However, the lower calorie Keto Diet also features a reduction in fats as well. In doing so, this Keto Diet accelerates fat loss and is better suited for losing weight. After all, between 2 Ketogenic Diet types, with one having a higher caloric intake than the second, which do you think would be the better choice for weight loss? Obviously the lower calorie diet. By reducing fats, your caloric intake is also reduced. As a result, the dieter’s weight loss will occur more rapidly.
I understand your point, and thanks for the reply. I suppose I'm wondering this because when I go through foods (meats in particular, it seems) in the database on MFP, the keto-friendly foods seem to be high in calories. So, I'm wondering if it will be difficult to keep a calorie ceiling of around 1200-1500 per day. My guess would be I'll have to emphasize vegetables moreso than meat in my diet to maintain that level.
From baseline to week 16, the mean body weight decreased significantly from 131.4 ± 18.3 kg to 122.7 ± 18.9 kg, BMI decreased from 42.2 ± 5.8 kg/m2 to 39.4 ± 6.0 kg/m2, and waist circumference from 130.0 ± 10.5 cm to 123.3 ± 11.3 cm (Table ​(Table3).3). The percent change in body weight was -6.6%. The mean percent body fat decreased from 40.4 ± 5.8% to 37.0 ± 6.0%. Systolic and diastolic blood pressures did not change significantly over the 16 weeks. The mean heart rate decreased from 81.2 ± 12.9 beats per minute to 74.6 ± 14.0 beats per minute (p = 0.01).
One area where food tracking can be especially helpful, though, is ensuring that you're hitting the right ratios of macronutrients—protein, carbs, and fat. "The most researched version of the ketogenic diet derives 70 percent of calories from healthy fats, 20 percent from protein, and only 10 percent from carbs," explains Charles Passler, D.C., nutritionist, and founder of Pure Change. "In the ideal world, each keto meal and snack should have that same (70/20/10) ratio of macronutrients, but studies have shown that you'll still achieve great results even if each meal varies slightly from that ratio, just as long as you don't exceed 50 grams per day of carbs, or eat those carbs in one sitting," says Passler. In order to achieve these ratios without a preset meal plan from a dietitian or doctor, some food tracking is probably going to be necessary. But once you get the hang of things, you may not need it anymore.

Hi Kim, there are several factors for developing autoimmune diseases, including Hashimoto's. I believe that in my case it was a combination of high-carb & low-calorie dieting that have contributed to it. I found out by accident because I went for allergy testing where they discovered I had thyroid antibodies. You should definitely avoid following a low-calorie diet (1000 kcal is not enough). Have a look at this tool: KetoDiet Buddy - Easy Macro Calculator for the Ketogenic Diet

^ Another publication of similar regimen was Hill LW, Eckman RS (1915). The Starvation Treatment of Diabetes with a series of graduated diets as used at the Massachusetts General Hospital. Boston: W.M. Leonard. This was so well received that it went into revised editions, eventually becomingThe Allen (Starvation) Treatment of Diabetes with a series of graduated diets (4th ed.). Boston. 1921. p. 140.


Carbohydrate has been wrongly accused of being a uniquely "fattening" macronutrient, misleading many dieters into compromising the nutritiousness of their diet by eliminating carbohydrate-rich food.[26] Low-carbohydrate diet proponents emphasize research saying that low-carbohydrate diets can initially cause slightly greater weight loss than a balanced diet, but any such advantage does not persist.[26][6] In the long-term successful weight maintenance is determined by calorie intake, and not by macronutrient ratios.[7][6]
A ketogenic diet (also known as “nutritional ketosis”) is a high-fat, adequate-protein, low-carbohydrate diet. On a ketogenic diet, your brain uses ketones (a byproduct of your fat-burning metabolism) for fuel, instead of glucose.[1] Since humans can burn either glucose or ketones for energy, this change is possible to make, although there is some controversy surrounding ketogenic diets regarding both their efficacy and health benefit.[2] Ketosis keeps your body in a “fasting” or starvation metabolism, and consequently encourages weight loss by burning off fat reserves. While the shift to a ketogenic diet can be difficult initially, you should begin to see results after a few weeks.
Wilder's colleague, paediatrician Mynie Gustav Peterman, later formulated the classic diet, with a ratio of one gram of protein per kilogram of body weight in children, 10–15 g of carbohydrate per day, and the remainder of calories from fat. Peterman's work in the 1920s established the techniques for induction and maintenance of the diet. Peterman documented positive effects (improved alertness, behaviour, and sleep) and adverse effects (nausea and vomiting due to excess ketosis). The diet proved to be very successful in children: Peterman reported in 1925 that 95% of 37 young patients had improved seizure control on the diet and 60% became seizure-free. By 1930, the diet had also been studied in 100 teenagers and adults. Clifford Joseph Barborka, Sr., also from the Mayo Clinic, reported that 56% of those older patients improved on the diet and 12% became seizure-free. Although the adult results are similar to modern studies of children, they did not compare as well to contemporary studies. Barborka concluded that adults were least likely to benefit from the diet, and the use of the ketogenic diet in adults was not studied again until 1999.[10][14]
When your body goes into ketosis, it will start to produce by-products called ketones. This includes acetone—yes, the same chemical found in nail polish remover, which your body actually naturally makes on its own, according to a 2015 review of research. Because acetone is a smaller molecule, it tends to make its way into your lungs. You’ll eventually exhale them out, resulting in “keto breath.” Your mouth might also have a metallic taste, but it won’t last forever as you adjust to the diet. Just be diligent about brushing your teeth!
Use fat as a lever.  We’ve been taught to fear fat, but don’t! Both keto and low carb are high fat diets. Fat is our source of energy as well as satiety. The key to understand, though, is that fat is a lever on a low carb or keto diet. Carbs and protein stay constant, and fat is the one you increase or decrease (push the lever up or down) to gain or lose weight, respectively. So if your goal is weight loss, eat enough fat to be satisfied, but there’s no need to “get your fats in” once you’re satisfied.
“As a family physician, I have been recommending a low carbohydrate diet to all my patients. Truthfully, I cannot recommend any other diet with a clear conscience. I discovered the scientific benefits of a low-carb diet from Diet Doctor in 2011 when I was looking for new and better ways to manage my patients with diabetes, and I have never looked back since. My patients have benefited immensely from this diet, and it’s the best way to manage obesity, PCOS, metabolic syndrome, insulin resistance and diabetes. To me, Diet Doctor is the one-stop website for everything low-carb.”

The association between the physical and psychological changes in the measures of the study was estimated with bivariate Pearson’s correlation. Due to the strong dependence, the relevance of these coefficients was not based on a significance test (low samples sizes tended to report nonsignificant R-coefficients, which effect size could be considered high), effect size was considered poor for |R| > 0.10, medium for |R| > 0.24, and large for |R| > 0.37 (these thresholds correspond to Cohen’s-d of 0.20, 0.50 and 0.80, respectively) [34].

Ariel Warren is a Registered Dietitian, Diabetes Educator, graduate from Brigham Young, and was diagnosed with Type 1 at the age of 4 years old. Ariel understands diabetes and enjoys working with clients to improve their blood sugar management, healthy eating, weight loss, fitness, and pregnancy. For coaching from a T1D Dietitian, you can contact Ariel directly, through her website: arielwarren.com.


Klein S, Sheard NF, Pi-Sunyer S, Daly A, Wylie-Rosett J, Kulkarni K, Clark NG. Weight management through lifestyle modification for the prevention and management of type 2 diabetes: rationale and strategies. A statement of the American Diabetes Association, the North American Association for the Study of Obesity, and the American Society for Clinical Nutrition. Am J Clin Nutr. 2004;80:257–263. [PubMed] [Google Scholar]
This content is strictly the opinion of Dr. Josh Axe and is for informational and educational purposes only. It is not intended to provide medical advice or to take the place of medical advice or treatment from a personal physician. All readers/viewers of this content are advised to consult their doctors or qualified health professionals regarding specific health questions. Neither Dr. Axe nor the publisher of this content takes responsibility for possible health consequences of any person or persons reading or following the information in this educational content. All viewers of this content, especially those taking prescription or over-the-counter medications, should consult their physicians before beginning any nutrition, supplement or lifestyle program.
Beta-hydroxybutyrate (BHB) – Not technically a ketone but a molecule. Its essential role in the ketogenic diet makes it count as the important ketone body. BHB is synthesized by your liver from acetoacetate. BHB is important because it can freely float throughout your body in your blood, crossing many tissues where other molecules can’t. It enters the mitochondria and gets turned into ATP (adenosine triphosphate), the energy currency of your cells. BHB = ATP = energy!
Before starting, ask yourself what is really realistic for you, Mattinson suggests. Then get your doctor’s okay. You may also work with a local registered dietitian nutritionist to limit potential nutrient deficiencies and talk about vitamin supplementation, as you won’t be eating whole grains, dairy, or fruit, and will eliminate many veggies. “A diet that eliminates entire food groups is a red flag to me. This isn’t something to take lightly or dive into headfirst with no medical supervision,” she says.
Nuts may offer unsaturated fats, but they also contain carbs, so look at the label to calculate exactly what you’re getting, says Whitmire. As an example, 1 tbsp of almond butter has 98 calories, 3 g of protein, 9 g of fat, 3 g of total carbs, and about 1.5 g of fiber (equaling about 1.5 g of net carbs), per the USDA. And, the USDA also notes, a 1-ounce (oz) serving of almonds (23 almonds) has 164 calories, 6 g of protein, 14 g of fat, 6 g of carbohydrates, and 3.5 g of fiber (totaling about 2.5 g net carbs).
Although the KD has shown promise as an alternative dietary strategy for weight management, it should be approached with caution. Acutely, the KD causes physiological changes which may manifest as the “keto flu,” a set of symptoms which commonly includes headache, nausea, gastrointestinal upset and fatigue. A recent study by Urbain et al. (22) illustrates this point, as they state, “Consistent with other studies, our subjects complained about headache, gastrointestinal symptoms, and general weakness mainly during the 1-week metabolic adaptation phase to a KD.” While these symptoms typically resolve within the first one to two weeks, this may present an unpleasant barrier for many individuals to overcome.
Studies have shown that people losing weight with a low-carbohydrate diet, compared to a low-fat diet, have very slightly more weight loss initially, equivalent to approximately 100kcal/day, but that the advantage diminishes over time and is ultimately insignificant.[6] The Endocrine Society state that "when calorie intake is held constant [...] body-fat accumulation does not appear to be affected by even very pronounced changes in the amount of fat vs carbohydrate in the diet."[6]
Keto flu is a real thing. Cutting your carbs to the bone and going into a state of ketosis (where your body burns fat for energy) can bring on a cluster of uncomfortable symptoms, such as headaches, fatigue, muscle aches, nausea, and diarrhea. The side effects are the result of your body transitioning to using fat as its primary source of energy instead of carbs, explains Kristen Mancinelli, MS, RDN, author of The Ketogenic Diet. Once it adapts to the new fuel source (usually within a week or two), you’ll start to feel better.
The popular belief that high-fat diets cause obesity and several other diseases such as coronary heart disease, diabetes, and cancer has not been observed in recent epidemiological studies. Studies carried out in animals that were fed high-fat diets did not show a specific causal relationship between dietary fat and obesity. On the contrary, very-low-carbohydrate and high-fat diets such as the ketogenic diet have shown to beneficial to weight loss.
Just because you're getting headaches doesn't mean your diet is the culprit. Berkeley University Health Services reports that headaches may also be a sign of muscle tightening in your neck triggered by fatigue, depression or emotional stress. However, if you're experiencing chronic headaches, you're not losing more than 2 pounds weekly and you're drinking plenty of water, it may be time to talk with your doctor. Although headaches can occur while dieting, chronic headaches that don't subside may be a sign of a more serious medical condition.
8. Van Lenten, B. J., Hama, S. Y., De Beer, F. C., Stafforini, D. M., McIntyre, T. M., Prescott, S. M., … Navab, M. (1995). Anti-inflammatory HDL becomes pro-inflammatory during the acute phase response. Loss of protective effect of HDL against LDL oxidation in aortic wall cell cocultures. Journal of Clinical Investigation, 96(6), 2758–2767. PMID: 8675645
Reduced hunger. Many people experience a marked reduction in hunger on a keto diet. This may be caused by an increased ability of the body to be fueled by its fat stores. Many people feel great when they eat just once or twice a day, and may automatically end up doing a form of intermittent fasting. This saves time and money, while also speeding up weight loss.
May cause irregularity. Dramatically increasing your fat intake while drastically cutting your carb intake may cause gastrointestinal issues, ranging from constipation to diarrhea. This is something that should resolve itself when your body gets fat-adapted [5]. There is also the potential for nausea, particularly when switching from a low-fat diet to the ketogenic diet. It can take a while for the gall bladder, pancreas, and liver to adapt to digesting high amounts of fat [17].
Several recent studies indicate that a low-carbohydrate diet is effective at improving glycemia. A few studies have shown that in non-diabetic individuals, low-carbohydrate diets were more effective than higher carbohydrate diets at improving fasting serum glucose [13,14] and insulin [6,14-16], and at improving insulin sensitivity as measured by the homeostasis model [6]. One of these studies also included diabetic patients and noted a comparative improvement in hemoglobin A1c after 6 months (low fat diet: 0.0 ± 1.0%; low carbohydrate diet: -0.6 ± 1.2%, p = 0.06) [6] and 12 months (low fat diet: -0.1 ± 1.6%; low carbohydrate diet: -0.7 ± 1.0%, p = 0.019) duration [5]. In a 5-week crossover feeding study, 8 men with type 2 diabetes had greater improvement in fasting glucose, 24-hour glucose area-under-the-curve (AUC), 24-hour insulin AUC, and glycohemoglobin while on the low-carbohydrate diet than when on a eucaloric low-fat diet [7]. In a 14-day inpatient feeding study, 10 participants with type 2 diabetes experienced improvements in hemoglobin A1c and insulin sensitivity as measured by the euglycemic hyperinsulinemic clamp method [8]. Hemoglobin A1c also improved in an outpatient study of 16 participants who followed a 20% carbohydrate diet for 24 weeks [9].
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.
The keto diet is made up of 75% fat, 20% protein, and 5% carbohydrates. This combination enables your body to enter a state of ketosis, where the body switches from burning carbs for fuel, to burning fat for fuel. Fat, protein, and carbohydrates are called macronutrients – “macros” for short. To achieve a keto macro breakdown of 75% fat, 20% protein, and 5% carbs, you first need to know that:
Collagen is a type of protein that has been shown to suppress appetite[*], provide fullness compared to other proteins like whey, casein, or soy[*], help retain muscle mass[*] and even help to reduce the appearance of cellulite due to it’s ability to improve skin elasticity and thickness[*]. Refer to this article for more information on the benefits of collagen and the best way to supplement it in your diet.

Proteins and fats promote satiety and help control blood sugar to reduce cravings. Resting metabolic rate increases somewhat, and does not continue to spiral downward as the body sheds excess fat. As you become more keto-adapted, calories burn at a higher clip. Elevated levels of ketones (beta-hydroxybutyrate) even reduce inflammation, whether introduced endogenously through diet or exogenously through HVMN Ketone.23
Prior to the advent of exogenous insulin for the treatment of diabetes mellitus in the 1920's, the mainstay of therapy was dietary modification. Diet recommendations in that era were aimed at controlling glycemia (actually, glycosuria) and were dramatically different from current low-fat, high-carbohydrate dietary recommendations for patients with diabetes [1,2]. For example, the Dr. Elliot Joslin Diabetic Diet in 1923 consisted of "meats, poultry, game, fish, clear soups, gelatin, eggs, butter, olive oil, coffee, tea" and contained approximately 5% of energy from carbohydrates, 20% from protein, and 75% from fat [3]. A similar diet was advocated by Dr. Frederick Allen of the same era [4].
At this point, we don’t know how long is safe to remain in ketosis. Based on the clinical trials, I recommend a trial of ketosis for up to 6 months, under the care of a knowledgeable functional medicine physician. There are some clinical trials up to 12 months, so that would be the maximum I would recommend under the watchful eyes of a collaborative professional and expert.

Remember, the point of the ketogenic diet is to enter ketosis by limiting your carbohydrate intake to about 5% of your total calorie needs and consuming about 75% of your calories in the form of fats. Vegetables and fruits naturally contain carbohydrates, and the ones included in the list above are lower in carbohydrates while not skimping on nutrients.
You can receive the FULL benefit of the 3-Week Ketogenic Diet without adding any exercise during the 3-weeks you'll be following the plan. If you choose to incorporate at least an hour of metabolic exercise during the week using my personal-trainer guided exercise videos, you'll see up to THREE times the results. Exercise contributes to hormonal balance, blood sugar stability, and lean muscle growth.
I went on low carb diet to lose weight. And it's working - though slowly - at 20 to 30 g of carbs a day. Sometimes a little more. I've been losing about a pound a week. What's really remarkable is I have also reduced my migraines, which were almost nightly. Now the only time I have one is if I happen to drink a beer or glass of wine in the evening. Those I can live without.
Sexual dysfunction in subjects with obesity has been scarcely studied. Recent studies evidenced a rate of sexual dysfunction in 29–60% of women and 24.8–45% of men with obesity [50]. In the current study, at baseline, the obese men reported a relatively good sexual function based on the EMAS–SFQ. The domains included in this questionnaire correlated with levels of testosterone, and the EMAS-SFQ scores reported in the current study are higher than those previously observed in patients with low levels of testosterone [27]. Accordingly, we did not find significant changes in the sexual function of men during the nutritional intervention. By contrast, women reported a general sexual dysfunction that improved, especially in the maximum ketosis phase, and then during the intervention. More concretely, women exhibited an improvement in excitation, lubrication, and orgasm capacity. Sexual dysfunction is usually related to impairments in parameters related to healthy, body image dissatisfaction, depressive symptoms, and lower levels of romantic relationship satisfaction [51]. Then, it could be hypothesized that the beneficial effects on several parameters of body composition and biochemicals induced by the VLCK diet, PNK method®, could be involved in an improvement in the sexual function of obese women.
HDL stands for high-density lipoprotein and its primary role in the body is actually to sweep up LDL particles and return them to the liver for recycling. This is because LDL is actually very susceptible to oxidation so it must be cleared from the blood efficiently. This means when LDL is exposed to chronic inflammation, it becomes damaged. The longer LDL remains in the blood stream and the higher your inflammation levels are, the higher your risk of heart disease.

Polycystic ovary syndrome (PCOS) is the most common endocrine disorder, and it affects women of reproductive age. Symptoms include obesity, hyperinsulinemia and insulin resistance. A pilot study took 11 women through 24 weeks of a low-carbohydrate ketogenic diet (20 grams or less per day). Among the five who completed the study, they lost 12 percent of their weight on average and reduced fasting insulin by 54 percent. Additionally, two women who previously experienced infertility problems became pregnant. (6)

What do LeBron James, Tim McGraw, and Halle Berry have in common? They all attribute their fab physiques to the keto diet plan, a high-fat, low-carb diet that is currently blowing up the internet. According to Google Trends, the keto diet peaked in popularity this week — and shows no signs of stopping. There are 4 million #keto posts on Instagram and more than 69 million keto diet recipes on Pinterest.[1] As the ketogenic diet goes mainstream, some news outlets have described it as another unhealthy celebrity fad diet. Here’s what you need to know about the keto lifestyle — and how the Bulletproof Diet does it one better. 

The Bulletproof Diet (download the roadmap for free here) counters these side effects by keeping protein levels even lower. It is a cyclical ketogenic diet, which means you eat keto for 5-6 days a week and then do a weekly protein fast, which lowers inflammation and kickstarts fat-burning. This is much better for your body and spurs weight loss even more. The Bulletproof Diet also involves a carb re-feed day, where you eat slightly more carbs than usual. Since keto diets mimic starvation, you want to make sure your body knows that food isn’t scarce (this is especially important for women trying to conceive).

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.
The insulin theory of obesity, in short, declares that the primary cause of obesity is higher carbohydrate diets because these diets increase insulin secretion more than any other diet. When insulin levels are high, fat storage will increase significantly and “starve” muscles and organs of energy.   This causes increased hunger and overeating that results in obesity.

We’re also going to keep it simple here. Most of the time, it’ll be salad and meat, slathered in high fat dressings and calling it a day. We don’t want to get too rowdy here. You can use leftover meat from previous nights or use easy accessible canned chicken/fish. If you do use canned meats, try to read the labels and get the one that uses the least (or no) additives!


Variations on the Johns Hopkins protocol are common. The initiation can be performed using outpatient clinics rather than requiring a stay in hospital. Often, no initial fast is used (fasting increases the risk of acidosis, hypoglycaemia, and weight loss). Rather than increasing meal sizes over the three-day initiation, some institutions maintain meal size, but alter the ketogenic ratio from 2:1 to 4:1.[9]
Now that we have discussed the role of the primary cholesterol molecules, you should have a better understanding of how they work together. Having high LDL isn’t necessarily bad, given that you have adequate HDL to help clear it from the blood stream and that you are not dealing with chronic inflammation. It is also important to have large particle LDL (pattern A) rather than small particle LDL (pattern B).
Carbohydrates are your body's favorite fuel source; it breaks them down into glucose. Without a steady intake of carbohydrates, your body turns to using protein for fuel. But if you also are limiting how much protein you eat, your body is forced to burn stored fat as its primary source of fuel. That can result in weight loss, and ketones are a byproduct of burning fat.

Fat: Most of the calories in a ketogenic diet come from fat, which is used for energy. The exact amount of fat a person needs to eat will depend on carbohydrate and protein intake, how many calories they use during the day, and whether they are losing weight (using their body fat for energy). Depending on these factors, somewhere in the range of 60 to 80 percent of calories will come from fats on a ketogenic diet (even up to 90 percent on, for example, the Ketogenic Diet for Epilepsy). People tend not to overeat on diets this high in fat, so calorie counting is rarely necessary.


Hi Kim, there are several factors for developing autoimmune diseases, including Hashimoto's. I believe that in my case it was a combination of high-carb & low-calorie dieting that have contributed to it. I found out by accident because I went for allergy testing where they discovered I had thyroid antibodies. You should definitely avoid following a low-calorie diet (1000 kcal is not enough). Have a look at this tool: KetoDiet Buddy - Easy Macro Calculator for the Ketogenic Diet
If you're new to keto, watch out for hidden carbs. Generally, dairy products and nuts are a good way to meet your daily fat intake, but know that some of those items may contain more carbohydrates than you think. For example, yogurt topped with nuts may seem like a great keto-friendly snack, but a 5.3 ounce serving of plain yogurt has 12 grams of carbohydrates. Vanilla flavored yogurt has 24 grams of carbohydrates. Add an ounce of cashews, weighing in at nearly nine grams of carbs, and you’re up to 21 to 33 grams of carbs for that snack, which could knock you out of ketosis. Be sure to read nutrition labels carefully and pay careful attention to serving sizes. Track foods using a keto-specific app like Senza or KetoDiet can help you stay within your recommended daily carb intake. 

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. 

Functional medicine M.D. Sara Gottfried contributes frequently to goop on the topic of weight-loss resistance. She’s spent the past two years rigorously studying the ketogenic diet—high-fat, low-carb, moderate-protein. Named for ketones, which Gottfried explains are “the energy source made by the body when there’s not enough carbohydrates to be burned for energy demand,” the goal of the diet is to get the body to burn fat instead of sugar.
Note: Are you a vegetarian or vegan and want to go on a ketogenic diet? It’s still possible! Just keep in mind that the dietary restrictions can sometimes be a little bit intense. Make sure to plan ahead and prepare to aid your success. To help out, we’ve published articles (with 7 day meal plans included) for both the vegetarian ketogenic diet and the vegan ketogenic diet.

Carbohydrate: Most of what determines how ketogenic a diet is will depend on how much carbohydrate is eaten, as well the individual's metabolism and activity level. A diet of less than 50 or 60 grams of net (effective) carbohydrate per day is generally ketogenic. Some sources say to consume no more than 20 grams of carbohydrates per day, while others cite up to 50 grams, and many recommend no more than 5 percent of calories from carbs. However, athletes and people with healthy metabolisms may be able to eat 100 or more grams of net carbohydrate in a day and maintain a desired level of ketosis. At the same time, an older sedentary person with Type 2 diabetes may have to eat less than 30 net grams to achieve the same level.


The average daily goal for keto is 20 grams of net carbs. Net carbs are the total carbs in a given serving of food, minus the carbohydrates that are supplied by fiber. You’ll find carb grams quickly add up, even when you’re choosing the best low-carb foods, like spinach and avocado. Keeping your body in a quasi-keto state can be hard on you, warns Santo: “This will leave you feeling sluggish, foggy, and discouraged,” he says. “It will most likely cause a weight plateau, and maybe even weight gain.” Here’s what it’s really like to be on a keto diet.
You can approach keto in a number of different ways. On some keto diets, like dirty keto, it doesn’t matter where your fats, protein, and carbs come from. So dinner could be a bunless cheeseburger with extra bacon. Eating bad fats like low-quality vegetable oils, packaged low-carb snacks, and processed cheese dials up inflammation, making weight loss more challenging.[8]
Melinda – I’m afraid there’s no getting around the fact that one of the Keto requirements is to *calculate your macros,* based on the amount of calories you need to consume each day, in order to (a) maintain your current weight level, or (b) lose weight. Go to an online Keto macro calculator – there’s one linked to a good one on this site, further up the thread. They are generally very easy to use. Then stick to your calculated results, with trust and patience. It may be slow, but you will absolutely see results. I did – and I’ve tried absolutely everything. I barely have time to exercise, but I still lost at least a couple of dress sizes, and I feel absolutely amazing – no more brain fog, tons of energy – maybe too much energy! And best of all, I’m no longer miserable about food, because on Keto, everything is delicious! One final thing in the interest of full disclosure – I am an uber-clean-Keto advocate. I put in the work to eat only healthy fats and carbs from healthy sources. I’m pescatarian – no meats except seafood. I also carefully limit my saturated fat intake to 10% of total calories (the recommended daily allowance), to keep my genetically problematic cholesterol level from skyrocketing, as it did when I first began. This is all working well for me so far – I was able to cut 40 points from my abnormally high LDL (bad cholesterol) level within three months, And hope to get it down to normal levels in three more months. You do want to make sure you get your regular physical exams and monitor your blood work whenever you change your nutritional lifestyle. I wish you the best!
We are brazilian, living in Brazil. My daughter, Isabel, 21y. o., born in 1996, has syndrome of deficiency of Glut1. She was diagnosed around her first year of life. At that time her baby bottle, her begining diet meal, was 50ml water plus 50ml oil plus vitamin. Since then, which means, for 20 years, she is under this diet. For almost 18 years under 4:1 proportion. At this right moment 3:1. The only problem she had since started the diet were kidney stones in 2002. Nothing else. Grateful to the diet she doesn’t take any kind of medicine to avoid seizures. Her health is perfect, no colesterol at all. We are at your will for any issues related to her health.
Hi Sylvie, thanks for the positive review! To answer your question about spaghetti squash – it could quite frankly go either way. It has about 7g total carbs per serving (1 cup) and 5.5 net carbs which could be considered a bit high for keto but still on the moderate/low range compared to all the other starchy veggies out there. I would just be mindful of this and consume in moderation 🙂
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]
The main limitations of our study are its small sample size, short duration, and lack of control group. That the main outcome, hemoglobin A1c, improved significantly despite the small sample size and short duration of follow-up speaks to the dramatic and consistent effect of the LCKD on glycemia. For other effects, however, such as the rises in serum LDL and HDL cholesterol, the small sample size might be the reason statistical significance was not reached. Future studies of larger samples and containing a control group are needed to better address questions about the effect of the LCKD on serum lipids in patients with type 2 diabetes.

Thanks for this inputs. 20 years ago I gain 17 pounds a year for 5 years. I was healthy but my dr told me start diet, any diet just come back in a month I want to see you start loosing… I started Atkins and lost 7 pound in a month. She was checking my progress every six months and checking my condition. I lost 64 pounds in 3 years. Now I started eating out of control. I am eating healthy but too much… I gain 40 pound back after 20 years. Now I will start again my Atkins to take off 30 pounds…

Taken together, these results demonstrate a positive effect of LCD/KD on body composition. While KD may not be superior to other dietary strategies aimed at weight reduction, the evidence does suggest that it may be equally effective. Nevertheless, the International Society of Sports Nutritionists, in their Position Stand on the effects of diets on body composition, suggest the KD holds little benefit over higher CHO diets, with one notable exception; KD may enhance appetite control (1).


10 pound weight loss , chicken broth works to relieve . But have to be careful of salt intake . I retain fluid, Dr gave script for dieuretic before I even started Keto . I have had the retention problem for a long time , when I took the dieuretic on a normal high carb diet ( I would drop 4 lbs ) but would make me really tired , afraid if I take it now on Keto I will pass out. Any idea what I should try other than the chicken broth
10. Crujeiras A.B., Morcillo S., Diaz-Lagares A., Sandoval J., Castellano-Castillo D., Torres E., Hervas D., Moran S., Esteller M., Macias-Gonzalez M., et al. Identification of an episignature of human colorectal cancer associated with obesity by genome-wide DNA methylation analysis. Int. J. Obes. (Lond.) 2018 doi: 10.1038/s41366-018-0065-6. [PubMed] [CrossRef] [Google Scholar]
Option 3: "Make your own keto 'lunchable' with cubes of grilled chicken, a slice of nitrate-free ham, cheese cubes, pickle slices, a hard-boiled egg, a few raw grape tomatoes, raw veggies like cauliflower or broccoli, a few almonds or walnuts, guacamole, and ranch dressing," says Stefanski. (Looking for something meat-free? Here are 29 Vegetarian Keto Recipes for Plant-Based Eaters.)
^ Jump up to: a b c d e f g h i j k l m n o p q r s Kossoff EH, Zupec-Kania BA, Amark PE, Ballaban-Gil KR, Bergqvist AG, Blackford R, et al. Optimal clinical management of children receiving the ketogenic diet: recommendations of the International Ketogenic Diet Study Group. Epilepsia. 2009 Feb;50(2):304–17. doi:10.1111/j.1528-1167.2008.01765.x. PMID 18823325
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)!
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.
The keto diet is made up of 75% fat, 20% protein, and 5% carbohydrates. This combination enables your body to enter a state of ketosis, where the body switches from burning carbs for fuel, to burning fat for fuel. Fat, protein, and carbohydrates are called macronutrients – “macros” for short. To achieve a keto macro breakdown of 75% fat, 20% protein, and 5% carbs, you first need to know that:

However, this diet is gaining considerable attention as a potential weight-loss strategy due to the low-carb diet craze, which started in the 1970s with the Atkins diet (a very low-carbohydrate, high-protein diet, which was a commercial success and popularized low-carb diets to a new level). Today, other low-carb diets including the Paleo, South Beach, and Dukan diets are all high in protein but moderate in fat. In contrast, the ketogenic diet is distinctive for its exceptionally high-fat content, typically 70% to 80%, though with only a moderate intake of protein.
Ariel Warren is a Registered Dietitian, Diabetes Educator, graduate from Brigham Young, and was diagnosed with Type 1 at the age of 4 years old. Ariel understands diabetes and enjoys working with clients to improve their blood sugar management, healthy eating, weight loss, fitness, and pregnancy. For coaching from a T1D Dietitian, you can contact Ariel directly, through her website: arielwarren.com.
"Obese. That's what the doc said. He said if I didn't change I'd be Morbidly Obese. So stopped eating big macs and started out by walking. But it wasn't really enough to undo the damage. Then I found on Shark Tank. So I found it online and ordered it. I figured, it was worth a shot. I'm glad I did. It jumpstarted my weight loss! I started shedding the weight. I'm down 60 pounds after just 9 months! Thank you - you really saved my life!"
The IWQOL-Lite, a shorter form of the original questionnaire, assesses the impact of weight on quality of life in individuals exploring treatments for weight loss. The IWQOL-Lite includes 31 statements that start with “Because of my weight…” with response options to each statement ranging from (1) “Never true” to (5) “Always true” that measure the impact of weight on 5 domains (i.e., physical function, self-esteem, sexual life, public distress, and work life). A score is calculated for each domain for each patient who answers at least 50% of the questions in any given domain. A total score is calculated if patients have responded to at least 26 out of the 31 questions. The total score is the sum of the raw scores of the 5 subscales. Raw scores (higher scores indicate poorer quality of life on the IWQOL-Lite) are converted into a T-score (0–100), with 100 representing the best possible health. Mean and standard deviations are reported for each domain [32].

The keto diet is made up of 75% fat, 20% protein, and 5% carbohydrates. This combination enables your body to enter a state of ketosis, where the body switches from burning carbs for fuel, to burning fat for fuel. Fat, protein, and carbohydrates are called macronutrients – “macros” for short. To achieve a keto macro breakdown of 75% fat, 20% protein, and 5% carbs, you first need to know that:
In conclusion, this study exhaustively assessed body composition changes during the weight reduction process induced by a VLCK diet. This assessment was performed using 3 complementary techniques: DXA, MF-BIA, and ADP. The VLCK diet induced a marked weight loss that was achieved mainly at the expense of total FM, and also visceral fat, with a maximum conservation of muscle mass and muscle strength. Additionally, MF-BIA was demonstrated to be an effective and convenient alternative for measuring body composition in clinical practice due to its minimal burden for the patient, ease of operation, low cost, and high accuracy.
Sharon M. Nickols-Richardson, PhD, RD, , Mary Dean Coleman, PhD, RD, Joanne J. Volpe, Kathy W. Hosig, PhD, MPH, RD, “Perceived Hunger Is Lower and Weight Loss Is Greater in Overweight Premenopausal Women Consuming a Low-Carbohydrate/High-Protein vs High-Carbohydrate/Low-Fat Diet,” The Journal of Pediatrics: Vol 105, Issue 9: 1433–1437; September 2005. http://www.sciencedirect.com/science/article/pii/S000282230501151X.
Protein can turn into carbohydrates via a metabolic process called gluconeogenesis (making new carbs) and will do in people at varying degrees. Protein turning into carbohydrates means you’re not in ketosis. However, this is generally an overblown statement that only happens at the extreme cases when you are drinking a lot of liquid protein shakes. 
Questionnaires were used to evaluate food craving as a trait, as a state, and to different nutrients. Statistically significant decreases were observed in the global score of trait and state when comparing all visits with baseline (Figure 2A). More specifically, the eight items of the FCQ-T (Table S1) decreased with statistical significances since the visit of maximum ketosis, except for the positive and negative reinforcement, which exhibited differences since the visit of reduced ketosis. Relevantly, a negative correlation was observed between B-OHB levels and the intention to eat (r = −0.46; p < 0.05) and feelings of hunger (r = −0.30; p < 0.05) during the phase of maximum ketosis. However, these effects on feelings of hunger were not evidenced at circulating levels of ghrelin, which showed no statistically significant changes during the intervention (data not shown).
A recent 2018 online survey of type 1 diabetics or their parents and caregivers has opened the door for others to use the ketogenic high-fat, low-carbohydrate, moderate protein diet to ease the burden of insulin injections and improve the day-to-day life of type 1 diabetics, potentially leading to remission. This was a breakthrough study, as the ketogenic diet has proven itself with diabetes type 2 sufferers, but there has been little looked into with keto for diabetes 1 patients. This study's focus was on serious carb production. Its title is Management of Type 1 Diabetes With a Very Low–Carbohydrate Diet, and it was published by Pediatrics, the "official journal" of the AAP (American Academy of Pediatrics). Dr. Lewis First, chief editor of Pediatrics, provided an article listing the top 10 items published by Pediatrics during 2018. This study was at the top of the list as the most popular article in Pediatrics for 2018.

During the 1920s and 1930s, when the only anticonvulsant drugs were the sedative bromides (discovered 1857) and phenobarbital (1912), the ketogenic diet was widely used and studied. This changed in 1938 when H. Houston Merritt, Jr. and Tracy Putnam discovered phenytoin (Dilantin), and the focus of research shifted to discovering new drugs. With the introduction of sodium valproate in the 1970s, drugs were available to neurologists that were effective across a broad range of epileptic syndromes and seizure types. The use of the ketogenic diet, by this time restricted to difficult cases such as Lennox–Gastaut syndrome, declined further.[10]
“I discuss nutrition with all my patients as I believe lifestyle choices have an important impact on both physical and mental health. I recommend a simple whole-foods, low-carbohydrate diet, intermittent fasting or both, to many of my patients. I use the Diet Doctor website myself as I enjoy the ad-free, simple, but very comprehensive approach to low-carb eating and I recommend it to my patients as well as to my colleagues, friends and family.”
We have solid evidence showing that a ketogenic diet reduces seizures in children, sometimes as effectively as medication. Because of these neuroprotective effects, questions have been raised about the possible benefits for other brain disorders such as Parkinson’s, Alzheimer’s, multiple sclerosis, sleep disorders, autism, and even brain cancer. However, there are no human studies to support recommending ketosis to treat these conditions.
The following measurements were made every other week: anthropometric and vital sign measurements; urine testing for ketones; and assessment for hypoglycemic episodes and other symptomatic side effects. Weight was measured on a standardized digital scale while the participant was wearing light clothes and shoes were removed. Skinfold thickness was measured at 4 sites – the average of 2 measurements at each site was entered into an equation to calculate percent body fat [12]. Waist circumference was measured at the midpoint between the inferior rib and the iliac crest using an inelastic tape; 2 measurements were averaged in the analysis. Blood pressure and heart rate were measured after the participant had been seated quietly without talking for 3 minutes. Certified laboratory technicians assessed urine ketones from a fresh specimen using the following semi-quantitative scale: none, trace (up to 0.9 mmol/L [5 mg/dL]), small (0.9–6.9 mmol/L [5–40 mg/dL]), moderate (6.9–13.8 mmol/L [40–80 mg/dL]), large80 (13.8–27.5 mmol/L [80–160 mg/dL]), large160 (>27.5 mmol/L [160 mg/dL]). Hypoglycemic episodes and symptomatic side effects were assessed by direct questioning of the participant and by self-administered questionnaires.
Early studies reported high success rates; in one study in 1925, 60% of patients became seizure-free, and another 35% of patients had a 50% reduction in seizure frequency. These studies generally examined a cohort of patients recently treated by the physician (a retrospective study) and selected patients who had successfully maintained the dietary restrictions. However, these studies are difficult to compare to modern trials. One reason is that these older trials suffered from selection bias, as they excluded patients who were unable to start or maintain the diet and thereby selected from patients who would generate better results. In an attempt to control for this bias, modern study design prefers a prospective cohort (the patients in the study are chosen before therapy begins) in which the results are presented for all patients regardless of whether they started or completed the treatment (known as intent-to-treat analysis).[19]
The keto diet is a high-fat and low-carb (HFLC) diet. I would actually describe it as extremely low-carb—you're allowed to eat just 20 grams in a day. Some people on keto follow a net-carb plan (you can subtract the grams of fiber from a food's total carbs) and you're allowed to eat more carbs in a day. For my 30-day diet and for the sake of simplicity, I stuck with total carbs.

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.
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]

“As a board certified physician practicing internal and obesity medicine, I reclaimed my health and lost over 150 pounds by ignoring conventional medical advice. I now focus on diabetes, hypertension and lipid management through lifestyle and dietary modifications whenever possible. As well as seeing patients in my clinic, I provide remote consultations via tele-medicine software and equipment, utilizing remotely-tracked bio-impedance scales, blood pressure cuffs and continuous glucose monitoring devices.”
The insulin theory of obesity, in short, declares that the primary cause of obesity is higher carbohydrate diets because these diets increase insulin secretion more than any other diet. When insulin levels are high, fat storage will increase significantly and “starve” muscles and organs of energy.   This causes increased hunger and overeating that results in obesity.
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