The bottom line? If you’re thinking about trying the ketogenic diet, run it by your doctor first — regardless of any preexisting health conditions. And consult a registered dietitian nutritionist (find one at EatRight.org) to find a nutrition professional who can work with you to create a meal plan you can stick to. People with kidney disease or a history of disordered eating should avoid the diet, and people with type 1 diabetes may want to avoid it, as well. If you have risk factors for heart disease, you’ll want to speak with your doctor before considering the diet.
Difficulty. Many experts question how long a person can realistically give up carbs. “This is a very restrictive diet that requires a drastic change in eating behaviors and even taste,” says Sandra Arevalo, MPH, RDN, CDE, a certified diabetes educator and spokesperson for the Academy of Nutrition and Dietetics. “It isn’t very practical or easy to maintain, for people both with and without diabetes.” That’s not saying you can’t stick with it, but before you commit, make a plan and set measurable goals to help you stay on track. Being prepared with the right foods can also help. Urbanski recommends making a shopping list that focuses on a few basic keto-friendly meals and snacks, so you’ll always have the right foods on hand to ensure success.
First – let’s admit that there are several different types of diets that produce dramatic improvements in weight loss and diabetes. The vegan diet is one of them (and one which also reduces risk in most other diseases better than the others) – but it is by unquestionably by far the very best diet for the environment and the survival of the planet. High protein (high meat and/or dairy) diets are absolutely TERRIBLE for the environment and are not sustainable in any way. A vegetable diet will END world hunger because we DO have enough earth to grow enough vegetables for everyone and we definitely do NOT have enough earth for meat eaters even at current levels.

Vegan ketogenic diet or vegetarian diet: Yes, both are possible. Instead of animal products, plenty of low-carb, nutrient-dense vegan and/or vegetarian foods are included. Nuts, seeds, low-carb fruits and veggies, leafy greens, healthy fats and fermented foods are all excellent choices on a plant-based keto diet. There’s also a similar plan called ketotarian, which combines keto with vegetarian, vegan and/or pescatarian diets for supposedly greater health benefits.
There is exciting research on the role of a keto diet as a form of treatment for cancer. In one study, the use of a keto diet on patients with advanced cancer was deemed safe, and some evidence suggested it played a role in stabilizing the disease or resulting partial remission. In another study, the keto diet was used as a form of therapy for patients with malignant brain cancer. The study found that the keto diet may carry anti-tumor effects when administered in experimental animal and human brain tumors. The researchers believe this may be due to the reduction in calories, which reduces the circulating glucose needed for tumor growth. It is still unsure whether a keto diet per se plays a role in this or simply calorie restriction. All of this is to say that the research is preliminary, however still promising.

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.


The ketogenic diet is a high-fat, low-carbohydrate, and moderate-protein diet that has been proved to be an effective treatment among patients with epileptic conditions such as glucose transporter 1 deficiency, pyruvate dehydrogenase deficiency, tuberous sclerosis complex, Rett syndrome, Dravet syndrome, and specific mitochondrial disorders (1, 2).
The aim is far broader than suggested by the article here: It’s not just about what you put in your mouth – it’s also about timing and exercise. There are three ways to be in ketosis – which simply means that “fat burning” and not being dependent on sugars. Fasting puts a man into ketosis in 3 days and a woman by 2 days. Endurance exercise gets you there in a couple of hours. Eating a high fat diet will do it too. The goal however is hidden by the detail – it is to acquire a “Flexible Metabolism”. The aim is to switch on the full fat burning capacity and keep it running – which takes from between 4 to 12 weeks physical adaptation (for the muscles to fully be able to use ketones). The heart runs approximately 27% more efficiently on ketones than on glucose! The brain works better too – Alzheimer’s being referred to by researchers as “diabetes 3”. Once you have a Flexible Metabolism you can consume carbs during or after exercise without dropping out of ketosis – though this depends on your own bio-individuality. I can eat quite a lot of carbs – without losing ketosis – my partner cannot.
Atherosclerosis starts with the weakening of arterial wall, to the point that it tears (this tear usually happens due to scurvy caused by high sugar consumption and the subsequent vitamin C deficiency). Once the integrity of the arterial wall is compromised cholesterol is used by human body to heal and patch the tear. That starts the process of numerous circulatory diseases including hypertension, atherosclerosis and heart disease.
A total of 316 individuals from the TypeOneGrit community were included in the study since they met the three eligibility criteria: having type 1 diabetes, taking insulin, and following the Bernstein low carb diet for at least three months.2 The clinical data were gathered using an online survey and confirmed with data obtained from medical charts and feedback from the patients' doctors; parents provided data for the participating child. The participants came from the United States, Canada, Australia, and Europe, of which 57i% were female, 42% were children (under 18 years), and 88% were Caucasian. 2
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!
Reduce daily net carb intake to less than 20 grams: Although it’s possible that you may not need to be this strict, eating fewer than 20 grams of net carbs every day virtually guarantees that you’ll achieve nutritional ketosis. What does 20 grams of carb look like? Use our visual guide to find out, or simply try our keto recipes and meal plans that limit carbs to less than 20 grams per day.
Changes in blood lipid levels. By changing the carb and fat content of your diet, your cholesterol levels will change. The current research indicates that cholesterol levels should improve while you are on the keto diet. However, the increased fat consumption can also send cholesterol into unhealthy ranges for some people, especially those who are already struggling with familial hypercholesterolemia.
To get into and stay in ketosis, you must restrict carbs and sugar – less than 50 grams per day. This initiates your body to burn the remaining carbohydrates present, after which it moves on to stored glucose (glycogen), and finally it taps into ketones. Ketones are produced by the liver and readily used by the body for potent energy production and critical brain-related functions.
One of the keto researches commented, (I think it was Steve Phinney) that change will come about only because enough of the the public will be become educated about this and will demand that the ADA change their recommendations because those recommendations are just wrong. What is the proof they are wrong? If you eat 45-60 g of carb daily, you will continue to have diabetes, and the epidemic will continue as it has for the last 25 years.
What happens is that fats get stored in your body if you do not have enough physical activity every day to break them up. As they get stored, they show in the form of belly fat. As a result of that, you appear obese. To make the body slim, you have to use up the daily fat as soon as you ingest it. Otherwise, it accumulates in the body and makes you obese.
The main electrolytes affected by this process are sodium, potassium and magnesium. There are other electrolytes in your bloodstream, such as calcium and phosphorus, but their levels don’t change much on a keto diet. However, getting sodium, magnesium, and potassium in balance can help prevent against symptoms of keto flu and fix some of the side effects you may have long term. Read on to find out more about them.

Carbs are still the primary fuel for the body during high-intensity exercise. A ketogenic diet may be better suited to athletes performing endurance sports (like marathon running or cycling). Athletes engaged in more intense cardio (like sprinting, hockey, football) may perform better with a higher percentage of carbohydrates. These athletes may experience a decrease in high-intensity output while following a ketogenic diet, but ultimately, a lowered carbohydrate intake as isn’t “dangerous” for athletes.

In addition, as the Harvard School of Public Health points out, “Carbohydrate metabolism plays a huge role in the development of type 2 diabetes, which occurs when the body can’t make enough insulin or can’t properly use the insulin it makes.” When a food containing carbohydrates is eaten, the digestive system has to process these carbs and turns them into sugar which then goes into the bloodstream. The ketogenic diet majorly minimizes carbohydrate intake so prediabetics, as well as type 1 and type 2 diabetics, aren’t challenging their bodies with carbohydrate breakdown that can raise blood sugar levels and create problematic insulin demands for the body.


My point here is that the warnings about the ketogenic principles are well taken and well documented. My concern is implications that this is a fad. I don’t use the word diet with my patients and I’m concerned that the principles behind the label and the real results that these readers have commented on might get minimized. I have found it best to encourage patients to read authors like: Stephen Phinney, Jeff Volek, Patricia Daly, and Charles Gant and the be partners with their doctors and check blood work as they move along. I am not for or against the article. If ketogenic principles offer people enduring, satisfying, and cohesive change then why not read about its potential and flexilbity?
I’ve lost 30 pounds in 2 months, I feel better than I ever have, energy levels are up, my skin issues have cleared up, and I am training to run a 5k with my 14 year old. This is the only diet I’ve tried that has been easy to stick to. For me I could never do a diet if I didn’t like the food. Not a chance I could go vegan. Anyone reading this I strongly suggest you do your own research. No offense to the writer but nobody should only look to one opinion as the be all and end all on any topic. Mark Sisson is an amazing resource, has been eating keto for a long time and *gasp* is a marathon runner. On Netflix check out The Magic Pill for some eye opening stuff. Just do as much research as you can before either jumping in or dismissing it. There are some amazing and delicious foods that are keto-friendly, you just gotta put in the time to find them. Keto is not just a diet, it’s a lifestyle that includes proper exercise (to avoid loss of muscle mass among many other health benefits), stress management and proper sleep. Be informed.
If you’re wondering why iron is at risk on a meat-based diet, hear me out. Many grain foods provide a considerable amount of iron, because wholegrains naturally contain iron in their inner layer called the ‘germ’. Another reason is that some grain products can have iron added to them during manufacturing. So, once you cut grains out, your iron status could suffer, which can lead to unpleasant symptoms like tiredness and lethargy. It can even compromise your immune system.
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