stuck to it with the help of some lemon water. The next 3 days became easier and easier. Today, I realized I was not at all hungry for dinner and was a little scared, because I didn’t want my metabolism to slow down (I’ve had problems in the past) so I googled up what this means. I saw that it was ketosis and was so excited. When I went to check the ketosis strips, it was actually working and I was so so happy. The fact that I was trying so hard with all of these fancy recipes and eating 3 meals a day frustrated me. I do not count my calories or anything else. I do some excercise for about 30 minutes everyday. For those who are struggling, please please please! Try intermittent fasting if the ketogenic diet isn’t working for you.


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]
I’m a type 2 Diabetic who just started Keto 3 days ago. I usually only take a small amt of long acting insulin once a day. Usually glucose is around 130 to 150. However today for first time EVER glucose 97!!!! I took no insulin today and find myself very satisfied having BP coffee and don’t get very hungry on Keto. Hoping my glucose stays low tomorrow as well. Is it ok if I don’t eat as I’m not hungry?
Yes, they're technically a fruit, but we think olives deserve a shout-out all of their own, since they're also a great source of healthy fats and are one of a few keto-approved packaged foods. Plus, they're a great source of antioxidants, will satisfy your craving for something salty, and are blissfully low-carb. “About a palm's worth only has 3 grams of net carbs,” Sarah Jadin, RD, told Health in a previous interview.
“I recommend low-carbohydrate and ketogenic diets to almost all my patients, from the general public to world-class Olympic athletes. A huge variety of benefits can be seen, from improvements in metabolic health and reductions in joint pains to enhanced athletic performance. While a degree of nuance is needed for specific recommendations, based on factors like general health and goals, the general principle is to reduce carbohydrates while ensuring appropriate intake of fat and protein. This addresses the key problem of insulin resistance, which is central to many modern disease states, including cardiovascular disease and type 2 diabetes.”

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]
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 >
Vegan ketogenic diet or vegetarian diet: Yes, both are possible. Instead of animal products, plenty of low-carb, nutrient-dense vegan and/or vegetarian foods are included. Nuts, seeds, low-carb fruits and veggies, leafy greens, healthy fats and fermented foods are all excellent choices on a plant-based keto diet. There’s also a similar plan called ketotarian, which combines keto with vegetarian, vegan and/or pescatarian diets for supposedly greater health benefits.
We know now that plaque formation is a culmination of inflammation at the plaque formation site along with a white blood cell mediated interaction between calcium, cholesterol and other biological substances. In fact, it is thought that cholesterol is actually used by the body as a kind of internal bandage when our arterial lining becomes damaged by inflammation. This means that cholesterol build up in the arteries may actually be a protective mechanism.
Eating out while going keto can be tricky. Planning ahead helps you know where your next snacks and meals will come from, so you aren’t tempted to reach for an easy—high-carb—fix, like fast food. Each week, plan out everything from meals to snacks and if you’re using an app, go ahead and fill in your estimated macronutrients ahead of time. This will help you get an idea of your overall intake, so you can make adjustments to reach your daily goals more easily. Get started by planning to make these 10 keto recipes so good you’ll never know you’re on a diet. 

There are three instances where there’s research to back up a ketogenic diet, including to help control type 2 diabetes, as part of epilepsy treatment, or for weight loss, says Mattinson. “In terms of diabetes, there is some promising research showing that the ketogenic diet may improve glycemic control. It may cause a reduction in A1C — a key test for diabetes that measures a person’s average blood sugar control over two to three months — something that may help you reduce medication use,” she says.
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]
But your heart health might depend on what you actually eat. Research published in the New England Journal of Medicine suggests that low-carb diets based mostly on plant sources of fat and protein (like avocados or nuts) can lower heart disease risk by 30 percent. But those benefits didn’t hold for people who ate mostly animal-based proteins and fats. (Think: bacon, butter, and steak.)
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.
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