Finally, the accuracy of MF-BIA and ADP in the estimation of body composition was studied in relation to DXA. As shown in Table 2, the unadjusted regression coefficients for FM, FM%, and FFM were consistently higher with MF-BIA in comparison with ADP throughout the study. Specifically, regression coefficients for MF-BIA were high (r2 > 0.8) for FM and FFM, whereas those regression coefficients for FM% were slightly lower (r2 > 0.7). However, most of the regression coefficients using ADP were lower (r2 < 0.7) for FM, FM%, and FFM. A similar pattern was observed when adjusting for age and sex. The regression coefficients for both MF-BIA and ADP decreased with weight loss.
“[This study] does support other existing research findings that you can indeed lose weight on a ketogenic-inducing diet, and higher levels of protein intake, while following a calorie-restricted diet does help preserve the loss of lean muscle mass,” says Lona Sandon, PhD, RDN, assistant professor in the department of clinical nutrition at the University of Texas Southwestern Medical Center in Dallas.

Fanatic? Someone with T2D, a disease usually claimed to be progressive and a never ending stream of problems and medications, was REVERSED. That’s something to shout from the rooftops. The drop in medication use alone, but the big pharma companies would prefer that people’s stories of reversing (well, putting it into remission) T2D get called fanatical instead of insightful.
Dr. Jockers, thank you so much for this clear and detailed article! I began a keto-style diet around August 2019. By late November, I had fallen from 197 lbs. to under 175 lbs., dropped from 28% to 18% body fat, and anecdotally felt much better in all aspects of my health. All of this occurred exclusively due to diet, I believe– I had almost no exercise routine to speak of, and my desk-based job is pretty sedentary. My family practice doc was surprised and happy with the results as well when I met with him in January… until my blood work came back showing total cholesterol at 257, triglycerides at 236, LDL-C at 162, and HDL at 50.
“I have been working as an internal medicine doctor and diabetologist for over 20 years, focusing on gestational diabetes mellitus (GDM), and also teaching future doctors and nutritionists. In 2016, we corrected our official dietary guidelines for GDM, removing the minimum recommended intake of carbohydrates and setting a maximum at 200 grams a day, with low-carbohydrate diets as an option. I would like to thank GDM dietitian Lily Nichols, Dr. Andreas Eenfeldt at Diet Doctor and the entire LCHF community for improving outcomes of Czech women with GDM and other patients with type 1 and type 2 diabetes or metabolic syndrome.”
“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.”

In terms of weight loss, you may be interested in trying the ketogenic diet because you’ve heard that it can make a big impact right away. And that’s true. “Ketogenic diets will cause you to lose weight within the first week,” says Mattinson. She explains that your body will first use up all of its glycogen stores (the storage form of carbohydrate). With depleted glycogen, you’ll drop water weight. While it can be motivating to see the number on the scale go down (often dramatically), do keep in mind that most of this is water loss initially.
In steps 4 and 5, the ketogenic phases were ended by the physician in charge of the patient based on the amount of weight lost, and the patient started a low-calorie diet (800 to 1500 kcal/d). At this point, the patients underwent a progressive incorporation of different food groups and participated in a program of alimentary re-education to guarantee long-term maintenance of the weight loss. The maintenance diet consisted of an eating plan that was balanced with respect to carbohydrates, protein, and fat. Depending on the individual, the calories consumed ranged between 1500 and 2000 kcal/d, and the objective was to maintain the weight loss and promote a healthy lifestyle.

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


For some, ketosis can cause more negative than positive side effects. Dorena Rode, a 52-year-old author, and speaker from Occidental, California, tried the diet for a month and experienced heart palpitations and dizziness. Unlike Drew, Rode says her cholesterol increased from 192 to 250 mg/dL after she introduced more fat into her diet. (Less than 200 mg/dL is considered desirable, while anything over 240 mg/dL is considered high.)
The observation that the VLCK diet severely reduced FM while preserving muscle mass was reinforced by the maintenance of its physiological action (i.e., muscle strength). Despite a slight reduction in ALM and ASLM, as determined by DXA and MF-BIA, respectively, crude HG remained unchanged during the study (Table 1). Moreover, HG/ALM and HG/ASLM showed a moderate increase in comparison with baseline [Fig. 3(C)].
Letting your blood sugar drop too low when following low-calorie diets -- often containing 1,000 to 1,200 calories daily for women and 1,200 to 1,600 calories a day for men -- can lead to headaches. Low blood sugar, which happens when too little glucose is in your bloodstream, can occur if you skip meals to reach your weight-loss calorie allotment. To help prevent headaches during weight loss, eat regular meals and snacks every few hours or so.
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].
Dieter beware: U.S. News & World Report, in its high-profile January cover story on "best diets," calls the DASH and Mediterranean diets tops for health, though these regimens represent the failed nutritional status quo of the last 50 years. It's clear that U.S. News — which employed an expert panel to rate 40 diets on various criteria — merely recapitulated questionable dietary advice that has gone by a succession of names since the 1970s — "low-fat," "DASH," "USDA-style," "plant-based." The basic set of recommendations have remained the same, emphasizing plant foods (grains, cereals, fruits and vegetables) over animal products (eggs, regular dairy, meat), and vegetable oils over natural animal fats such as butter. According to government data, Americans have largely followed these recommendations over the last 50 years, notably increasing their consumption of grains, vegetables and fruits and eating less whole milk, butter, meat and eggs. The outcome? In that time, rates of obesity and Type 2 diabetes have skyrocketed. Something has gone terribly wrong. Why would 25 doctors, dietitians and nutritionists on the U.S. News panel choose a dietary philosophy that has — so far, at least — failed us?
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).

The results of the Bland-Altman approach in regard to the FM% are shown in Fig. 4. MF-BIA underestimates the FM% during all visits, although with increasing body fat there is a trend toward better agreement [Fig. 4(A)]. This negative slope was significant in visits C2 (P = 0.015), C3 (P = 0.003), and C4 (P = 0.005). Importantly, MF-BIA had a consistent variability of about 5% in determining FM% when compared with DXA. However, the concordance between DXA and ADP is shown in Fig. 4(B). In visits C1 (P = 0.005), C2 (P = 0.010), and C3 (P = 0.004) significant negative slopes were observed, indicating underestimation of ADP at lower levels of FM%, but ADP seemed to overestimate FM% with increasing body fat. During visit C-4, a similar pattern was observed, although the slope did not reach statistical significance (P = 0.093). During all visits there was a high variability in the FM% determined by ADP, reaching values of up to 20% in comparison with DXA.
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