Using the Bulletproof Diet, including Brain Octane Oil every day for long periods of time, and eating carbohydrates some of the time but not always, avoiding inflammatory foods, and using Bulletproof Intermittent Fasting, I was able to recently test with perfect insulin sensitivity — I scored a one on a scale of 1 to 120 (see my numbers below). I also had above average glucose tolerance. That’s metabolic flexibility by the numbers!
The upsides: While the precise mechanisms are unclear, ketosis is thought to have brain-protecting benefits: As many as half of young people with epilepsy had fewer seizures after following the diet. And some early research suggests it may have benefits for blood sugar control among people with diabetes. An upcoming study will look at the ketogenic diet as a weight maintenance strategy.
I have been on a low carb keto diet for more than a year. As T2DM my A1C dropped from 9% to 5.4% & I discontinued meds. All my lipids improved even with ample healthy saturated fat. More than a year now so I wonder why this would be a short term improvement when its obvious that I will not go back to a high A1C and taking 3 diabetes medications including sulphonylureas. It is clear from this article that you lack the necessary experience that would be gained from wholeheartedly trying the diet or monitoring patients doing it properly like me. I would be probably be facing my first amputation if I believed the negativity in your article. So for people with diabetes who may be dissuaded by your article. Ignore it and take back your health by restricting carbs (<25 g a day) or as low as you reasonably can below 130g while being satisfied that you are getting adequate nutrition.

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 Doctor’s recommend Keto to their patients that less drugs and no kick back from pharmaceutical companies, they need to keep people medicated because pharmaceuticals run this entire country. I followed a strict diabetic diet when my husband was diagnosed with Type 2 NEVER could keep his blood sugars under control still would be 220 after a meal.. Keto has brought that down to 95-98 AFTER a meal.
Keto has become synonymous with low carb, but as you have just read, reaching ketosis is much more complex than just eating fewer carbs. Healthy, young active people are taking up ‘the keto diet’ recreationally without any clinical reason in an attempt to lose weight, drop body fat, get a six-pack, or just to follow a trend their friends have taken up.
Ketosis: What is ketosis? Ketosis is a metabolic process, and it involves the body burning stored fat instead of glucose. Some people try to induce this with a low-carb diet, which can be healthy. However, ketosis also produces acid, and high levels of this can cause severe complications, especially for people with diabetes. Learn more here. Read now

Ketoacidosis most commonly arises with people with diabetes. Diabetic ketoacidosis occurs in response to a severe lack of proper insulin activity whereas alcoholic ketoacidosis is a harmful metabolic condition arising when someone consumes alcohol but no food, explains Michael J. Gonzalez-Campoy, MD, PhD, medical director and CEO of the Minnesota Center for Obesity, Metabolism, and Endocrinology, in Eagan, Minnesota. Either way, this is a dangerous situation.
Additionally, people with gallbladder disease, pancreatic insufficiency, a history of kidney stones, or a history of anorexia should talk with their doctor regarding the safety of a ketogenic diet program. Last, women who are pregnant or breastfeeding require higher protein intake and should adjust the ketogenic diet plan to meet this macronutrient need.
The diet is called "keto" in reference to the ketogenic state your body enters when it gets essentially no carbs — its default form of fuel for energy — and instead, uses fat as its source of energy. If you think about it, that's a pretty dramatic shift for your body to make. So it shouldn't come as a surprise that aside from hastened weight loss, keto can bring with it some significant complications.
I can’t tell you how often through the years I have been asked the question, “If I lose 20 pounds, will I no longer have diabetes?” Let me answer this very clearly, there is currently no cure for diabetes. Once you have been diagnosed, you have it for life. Every day, our most brilliant researchers are busy searching for a cure though. There is good news however; you can manage your diabetes, get it under control, prevent all the complications of diabetes and live a normal, healthy life.
Known primarily as a weight-loss diet, a ketogenic approach will allow your body to use higher-quality food sources for energy, and store less fat. When it comes to carbohydrates, any excess calories will be stored as fat for future use. This will only result in weight gain, and lower energy levels, particularly after the initial sugar rush of energy from simple carbohydrates. More protein in the body will also kickstart the metabolism, which will increase fat-burning potential, particularly if you are eating high-quality fats as a part of the ketogenic 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.
I must tell you when looking at this link they say the American Diabetes Association Guidelines call for 60-75 carbohydrates per meal and that is simply not true. The ADA has recommended since 2013 we use our best clinical judgement in recommending a low carbohydrate diet for people with diabetes, recognizing it needs to be individualized. 60-75 grams is the carbohydrate amount I would give to a very tall, large boned man or perhaps an active teen or young adult. I would never recommend that many carbohydrates for an average size man who was trying to lose weight; he would get 45-60 grams of carbohydrates per meal and 15-30 grams for snacks. A women trying to lose weight would get 30-45 grams of carbohydrates per meal and 15 grams for snacks.
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.
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.
Chronic exercise patterns: Fat-based metabolisms are great for long, slow movement, quick bursts of speed with rest in between, and feats of explosive strength. In other words, making your way through the world, doing some strength training, going for hikes, playing with kids, running some sprints, and are all tenable on keto. Heavy CrossFit training or anything else that burns a lot of glycogen at a lot of workouts each week, however, might pose issues. Resolve this by either scaling back the training or eating some carbs before, during, or after your workouts.
If you are on medication, Dr. Ede recommends you work closely with your psychiatrist or mental health care provider. “Ketogenic diets cause profound shifts in brain and body chemistry rather quickly. These changes are almost always positive and healthy, but they can have a major impact on medication levels, dosages and side effects that require close medical supervision,” she says.

In a study of 51 obese people using an extremely low fat low calorie diet (just one gram of fat a day!) the gallbladder was examined by ultrasound before the diet and after one and two months. After one month four of the 51 participants had developed new gallstones. After two months more than one in four (13 people) had new gallstones! This on an almost fat free diet. Three participants needed to have their gallbladder removed during the study.


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.
I am with you! I have been a WW member and been years without going outside of my suggested guidelines. I would lose weight, plateau, go on one of their plateau breaking diets for two weeks then have to go off and slowly gained weight again. I was teaching my body to live on less. I have been down as low as 800 kcal a day and not losing. Eat more fiber so you feel full was what I was told. Try eating 800 kcal, high fiber and see how balanced your diet is. I am eating between 1800 – 2000 kcal now and dropping 10 – 15 lbs a month on Keto. Long term diuretic user, I no longer have water retention. I am salting and using fat and I am off my blood pressure medicine. I am not hungry so I am wondering why is this not sustainable? I eat mostly carbs from vegetables, I eat a variety of meats, I eat a variety of vegetables, I feel great and my blood tests are better than they have been in 2 decades. I am starting to feel that the carb revolution is because we are told by the government what is good to eat. We all know that vegetables are good to eat but the government subsidizes corn, wheat and soy, not spinach, kale and cucumbers. Do your research, follow your hearts, do what works for you.

With fats being my main source of calories, my body and energy levels have never been better. When I educated myself on it and understood the science behind it, it was clear to see why my joints started feeling better, and ailments started to go away. I now have more “oil” lubricating my cells so they’re more receptive/flexible/malleable to the nutrients in my foods. People can loose weight very fast, but honestly the first 10lbs or so is a lot of water weight so that’s really nothing to write home about.

Achieving ketosis by engaging in a very low-carbohydrate, high-fat lifestyle is—without a doubt—an effective means of losing weight, breaking insulin and leptin resistance, reversing type 2 diabetes and fatty liver, reducing blood pressure, reversing the inflammation of visceral fat, and may even cause partial or total remission of selected cancers. It means taking advantage of a natural physiological response to accelerate benefits.

So yes, the ketogenic diet is safe for diabetics. However, they still need to be closely monitored because diabetes medications including insulin, blood pressure, and beta blockers will have to be adjusted down when following a ketogenic diet. Therefore, the diabetic should do this with supervision from a doctor who is up to date with the nutritional literature.


After 32 weeks, those in the keto diet group lowered their HbA1c more than those in the plate group with more than 50% achieving a reduction to less than 6.5%, basically reversing their diabetes. None in the plate group did this well. As for weight loss, those in the keto low-carb group lost on average of 28 pounds, while those in the plate group lost an average of 6.6 pounds.1

Diets require discipline, and it is not always easy for people to follow them without indulging in a "cheat day." One day may not make a big difference in the long-term, but a recent study from the University of British Columbia in Okanagan, Canada (UBCO), found that when it comes to the keto diet, a single dose of carbohydrates may have dangerous side effects.
The possible benefits of the diet are impressive, but there are a few potential downsides to note. One is it’s tough to stick to. In fact, in a review of 11 studies involving adults on the keto diet, which was published in January 2015 in the Journal of Clinical Neurology, researchers calculated a 45 percent compliance rate among participants following the approach with the aim of controlling epilepsy. (13) “The diet is pretty hard to follow because it’s a complete shift from what you’re used to,” Nisevich Bede says. Slashing your intake of carbs can also make you feel hungrier than usual — a feeling that can last until you’re three weeks in.

I can’t tell you how often through the years I have been asked the question, “If I lose 20 pounds, will I no longer have diabetes?” Let me answer this very clearly, there is currently no cure for diabetes. Once you have been diagnosed, you have it for life. Every day, our most brilliant researchers are busy searching for a cure though. There is good news however; you can manage your diabetes, get it under control, prevent all the complications of diabetes and live a normal, healthy life.
The most important thing that diabetics have to learn is that there is no reason to avoid fat, not even saturated fat. It is not saturated fat that causes arteriosclerosis and heart disease, but an excess of refined carbohydrates like sugar and flour. Seed oils are implicated in the disease although by other mechanisms that involve damaged lipids and mitochondrial toxins.
What the doctors never tell you is that you could also just eat completely different and take none of this crap. So that’s what I did. I stopped all of them all at once. Sure I don’t recommend that, but this damn disease and my disgusting visceral fat filled stomach ruined every aspect of my life-professional, relationships, sexual, mental. I am now 41 living back at home having to start from the bottom. I don’t want what the book recommends. I want every disgusting piece of fat off this body so I can excel again. If staying in ketosis every moment for the rest of my life will get me there then that’s what I’m going to do.
The keto diet is a low-carb, high-fat dietary regimen which has been linked to improvements in insulin sensitivity and higher rates of weight loss — both positive factors in managing type 2 diabetes. Lowering carb intake induces a metabolic state known as ketosis, through which the body produces ketones which burn fat — rather than carbohydrates — for energy.
Financial disclosures: There were no conflicts of interest reported except for Dr Bernstein who has received royalties for books on the management of diabetes (which were used by members of the online social media group surveyed in this study). Dr. Hallberg who holds stock options and receives research support from Virta Health, and consulting fees from Atkins. Dr. Rhodes is the site principal investigator in clinical trials for pediatric type 2 diabetes that are sponsored by Merck and AstraZeneca. Dr. Westman has an ownership interest in companies using low-carbohydrate principles, and he receives royalties for books related to low-carbohydrate diets. Dr. Ludwig has received royalties from books on nutrition and obesity; and Dr. Galati is author of Eating Yourself Sick: How to stop obesity, fatty liver, and diabetes from killing you and your family (2018).
According to Dr. Cabeca, “Fasting is a key aspect of a healthy diet and has many anti-aging effects.” In particular Dr. Cabeca recommends fasting to women during or after menopause due to it’s anti-aging effects. For example, a 2016 study published in the Journal of the American Medical Association found that when women went 12.5 hours between dinner and breakfast (a common form of fasting), the overnight fast seemed to help improve immune system functioning to the point that it reduced their risk for breast cancer. (03) 
A great long-term benefit of the ketogenic diet is reduced cravings for sugar and other unhealthy foods. However, you might initially have stronger cravings for carbs during the transition period. This can last anywhere from one to two days to around three weeks. But stick it out! At the end, you’ll be pleased with the reduced, and often eliminated, cravings.
“If not done right, this diet can cause havoc on our bodies,” says Mancella. “As a society, we’ve turned to a culture of restriction and extremes in order to obtain unrealistic beauty and aesthetic standards without considering the long-term consequences. This diet doesn’t only affect metabolism, but also every other component of our bodies. By introducing potential vitamin and mineral deficiencies, we’re possibly trading the present moment for quality ones in the future.”
Across the globe, diets high in vegetables and fruit are linked to reducing long-term chronic disease risk, including diabetes, heart disease, and lifestyle-related cancers. Data suggests that the more produce we eat, the better off we are. On keto, however, you have to restrict how many net carbs (and therefore, veggies) you’re consuming per day, minimizing their beneficial effects.
Lele says that it’s important to remember that, while keto is a “high fat” diet, the goal is to use your body fat as an energy source, not the fat that’s on your plate. “You don’t need to necessarily add more fats to your diet to adhere to keto. For instance, if your dinner consists of avocado, bacon, and eggs, you really don’t need to add butter to that to make it ‘more keto’,” she says.
A growing body of research is finding that behind many psychiatric and neurological issues — such as bipolar disorder, epilepsy, migraine — are malfunctions in the work of sodium, potassium and calcium ion channels in brain neurons, which pass the electric charge between nerve cells. As noted above, two thirds of the brain’s energy is used to help nerve cells “fire,” or send signals between cells. Another nerve cell signaling chemical (neurotransmitter), called GABA (Gamma-aminobutyric acid) has also been found to be disordered in bipolar, epilepsy and schizophrenia. A 2017 genetic study also found common genetic and biochemical pathways between bipolar disorder and epilepsy that create “excessive circuit sensitivity” in the neurons of both conditions.
In this study, researchers compared the impact of a low-carbohydrate diet and three other diets on blood pressure and other measures of cardiovascular fitness in women. After the 12 month trial, all subjects who successfully completed their respective diet experienced notable reductions in body mass, triglycerides, and LDL cholesterol. Those in the low-carbohydrate diet group, however, had the best results.
The Service offers health, fitness and nutritional information and is designed for educational purposes only. You should not rely on this information as a substitute for, nor does it replace professional medical advice, diagnosis, or treatment. If you have any concerns or questions about your health, you should always consult with a physician or other health-care professional.

Thankfully, a few keto variations have been developed that are a little more flexible, and easier to stick with long-term. The traditional or standard ketogenic diet puts your body into ketosis: In this metabolic state, you burn fat (rather than carbs) as your primary fuel source, and that promotes fat loss. On a modified keto diet, your body will go in an out of ketosis, but still shed weight and body fat. Check out the guide below to see how each of the four keto diet types work. 
There are various ways to practice intermittent fasting on keto, including some that are less likely to trigger side effects like fatigue or cravings. Crescendo fasting gives you a break from fasting throughout your week, but is still very helpful for achieving the benefits of IMF. Dr. Cabeca and other experts, such as Amy Shah, M.D., advise their patients to check their urinary ketone levels (using ketone strips) and to aim for testing positively for ketones about three days per week.

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.


It’s a habit to enjoy a brie cheese for desert instead of a piece of chocolate cake but each are favored deserts in France. I’m personally more satisfied after a 350 calorie sized wedge of brie than the same number of calories of cake.. which will give me sugar crash and .. really I’d like two slices of cake(I’ve got a sweet tooth that once I get going it wants to keep being fed)
Many CDEs actually have diabetes…it’s what draws them to choose this career…to help others with diabetes, to share their knowledge. Most already wear an insulin pump and continuous glucose sensors (CGMs) also. When I first became certified on each new pump and CGM, I would wear them (and check my BG 4-6 times per day) for 2-3 weeks, not only to learn the technology really well, but to gain a sense of how my patients must feel having to wear them 24 hours per day. Since, I’ve started a 6 month old baby on a insulin pump and CGM all the way up to a 89 year old…there are no boundaries for people with diabetes!

As both study groups acknowledge, additional research is needed to tease out any and all of the factors that may be producing the weight loss and decrease in HbA1c, says Dr. Gonzalez-Campoy, for example  there may be other mechanisms of action that are helping these individuals to achieve weight loss, including changes in the gut microbiome, increased insulin sensitivity, enhanced leptin response, and decreased ghrelin levels, each of which contribute to weight loss.


That first drop might be mostly water weight. But research suggests that the keto diet is good for fat loss, too. An Italian study of nearly 20,000 obese adults found that participants who ate keto lost around 12 pounds in 25 days. However, there aren’t many studies looking at whether the pounds will stay off long-term, researchers note. Most people find it tough to stick with such a strict eating plan, and if you veer off your diet, the pounds can easily pile back on.
Carbs turn into glucose (aka sugar) in the body. Eating too many carbs causes your blood sugar to spike. When you switch from carbs to fat for energy, you stabilize your blood sugar. Keto can be particularly beneficial for diabetics, who have high blood glucose levels. The keto diet may even cure diabetes — many diabetics are able to come off their medication when switching to keto. Find out more about keto and blood sugar here.
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What is the ketogenic diet exactly? The classic ketogenic diet is a very low-carb diet plan that was originally designed in the 1920s for patients with epilepsy by researchers working at Johns Hopkins Medical Center. Researchers found that fasting — avoiding consumption of all foods for a brief period of time (such as with intermittent fasting), including those that provide carbohydrates — helped reduce the amount of seizures patients suffered, in addition to having other positive effects on body fat, blood sugar, cholesterol and hunger levels. (1)

Of all the high-carbohydrate foods that are eliminated in the low-carb ketogenic diet cutting out wheat products — bread, cereals, baked goods, pasta — may be the most significant for mental health disorders. It has been known for more than 50 years that an associate appears to exist between wheat consumption and symptoms for some people with schizophrenia. 


It’s also worth mentioning that if you have a history of irregular periods, any type of eating disorder, or a thyroid disorder than it may be best to begin this type of dietary program only while being guided by your doctor or a nutritionist. Pregnant women or those who are breastfeeding should not start the keto diet to be safe. A professional can help you ease into an alkaline keto diet in a moderate, safe way if you’re unsure of how to do this on your way, giving you feedback so the diet won’t negatively interfere with normal hormone production, appetite, sleep or mental focus.
The Keto diet versus Plate Method study triggered some challenges and a bit of criticism. In an editorial, Andrew Reynolds, PhD, a postdoctoral research fellow at the University of Otago, New Zealand, suggests that the much better results in those on the ketogenic diet may be due not to the diet itself but to the lifestyle changes and ongoing support that keto diet group received.5
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. 

Either there are very few participants in the studies, they don’t have an even number of males vs. females, or they don’t last but a few months. One study only looked at 28 people; only 21 completed the study and 20 of these participants were men. On top of this, they were only followed for 16 weeks. Okay, so we see that 20 men can limit their carbohydrates severely for 4 months and lose weight which automatically makes their A1c come down. Great! So, the real question is, how long can these 20 men stay on this diet for the rest of their lives? How long would you like to go without eating any fresh fruit? I’m craving some now, so I’m taking a break to go grab a snack now!
Dehydration. With fewer water-binding carbohydrates in the diet, the body is less able to hold onto fluids, which can lead to dehydration. Eating more salt can help offset this, but it can also raise blood pressure, creating a whole new set of issues. If you plan to follow a keto diet, hydration is key. To know how many ounces of fluid you need each day, Yancy recommends dividing your body weight in half. Then think of the resulting number as your daily fluid goal in ounces. So if you weigh 200 pounds, strive for 100 ounces of water a day.
When the body is first deprived of carbohydrates, usually felt at around 50 grams per day or less, the body starts with gluconeogenesis which is the body using stored glucose (glycogen) from the liver and muscles for energy. When the stored glucose can no longer keep up with energy demands, which will happen because there’s limited storage of glucose, the body turns to using ketone bodies for energy.
I was hypoglycemic as a teen because I avoided eating most carbs because obesity and diabetes runs in my family. When I got pregnant the dietician scared the he’ll out of me by telling me I was going to starve my baby if I continued to eat like I was. I immediately added good carbs into my diet and developed grata Iona’s diabetes and had a hell of a time controlling it. After I had my baby I went back to avoiding carbs and got back from yo where I was before my pregnancy. My brother died from complications due to his diabetes and at my mothers urging I went to a dietician and talked about food and what’s healthy and what’s not. I was once again scared that I was making a grave mistake and added in the carbs, I never should have. I developed diabetes and 80+ pound weight gain. After trying like hell to control my diabetes their way I’m back to my way. I’m tired of beating myself up for not being able to “apply” their recommendations correctly and the condescending attitude of the dietician when I tried asking about my old way of eating. I know me best and that’s it.
Keto Ultra Diet burns fat in the user’s body. It does so by two different ways. As mentioned above, the supplement plays a role in the mobilization of fats in the body. Consequently, the fats are burnt for energy. As long as these fats are kept in their stored form, they are not used up. Keto Ultra Diet removes excess fat from the body so that the user can be slim.
Dementia and Alzheimer’s Disease A small study published in February 2013 in the journal Neurobiology of Aging found that older higher-risk adults on a keto diet experienced better memory functioning after just six weeks. (11) Some experts, like Richard Isaacson, MD, director of the Alzheimer’s Prevention Clinic at Weill Cornell Medicine and NewYork–Presbyterian in New York City, support low-carb diets for patients as one way to delay brain aging and possibly Alzheimer’s disease, the most common form of dementia.
In a pilot study, five out of seven patients trialed a keto diet for 28 days and showed marked reduction in physical symptoms. Parkinson’s attacks our human nervous system, partially as a result of an abnormal accumulation of a protein called alpha-synuclein. Research suggests that a ketogenic diet may reduce the associated cognitive and motor symptoms.Obviously, we need more research here but its an exciting finding.
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.
After your body enters this carb-deficient state, it begins burning fat to provide energy, and this burning of fat causes a release of ketones. Ketones are dense sources of energy that can stimulate critical parts of the body, such as the brain. By drastically shifting your diet from carbohydrate dependence to fat dependence, you can enjoy a number of impressive health benefits, in addition to weight loss.
Keto breath, on the other hand, is less of a side-effect and more of a harmless inconvenience (your breath literally smells like nail polish remover). Basically, when your body breaks down all that extra fat on the keto diet, it produces ketones—one of which is the chemical acetone, Keatley previously told WomensHealthMag.com. (Yes, the same stuff that's in nail polish remover.)

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.


Once the body gets used to manufacturing ketones as the main energy substrate, the body actually has more energy than it previously had, and you won't have to be fighting through all those low-blood-sugar crashes your high-carb meals previously gave you. Additionally, hydration should be an area of high priority, especially before, during, and after exercise.


A study published in the American Journal of Clinical Nutrition established that a low-carb approach is far more useful for weight loss than a high-protein diet which is also rich in carbohydrates. Moreover, a study developed in 2013 outlined that the ketogenic eating plan annihilates the function of the hunger hormones much more efficiently than other diets.

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.


While it’s an extremely important factor, your diet is not the only variable that affects your pH level and hormones. Other factors that influence alkalinity, aside from the foods you eat, include: the level of stress you deal with on a daily basis, how much sleep you get nightly, the amount of sunlight exposure you get and the level of environmental toxicity you’re exposed to.
Roxy, I started at 283 in February 2018. I am now 212 with the hope to make 100lbs lost by Feb 2019. KETO is a life choice and comes with changes that have to be made! My mantra at difficult times in the beginning was to be different i must do different! Also most modern foods pizza and tacos can be adapted to keto way of eating. Just takes research and a little planning. I have tacos weekly!
MCTs are natural sources of essential healthy fats for energy. They are easily digestible and absorbed by the body, providing instant but lasting energy. Including MCT oil in the keto diet can stabilize blood sugar levels and enhance the production of ketones. Since that is the goal of your keto diet, optimal blood ketone levels, MCT Oil is a no-brainer.
The truth is though, her reaction is part of the problem. “I can’t believe your numbers improved so drastically without taking the medication.” THAT is the main problem with our medical community. They have been taught, and most have bought into the lie, that everything is better with medication. Medication is the go to. That is why we have so many health issues in this country. Let’s eat a crappy diet because our government/medical community recommends it…and then when that diet leads to medical complications…let’s throw drugs/medication at it. Many, if not the majority, of the medical issues we have could be done away with if we actually ate as we should. But no…we want cake.
Glucose is stored in your liver and released as needed for energy. However, after carb intake has been extremely low for one to two days, these glucose stores become depleted. Your liver can make some glucose from amino acids in the protein you eat via a process known as gluconeogenesis, but not nearly enough to meet the needs of your brain, which requires a constant fuel supply.
"The diet was introduced in the 1920s as a way to treat epilepsy and then sort of fell out of popularity with the introduction of anti-seizure drugs," Turoff says. What's more, ketosis (the goal of keto, a state where the body uses fat for energy instead of carbs) is something seen in people during periods of starvation—including in people with anorexia nervosa. "The body is deprived of carbohydrates and thus has to turn to ketone bodies as a fuel source," Turoff explains. "People really need to understand that it's not just a low-carbohydrate, high-fat diet—it actually changes the way your body uses fuel."
A ketogenic diet puts the body in a state of ketosis, where the primary fuel for the body is a broken down product of fat called ketone bodies. Ketosis can occur through reduction of carbohydrates in the diet or through fasting (or through taking an external ketone-producing product). It is the liver that produces ketone bodies by breaking down fatty acids, either from body fat or the fat that we eat.
Ben Tzeel is a Registered Dietitian and Certified Strength and Conditioning Specialist (CSCS), holding a Masters in Nutrition from the University of North Carolina at Chapel Hill.Ben has lived with Type 1 Diabetes since 1999 and has never allowed it to hold him back from achieving his goals. He is a published fitness model and author who writes about exercise, nutrition, and diabetes.
Parkinson’s Disease Because these patients are at a higher risk for dementia, researchers like Robert Krikorian, PhD, professor of clinical psychiatry and the director of the division of psychology at the University of Cincinnati College of Medicine in Ohio, are studying how inducing nutritional ketosis may be used to preserve cognitive functioning.
Kimberly is the reference editor for Live Science and Space.com. She has a bachelor's degree in marine biology from Texas A&M University, a master's degree in biology from Southeastern Louisiana University and a graduate certificate in science communication from the University of California, Santa Cruz. Her favorite stories include animals and obscurities. A Texas native, Kim now lives in a California redwood forest. You can follow her on Twitter @kimdhickok.
Lorraine Turcotte,  a metabolism researcher at the USC Dornsife College of Letters, Arts and Sciences, said that although it’s less trendy, long-term healthy eating is the tried-and-true solution. She’s not sure why people prefer “difficult dietary manipulations than to say ‘I’m just going to eat moderately — a well balanced diet, lots of fruits and vegetables.’”
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.
A ketogenic diet is clinically and experimentally effective in antiepileptic and antiobesity treatments; however, the molecular mechanisms of its action remain to be elucidated. In some cases, a ketogenic diet is far better than modern anticonvulsants (25). Recently, it has been shown that a ketogenic diet is a safe potential alternative to other existing therapies for infantile spasms (27). It was further shown that a ketogenic diet could act as a mood stabilizer in bipolar illness (28). Beneficial changes in the brain energy profile have been observed in subjects who are on a ketogenic diet (28). This is a significant observation because cerebral hypometabolism is a characteristic feature of those who suffer from depression or mania (28). It has also been found that a ketogenic diet affects signal transduction in neurons by inducing changes in the basal status of protein phosphorylation (29). In another study (30), it was shown that a ketogenic diet induced gene expression in the brain. These studies provide evidence to explain the actions of a ketogenic diet in the brain.

Compared to other diets, the keto diet actually has positive effects on appetite control. A major reason that people tend to lose weight and reduce their risk for certain diseases on the KD is because ketosis causes a decreased appetite, thanks to lowering hunger hormones such as ghrelin. It does this even while not negatively affecting levels of leptin, another hormone that regulates appetite, food intake and body weight. Having adequate leptin levels signals to the body that its energy needs are being met and makes weight loss possible.

Insulin resistance is caused by several mechanisms, one of which is chronically elevated insulin levels. So what increases insulin levels? Mainly sugar. A poor nights sleep can do it too, but sugar is a big one. This can be sugar that is part of our diet or carbohydrates that are broken down to glucose or other simple carbs. Proteins put together with fats can also be converted into sugar, a process called gluconeogenesis. However, it is really the effect of dietary refined sugars and starches (flour) causing blood sugar and insulin spikes (not protein). These insulin spikes from added sugars and flour are then often followed by a blood sugar crash, leading to a sense of discomfort, even sweating, and usually a craving for more high-carb foods.
Sleep improvements are a bit more of a mystery. Studies have shown that ketogenic dieting improves sleep by decreasing REM and increasing slow-wave sleep patterns. While the exact mechanism is unclear, it likely is related to the complex biochemical shifts involving the brain’s use of ketones for energy combined with other body tissues directly burning fat.
After reading that article I have to say that the “USC experts” are full of it. It’s the usual scare stuff that the mainstream docs and dietitians trot out to attempt to discredit LCHF and keto diets. There’s no reason why a keto diet should be any worse for bone health than any other diet provided it has adequate calcium, phosphate and Vit K2 and you have good Vit D levels. As for the recommendations of dietitians – eat lots of healthywholegrains and “vegetable” oils but no saturated fats – we know what the long-term results are of that: diabetes, heart disease and osteoporosis. 

Purnell JQ, Hokanson JE, Marcovina SM, Steffes MW, Cleary PA, Brunzell JD. Effect of excessive weight gain with intensive therapy of type 1 diabetes on lipid levels and blood pressure: results from the DCCT. Diabetes Control and Complications Trial. JAMA. 1998;280:140–146. doi: 10.1001/jama.280.2.140. [PMC free article] [PubMed] [CrossRef] [Google Scholar]
Finding keto-friendly foods can be difficult at social gatherings — so consider bringing your own snacks. “If I know the restaurant where I’m meeting my family or friends, I usually look through the menu in advance and see if there’s something I can eat,” says Lele. “Salads are generally safe, with ranch or another low-carb dressing and a non-marinated protein. There are a lot of hidden carbs in restaurant food!”
The same goes for people with type 2 diabetes. While some preliminary research suggests the keto diet may be safe and effective for certain people with type 2 diabetes, there’s still the risk for low blood sugar, especially for those on insulin, and the keto diet omits certain food groups known to benefit those with this disease. For example, a study published in September 2016 in the journal Nutrients highlights the importance of whole grains for helping to control weight as well as episodes of high blood sugar. Whole grains are off-limits on the ketogenic diet.

Where is the science? And if insolin intolerance is a diabetic problem why keep trying to regulate insolin? The stuff isn’t working because your patients are not getting better just deteriorating slower while you make more money keeping them on drugs!!!!! Your hole point is ketosis is bad cause they don’t have to see you after they adjust off the medication that keeps them having to see people like you!!! I have been eating keto for 6 months and feel amazing!!! These people are twisting the truth to keep you sick for there own pockets!!!!!!
Before the discovery of neuroplasticity, scientists believed that a damaged brain cannot regenerate. However, by improving mitochondria health, reducing inflammation, and stimulating cellular cleanup, ketogenic diets can help a damaged brain repair itself. Thus, the ketogenic diet is almost a miracle for many brain diseases that were thought of as incurable.
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.
A related clinical diet for drug-resistant epilepsy is called the medium-chain triglyceride ketogenic diet, in which MCT oil is extensively used because it’s more ketogenic than long-chain triglycerides. (13) Another dietary therapy for epilepsy called Low Glycemic Index Treatment (LGIT) was developed in 2002 as an alternative to the keto diet. LGIT monitors the total amount of carbohydrates consumed daily, and focuses on carbohydrates that have a low glycemic index.) (14)

From an outpatient clinic, we recruited 28 overweight participants with type 2 diabetes for a 16-week single-arm pilot diet intervention trial. We provided LCKD counseling, with an initial goal of <20 g carbohydrate/day, while reducing diabetes medication dosages at diet initiation. Participants returned every other week for measurements, counseling, and further medication adjustment. The primary outcome was hemoglobin A1c.
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.
Ketogenic diets (learn how to get the most from the diet here) are diets that take the concept of low carb to the next level, and encourage people to consume a large amount of protein and a moderate amount of fat, but almost no carbohydrates, so that their bodies are forced to burn fat for energy, entering what is known as a ketogenic state, or ‘ketosis’ (get the full ketosis story here).
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.
The original therapeutic diet for paediatric epilepsy provides just enough protein for body growth and repair, and sufficient calories[Note 1] to maintain the correct weight for age and height. The classic therapeutic ketogenic diet was developed for treatment of paediatric epilepsy in the 1920s and was widely used into the next decade, but its popularity waned with the introduction of effective anticonvulsant medications. This classic ketogenic diet contains a 4:1 ratio by weight of fat to combined protein and carbohydrate. This is achieved by excluding high-carbohydrate foods such as starchy fruits and vegetables, bread, pasta, grains, and sugar, while increasing the consumption of foods high in fat such as nuts, cream, and butter.[1] Most dietary fat is made of molecules called long-chain triglycerides (LCTs). However, medium-chain triglycerides (MCTs)—made from fatty acids with shorter carbon chains than LCTs—are more ketogenic. A variant of the classic diet known as the MCT ketogenic diet uses a form of coconut oil, which is rich in MCTs, to provide around half the calories. As less overall fat is needed in this variant of the diet, a greater proportion of carbohydrate and protein can be consumed, allowing a greater variety of food choices.[4][5]

When the body is first deprived of carbohydrates, usually felt at around 50 grams per day or less, the body starts with gluconeogenesis which is the body using stored glucose (glycogen) from the liver and muscles for energy. When the stored glucose can no longer keep up with energy demands, which will happen because there’s limited storage of glucose, the body turns to using ketone bodies for energy.
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?
The keto diet is often called a fad diet. Make no mistake: it is. But unlike other trendy diets, the keto diet is unique because it actually pushes the body into an alternate, natural metabolic state called ketosis. When this happens, you can reliably expect a few negative side effects, notably those that come with the "keto flu." But other side effects emerge only when people implement the keto diet poorly, typically by failing to eat balanced, nutrient-rich foods as a part of a high-fat, low-carb diet.
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.

I lived the last 10 years with this disease and a mentality of “Well all those other people around me are eating and drinking this stuff, so I want to be normal like them” I’m lucky that mentality didnt kill me. I’ve had A1C of 12, bad cholestoral in the high 600s and triglycerides of almost 2000. And yes, the author is right, our lives are ridiculously built around food. That’s why we have an obesity epidemic in this country. I am the only person I know that eats healthy. Everywhere I went for the last 10 years I was surrounded by food and drink. Oh well. Moderation is only the key for people with good genes. For people like me, sacrifice is the key. I don’t want a normal life anymore. Excuse my vulgarity, but I want energy, six pack abs, and a hard dick again. This disease wrecked my life and I’m never going back there again.


Great article Doc! Question: One of the world top experts in high fat low carb diet, Dr Tim Noakes has stated that top level athletes actually perform better on keto, as himself an extreme marathoner , cured his type 2 diabetes by going keto. In the light of what we know today about keto, would you still assert that athletes shouldn’t adopt ketosis as their desired state?
Lele says that it’s important to remember that, while keto is a “high fat” diet, the goal is to use your body fat as an energy source, not the fat that’s on your plate. “You don’t need to necessarily add more fats to your diet to adhere to keto. For instance, if your dinner consists of avocado, bacon, and eggs, you really don’t need to add butter to that to make it ‘more keto’,” she says.

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.


I started the ketogenic diet because I am a diabetic and refuse to take the medications that Drs advise because I’ve had bad reactions to them. I have lost about 20 pounds and the blood glucose is better controlled. I am also sleeping well most of the time. I did have the diarrhea but that has worked itself out. The one problem I am having is low blood pressure. I awoke dizzy one night and decided to check it and it was 73/48. I add himalayan sea salt to the water as recommended but sometimes still have a problem. A friend recommended using cream of tartar but what I have read said that it lowers blood pressure. Would I have to worry about low blood pressure if I added this to my water???

Thank you so much for this article! My husband and I have been following keto for a little over a month now and we love it! I did a lot of research before starting, and am still doing lots of research because I like to be armed with the best information I can have when friends question my choices. Just yesterday I had a friend tell me that our brains need carbs to function (more than what we get from veggies). I hadn’t heard that before so I didn’t know what to answer. Thanks to your article now I know, and I have lots more answers in case more points come up. 😉
7. I should mention ALL my health markers have DRASTICALLY improved including cholesterol and inflammation markers? My fatty liver is resolving and my cardio markers are perfect! The study where you cited there were not significant changed in diabetes markers in two months, well it takes longer! Check it out at 6 and 8 months. Most people will show a VERY different story than what you are reporting!
Keto is not hard to follow at all. See, this is why I took my diet and nutrition into my own hands. I have PCOS and the ketogenic diet has worked wonders for me. I’m finally pregnant at the age of 32 and after 11 years of marriage because the ketogenic diet made me lose over 100 lbs and brought my insulin resistance under control. I feel better than I’ve ever felt. Sometimes doctors don’t seem to know as much as they should, or as much as they assume they do, and that’s pretty disturbing. Just like they’re still using the old school and very inaccurate BMI charts that are just pure bs. I’ll just take care of myself outside of certain situations involving illness or injury. I’m doing great on my own.

The word “keto” often has negative associations for people living with diabetes, especially Type 1. DKA, diabetic ketoacidosis, is a life-threatening condition arising when the body produces too many ketones. So how does entering ketosis deliberately through a conscientious diet differ from entering it accidentally? The answer has to do with the level of ketones, the former causing “regulated and controlled production” and the latter causing an overabundance.

It’s not a good idea to include a lot of dairy in a ketogenic diet because the protein in dairy can deactivate Sirtuin, the anti-aging pathway, and create an insulin spike. While butter and ghee (from quality pastured sources) generally don’t cause this effect, high-fat cheeses and heavy creams do. In addition, dairy products can be inflammatory for many people.
The catch, of course, is that if it sounds too good to be true, it probably is. And that’s exactly what hopeful dieters need to keep in mind when approaching the ketogenic diet (if we're calling it by its formal name). It’s not that this high-fat, moderate-protein, low-carbohydrate approach to eating can’t deliver weight loss in a delicious package, but it’s a restrictive, sometimes complicated affair that isn’t sustainable for most people.
Our bodies are incredibly adaptive to what you put into it – when you overload it with fats and take away carbohydrates, it will begin to burn ketones as the primary energy source. Optimal ketone levels offer many health, weight loss, physical and mental performance benefits.1There are scientifically-backed studies that show the advantage of a low-carb, ketogenic diet over a low-fat diet. One meta-analysis of low-carbohydrate diets showed a large advantage in weight loss. The New England Journal of Medicine study resulted in almost double the weight loss in a long-term study on ketone inducing diets.
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.
Thank you for your wonderful comments Marcia. To share more about me personally with you all…I am not a completely non-diabetic Certified Diabetes Educator. I found out I had Prediabetes 15 years ago when I became a Diabetes Educator. I tested my own A1c and found it was 5.8%. The incredible news? There have been years when my A1c dropped to a normal level of 5.4%…out of the prediabetes range. My last A1c in May was 5.8%, so I still have Prediabetes 15 years later, but not diabetes, and without any medication, just the sensible diet I’ve discussed and exercise, so I really am living with this. I feel it everyday, I wonder what my A1c is going to be just like you every 6 months when I go to have it drawn.
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]
Make sure you’re eating whole, unprocessed foods when on keto. There are different types of keto diets, and some, like dirty keto, may be low-carb but they’re still full of inflammatory foods. Learn more about how dirty keto works. Your best anti-inflammatory game plan is to emphasize good fats, grass-fed proteins, and fresh, organic vegetables, like on the Bulletproof Diet. Learn more with this Bulletproof Diet Roadmap.
I think what bothered me most about the article was the way in which the writer has put her own fears about living without cake onto the shoulders of any diabetic she might treat. In the same way an epileptic might choose a life without cake in order to remain seizure free I choose a life without cake to remain “undiabetic”. I must admit that when I was researching this diet I did worry that I would not have the stamina, but the thought of going blind is a useful motivator.

In this study, researchers compared the impact of a low-carbohydrate diet and three other diets on blood pressure and other measures of cardiovascular fitness in women. After the 12 month trial, all subjects who successfully completed their respective diet experienced notable reductions in body mass, triglycerides, and LDL cholesterol. Those in the low-carbohydrate diet group, however, had the best results.
One study from 2005 followed 22 people with Type 1 Diabetes for 12 months. The difference here however is they consumed 70-90 grams of carbohydrates per day versus the restrictive less than 20 grams per day on the Ketogenic Diet. Remember my motto? Moderation is the key! The results were positive; less hypoglycemia, insulin requirements were reduced and their A1c dropped from 7.5% to 6.4%.
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