Ketones are more beneficial to the brain than glucose is.  This is great news for patients with Type 1 Diabetes, because it will not affect the brain function when you are running low in glucose. Ketosis prevent raising blood glucose levels, since you are not introducing large amounts of carbs into your system. They help in stimulating the growth of healthy brain cells.


This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.
If you want to use a ketogenic diet as a health tool, it would be wise to do so for no more than a few weeks at a time, as nobody knows how long is too long. And, of course, the period of time during which ketosis is safe can vary from individual to individual. Breaking ketosis is as easy as upping protein intake or having a glass of wine or whole piece of fruit.

“When you start the keto diet, you lose sodium and other electrolytes in the urine due to reductions in insulin,” says Yawitz. “This is a major contributor to symptoms of keto flu.” So it’s important to replenish sodium through the diet, especially if you exercise or sweat a lot. “This can help ward off more serious side effects that are seen with long-term sodium deficiencies,” says Yawitz. These include lethargy and confusion — and in extreme cases, seizures, coma, and death, according to the Mayo Clinic.

Eating in a restrictive way can be socially isolating, Brown says. "You may avoid parties and other gatherings because you may worry about what food will be available for you, or even what foods may tempt you. Having to plan and control what you are eating so closely may lead to increased anxiety and stress. And who doesn't want to enjoy a beer with a friend or a piece of cake on your birthday?" As you probably know, emotional well-being and physical health are closely linked, which is all the more reason to choose foods that make you feel good both mentally and physically. If keto does that for you, great! But if it doesn't, know you're not alone.
Two, exercise, perhaps our most reliable and potent booster of mitochondrial biogenesis in the brain, is downright nootropic. Exercise increases blood flow to the brain, which provides more oxygen and energy but also reduces free radical damage and enhances memory. It stimulates the creation of new neurons and the production of brain-derived neurotrophic factor (BDNF), a chemical that is instrumental in neuron preservation and formation. Exercise also promotes gene expression that supports plasticity, the brain’s crucial power to alter neural pathways.
Although studies have shown that the keto diet can reduce seizures for children with epilepsy, there is no evidence indicating that keto helps with other brain disorders or improves mental cognition, according to Harvard Health Publishing. Some studies show that keto may lower blood sugar for people with type 2 diabetes, but there is not enough long-term research to determine whether it’s safe and effective for diabetics.
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Let me introduce myself. My name is Mark Sisson. I’m 63 years young. I live and work in Malibu, California. In a past life I was a professional marathoner and triathlete. Now my life goal is to help 100 million people get healthy. I started this blog in 2006 to empower people to take full responsibility for their own health and enjoyment of life by investigating, discussing, and critically rethinking everything we’ve assumed to be true about health and wellness...
If you are pregnant or are nursing, you should not follow a Ketogenic diet. You will not receive enough of the recommended carbohydrates, vitamins and nutrients necessary for yourself and your growing baby on this diet. Your obstetrician will recommend how many carbohydrates you should consume per meal and for snacks during each phase of your pregnancy. They will likely refer you to a Certified Diabetes Educator for nutritional counseling as well. Please check out The Diabetes Council’s FAQ’ About Gestational Diabetes for all your gestational diabetes related questions.
ME: It is not essential. You can be fully ketogenic without any intermittent fasting. However, most people find it natural to do intermittent fasting as their hunger is reduced to where they don’t need a third meal. Keeping feeding time reduced to a smaller window during the day enables the body to use stored body fat for fuel longer, which benefits weight loss. My husband Craig and I still do intermittent fasting every day as maintenance. It just makes life easier only having to make two meals a day instead of three.
Doctors can measure levels of inflammation in the body using blood tests for high-sensitivity C-reactive proteins (hsCRP) and white blood cell (WBC) counts. In Dr. Phinney’s study, “patients experienced a hsCRP reduction of 39 percent, and white blood cells were reduced by 9 percent,” Dr. Phinney says. “Similar results were demonstrated in a two-year study, which showed a 29 percent decrease in hsCRP following a low-carbohydrate diet.” Inflammation, Dr. Phinney notes, is directly associated with many different health conditions, such as heart disease, diabetes, arthritis, and autoimmune conditions. “It is very possible that reducing inflammation through nutritional ketosis could improve a whole host of conditions,” he says. These 10 keto diet recipes are reason enough to give it a try.
It is completely wrong to discuss “average lifespan”. The average lifespans of pre-industrial peoples is heavily reduced by infant and early childhood mortality, which has nothing to do with lack of fresh fruit. Once you remove this bias in the numbers, pre-industrials can have lifespans almost as long as ours. And usually without many of the degenerative diseases that bother our middle and old ages.
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.
This diet also entails weight loss because it gets rid of excess water content in the body due to a lower amount of insulin produced. The food is broken down into simple sugars, with excess energy stored as complex sugars. The pancreas produces insulin that helps regulates sugar breakdown in the body. The body needs less sugar in switching to higher intake of fat. The liver can break down fatty acids to energy in ketogenic diets. Due to eating less carbohydrate or sugars, the production lowered. In a study, 90% of all type 2 diabetics were able to lower or completely eliminate their diabetic medication after 6 months of being on a low carbohydrate diet.
But all those studies were very small, and not all research on the keto diet is as promising. One American Society for Clinical Nutrition study of 20 participants found that those on the diet didn’t lose more weight than those on a non-keto diet. But they did have fouler moods and higher levels of inflammation, which has been linked to a variety of conditions, including heart disease and cancer.
What makes the the ketogenic diet unique among low-carb diets is that it’s characterized by a drastic reduction in carbohydrates (usually less than 30–50 grams per day, depending on individual goals) and also a significant increase in fats, as opposed to protein. The goal of the KD is to enter the metabolic state of ketosis, which happens after a few days of strict carbohydrate restriction.
For many people, one of the more surprising side effects of starting a ketogenic diet is a bout with the “keto flu.” How so? “When you go on this diet, your kidneys don’t retain as much salt or water, which can lead to flu-like symptoms, such as fatigue and headache, or constipation,” says Laura Saslow, PhD, an assistant professor at the University of Michigan School of Nursing. “But these are typically short-lived symptoms that can be prevented or treated by increasing your salt and water intake.” However, if you have high blood pressure, speak with your doctor before adding more sodium to your diet. And know that the keto flu only lasts a week or two; symptoms typically subside once the body adjusts to the diet.
The answer is yes! In the years that Dr. Cabeca has been using the keto diet to help treat women, especially those in perimenopause or menopause, she’s hardly ever seen the diet fail to produce benefits. Her clients and patients have experienced weight loss, improved blood sugar control, better quality sleep and reduced menopause symptoms like hot flashes or night sweats.

It should be noted that the concept that fat can be eaten ad libitum and still induce weight loss in obese subjects is not a recent one (13–33). Ketosis occurs as a result of the change in the body’s fuel from carbohydrate to fat. Incomplete oxidation of fatty acids by the liver results in the accumulation of ketone bodies in the body. A ketogenic diet maintains the body in a state of ketosis, which is characterized by an elevation of D-b-hydroxybutyrate and acetoacetate.


Cyrus Khambatta earned a PhD in Nutritional Biochemistry from UC Berkeley after being diagnosed with type 1 diabetes in his senior year of college at Stanford University in 2002. He is an internationally recognized nutrition and fitness coach for people living with type 1, type 1.5, prediabetes and type 2 diabetes, and has helped hundreds of people around the world achieve exceptional insulin sensitivity by adopting low-fat, plant-based whole foods nutrition.
The crazy thing is it is not hard, if it matters. Sure I can see it being hard for someone who does it to lose weight, then when they get closer to their ideal, they want to have treats, etc. Well, for a type one diabetic there’s no end in sight, this is it, and it’s a relatively complication free life (many people reverse their complications when they bring their A1C down to normal) vs. one with inevitable complications. So, perhaps it was too hard for you after a year (you didn’t say, but I assume you are not a type one diabetic), but that is a choice you can make. Not I.

When we eat this carby kind of food multiple times per day with little time in-between meals, insulin levels are consistently high throughout the day. Over the years, cells react to this constant overflow of glucose and fat by shutting down their insulin receptors. With fewer insulin receptors, cells become less sensitive to the action of insulin. For the same amount of glucose to be taken up, the pancreas has to produce more insulin.
Unfortunately, there’s no long-term data on ketogenic diets versus other diets. In a 2015 Italian study, those on a ketosis diet lost 26 pounds in three months. About half of the participants stayed on the diet for a year but lost little additional weight in the next nine months. People in a 2014 Spanish study who followed a very-low-calorie ketogenic diet lost an average of 44 pounds in a year—but a third of them dropped out, possibly because it was too hard to maintain.
Kidney stones are mineral deposits in the kidneys. They can be caused by multiple things–including dehydration, high sodium intake, family history, and excessively high consumption of protein (> 200g per day). A true ketogenic diet is low-carb, moderate-protein, and high-fat. So there’s no solid evidence that protein consumption at levels seen in a typical ketogenic diet could cause kidney stones.

Long-term disruption of menstruation can bring on serious side effects, including low bone density. “This is because estrogen is very important to bone health,” says Yawitz. “Studies have also found prolonged menstrual irregularity to increase risk for cardiovascular disease, depression, anxiety, and sexual dysfunction. It’s important to contact your ob-gyn if your cycles become irregular or if you stop having periods.”
The prospective study was carried out at the Academic Department of Surgery, Consultation and Training Centre, Faculty of Medicine, Kuwait University (Jabriya, Kuwait) in 83 obese subjects (39 men and 44 women). The body mass index (BMI) of men and women was 35.9±1.2 kg/m2 and 39.4±1.0 kg/m2, respectively. The mean age was 42.6±1.7 years and 40.6±1.6 years for men and women, respectively. The mean age, initial height, weight and BMI for all patients are given in Table 1. Fasting blood tests were carried out for all of the subjects. Initially, all patients were subjected to liver and renal function tests, and glucose and lipid profiles, using fasting blood samples, and a complete blood count. Thereafter, fasting blood samples were tested for total cholesterol, high density lipoprotein (HDL) cholesterol, low density lipoprotein (LDL) cholesterol, triglycerides, blood sugar, urea and creatinine levels at the eighth, 16th and 24th week. In addition, weight and height measurements, and blood pressure were monitored at each visit.
Diet Doctor has a number of videos and posts about positive impacts of the ketogenic diet for migraines, brain cancer, and traumatic brain injury. Recently, two psychiatrists reviewed the research base for psychiatric issues and noted that while promising, it is slim. Dr. Ede takes a more hopeful view. “My mantra is that the most powerful way to change your brain chemistry is by food, because that’s where brain chemicals come from in the first place,” she says.
The ketogenic diet has recently been investigated a great deal for how it may help prevent or even treat certain cancers. One study found that the ketogenic diet may be a suitable complementary treatment to chemotherapy and radiation in people with cancer. This is due to the fact that it would cause more oxidative stress in cancer cells than in normal cells.
"Many of the richest sources of fiber, like beans, fruit, and whole grains are restricted on the ketogenic diet," registered dietician Edwina Clark told Everyday Health. "As a result, ketogenic eaters miss out on the benefits of fiber-rich diet such as regular laxation and microbiome support. The microbiome has been implicated in everything from immune function to mental health."

There are different types of ketogenic diets that you may choose from depending on your specific needs. Dr. Mercola usually recommends the standard ketogenic diet (SKD) for most people. It’s highly effective and involves allotting around 70 percent of your diet to healthy fats, 25 percent to high-quality protein and only 5 percent to carbohydrates.
Keto decreases inflammation and improves brain function — so much so that Alzheimer’s patients who switch to a keto diet actually begin to recover their brain function, which up until now was unheard of.[20][21][22][23][24] So there’s that. (Dale Bredesen and Mark Hyman have discussed these on the Bulletproof Radio podcast. Check out Dale’s episode here, and Mark’s here.)  
Thanks for posting this Edward. While I agree that the thought of a lifetime without any sweets or any grains sounds miserable, it’s even more miserable every time I see a number above 120 on my meter, which is guaranteed to happen every time I eat even a few bites of one of those foods. Yeah, it’s stressful (and cortisol is just as much of a pain as T2D), but I want a better life and a life off of drugs. I was on three orals and two shots of insulin daily.
Slightly increase carbs. If you wait a few more weeks and still have trouble with the ketone smell, you might consider eating slightly more carbs to reduce the ketosis. Try increasing to between 50 and 70 grams per day. You might also try combining this with intermittent fasting, such as only eating within an 8-hour window, to maintain the benefits of ketosis without the side effect of fruity breath.
Here’s another controversial yet promising area of study: Research suggests that when patients with diabetes take on a low-carb diet (like keto), they experience improvements in insulin sensitivity by up to 75 percent, as well as a reduction in blood sugar control medications. What we aren’t sure of, however, is whether these improvements are due specifically to the effects of ketosis or to weight loss in general, so similar results could theoretically be found with any successful diet.
It is important to understand that the statement that carbohydrates are “nonessential” is not only factually inaccurate, it results in adopting a low-carbohydrate diet or ketogenic diet that increases your risk for a wide variety of chronic health conditions that may ultimately shorten lifespan, decrease your quality of life, and accelerate your risk for chronic disease.
If you decide to follow the diet, you’ll want to have an individualized meal plan, stresses Dr. Gonzalez-Campos. “The best possible clinical outcome is for each individual to meet her nutritional needs from well-balanced meals,” he says. “Ideally, we should all have the benefit of medical nutrition therapy and we should all avoid extremes in nutrient restrictions.” 
Metabolic Syndrome Limited research, including a study published in November 2017 in the journal Diabetes & Metabolic Syndrome: Clinical Research & Reviews, has suggested that adults with metabolic disease following keto shed more weight and body fat compared with those on a standard American diet, which is heavy in processed food and added sugars. (6)
Protein: A typical recommended keto protein intake is between one and 1.5 grams per kilogram of your ideal body weight. To convert pounds to kilograms, divide your ideal weight by 2.2. It’s important to note that Kidney Disease: Improving Global Outcomes (KDIGO) recommends that adults with diabetes limit their protein intake to less than one gram per kilogram of body weight each day and that adults with chronic kidney disease avoid protein intake greater than 1.3 grams per kilogram per day.

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Thanks Dr. Jockey…very informative article. Im into pure keto diet almost a week now but started illiminating sugar and carbs 3weeks ago and the side effects that i’ve encountered are frequently urinating and light headache only. Is it good or not? I’ve never consult a specialist before doing keto diet but i do my research, is it okay? As of now i’ve loose almost 11lbs. Im just curious how can i get the percentage of fats, protein etc in my meals? Do i need to measure it all? How can i measure the percentage of foods that i need to eat?is there any ways?
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Thank you for this comment. It is truth! I keep telling people about this diet. It is literally the best diet I have ever been on. I can eat good food, I feel full, my weight is dropping, I feel better and I can actually feel the difference. While it is great for a professional to be skeptical of emerging diet trends (and lets face it, most diet trends are garbage peddled by snake oil salesmen), this one actually has science from some prestigious institutions behind it, not a marketing scheme.
There are many physiological reasons for eating enough carbohydrates throughout the waking hours to maintain a steady blood glucose level…a couple of important reasons are to minimize the hepatic release of glucose (from the liver) and to help prevent hypoglycemia which can be very dangerous and lead to hypoglycemic unawareness over a short period of time. Each person is different of course..if you aren’t taking insulin, or pills that lower your blood glucose levels, you may not have to worry about low blood sugars. The reality is, most people with diabetes do; it can be very dangerous for some to not get enough carbohydrates at each meal.
Most people already know about the keto flu, which can happen when you start the diet. It’s a result of the body adapting to the low-carb state. Lowering carb intake forces the body to burn ketones for energy instead of glucose. Once the body is in ketosis — burning fat instead of glucose — the keto diet is working. But you may not feel so great at first, hence the term keto flu.
Still, research on the relationship between the keto diet and mental clarity, as well as anxiety and depression, is still in its early stages, and not all people who try the keto diet report noticeable changes in the ways they think. In fact, some people report an increase in brain fog after switching to the keto diet, though this might be explained by the "keto flu", which describes the flu-like symptoms people tend to experience in the first few weeks after beginning the keto diet.
Ketogenic diet for diabetics is a highly controversial topic, but we will break down everything here for you! As a Certified Diabetes Educator (CDE), I have to tell you from the start I will have a biased view here. Sorry, but I feel that I need to be completely honest right up front! I will however, present all the evidence that is available currently on the subject.
Dirty keto diet: “Dirty” is the apt term, as these version of keto follows the same strict percentages (75/20/5 of fat/protein/carbs) but rather than focusing on healthy versions of fat like coconut oil and wild salmon, you’re free to eat naughty but still keto friendly foods like bacon, sausage, pork rinds, diet sodas and even keto fast food. I do NOT recommend this.
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.
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The side effects of extreme low-carb diets are still a mystery. "The first major drawback is the fact that we really don't have any long-term research about how keto followers fare 10, 20, 30 years down the line," Turoff says. "What will the results look like? Will they regain the weight? Will they suffer health consequences? We also thought smoking and diet pills were a good idea, until long-term studies showed us that we were wrong."

Although this may repel people away, it also provides you with a clear sign that you are on your way to reaping all the benefits of keto and ketosis. As your body continues to produce ketones, it will become more efficient at creating and using the energy-shuttling ketone bodies, beta-hydroxybutyrate and acetoacetate, which will help reduce acetone levels and normalize your breath. In the meantime, while your body is adapting to ketosis, make sure you have breath-freshening gum or spray that you can use throughout the day to cover up keto breath (if you have it).
Also, as I believe is mentioned, this diet has been around for along time and was the only way to treat diabetes. And some people did die. However, people still end up dead from t2d even after all the diet advice from educators and with all that pharmacy has to offer. An industry which gains nothing if people just choose to eat less. But has lots to gain if we just keep taking the tablets.
Another possible nutrient deficiency: potassium, a mineral important for both electrolyte balance and blood pressure control, notes MedlinePlus. “Inadequate intake of potassium is likely when consumption of fruits and starchy vegetables are decreased,” says Asche. She recommends adding lower-carb sources of potassium to the diet, including avocado and spinach — as well as lower-carb sources of fiber, such as chia seeds and flaxseed (be sure to enjoy ground for the best health benefits).
Use Fat Wisely Rather Than Excessively. While the keto diet means your food choices are geared to a low carb/high fat intake, it does not mean adding fat to everything you eat. You do not need to fall for one of the most trendy keto tricks— adding a pat of butter to your coffee. This might be useful at the very beginning as you transition away from a high carb diet but should not be continued once you are past the initial shift once your body has adapted to this new eating rhythm.  Instead, listen to your body for cues. If you are feeling hungry right after a meal, you probably didn’t have enough protein or fat. When followed correctly, a keto-based meal will leave you feeling full and satiated for hours.
Lazy keto diet: Last but not least, the Lazy keto diet often gets confused with dirty keto … but they’re different, as the “lazy” refers to simply not carefully tracking the fat and protein macros (or calories, for that matter). Meanwhile, the one aspect that remains strict? Not eating over 20 net carb grams per day. Some people find this version less intimidating to start with or end with … but I will caution that your results will be less impressive.
However, this diet isn’t for everyone. If traditional bread, pasta, rice, potatoes and/or fruit are what you live for, then you might just be miserable on keto. However, if you’re open to exploring different tastes, then the good news is there are substitutes for many of these foods. Cauliflower pizza crust, rice, and even gnocchi; zoodles (noodles made from zucchini); almond flour bread and almond milk are all readily available from most stores now.  A small amount of berries is acceptable, but for the most part say goodbye to apples, melons, plums and peaches. Booze and sugar are also out, but if you’re living with diabetes, you likely already know how to manage these desires.

While a ketogenic diet helps normalize blood sugar (glucose) levels and can help you maintain or reach a healthy weight, an alkaline diet is beneficial for its anti-aging effects— especially lowering inflammation, boosting detoxification, and promoting hormonal balance, immunity and more. Traditional ketogenic diets usually miss the important factor of restoring alkalinity. For many patients the key is to reach an alkaline pH first before beginning keto in order to prevent feeling agitated, anxious, uncomfortable or overly hungry.


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Dr. Campos, it is so discouraging to see that you disparage the ketogenic diet based on your assumption that it is very heavy in poor quality processed meats. No diet that relies on processed foods can be viewed as “healthy”. Become better informed by getting up to speed with what Jeff Volek, RD, PhD, calls a “well-formulated ketogenic diet.” Also, learn more about the potential of the diet to slow cancer progression (my specialty). You owe it to your patients who are depending on you for advice. Present them with facts, not opinions.
Researchers who set out to review the current state of research as it relates to the ketogenic diet published their results in the highly respected European Journal of Clinical Nutrition. Their comprehensive evaluation showed that the ketogenic diet held promise in a vast array of medical conditions and is promising results in other conditions, such as:

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.
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