Keto diets, like most low carb diets, work through the elimination of glucose. Because most folks live on a high carb diet, our bodies normally run on glucose (or sugar) for energy. We cannot make glucose and only have about 24 hours’ worth stored in our muscle tissue and liver. Once glucose is no longer available from food sources, we begin to burn stored fat instead, or fat from our food.
“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!”
Your individual fat adaptation period. Remember your body needs time to become fat-adapted and that time depends on your metabolism. For instance, if you’re coming off a Standard American Diet (SAD) and your adult body has never run on ketones before, your adaptation period might take a little longer. You’ll only experience the true weight loss effects of keto when your body is actually running on ketones.
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.

–Make healthy breakfast fun with these little low carb blueberry pancake dippers. They're easy enough to make on a weekday morning! This post is sponsored by Wyman's. Do you get into a breakfast rut? You wake up, wander to the kitchen, grab a cup of coffee and think...same old same old. You could have eggs...again. Or you could have a low carb muffin...again. Maybe you have some low carb bread on hand for toast...again. Whatever your breakfast routine, you're sick of it and you want something different. Yep, this happens in my house too, with relative frequency.All Day I Dream About Food
Keto is not hard to follow at all. See, this is why I took my diet and nutrition into my own hands. I have PCOS and the ketogenic diet has worked wonders for me. I’m finally pregnant at the age of 32 and after 11 years of marriage because the ketogenic diet made me lose over 100 lbs and brought my insulin resistance under control. I feel better than I’ve ever felt. Sometimes doctors don’t seem to know as much as they should, or as much as they assume they do, and that’s pretty disturbing. Just like they’re still using the old school and very inaccurate BMI charts that are just pure bs. I’ll just take care of myself outside of certain situations involving illness or injury. I’m doing great on my own.
“I started gaining weight in college. Too Much Beer. And it didn't stop, sitting at a desk job all day, going out to dinner ever night. I packed on the pounds. I knew something had to change. My friend recommened to me. I suddenly had energy again! I started taking the stairs at work. Biking on the weekend. I've been using it for 18 months now - and let me tell you - I'm back baby! ” - Carlos Thomas

The ketogenic diet is indicated as an adjunctive (additional) treatment in children and young people with drug-resistant epilepsy.[26][27] It is approved by national clinical guidelines in Scotland,[27] England, and Wales[26] and reimbursed by nearly all US insurance companies.[28] Children with a focal lesion (a single point of brain abnormality causing the epilepsy) who would make suitable candidates for surgery are more likely to become seizure-free with surgery than with the ketogenic diet.[9][29] About a third of epilepsy centres that offer the ketogenic diet also offer a dietary therapy to adults. Some clinicians consider the two less restrictive dietary variants—the low glycaemic index treatment and the modified Atkins diet—to be more appropriate for adolescents and adults.[9] A liquid form of the ketogenic diet is particularly easy to prepare for, and well tolerated by, infants on formula and children who are tube-fed.[5][30]
Your glycogen stores can still be refilled while on a ketogenic diet. A keto diet is an excellent way to build muscle, but protein intake is crucial here. It’s suggested that if you are looking to gain mass, you should be taking in about 1.0 – 1.2g protein per lean pound of body mass. Putting muscle on may be slower on a ketogenic diet, but that’s because your total body fat is not increasing as much.5Note that in the beginning of a ketogenic diet, both endurance athletes and obese individuals see a physical performance for the first week of transition. 

Hi Courtney, I’m currently working on a 21-Day Keto Meal Plan. Unfortunately, it’s super time-consuming. And after buying a keto cookbook yesterday and returning it the same day because it wasn’t well researched and the recipes clearly not created specifically for the Keto diet you wouldn’t want me to rush this. I want to make sure the Meal Plan is SPOT on and the recipes complement each other and make eating Keto easy. Give me another month or two and I’ll hopefully have more news on progress. Currently working on a rough sketch but still have to test all recipes and photograph them, too. You definitely don’t need nuts to be able to eat Keto. For now, I recommend to keep it as simple as possible. You can eat my 1-day meal plan 4 days a week and find other recipes you like to build another similar day and then keep switching between mine and the other.
Constipation is a common side effect of low-carb eating plans, including the ketogenic diet. Severely curbing your carb intake means saying goodbye to high-fiber foods like whole grains, beans, and a large proportion of fruits and vegetables, says Ginger Hultin, MS, RDN, Seattle-based nutritionist and spokesperson for the Academy of Nutrition and Dietetics.

Try and aim to keep your protein the same at one gram per pound of body weight and then take in 10-12 grams of carbohydrates for every kilogram of body weight. Start taking these carbohydrates (usually the first bit in liquid form) right after your last workout on Friday night. This is when your body is primed and ready to uptake the carbohydrates and it will be most beneficial for you.
Lastly, if you're active, you might need to make some adjustments to take that into account. "For the first one to two weeks, temporarily reducing your exercise load can be helpful as your body adjusts to being in ketosis," he says. "Additionally, for those who have an intense workout schedule, carb cycling may be a good option." Carb cycling essentially means you'll increase your carb intake on the days you're doing exercise, ideally just two to three days per week. "While low-carb days may be around 20 to 30 grams of net carbs daily, high-carb days can range all the way up to 100 grams, although it can vary based on your size and activity level," says Dr. Axe. (Related: 8 Things You Need to Know About Exercising on the Keto Diet.) 
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.
The FCQ-inventory was based on the validated FCQ-inventory containing 28 item foods. Participants were instructed to indicate how often, in the last month, they have experienced food cravings for each item on a Likert scale where 1 = never, 2 = rarely, 3 = sometimes, 4 = often, and 5 = always/almost every day. There were 3 subscales that categorized foods of similar composition: simple sugars/trans fats, complex carbohydrate/proteins, and saturated fats/high caloric content. To calculate each subscale score, the values given for the corresponding items were summed, and the mean was recorded. A higher score in the FCQ indicated greater food cravings.
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.”

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 have been applying low carb solutions to metabolic problems since the moment I closed the cover of Good Calories, Bad Calories. I share with my low-carb colleagues the wonderful experience of offering effective advice and seeing real results. In addition to metabolic and hormonal problems, I have more recently focused on flexible low-carb approaches for Alzheimer’s and other neurodegenerative conditions. I greatly enjoy the lively online low-carb community and rely on Diet Doctor as a resource for myself and my patients.” 

Those who’ve had their gallbladder removed may need ox bile supplementation to support their body in breaking down fats[*] and aid in overall digestion. When taken with a meal, ox bile provides a concentrated source of bile which takes the place of the bile that would have been secreted by your gallbladder. As mentioned before, proper digestion is key to helping aid in weight loss and optimizing overall health and wellness.
Therefore, when you’re following a ketogenic diet plan for beginners, your body is burning fat for energy rather than carbohydrates, so in the process most people lose weight and excess body fat rapidly, even when consuming lots of fat and adequate calories through their daily food intake. Another major benefit of the keto diet is that there’s no need to count calories, feel hungry or attempt to burn loads of calories through hours of intense exercise.

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.
Most condiments below range from 0.5–2 net carb grams per 1–2 tablespoon serving. Check ingredient labels to make sure added sugar is not included, which will increase net carbs. (Stevia and erythritol will become your go-to sweeteners because neither raise your blood sugar — combine for a more natural sweet taste and, remember, a little goes a long way!)
Recently, many of my patients have been asking about a ketogenic diet. Is a ketogenic diet safe? Would you recommend it? Despite the recent hype, a ketogenic diet is not something new. In medicine, we have been using it for almost 100 years to treat drug-resistant epilepsy, especially in children. In the 1970s, Dr. Atkins popularized his very-low-carbohydrate diet for weight loss that began with a very strict two-week ketogenic phase. Over the years, other fad diets incorporated a similar approach for weight loss.

The ketogenic diet is calculated by a dietitian for each child. Age, weight, activity levels, culture, and food preferences all affect the meal plan. First, the energy requirements are set at 80–90% of the recommended daily amounts (RDA) for the child's age (the high-fat diet requires less energy to process than a typical high-carbohydrate diet). Highly active children or those with muscle spasticity require more food energy than this; immobile children require less. The ketogenic ratio of the diet compares the weight of fat to the combined weight of carbohydrate and protein. This is typically 4:1, but children who are younger than 18 months, older than 12 years, or who are obese may be started on a 3:1 ratio. Fat is energy-rich, with 9 kcal/g (38 kJ/g) compared to 4 kcal/g (17 kJ/g) for carbohydrate or protein, so portions on the ketogenic diet are smaller than normal. The quantity of fat in the diet can be calculated from the overall energy requirements and the chosen ketogenic ratio. Next, the protein levels are set to allow for growth and body maintenance, and are around 1 g protein for each kg of body weight. Lastly, the amount of carbohydrate is set according to what allowance is left while maintaining the chosen ratio. Any carbohydrate in medications or supplements must be subtracted from this allowance. The total daily amount of fat, protein, and carbohydrate is then evenly divided across the meals.[37]
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.
We would like to thank A. Menarini Diagnostics Spain for providing, free of charge, the portable ketone meters for all the patients. We acknowledge the PronoKal Group® for providing the diet for all the patients free of charge and for support of the study. The funding source was not involved in the study design, recruitment of patients, study interventions, data collection, or interpretation of the results. The Pronokal personnel (I.S.) revised the final version of the manuscript, without intervention in the analysis of data, statistical evaluation and final interpretation of the results of this study.
Already in ketosis but not losing as quickly as you’d like, or stuck in a stall?  The wildly popular and effective Keto Egg Fast Diet Meal Plan below has helped thousands of people lose up to 10 pounds in just five days – while eating delicious Fettuccini Alfredo, snickerdoodle crepes, and salted caramel custard!  Be sure to join our IBIH Egg Fast Facebook Group to get support, encouragement, and have your questions answered by seasoned egg fasters!

While in ketosis, your body effectively uses fat for fuel. In general, the daily intake of net carbs required to enter ketosis could vary from 20 to 100 grams per day. Most people, who have experienced ketosis, claim to have reached that state at about 20-50 grams of net carbs per day. I'd suggest you start at 20-30 grams and see how you can adjust it for your needs.
The ketogenic diet first gained fame through its effectiveness for weight loss. The high-fat, low-carb diet promotes nutritional ketosis–a normal metabolic state marked by moderate levels of ketones in the blood. The idea with carb restriction in terms of weight loss is that it prompts the release of body fat to be burned or converted to ketones for energy (extra dietary fat also contributes to ketone production).
Most vegetables are low- or moderate-carbohydrate foods (in some low-carbohydrate diets, fiber is excluded because it is not a nutritive carbohydrate). Some vegetables, such as potatoes, carrots, maize (corn) and rice are high in starch. Most low-carbohydrate diet plans accommodate vegetables such as broccoli, spinach, kale, lettuce, cucumbers, cauliflower, peppers and most green-leafy vegetables.[21]
“When the low-fat dietary advice I had been preaching for decades didn’t work for me in middle age, I changed to low-carb. After mentorship from Dr. Eric Westman, I introduced low-carb to my patients with astonishing results reversing diseases I had only been “managing”. In fact, more than 90% of patients who come to me on insulin are able to come off. I run a multidisciplinary medical weight loss clinic helping to restore health. This has brought the joy back into medicine for me. Diet Doctor has been an amazing resource to help me and my patients in this journey.”
Still, there are limitations to the keto diet. The first few weeks on the diet can be rough, and cause what’s known as the keto flu. And some people may experience side effects like thyroid or hormone imbalance, adrenal fatigue, poor sleep quality, and extremely dry eyes. It’s also true that permanent ketosis may not suit everyone. However, there is a way to build a sustainable keto diet which utilizes intermittent, cyclical ketosis as opposed to long-term ketosis…

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.

However, maintaining muscle mass and its functionality (i.e., muscle strength) has an important role in preventing weight regain, maintaining physical functionality, improving cardiometabolic risk factors, and reducing cardiovascular outcomes (5, 7–9, 32, 33). It is commonly assumed, and stated in several textbooks on obesity, that weight loss is associated with an important loss of muscle mass that evolves in parallel with the fat reduction. Some dietary guidelines have even suggested that diets that induce rapid weight loss, such as VLCK diets, create a greater energy deficit and contain lower amounts of protein, and therefore increase the risk of reductions in muscle mass compared with other interventions with more gradual weight loss (34, 35). In this article it was shown that the reductions observed in lean mass were mostly a result of body water loss, both intra- and extracellular. The combined information from the DXA and MF-BIA methods allows for such differentiation (28, 36–38). The loss attributable to muscle mass was minimal (∼1 kg), and an absolute preservation of HG strength was observed, a remarkable fact considering that the patients have experienced a weight reduction of ∼20 kg.


“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.”
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.
After 4 months the VLCK diet induced a −20.2 ± 4.5 kg weight loss, at expenses of reductions in fat mass (FM) of −16.5 ± 5.1 kg (DXA), −18.2 ± 5.8 kg (MF-BIA), and −17.7 ± 9.9 kg (ADP). A substantial decrease was also observed in the visceral FM. The mild but marked reduction in fat-free mass occurred at maximum ketosis, primarily as a result of changes in total body water, and was recovered thereafter. No changes in muscle strength were observed. A strong correlation was evidenced between the 3 methods of assessing body composition.
It is possible to combine the results of several small studies to produce evidence that is stronger than that available from each study alone—a statistical method known as meta-analysis. One of four such analyses, conducted in 2006, looked at 19 studies on a total of 1,084 patients.[23] It concluded that a third achieved an excellent reduction in seizure frequency and half the patients achieved a good reduction.[18]
Studies are needed to investigate whether the diet can specifically inhibit cancer cells, but the ketogenic diet is shown to reduce levels of insulin and IGF-1. For example, a 2017 study in which participants fasted, omitting carbohydrates during their fasting times, reduced their blood pressure, levels of inflammation, fasting blood glucose and levels of IGF-1.
When you’re on keto, you’re less hungry. Ketones help control hormones that influence appetite.[2] They suppress ghrelin, your “hunger hormone,” and at the same time they boost cholecystokinin (CCK) — the hormone that keeps you feeling full.[3] You won’t want to snack as regularly, making it easier to go longer without food. Your body will then reach into its fat stores for energy. The result? More weight loss. Learn more here about how the keto diet suppresses appetite.
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More Sustained Energy: 90-120 minutes after you eat carbohydrates, your body doesn’t have readily available energy produced from the mitochondria in your cells, so you start “crashing” or lowering your energy. When you are in ketosis, your body can run off your body fat, which is an essentially limitless source of fuel. This prevents any type of crash.
Adding heavy cream or half-and-half to your coffee is one way to get an additional source of fat into your day, says Keatley. Just realize that it is a source of saturated fat — and, given the small serving size, it’s easy to go overboard. According to the USDA, 1 tbsp has 51 calories, 5 g of fat (3.5 g saturated fat), and is just shy of ½ g of carbohydrate.
On a ketogenic diet, your entire body switches its fuel supply to run mostly on fat, burning fat 24-7. When insulin levels become very low, fat burning can increase dramatically. It becomes easier to access your fat stores to burn them off. This is great if you’re trying to lose weight, but there are also other less obvious benefits, such as less hunger and a steady supply of energy. This may help keep you alert and focused.
Dietary fiber keeps you full longer and contains prebiotic nutrients that support a healthy gut flora, creating a win-win for weight loss. Getting insufficient dietary fiber (yes, I'm talking to you, all-meat carnivore or cave-man diet folks) adversely shifts your healthy gut flora, which will increase inflammation, insulin resistance, fat deposition around the middle, and weight gain. Leafy green and cruciferous vegetables, avocado, coconut, and berries make great fiber-rich, keto-friendly foods.
“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!”
Supporting these results, Naude et al. (15) found a similar outcome in obese adults with and without type 2 diabetes. This meta-analysis of 19 randomized, controlled trials compared dietary interventions using standard CHO recommendation (i.e., 45 – 65%), low-carbohydrate/high protein (LCHP) and low-carbohydrate/high fat (this group, although not specifically stated, met the criteria for KD). Results demonstrated significant weight loss among all groups in the short-term (3 – 6 months) and long-term (1 – 2 years), with no significant difference among dietary interventions. The authors concluded that weight loss interventions using CHO restriction are equally effective as isocaloric diets of standard CHO recommendation.
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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