She adds that the research supports the safety and effectiveness of following a keto diet even in older adults with obesity as it seems to help improve body composition and improve metabolic health.6 “We saw significant reduction in body fat while lean mass was preserved and significant improvements in insulin sensitivity and the lipid profile in response to a ketogenic diet when compared to a standard ‘balanced’ diet,” Dr. Goss explains.
Iwould hope to meet a diabetic nurse in the uk who was open minded about keto, but that has not been my experience as a patient. As a nurse speaking to colleagues as an equal and frmy experience has been very different. I have not spoken to one nurse with personal/professional interest in this subject that has said if they were diabetic they would follow the guidance of our health service. All have said they would do keto.
What is the keto diet? Rather than relying on counting calories, limiting portion sizes, resorting to extreme exercise or requiring lots of willpower, this low-carb diet takes an entirely different approach to weight loss and health improvements. It works because it changes the very “fuel source” that the body uses to stay energized: namely, from burning glucose (or sugar) to dietary fat, courtesy of keto diet recipes and the keto diet food list items, including high-fat, low-carb foods.

But when you consume a high-carbohydrate diet, your brain often can't convert enough glutamate into GABA because it's using glutamate as an energy source. This imbalance can lead to neurotoxicity, and this impaired functioning could potentially lead to brain fog. For reasons not completely understood, ketosis seems to favor an increased production of GABA, which can lead to reductions in neurotoxicity and, therefore, brain fog.
The comments defending the keto diet suggest that the individuals are successfully using the keto diet to help them maintain a healthy weight and a healthier A1C level. The individuals also suggest that they view it as a way of life rather than a diet. This is good news for many of us who are facing the question of whether it will be helpful and necessary to reduce carbohydrate intake to keto producing levels in order to halt or reverse the onset of type II diabetes. I think like those individuals, Tami is speaking from her own personal experience where she had success losing weight, but had difficulty maintaining the keto diet long-term. I am sure that though you have been successful, you can understand that there are many who might find it difficult to maintain. I too have been given very bad guidance by Medical Doctors who lean on old Med School information to practice medicine rather than continuing to broaden their knowledge base and learn more about nutrition. I cannot get back the 20+ years of suffering with a debilitating disease that could have been cured because my doctors were not well informed or willing to listen to information that disagreed with their limited knowledge base. Those years are gone and the destruction to my body is not reversible. So I understand the anger you feel toward a system that isn’t working in the best interest of the patient. But I think that expressing anger toward those who disagree with our personal experience, is not solving the problem. Hopefully we can change the ADA guidelines by respectfully urging them to reconsider their position based on the sheer volume of the comments they receive from successful people like you, who are living the keto diet lifestyle and living better. I commend you for becoming your own best health advocates. Thanks for your encouragement and your passion. And thanks to Tami as well for sharing her personal experience and the information she had collected. We all have to be true to what we believe and we all have a right to come to our own conclusions. It is good to know that there are success stories out there. I wish you all good health and continued success. I also hope that one day medical training will do a much better job of preparing doctors to become their patient’s best advocates, actively learning and searching for cures rather than treating symptoms in ways that cause even more disease to develop. The system is failing so many of us.
Ketosis is different, because, when in the state of ketosis, the brain will prefer ketones over glucose. For the dieter this is good! The body will not have to break down protein for energy. In turn the body will be forced to use its fat reserves, a.k.a. your love handles, for its energy. This is why a low-carb diet is such a good method of dieting.
Well… what are many people on a Keto diet trying to do? Lose weight right?  I would guess that prior to discovering the Keto diet many of these people were caught in the trap of low fat dieting.  This lead to months or years of low fat intake and consequentially low gallbladder activity.  The gallbladder wasn’t needed to digest fat and so it sat idle and stones were more likely to form.  Once they made the shift to a ketogenic lifestyle and their fat consumption increased upwards of 1000%, the gallbladder kicked into high gear.  If the previous period of low fat dieting had caused stone formation they are going to have to deal with flushing those stones out now while on a high fat Keto diet.
In the first week, many people report headaches, mental fogginess, dizziness, and aggravation. Most of the time, this is the result of your electrolytes being flushed out, as ketosis has a diuretic effect. Make sure you drink plenty of water and keep your sodium intake up.6One of the fathers of keto, Dr. Phinney, shows that electrolyte levels (especially sodium) can become unbalanced with low carb intake.

The keto diet — eat all the fat you want, minus the carbs — seems like a miracle diet for those who are looking to lose weight fast while still enjoying their favorite foods. For obese individuals, it may be the golden ticket. Repeated studies have shown that following a keto diet can significantly reduce body weight, triglycerides, LDL cholesterol and blood glucose levels.

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.
In the last 15 years, about two dozen studies have been conducted on low-carb diets and all of the studies came out with one conclusion – the Ketogenic diet works! It is a much healthier and more effective option for weight loss compared with any high-carb calorie restricted diet. This article explores the numerous health benefits of ketogenic diet in addition to weight loss.
What is diabetic ketoacidosis? When a diabetic (usually a Type I diabetic, but sometimes this occurs in very late-stage, insulin-dependent, Type II diabetics) fails to receive enough insulin, they go into an effective state of starvation.  While they may have all the glucose in the world in their bloodstream, without insulin, they can’t get any into their cells.  Hence, they are effectively going into starvation.  The body does what it would do in anyone – it starts to make ketones out of fat and proteins.  Here’s the problem: the diabetic patient in this case can’t produce any insulin, so there is no feedback loop and they continue to produce more and more ketones without stopping.  By the time ketone levels (specifically, beta-hydroxybutyrate) approach 15 to 25 mM, the resulting pH imbalance leads to profound metabolic derangement and the patient is critically ill.
One problem with the keto diet, however, is that to date, research studies aimed at investigating its efficacy and safety have involved only men or animals (mainly mice). Some have been skeptical then that the keto diet can work equally well for women. Others question whether it’s necessarily a good idea for women to even try keto given the fact that women’s hormones tend to be more sensitive to most dietary and lifestyle changes.
Twenty-one of the 28 participants who were enrolled completed the study. Twenty participants were men; 13 were White, 8 were African-American. The mean [± SD] age was 56.0 ± 7.9 years and BMI was 42.2 ± 5.8 kg/m2. Hemoglobin A1c decreased by 16% from 7.5 ± 1.4% to 6.3 ± 1.0% (p < 0.001) from baseline to week 16. Diabetes medications were discontinued in 7 participants, reduced in 10 participants, and unchanged in 4 participants. The mean body weight decreased by 6.6% from 131.4 ± 18.3 kg to 122.7 ± 18.9 kg (p < 0.001). In linear regression analyses, weight change at 16 weeks did not predict change in hemoglobin A1c. Fasting serum triglyceride decreased 42% from 2.69 ± 2.87 mmol/L to 1.57 ± 1.38 mmol/L (p = 0.001) while other serum lipid measurements did not change significantly.
There’s many suggested interventions for these short-term keto side effects on the internet, but know that there are potential pitfalls of these dietary supplements. While there are benefits for some specific cases, many of us will experience nausea, vomiting, diarrhea, and constipation as a result. Plus, unless they’re prescribed to you by a physician, dietary supplements come with their own safety gamble.
While many of the problems that develop with prolonged ketosis may be addressed simply by minding intake of prebiotic fibers, not all are, such as selenium deficiency and stunted growth. (Note that the ideal intake of prebiotic fibers, the level we aim for in Wheat Belly and Undoctored programs, is 20 or more grams per day.) Some have argued that higher beta-hydroxybutyrate ketone levels that develop with a ketogenic diet is all you need to do to maintain healthy bowel flora, but this is a huge extrapolation that does not make sense in light of the newest insights into the microbiome and its metabolites. It ignores the role of hundreds of other microbial metabolites that are required and/or produced that are changed with prolonged deprivation of prebiotic fibers. Also, some have blamed the adverse long-term effects in kids on the seizure medications they take, but the side-effects of, say, drugs such as tegretol, valproic acid, or topiramate do not include the above phenomena.
Although the ketogenic diet has been a source of controversy and debate, one cannot dispute its astounding health benefits. Initially, it was created by specialists at John Hopkins Medical Center, particularly for individuals who have epilepsy. The researchers established that fasting enhanced the number of seizures the patients experienced. Nonetheless, since fasting isn’t an accomplishable purpose nowadays, a diet has been developed that would trick the body into believing it was in that process.
Is the keto diet safe for diabetics? Most research shows that yes, it is. However, even though the KD can help reduce insulin resistance while someone adheres to the diet’s principles and strictly limits their carb intake, these positive effects may be short-lasting. Results from some animal studies show that insulin resistence/glucose intolerance may potentially be increased once carbs are reintroduced back into the diet.
In order for this process of fat breakdown to ‘work’, the protein content must be kept low enough to prevent gluconeogenesis. So, just because you are eating a low carbohydrate diet, does not mean you are in ketosis. It is important to note here, that this nutritional ketosis is different from ketoacidosis, which is the setting of low blood pH level that occurs in people with diabetes and can be very dangerous.

Great article! Sustainability is key and Keto diet is extremely restrictive compared to others. Many of the comments I see don’t understand the importance of many years of research before stating something has a “significant difference” than the recommendations that are already in place. Also, understanding the pro/carb/fat balance in each meal instead of focusing on just carbohydrates. We have practiced the same modified Mediterranean diet at my practice where someone can enjoy life, eat complex carbohydrates and years later they are still successful and hundreds of pounds have been lost for good 🙂 Thank you for the reminder (and the comparison of Adkins supported research).
Reynolds, AN. "Comment on 'An Online Intervention Comparing a Very Low-Carbohydrate Ketogenic Diet and Lifestyle Recommendations Versus a Plate Method Diet in Overweight Individuals with Type 2 Diabetes: A Randomized Controlled Trial." Journal of Medical Internet Research. 2018; 20(5):e180, May 2018. Available at: http://www.jmir.org/2018/5/e180/  Accessed May 4, 2018.
I must note here, that as a nutrition professional who has worked in pediatrics and seen children who must follow this diet, it is incredibly challenging for both the child and family. Most people who must follow this diet for therapeutic medical reasons have trouble actually reaching ketosis with diet alone, and need to drink poor-tasting formula drinks to keep their carb-to-fat ratio in tight control. Many of these individuals must follow this way of eating to survive or have any sort of quality of life.
In the mid-1990s, Hollywood producer Jim Abrahams, whose son's severe epilepsy was effectively controlled by the diet, created the Charlie Foundation to promote it. Publicity included an appearance on NBC's Dateline programme and ...First Do No Harm (1997), a made-for-television film starring Meryl Streep. The foundation sponsored a multicentre research study, the results of which—announced in 1996—marked the beginning of renewed scientific interest in the diet.[1]
"Your brain runs on glucose (a simple form of carbohydrates)," notes Adrien Paczosa, R.D., L.D., a registered dietitian and eating disorder specialist. "When you cut out carbs, your body has to 'make' carbs from breaking down other parts of the body. This results in what I like to call a hungry brain. You experience slower cognition, memory loss, headaches, and confusion." That doesn't sound so great, right? "Also, those who suffer from depression and anxiety may have higher levels of those periods when not eating carbs on a regular basis." Because of this, keto might not be the best choice for those with mental health issues.
Several comprehensive studies and meta-analyses have demonstrated that after a few months or even a year of a low carb diet versus a moderate/high carb diet, there are no significant differences in the amount of weight lost (2,3,4,5).  I will say, however, most of these diets are NOT keto and are simply lower carb (i.e. 20%).  Also, long-term effects (beyond 1 year) are not often studied due to budgetary constraints, so interpret results as you wish.

In fact, the diet first gained popularity in the 1920s when it was discovered to have benefits for children suffering from extreme epilepsy. Now, researchers are conducting studies to determine whether it could have benefits for any number of disorders, including the treatment of ALS, Alzheimer’s disease, brain tumors, traumatic brain injury, diabetes, weight loss, polycystic ovary syndrome, glaucoma, Parkinson’s disease, narcolepsy, and some cancers.
As long as insulin is present, fatty acids are stored away, preferentially in adipose tissues. Insulin also suppresses lipolysis, the release of free fatty acids from stored fat. Insulin resistance is the opposite of insulin sensitivity; insulin-sensitive means that cells respond well to a little insulin and insulin resistant means that they need more insulin to respond appropriately.
We recently published an article documenting the grim long-term effects of low-carbohydrate diets, in which we explain the evidence-based research showing that low-carbohydrate diets high in fat and protein including meat, dairy products, eggs, fish, and oil actually worsen diabetes health, increase cancer risk, increase cholesterol, increase atherosclerosis, harden blood vessels, and increase all-cause mortality.
I have multiple autoimmune diseases. I fought 4 doctors, all of whom told me that adults can’t get type 1. I finally went to the Jefferson Diabetes Center. Yup! Type 1 diabetes. I’m slender, do marathons, bp 100/60, triglyceride/HDL ratio 1.08. And I STILL fought 4 doctors because of the ADA misinformation. All it takes is a simple blood test to look at antibodies. That’s all it takes, but the test is almost never run.
Early humans probably were on an LCHF diet. But when did humans become the “intelligent” species that they are? Can that be related to invention of agriculture? When humans began settling down on river banks to grow their crop, be it rice or wheat or maize, may be the rich alluvium, elevated mineral contents and higher glucose levels associated with grains might have given them increased brain activity leading to their cultural and intellectual development. My only worry is, this”new found” ketogenic diet shouldn’t push us back to stone age, though on a positive note, that might save our planet from anthropogenic destruction!
Josh Axe, a doctor of natural medicine and clinical nutritionist, estimates that about 25% of people who try a ketogenic diet experience these symptoms, with fatigue being the most common. “That happens because your body runs out of sugar to burn for energy, and it has to start using fat,” he says. “That transition alone is enough to make your body feel tired for a few days.”

To avoid the overload of stress, I find my relief by being the person at the origin of my son’s quality of life. I am not a doctor, a pharmacist, or a research person. I am just Max’s mother. For almost 15 years I have been using food to treat the adverse side effects of his syndrome. Angelman Syndrome (AS) is one of many neurological disorders that can be treated with therapeutic diets.

The Ketogenic Diet is a low carbohydrate diet, consisting initially of less than 20 carbohydrates per day. Not per meal, yes, you heard me correctly, per day. It is not for the faint of heart and yes I am writing from experience. Of course I have tried it! Hasn’t everybody in America at some point who has wanted to lose weight? Does it work you ask? Of course it does! The problem is how long can you keep it up?
Everyone has emerging cancer cells, but the cells can only develop into full-blown cancers if the body fails to kill off them off. DNA damage, inflammation, poor cellular cleanup, high blood sugar, and inability of the immune system to kill emerging cancer cells together lead to cancers. Proponents claim that ketogenic diets may help prevent cancers by addressing all of these aspects.
Thank you for posting Julie Martin. Abbey, have you ever been forced to loose a significant amount of weight? It is unfair to minimize the challenges that come along with consistent weight loss over a long period of time. Please provide information about any diet that has high success statistics when it comes to significant weight loss. Julie I plan to join your Facebook group and would absolutely love to have someone with your positive outlook to support my weight loss challenges.

Researchers are divided over whether the keto diet is good for people who don’t need to follow it for medical reasons. Since it doesn’t differentiate between saturated and unsaturated fats, dieters are at risk of raising their cholesterol levels. And because the heavily restrictive diet cuts out most fruits and vegetables, it can also lead to nutrient deficiency. The Harvard Health Letter warned that with so much fat and protein to metabolize, keto practitioners may experience liver and kidney problems as well.  
Increases in cholesterol levels need discussion too. We do see temporary increases in cholesterol levels often as individuals transition onto a ketogenic diet. However, when you examine lipid particle size (a more important way to look at the cardiovascular risks), the risk pattern doesn’t seem to increase with a ketogenic diet. Harvard Health has written about lipid particle size here before: http://www.health.harvard.edu/womens-health/should-you-seek-advanced-cholesterol-testing-
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