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 🙂

Metabolic flexibility: The ketogenic diet is not metabolically flexible. On the diet, your body adapts to using fats for fuel, which, in turn, means it is no longer adapted to using carbs efficiently. People have the tendency to follow the diet strictly for a few months, get the results they want, and then switch right back to a carb-happy diet.  If you introduce a lot of carbs when your body isn’t adjusted to handling them, you may gain back all of the fat you lost, if not more. It's often the case that many people gain fat after reintroducing carbs because their calories inadvertently go up or they get nutrient timing wrong. When transitioning out of keto, re-introduce carbs carefully to ensure your suffering wasn’t all for nought.
Transformation Tuesday::: I wore shorts once last year, i felt good because they were a size 16 I think, down from a size 20. My size 2 shorts in the after picture are now too big. About a year between these pictures and at least 100lbs. I was working out, but @coach_jmo had just had the food conversation with me. It was vacation time and I was sad about not being beach ready in a little over 3 months. 😂 I was still making bad choices to help me cope with my weight gain from Postpartum depression and anxiety. I was still eating horribly, with cheat weekends and lots of pizza. 😂 I still thought exercising was enough to help me reach my goals. Working out 7 days a week with my trainer and a Ketogenic diet have changed my life. Down from a size 18/20 to a Size 0/2, over 130 pounds, and over 115 inches. 🎉🙌🎊
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.
You know you’re in ketosis by checking blood ketones with a hand-held ketone meter (a test for beta-hydroxybutyrate). A ketone meter can be purchased online for about $100-120, along with ketone test strips. You prick your finger and use a drop or two of blood to measure ketones. Aim for 0.5-3.0 mm. I use Precision Xtra, which can check for both ketones and glucose in the blood (useful if you’re overweight). Some people measure ketones in the urine or via a breath taste, but I’ve found them to be not as accurate.
Basically, carbohydrates are the primary source of energy production in body tissues. When the body is deprived of carbohydrates due to reducing intake to less than 50g per day, insulin secretion is significantly reduced and the body enters a catabolic state. Glycogen stores deplete, forcing the body to go through certain metabolic changes. Two metabolic processes come into action when there is low carbohydrate availability in body tissues: gluconeogenesis and ketogenesis.[4][5]

Most carbs you consume are broken down into sugar that enters the bloodstream. When you rein in carbohydrates on the keto diet, you have lower levels of blood glucose (high blood glucose can lead to diabetes). A study in the journal Nutrition reveals that a ketogenic diet improves blood glucose levels in type 2 diabetics more significantly than a low-calorie diet and can also decrease the dosage of your diabetes meds.
You're using it for a particular, short-term period.The meal substitute diet can function so quick and so well that you might decide to keep on following it for a longer while. You've acquired the flavor and habit of consuming the yummy meal substitute products that you think you'll stick to the program for a vague period. However, you need to understand that enduring high-calorie deficit in your system may not be good on an extended basis. Take advantage of the diet only as a boost to significant weight reduction or to be a procedure for a huge occasion arriving soon or under strict doctors monitoring.

Look, the good doctor is right – he only forgot to stress “portion control” which is why many fanatical dieters are so kee-jerk reactive to any discussion – odds are you over ate like a hog before your keto diet, and are weak and insecure in your diet plans. Eat EVERYTHING in small amounts, and you will live long and prosper. The only thing to avoid are processed foods. Cook your meals from scratch using quality ingredients.


Diego Gomez-Arbelaez, Diego Bellido, Ana I. Castro, Lucia Ordoñez-Mayan, Jose Carreira, Cristobal Galban, Miguel A. Martinez-Olmos, Ana B. Crujeiras, Ignacio Sajoux, Felipe F. Casanueva, Body Composition Changes After Very-Low-Calorie Ketogenic Diet in Obesity Evaluated by 3 Standardized Methods, The Journal of Clinical Endocrinology & Metabolism, Volume 102, Issue 2, 1 February 2017, Pages 488–498, https://doi.org/10.1210/jc.2016-2385

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.
Is there a possible middle ? Where I can still lose weight, eat low carb but without having to be paranoid about electrolytes  and feeling like I'm possessed by the spirit of keto doom ? Can I up my carbs to say 50 - I don't need rice, bread and stuff I do great with just veg and protein ... but Im supposed to feel great in keto ... though I really love the benefits I hate how it makes me feel 🤔  Would love your feedback !
Most carbs you consume are broken down into sugar that enters the bloodstream. When you rein in carbohydrates on the keto diet, you have lower levels of blood glucose (high blood glucose can lead to diabetes). A study in the journal Nutrition reveals that a ketogenic diet improves blood glucose levels in type 2 diabetics more significantly than a low-calorie diet and can also decrease the dosage of your diabetes meds.

Keto runs counter to many of the low-fat diet fads of the 1980s and 1990s: It actually emphasizes fat. “That is hard to comprehend because we don’t eat anything that’s pure fat, says Kristen Mancinelli, RD, author of The Ketogenic Diet. “We don’t eat a stick of butter or a spoonful of olive oil or even a nice cup of lard. That would be unpleasant, so we really have a hard time wrapping our heads around this concept of the ketogenic diet.”


Christopher D. Gardner, PhD; Alexandre Kiazand, MD; Sofiya Alhassan, PhD; Soowon Kim, PhD; Randall S. Stafford, MD, PhD; Raymond R. Balise, PhD; Helena C. Kraemer, PhD; Abby C. King, PhD, “Comparison of the Atkins, Zone, Ornish, and LEARN Diets for Change in Weight and Related Risk Factors Among Overweight Premenopausal Women,” JAMA. 2007;297(9):969-977. http://jama.jamanetwork.com/art icle.aspx?articleid=205916.


May help slow tumor growth for certain types of cancer: Early research shows that a calorically-restricted ketogenic diet is an effective alternative therapy for malignant brain cancer (13). Since high levels of circulating glucose in the blood are needed for tumor growth, the glucose-reducing effects of the keto diet help to slow tumor growth (14).
To find out whether you have achieved ketosis, you can test your blood or urine for the presence of ketone bodies. Depending on your diet, your activity level, and your body type, it can take a couple of days to a couple of weeks to reach ketosis. Testing for ketosis is a personal preference. For some, it’s an added inconvenience; for others, it provides added incentive to stay on track.
“I recommend LCHF nutrition to all my patients to shift their metabolism to a more beneficial state. This nutrition is often enough to reverse diseases like obesity, diabetes and fatty liver disease, improving the health and quality of life of my patients. In my experience, other medical interventions also become much more efficacious. I recommend the Diet Doctor website, due to its panel of experts, to all my patients to make their transition easier.”
There is a lot of information out there on the ketogenic diet, and sometimes that abundance of information can be confusing!  Do you need to count macros? What are macros anyway?!?  How many carbs can I eat on the Keto Diet?  What is keto flu?  How do you get enough electrolytes in your Keto Diet to avoid cramps and other keto flu symptoms?  How much water should you drink?  Is diet soda ok on keto?  What foods are keto approved?  Will I gain the weight back after keto?  Is the Keto Diet safe?
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).
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.

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.”
The classic ketogenic, or “keto,” diet calls for consuming a low amount of carbs, a high amount of fat, and a moderate amount of protein. But in the current study, participants induced ketosis by getting the majority of their calories from protein, a small amount from fat, and a low amount from carbs. One of the side effects of very low-calorie diets is loss of lean muscle mass, but on the adjusted keto diet in the study, participants preserved lean muscle mass. Researchers attributed the preservation of lean muscle mass to participants’ sustained RMR, and their results support those of a prior study, published in February 2017 in the Journal of Clinical Endocrinology and Metabolism.
If you want to successfully lose weight with a Ketogenic weight loss program…successful meaning you lose weight and learn how to keep it off…then a Keto Diet is NOT another do-it-yourself, magazine of the month yo-yo diet trend. Ketogenic Diets are based on the science of weight loss and how human physiology responds to sugar, carbohydrates, insulin and fat storage.
Thank you, Dr. Jockers. I really appreciate your reply. I was wondering if insulin resistance would make my cholesterol go up on the ketogenic diet from a total of 220 before I went on it to 378 after being on it for six months. I have always been in a healthy weight range for my height, but I have always been extremely hungry most of the time. I really got on the ketogenic diet hoping that this would be regulated after being on it for some time, but it hasn’t helped that much. Would this signify that insulin resistance may be the culprit for my sudden rise in cholesterol even though I am following the ketogenic diet perfectly?
It’s also currently as trendy to the fitness world as kale and açaí are to the pseudo-hipsters who wear beanies, even in the dead-heat of summer. If you haven’t tried keto on for size, maybe give it a go (unless you’re a complete and utter carb bitch, and cramming yourself full of bagels and pancakes just makes your abs really pop - in which case, the rest of us hate you on the inside. Just a little.)
H. Guldbrand, B. Dizdar, B. Bunjaku, T. Lindström, M. Bachrach-Lindström, M. Fredrikson, C. J. Östgren, F. H. Nystrom, “In Type 2 Diabetes, Randomisation to Advice to Follow a Low-carbohydrate Diet Transiently Improves Glycaemic Control Compared with Advice to Follow a Low-fat Diet Producing a Similar Weight Loss,” Diabetologia (2012) 55: 2118. http://link.springer.com/article/10.1007/s00125-012-2567-4.
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.
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.
The ketogenic diet, or even just a higher-fat, low-carb diet, has now gained massive support as a modern-day healing strategy. In fact, our ideas about fats and cholesterol seem to have been almost completely reversed in recent years. That being said, many people see their cholesterol go up after beginning more of a ketogenic lifestyle. Some people get concerned when this happens, so in this article, I am going to address the phenomena of high cholesterol on a ketogenic diet.

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.
A ketogenic diet helps control blood sugar levels. It is excellent for managing type 2 diabetes, sometimes even leading to complete reversal of the disease. This has been proven in studies. It makes perfect sense since keto lowers blood-sugar levels, reduces the need of medications and reduces the potentially negative impact of high insulin levels.

What about fruits and vegetables? All fruits are rich in carbs, but you can have certain fruits (usually berries) in small portions. Vegetables (also rich in carbs) are restricted to leafy greens (such as kale, Swiss chard, spinach), cauliflower, broccoli, Brussels sprouts, asparagus, bell peppers, onions, garlic, mushrooms, cucumber, celery, and summer squashes. A cup of chopped broccoli has about six carbs.


Once your body adapts to using fat for fuel (can take anywhere from a couple of weeks to over a month) you'll find your apetite changes and it's very easy to eat very low calorie - you won't feel hungry as often and you'll have an easier time recognizing when you should stop eating. A lot of people on keto naturally fall in to some sort of intermittent fasting (eating only 1, 4, 6 or 8 hours of the day and fasting the rest) because they just aren't hungry.
The Johns Hopkins Hospital protocol for initiating the ketogenic diet has been widely adopted.[43] It involves a consultation with the patient and their caregivers and, later, a short hospital admission.[19] Because of the risk of complications during ketogenic diet initiation, most centres begin the diet under close medical supervision in the hospital.[9]
The ketogenic diet is usually initiated in combination with the patient's existing anticonvulsant regimen, though patients may be weaned off anticonvulsants if the diet is successful. Some evidence of synergistic benefits is seen when the diet is combined with the vagus nerve stimulator or with the drug zonisamide, and that the diet may be less successful in children receiving phenobarbital.[18]
Diet is the most important lifestyle factor for weight loss. In order to effect significant loss of weight it is necessary to create a consistent caloric deficit. This has the rather obvious side effect of leaving individuals feeling hungry and as though they are in a constant state of deprivation. Dieting is based upon this basic concept, which is the most likely reason why dieting is very likely to fail in the long-term. The ketogenic diet, while controversial and a highly polarizing subject, has demonstrated promise as an alternative dietary strategy for weight management. The KD may hold an advantage over traditional calorie-restricted diets, in that nutritional ketosis may enhance appetite control, and subsequently improve dietary adherence and long-term success. Nevertheless, the KD should be approached with caution, as there are both short- and long-term potential negative side effects. More research into this unique dietary strategy is warranted to fully investigate all potentially positive and negative aspects.
I’ve been on WFPB diet for 8 months because of high chloresterol and it didn’t drop any, but my husband did the diet with me and his went way down. I have decided to try low carb diet for the next 3 months and do labs to see if it helps. Then I might try keto after that, but between doing WFPB and low carb, I like WFPB best! My doctor said my chloresterol might be “genes”! Loved reading about different diets! I may just need pills or have high chloresterol! Nancy
The purpose of this study was to evaluate the effects of a low-carbohydrate, ketogenic diet (LCKD) in overweight and obese patients with type 2 diabetes over 16 weeks. Specifically, we wanted to learn the diet's effects on glycemia and diabetes medication use in outpatients who prepared (or bought) their own meals. In a previous article, we reported the results observed in 7 individuals [10]; this report includes data from those 7 individuals along with data from additional participants enrolled subsequently.
The ketogenic diet is usually initiated in combination with the patient's existing anticonvulsant regimen, though patients may be weaned off anticonvulsants if the diet is successful. Some evidence of synergistic benefits is seen when the diet is combined with the vagus nerve stimulator or with the drug zonisamide, and that the diet may be less successful in children receiving phenobarbital.[18]
In order to transition and remain in this state, aiming for about 30–50 net grams is typically the recommended amount of total carbs to start with. This is considered a more moderate or flexible approach but can be less overwhelming to begin with. Once you’re more accustomed to “eating keto,” you can choose to lower carbs even more if you’d like (perhaps only from time to time), down to about 20 grams of net carbs daily. This is considered the standard, “strict” amount that many keto dieters aim to adhere to for best results, but remember that everyone is a bit different.
Weight loss is the primary reason my patients use the ketogenic diet. Previous research shows good evidence of a faster weight loss when patients go on a ketogenic or very low carbohydrate diet compared to participants on a more traditional low-fat diet, or even a Mediterranean diet. However, that difference in weight loss seems to disappear over time.

Ketones are generally an efficient source of fuel for your human body. They're created the fatty acids in your liver; a consequence of the breakdown of fatty tissue. These only appear when there's a lack of glucose and sugar. Inside Atkins diet plan, you reduce the amount of glucose and sugar that may be from the bloodstream. Hence, your system produces ketones for fuel. When your system is creating ketones it is known as ketosis.


But what does the science say? Results are mixed. In one Spanish study of 20 obese adults, participants were put on a low-calorie keto diet and lost an average of 40 pounds over four months. Another small experiment had a similar outcome. In a six-month Experimental & Clinical Cardiology study of 83 obese adults, those on the keto diet lost an average of 33 pounds, while lowering their bad (LDL) cholesterol levels and increasing their good (HDL) cholesterol.
MCT oil powder is a unique form of dietary fat rapidly absorbed by the body and has a wide range of health benefits. Supplementation with MCT powder can help combat fatigue, suppress appetite[*], enhance thermogenesis (aka ‘fat burning’)[*] and help your body adapt to using ketones for fuel. A recent scientific review showed that MCTs can effectively decrease body weight, total body fat, hip circumference, waist circumference, total subcutaneous fat and visceral fat[*]. Check out this articlefor more information on how to supplement with MCTs.
Check the nutrition labels on all your products to see if they’re high in carbs. There are hidden carbs in the unlikeliest of places (like ketchup and canned soups). Try to avoid buying products with dozens of incomprehensible ingredients. Less is usually healthier.Always check the serving sizes against the carb counts. Manufacturers can sometimes recommend inconceivably small serving sizes to seemingly reduce calorie and carb numbers.
A keto diet works for almost anyone since you can be vegan or vegetarian and still achieve ketogenesis. As a rule of thumb, focus on foods that are naturally high in fat and avoid highly processed foods that are labeled with trans-fats as much as possible. Eat fruits that are low on the glycemic index but are still rich in fiber and, eat other foods like avocados (also for the fat) and berries. Additionally, eat lots of green, yellow and red vegetables.
As you will see, simple keto meals begins with the healthy fat consideration first, making sure plenty of low-starch veggies surround the fat along with a moderate protein source. Wild-caught salmon, as a high-fat fish, is a perfect keto choice, and easy keto meals can be a fatty cut of healthy protein like salmon or lamb served with plenty of green veggies.
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!!!!
×