Controls glucose and reduces diabetic symptoms. In a randomized study of overweight adults with type 2 diabetes, the participants were divided into two groups. The first group followed a 32-week ketogenic diet program while the second group followed the conventional low-fat, diabetes diet plan. At the end of the study, the ketogenic diet group improved their glycemic control and lost more weight than the other group. The research showed that the ketogenic diet improved the participants’ blood glucose levels while also reducing the need for insulin.


Test for allergies and intolerances. For suspected allergies and intolerances, It is best to try an allergy test and an elimination diet that removes all common allergens and intolerances (wheat, eggs, fish, dairy, nuts, peanuts, shellfish, soy, and nightshade vegetables) for a period of time (3-4 weeks). If you are noticing positive changes and want to start adding these foods back into your diet, choose one at a time and tread slowly. Take note of how you feel. If you are still feeling great, move onto the next one. If at any time you experience adverse reactions to a certain food, chances are you have an allergy or intolerance to it.

Regarding metabolism: one study found when men on either the ketogenic diet or the low-fat diet were compared, their resting metabolic rates were not different despite lowered T3 on the ketogenic diet.21 Of the several studies done on the ketogenic diet, none have reported significant cases of hypothyroidism–essentially, the thyroid can function fine while following a ketogenic diet.
The diet is extremely regimented and very difficult to stick to, as just one baked potato and one slice of bread could hold an entire day’s worth of carbohydrates. While this is a deterrent for many, Christy Brissette, RD, a private-practice dietitian in Chicago, notes that many of her patients like the diet because of its strictness. “Some of my clients feel that the keto diet works for them because it doesn't involve any calorie counting and the rules are simple to understand,” she says. “They feel they have strict parameters that can take the guesswork out of dieting.”

Ketogenic diets were first proposed as a way to control epileptic seizures in children. Before keto diets, epileptics often fasted to reduce seizures, so the keto diet offered a less restrictive alternative. Though effective, the diet was mostly supplanted by medications – except in a segment of the population suffering from epilepsy that cannot control it with medicine, and for them, the ketogenic diet has had great success. Along with the benefits it offers to epileptics, especially children, the keto diet is also being studied as a possible salve for many neurological conditions and diabetes, too.[1]
In 2009, Drs. Eric Westman and Bryan Kraft published a case study and a review of the literature for a 70-year-old woman with life-long schizophrenia. Diagnosed at age 17, she had experienced daily visual and auditory hallucinations (skeletons that urged her to hurt herself) since the age of 7. She also had obesity, sleep apnea, hypertension, and gastro-esophageal reflux disease (GERD) among a number of other health issues. After only 8 days on the ketogenic diet, the voices and hallucinations stopped. At the time of publication she had continued the ketogenic diet for more than a year, with no return of hallucinations, and had lost more than 10 kilograms (22 lbs).
A ketogenic diet is very low in carbs, high in fat and moderate in protein. For a weight stable person, no more than 5% of calories should come from carbs, 70-80% from fat and 20-30% from protein. With this macronutrient-distribution, individuals do not rely on glucose as a major source of energy but use fat for fuel instead. Fat is used to produce ketone bodies, which are used for energy or to regulate certain genes. Two ketone bodies circulate in in your blood: Acetoacetate (AcAc) and Beta-hydroxybutyrate (BHB). A third ketone, acetone, is spontaneously created from Acetoacetate. It is not a source of energy but is useful for ketone measurement. Check our ketone measurement guide to learn more.
Because it lacks carbohydrates, a ketogenic diet is rich in proteins and fats. It typically includes plenty of meats, eggs, processed meats, sausages, cheeses, fish, nuts, butter, oils, seeds, and fibrous vegetables. Because it is so restrictive, it is really hard to follow over the long run. Carbohydrates normally account for at least 50% of the typical American diet. One of the main criticisms of this diet is that many people tend to eat too much protein and poor-quality fats from processed foods, with very few fruits and vegetables. Patients with kidney disease need to be cautious because this diet could worsen their condition. Additionally, some patients may feel a little tired in the beginning, while some may have bad breath, nausea, vomiting, constipation, and sleep problems.
The keto diet is known for helping people lose a few pounds very quickly, says Becky Kerkenbush, RD, a clinical dietitian at Watertown Regional Medical Center. Carbs hold on to more water than protein or fat, so when you stop eating them, your body releases all that extra H2O by making you pee more. As a result, the scale might read a few pounds lower, and you may look a bit leaner. 

"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."
The alluring promise of the keto diet, potentially filled with as much bacon, butter, eggs, and avocado as you can eat, sounds like the grown-up version of scoring a golden ticket to Willy Wonka’s Chocolate Factory. I mean, who wouldn’t want to chow down on bacon and butter at every meal? Especially if you ended up dropping a few pounds along the way?

Dr. Campos, it is unfortunate that you retain the medical community’s negative stance on the ketogenic diet, probably picked up in medical school when you studied ketoacidosis, in the midst of an obesity and type II diabetes epidemic that is growing every year, especially among populations who will never see the Harvard Health Letter. The medical community has failed in reversing this trend, especially among children, and the public is picking up the tab, in the form of higher health insurance premiums to treat chronic metabolic diseases which doctors cannot cure. The ketogenic diet does not bid its adherents to eat unhealthy processed meats, and the green leafy vegetables that it emphasizes are important in a number of nutritional deficiencies. People lose weight on the ketogenic diet, they lose their craving for sugar, they feel more satiety, they may become less depressed, their insulin receptors sensitivity is improved, and these are all the good outcomes you fail to mention. There is a growing body of research which demonstrates the neuroprotective effects of the ketogenic diet to slow cancer progression, as well as diseases like Parkinson’s and Alzheimer’s, for which there are no effective medical treatments. Please respect your patients by providing them with evidence-based medical outcomes, not opinions.

Look for natural sources of electrolytes or take an over-the-counter supplement. “Avocados, leafy greens, asparagus, and cruciferous veggies are great for providing important electrolytes, says Josh Axe, DNM, DC, CNS, a certified doctor of natural medicine and clinical nutritionist. Dr. Axe also suggests a magnesium supplement to help you sleep and avoid cramps or constipation.
Once you’ve stayed on keto for a couple of days, you may notice a new odor coming from your mouth that smells like overripe fruit or nail polish remover. This is an unfortunate side effect of ketosis that occurs when acetone (i.e., the primary ingredient in nail polish remover) is created as a by-product of ketone production. Unfortunately, your body can’t do much with the acetone it makes, so most of it will be excreted with each breath.

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. 😉
Lots of apps and websites offer keto diet challenges—basically, a blueprint for the keto diet with a fixed starting and ending point (they typically last for a week to a month, though some may be longer). Speaking of apps, plenty of keto-centric ones are right at your fingertips (a.k.a., your smartphone), like the KetoDiet app, which can help you calculate your macros and track your keto diet effectively.
It builds mitochondria. Mitochondria are the power plants of our cells, transforming incoming nutrients into ATP. The more mitochondria we have, the more energy we can utilize and extract from the food we eat—and the more performance we can wring out of our bodies. Ketosis places new demands on our mitochondria, who adapt to the new energy environment by increasing in number.
Carbohydrate facts: Simple = bad, complex = good? Carbohydrates provide energy for the body, but the health benefits they offer depend on the type of carbs we consume. Complex carbs, found in brown rice, for example, contain more nutrients than simple carbs, such as white rice. Refined carbs, such as sugary drinks, are best avoided, as their nutritional value is low. Read now
🙌🙌 thank you for some great info! USC just had an article about Keto, saying they don’t know the impact on bone health. So I’m not sure why all these articles are written without the documentation to prove the claims. We all know too much calcium supplementation can cause problems but every Dr wants you to supplement calcium. Most people could do a lot worse than doing Keto! The SAD will cause more problems for you than eating whole, unprocessed Keto food! Sugar seems to be the real issue along with aspartame and stressful living.
The keto diet restricts carbs so much that anyone who is on blood sugar lower medication or who has type 1 or type 2 diabetes must consult his or her doctor before making such a severe dietary change. As the body adapts to low-carb dieting, medication dosages and treatment plans will have to be revised, and blood sugar levels must be carefully monitored.
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!
People With a History of Eating Disorders Going on a strict diet that eliminates food groups could trigger a relapse if you have a personal history of having an eating disorder. And while there’s a growing popularity in treating binge eating disorder (BED) with keto, experts strongly advise against it. Treatment of BED requires regular, adequate food intake without restriction, says Sumner Brooks, MPH, RDN, a certified eating disorder dietitian in Portland, Oregon.

People claiming huge benefits of these supplements – despite the lack of solid scientific support – may sometimes have a financial reason to believe in the supplements. Some of these products are sold under a multi-level marketing arrangement, where sales people are paid based on commission. For example, the company Prüvit sells drinkable ketones, called KETO//OS with a multi-level marketing structure.
When your body goes into ketosis, it will start to produce by-products called ketones. This includes acetone—yes, the same chemical found in nail polish remover, which your body actually naturally makes on its own, according to a 2015 review of research. Because acetone is a smaller molecule, it tends to make its way into your lungs. You’ll eventually exhale them out, resulting in “keto breath.” Your mouth might also have a metallic taste, but it won’t last forever as you adjust to the diet. Just be diligent about brushing your teeth!
This whole post must have taken so much effort and I think it’s incredible that you do this. The issue with these diets is that people hear about it, think it sounds good and do it. No questions! We are so lucky to have dietitians like you actually laying out all the research, the good, the bad, and everything in between about these diets, so THANK YOU!
“These diets are so unsustainable and in the long term, just not worth it!” Most definitely in your opinion. I did a LOT of research on Keto before I started it in 2009. I lost 130lbs. It’s not a diet, it’s changing the way you think about food and fuel for your body. And once you do that you understand food freedom. I eat mostly Keto but if I want a beer and a piece of Watermelon I will let myself have one. True it’s not for everyone, not everyone has the willpower to control what they put in their mouth. We tend to reward ourselves with food instead of using it what its for, nourishment and fuel. It’s why our country is dying of obesity. Awesome that a size 10 women can put what she wants in her mouth everyday, exercise, and it not affect her weight but guess what, you are becoming the minority.

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.” 
Katie Wells, CTNC, MCHC, Founder and CEO of Wellness Mama, has a background in research, journalism, and nutrition. As a mom of six, she turned to research and took health into her own hands to find answers to her health problems. WellnessMama.com is the culmination of her thousands of hours of research and all posts are medically reviewed and verified by the Wellness Mama research team. Katie is also the author of the bestselling books The Wellness Mama Cookbook and The Wellness Mama 5-Step Lifestyle Detox.
I, too, am finding the keto diet to be beneficial. My weight is moving down. My recent A1c was 5.7. I am consistently below 90 each morning when I check my blood. I am learning to adapt my cooking to the needs of maintaining this way of eating. I have incorporated walking because now I FEEL like it. I don’t feel deprived. I feel empowered. No medications for diabetes!

“It’s unhealthy and unsustainable,” they say. “How can a high-fat diet help you lose weight? It’s dangerous for the heart, increases the risk of ketoacidosis, leads to poor mineral intake and electrolyte imbalance,” they say. But the ketogenic diet has a well-established history of aiding in disease treatment. It has been used to help people with epilepsy (especially children) since the early 1900’s, and more recently, it has been used to manage type-2 diabetes (since it lowers the need for insulin therapy).1

“The major benefit of the keto diet is that it does work so you lose weight,” says Ms. Zarabi. “But then again, it is a diet and like all diets, it is a short term solution, something you do, then you stop. It is not really a sustainable diet in real life situations. More importantly, your goal is not just to lose weight—anyone can lose weight. The more necessary goal is to keep the lost weight off.”  

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.


Another organ that plays an essential role in blood sugar regulation is the liver. It stores excess glucose as glycogen, and when glucose levels are low, glycogen is broken down to provide glucose [6]. This process is regulated by two hormones: insulin and glucagon. Insulin normally promotes glycogen synthesis and interferes with glucose release from the liver.

Ketogenic diets are not for everyone. There are some people who should be very careful with the ketogenic diet, or at least should not do it without medical supervision. While I understand not many mainstream doctors will be well versed in the ketogenic diet, there are online services that can pair you with a primary care doctor who understands keto in detail.


Many people on a ketogenic diet report sleeping much deeper, says Pamela Ellgen, a personal trainer and author of Sheet Pan Ketogenic. However, during the adjustment period (the first three to five days after you start keto), you may experience insomnia or difficulty staying asleep. This will end once your body adjusts to ketosis and burning stored fat. Then, you may find you’re able to sleep longer, sleep deeper, and feel more relaxed and rested when you wake up. Here are 15 things you need to know before starting the keto diet.

It is important to point out however, that type 2 diabetes also improves during any form of caloric restriction and it is likely that a keto diet is not unique in that aspect, rather it is causing a caloric deficit by severely restricting carbohydrate intake. We have helped numerous clients lose fat while on a moderate carb intake in a caloric deficit.


In this single-arm, 4-month diet intervention, an LCKD resulted in significant improvement of glycemia, as measured by fasting glucose and hemoglobin A1c, in patients with type 2 diabetes. More importantly, this improvement was observed while diabetes medications were reduced or discontinued in 17 of the 21 participants, and were not changed in the remaining 4 participants. Participants also experienced reductions in body weight, waist circumference, and percent body fat but these improvements were moderate and did not predict the change in hemoglobin A1c in regression analyses.

The good news is, it is not necessary to stay on a ketogenic diet at all times to reap this benefit. Our ancestors went through fast and feast cycles and the body is designed for flexibility. We may be able to reduce cancer risk, prolong life, improve brain function, and benefit from ketosis otherwise by being in ketosis or fasting a few days a week.
The ketogenic diet—also known as "keto"—has become the latest big thing in weight-loss plans, touted recently by celebs like Jenna Jameson, Mama June, and Halle Berry. The diet involves cutting way back on carbohydrates, to 50 grams a day or less, to help the body achieve a state of ketosis, in which it has to burn fat (rather than sugar) for energy.
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!”
You say keto is a highly controversial topic. For those of us following a keto diet, there is no controversy whatsoever because the diet proves itself efficacious very quickly. I think the real controversy comes in because the ADA has been recommending dangerous levels of carbs for decades now, and they would lose face if they had to change their recommendation and admit they’ve been wrong for so long. You say there are not many studies on the keto diet, and I disagree with you. You’ll find the evidence if you look for it. Eric Westman, Steve Phinney, Jeff Volek and many other researchers have written volumes about this.
MCT oil can be used alongside Coconut Oil  in cooking, frying, sautéing, and baking. If you don’t like the coconut flavor then it is recommended to opt for the “refined” version of Coconut Oil. You can add both Coconut Oil or MCT Oil to any food you like, especially if you like the sweet flavor of Coconut Oil.  A few drops of MCT Oil in almost anything can enhance its richness, and add fullness. MCT Oil is a great alternative to olive oil as a salad dressing, and a good addition to any smoothie.
Once you’ve stayed on keto for a couple of days, you may notice a new odor coming from your mouth that smells like overripe fruit or nail polish remover. This is an unfortunate side effect of ketosis that occurs when acetone (i.e., the primary ingredient in nail polish remover) is created as a by-product of ketone production. Unfortunately, your body can’t do much with the acetone it makes, so most of it will be excreted with each breath.

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.
In March 2018, our friend Vickie, who is a type 1 diabetic, told us about the keto way of life. She shared some interesting data Dr. Ken Berry puts out on YouTube. The things Dr. Berry said made total sense to us and we decided we needed to give keto a try. Both I and my girlfriend decided to give this Keto way of life a try. We officially started on March 5, 2018.
Sofia Norton is a driven, dedicated and team-oriented professional with more than 6 years of experience providing wellness and nutritional support in various capacities. After Sofia learned about "food deserts" as a kid, she became determined to devote her life to like to making healthy foods accessible to everyone, regardless of income or location. Sofia has traveled around the world, teaching nutrition to communities in extreme poverty. In her spare time, Sofia loves long bike rides and exploring local farmer's markets.

Another thing we know about diets and weight loss is that the results are not easily maintained. I’ve written about this in depth with regards to the participants on the Biggest Loser. This was evident in a study  analyzing 31 long term studies on dieting, which found 2/3 of dieters put back the weight they lost. Other research has reported the failure rate may be as high as 95%. This isn’t specific to the keto diet but rather, any diet that is restrictive and unrealistic may be nearly impossible to sustain.
Regarding metabolism: one study found when men on either the ketogenic diet or the low-fat diet were compared, their resting metabolic rates were not different despite lowered T3 on the ketogenic diet.21 Of the several studies done on the ketogenic diet, none have reported significant cases of hypothyroidism–essentially, the thyroid can function fine while following a ketogenic diet.
The problem is: it flies in the face of the way we have been taught. Our society (as an American), and our medical community, have preached for years that FAT is bad, and you should limit it. However, recent FACTS beg to differ. So many people rail against the keto diet because they just feel that it can’t be good…after all, you eat so much fat on it, it can’t be good for you! Facts are facts…they don’t care about your feelings. Fat is not the enemy. Sugar is.

This effect can also be demonstrated by researchers at Kraft Foods, published in the American Journal of Clinical Nutrition. For 12 weeks one group ate a low fat, calorie restricted date, and the other ate a low-carb, high-fat diet without restriction… other than low carb of course. After 12 weeks, the low-fat group lost 5.5 pounds and the low-carb group lost 10.8 pounds.

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.
As someone who is prediabetic, Keto has been a godsend! I thought I was just a glutton, but now I’m certain I am actually insulin resistant. I am on Keto and can manage half a cup of blackberries without coming out of ketosis, but almost any other carb/sugar and I become a mindless food consuming zombie. I literally feel like I have zero control over my ability to stop eating. Also before trying Keto, if I was not able to eat constantly throughout the day I became grumpy and tired. Like none tired where it felt like I had lead running through my veins. On Keto, I can go a good 5-7 hours without eating and I don’t feel off at all. I am hoping to lose weight, but mostly I do not want to become diabetic and my problem is that I am insulin resistant. I do plan eventually to eat more black beans, vegetables and fruits again. Maybe a little chocolate on holidays and cake and ice cream on my

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.
And science is now catching up, this review paper on ketogenic diets   as a form of cancer therapy concluded: “Although the mechanism by which ketogenic diets demonstrate anticancer effects … has not been fully elucidated, preclinical results have demonstrated the safety and potential efficacy of using ketogenic diets.. improve responses in murine cancer models”
As the popularity of the Keto Diet has exploded in recent years the true nature of Ketogenic weight loss has gotten blurred. So what is Keto? Very simply Keto refers to Ketosis, the state into which your body enters when it shifts to burning fat for energy instead of carbohydrates. As carbohydrates and sugar intake is restricted, your body begins to break down its fat stores to use as a source of energy. Therefore, the very basics of a Ketogenic Diet are:
That's certainly the case with the ketogenic diet—a very low-carb meal plan—based on the findings of two recently published studies.1,2  Dr. Saslow and her team report that the individuals with type 2 diabetes who followed the keto diet lost significantly more weight than those on the low-fat diet espoused by the American Diabetic Association.1 These dieters also were able to get their hemoglobin A1c (HbA1c) below 6.5%, suggesting that some may have reversed their type 2 diabetes.1
Test ketones in the late morning or afternoon. Blood and urine ketones are usually lowest right after waking up. Try testing later on, preferably a few hours after eating. Even if you’re only in ketosis for a portion of the day, you’re still getting some benefits, as discussed in this talk by Dr. Steve Phinney: Achieving and maintaining nutritional ketosis.
Ketosis, similarly to fasting or caloric restriction, turns on a group of genes called Sirtuins. When scientists activate Sirtuins in animals, they found that these animals live longer. In addition, Sirtuins can help keep you lean and energetic during the day and sleeping well at night. More research is needed to know if this effect is the same in humans, but evidence seems strong that spending some time in ketosis is beneficial.
The diet that I’m calling ‘keto’ here, and is designed to put the person in ketosis (where we’re getting the ‘keto’ from), is called the ‘Modified Atkins Diet’ in most medical literature. In the Modified Atkins Diet (MAD) the benefits of the body being in a state of ketosis are seen, and it is thought that the unrestricted protein and calories will prevent the children’s growth from being stunted. (source)
"Electrolyte imbalances can also be common if keto followers aren't aware of hydration needs," Turoff says. It's important to stay hydrated on keto, she says, especially in the beginning. "As you limit carbohydrates, your body produces less insulin, and glycogen stores (how carbs are stored) in the muscles and liver are depleted. For every 1 gram of glycogen that's depleted, you lose about 3 grams of water." This causes the kidneys to flush out more water, and along with it, electrolytes your body needs like magnesium, calcium, sodium, and potassium. "Imbalanced electrolytes can lead to muscle cramps, irregular heartbeat, fatigue, cognitive distortions, and lack of body temperature control," Turoff says. Some people may also be more likely to get kidney stones while on keto due to inadequate hydration, according to Turoff. (PS: These Are the Hydration Tips Every Fit Girl Needs.)
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).
After the depletion phase, your body will enter a survival mode where it starts to signal the liver to produce ketones from available dietary fat sources and body fat stores. These ketones will replace glycogen as the body’s fuel source in the absence of glycogen. The body will go back to burning glycogen for energy when you start eating carbs again.

Let’s also get one thing cleared up, there’s a difference between not pooping and constipation.  Constipation is obvious blockage and discomfort–there’s something there but it ain’t movin’.  Not pooping is well, not pooping.  There’s nothing there to come out.  When you  produce less waste, you poop less often–and on Keto, you’re going to poop less often.  The body is very efficient at extracting nutrients from meats and fatty foods.  The result is less waste.  So don’t mistake fewer bowel movements with constipation.

I am a T2D, finally fully keto starting at the end of March. I am down 28 lbs. My goal is 50, so I am feeling encouraged and fitting into smaller sizes already. In May my A1C was 5.6. This morning, according to a home test kit I purchased from CVS, my A1C is 5. I believe that is fairly accurate based on my blood sugar readings, which are staying well below 100.
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)
In the present study, 83 obese patients (39 men and 44 women) with a body mass index greater than 35 kg/m2, and high glucose and cholesterol levels were selected. The body weight, body mass index, total cholesterol, low density lipoprotein (LDL) cholesterol, high density lipoprotein (HDL) cholesterol, triglycerides, fasting blood sugar, urea and creatinine levels were determined before and after the administration of the ketogenic diet. Changes in these parameters were monitored after eight, 16 and 24 weeks of treatment.
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.
OK, so this is the one most people probably actually care about. The great thing about the keto diet is that most dieters report not feeling hungry at all, likely because ketosis tends to suppress the hunger hormone, ghrelin, which helps tame our hangry monster within. So when you combine a satiating diet with the fact that you’re just cutting out a lot of foods, it makes perfect sense then that you’ll lose weight. One meta-analysis found that participants lost more weight on a very low-carb diet (like keto) compared with those on a low-fat diet.
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.
Good article. A friend at work is stating this diet and of course being new at it, he is quite the Zealot. I have been into nutrition and exercise for over 40 years (57 years old now). I have tried s few different eating philosophies (I never use the word the word diet. Negative connotation and dieting isn’t good the way most practice it.). Eating Keto style and the logic behind it aren’t too different than some others. And you pointed out many of the misconceptions about cholesterol and triglycerides ect. For about the last 20 plus years I have pretty much followed a “Zone” type diet. 40% carbs, 30% fat, 30% protein. And I always get weird looks at the 30% fat part. Well, I’m 57 with 7% body fat. Not bad for and old guy. I work out and I supplement with protein as I lift weights. It’s worked well. The ratios may be different, but the emphasis on vegetable carbs and good fats are the key to either way to eat. There were only a couple things that kinda struck me as something that made me go hmmmmm. Using the Inuit people isn’t a good example really. They have evolved some different physical features over hundreds of years than we have. And there is no evidence if ketosis occurring in examination. And somehow when you mention eating large amounts of animal fat, just hit me as counterintuitive. It’s a much different fat than an avocado. Finally, and this is just me, I love fruit. True it’s probably less efficient, but its good, sweet, and beats the hell outta donuts for your health. It fulfills the reward need many of us have. I also feel if God put it on the earth naturally, it’s got a place in our food source. I’ve had a philosophy about excersise that’s served me well. What’s the best exercise? The one that you’ll do regularly. Get up and move and find out what works for your own body. It applies to good too. If you feel deprived or for various reasons can’t stay on the supposed best food program, what good is it? But if you stay with more natural and Balanced foods that usually leads to more energy then more and regular excerise. Check in. It looks like it’s been 2 years since you wrote this. I’d live to hear how your doing.
"Your brain runs on glucose (a simple form of carbohydrates)," notes Adrien Paczosa, R.D., L.D., a registered dietitian and eating disorder specialist. "When you cut out carbs, your body has to 'make' carbs from breaking down other parts of the body. This results in what I like to call a hungry brain. You experience slower cognition, memory loss, headaches, and confusion." That doesn't sound so great, right? "Also, those who suffer from depression and anxiety may have higher levels of those periods when not eating carbs on a regular basis." Because of this, keto might not be the best choice for those with mental health issues.

The high-fat intake required for ketosis may change the structure of LDL ("bad") cholesterol and lipoproteins, which could induce inflammation over time. Chronic inflammation is a biological state in which your body's cells work overtime to get their regular job done. Healthcare professionals can ID inflammation through blood work by looking for signs of oxidative stress (a.k.a. the damage done by free radicals to organ tissues).
“Tremendous Results”….guess that’s why the diabetes nationwide gets worse every year, because of the stellar advice your kind is giving out. I’ve been on the virta clinic for two months and already went off insulin, Janumet and Jardiance, which I’ve been on for 10 years, with blood sugars between 80 and 150. The advice you give makes people get sick slower. The ketogenic approach deals with the real issue, carbohydrate intolerance. If you are lactose intolerant you stop ingesting lactose. Type two diabetes is simply carbohydrate intolerance. Stop eating the carbs and the symptoms go away. I think you meet to cite some of the other research out there I’ve read in other books and the work the Virta Clinic has done. In my opinion you’ve cherry picked data to suit your preconceived beliefs.
Type 1 diabetes causes the same blood sugar control issues as type 2 diabetes, but in an entirely different way. Type 1 diabetics cannot produce enough insulin or any insulin at all, which requires them to have insulin administered exogenously. On top of that, the perfect diet will not be able to reverse this disease as the ketogenic diet can for type 2 diabetes.
A recent pilot study put five patients on the ketogenic diet (less than 20 grams per day of carbohydrate). At the end of six months, the average weight loss was 28 pounds (but this wasn’t the most surprising finding). Each patient underwent a liver biopsy, and four of the five patients had a reduction in liver fat, inflammation, and fibrosis. However, this is a small pilot study that also used supplements, so the results are not conclusive. What does the rest of the research say?
A typical keto diet is comprised of 80 percent fat, 15 percent protein, and a mere 5 percent of calories from carbohydrates. If you consume 2,000 calories a day, that means just 100 of them are coming from carbs—including healthy carbs like fruits and vegetables. When you eat this way, it triggers ketosis, which means your body has burned through all its carbs and needs to begin burning fat for energy.
I have been on a low carb diet for over 2 years. I was diagnosed a diabetic with a blood glucose over 400 mg/dl and an A1C of 12. I tried my doctors recommendations for about a year and took all the medications they told me to take. not much changed. they wanted to put me on insulin after a year. I told my doctor that I thought I could control my condition with diet and he said, “you are to far gone for that”.
By going on a ketogenic diet, you are far more likely to increase your level of fiber intake, primarily through fruits and non-starchy vegetables. This increase in dietary fiber will help aid digestive health by promoting peristaltic motion and easing the passage of bowel movements. This can lower your risk of indigestion, constipation, diarrhea, bloating, cramping, gastric ulcers and even colorectal cancer.

I do not think you are glad this diet was effective for this person. Your video recipe reviews are juvenile at best, and your overall review is extremely negative. My personal experience is wt loss of 60 lbs in 11 mos; three migraines in 11 mos vs minimum of three per month for over 53 years, and all I was trying to do by starting keto was delay type 2 genetic diabetes onset . I am no longer prediabetic and I have taken less sumatriptan in one year than I have historically taken in one month. I sincerely hope your review has not prevented one person from enjoying their life to the degree I have in the past 11 months as a direct result of the keto diet. Shame on you!
In the present study, 83 obese patients (39 men and 44 women) with a body mass index greater than 35 kg/m2, and high glucose and cholesterol levels were selected. The body weight, body mass index, total cholesterol, low density lipoprotein (LDL) cholesterol, high density lipoprotein (HDL) cholesterol, triglycerides, fasting blood sugar, urea and creatinine levels were determined before and after the administration of the ketogenic diet. Changes in these parameters were monitored after eight, 16 and 24 weeks of treatment.
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.

Like the stress response, ketosis is a natural, physiological adaptation designed for short-term responses. In other words, an acute stress response to some danger or threat that involves increased adrenaline and cortisol release, increased heart rate and blood pressure, and heightened alertness is normal and can even save your life. But, if the stress response becomes chronic, as it may with divorce, prolonged caretaking of an impaired child or demented adult, PTSD, financial struggles, etc., then the stress response can have terrible health implications that include increased risk for Alzheimer’s dementia, heart disease, dysbiosis, inflammation, diabetes, and cancer. The same applies to ketosis: Acutely, ketosis is a normal physiological adaptation that serves us during periods of carbohydrate or calorie deprivation. Chronically, however, peculiar things happen with consequences that range from constipation, to selenium deficiency and cardiomyopathies, to colon cancer.
Certain Cancers Keto may be used in combination with chemotherapy and radiation, some studies have suggested, including one published in November 2018 in the journal Oncology. (12) But ultimately more studies are needed to determine if keto can play a role in cancer therapy, and patients should not use it as a stand-alone treatment or without a doctor’s consent.
If you’re science oriented, you can also try his 2008 book “Good Calories, Bad Calories”. For a more journalistic view on the events that led to fat phobia starting in the 1950’s (as well as the joke that is the Mediterranean Diet), there is also Nina Teicholz’s 2014 book “The Big Fat Surprise.” Be sure to check out youtube for some of these folks’ lectures and discussions. They are not advocating whacky stuff.
“These diets are so unsustainable and in the long term, just not worth it!” Most definitely in your opinion. I did a LOT of research on Keto before I started it in 2009. I lost 130lbs. It’s not a diet, it’s changing the way you think about food and fuel for your body. And once you do that you understand food freedom. I eat mostly Keto but if I want a beer and a piece of Watermelon I will let myself have one. True it’s not for everyone, not everyone has the willpower to control what they put in their mouth. We tend to reward ourselves with food instead of using it what its for, nourishment and fuel. It’s why our country is dying of obesity. Awesome that a size 10 women can put what she wants in her mouth everyday, exercise, and it not affect her weight but guess what, you are becoming the minority.

My pick for the healthiest meal plan for diabetes? My favorite is the Mediterranean Diet. It’s high in fiber, low in saturated fats and includes no processed foods which is the challenge for all of us at this point in history. If we could all eat like they do in Italy and Greece! Think of Sicily and the coasts of Greece where their diet consists of fresh fish, fresh fruits and vegetables, nuts, beans, seeds, olives and olive oil, lean meats such as chicken and pork, some eggs and little red meat. The American Heart Association recommends it as well as the American Diabetes Association as being one healthy diet choice for people with diabetes.
The more recent study was conducted online to ascertain if this online approach proved effective in eliciting weight loss.1 Dr. Saslow's team randomly assigned the 12 participants to the Keto diet and lifestyle improvement group and another 13 individuals to the traditional low-fat diet known as the Plate Method,1 supported by the American Diabetes Association. 
And what benefit you will have with “moderate” diets that let you eat bread and others carbohydrates but high insulin ? remember that it is critical to not only look after glucose levels on blood, it is very very important to reduce your intake of insulin to avoid a lot of diseases including metabolic syndrome for high insulin and insulin resistance.
For me, I chose to become a CDE because I had worked as a Registered Nurse first on a medical unit, then in a Medical ICU. These are the units where most of the people with diabetes are, so I had seen every horrific complication that diabetes can cause. When I had a chance to become a Diabetes Educator…to actually help PREVENT some of those horrible complications…I jumped at the chance!
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?
In the first few days of the keto diet, it’s not uncommon for people to experience the “keto flu,” a brief period in which you may have headaches, fatigue, confusion, and nausea. These symptoms are a sign that your body is making the switch from burning glucose (sugar from carbs) for energy to burning fat—a process called ketosis. The changeover can leave you feeling depleted for a day or two, but once you break through to the fat-burning phase, you may find you have much more energy and greater endurance. “You are able to do more without hitting ‘the wall,’ says Carrie Burrows, PhD, a health and fitness expert. “When we use fat as fuel, our endurance improves and is more sustainable.” That extra energy will carry over to your workouts, Dr. Burrows says. Here are more things you need to know before starting the keto diet.
Researchers note that subjects taking between 40 to 90 units of insulin before the study were able to completely eliminate their insulin use while also improving blood sugar control! They also point out that this effect happens “immediately upon implementing the dietary changes” so people with type 2 diabetes need to monitor their blood sugar closely and likely adjust their medication dosages/needs with the help of their doctors.
If you’re science oriented, you can also try his 2008 book “Good Calories, Bad Calories”. For a more journalistic view on the events that led to fat phobia starting in the 1950’s (as well as the joke that is the Mediterranean Diet), there is also Nina Teicholz’s 2014 book “The Big Fat Surprise.” Be sure to check out youtube for some of these folks’ lectures and discussions. They are not advocating whacky stuff.
The primary drawback of keto for the general population is how restrictive the diet is. “It requires more thought than some other diets,” Santos-Prowse says. And whenever a diet requires too much thought or effort, the likelihood of effectively sticking with it becomes diminished. People just don’t like having to think about how, when, and where to get their next meal when they’re so used to grabbing something quick from the nearest fast food joint.
In some ways, it’s similar to the Atkins diet, which similarly boosts the body’s fat-burning abilities through eating only low-carb foods, along with getting rid of foods high in carbs and sugar. Removing glucose from carbohydrate foods will cause the body to burn fat for energy instead. The major differences between the classic keto and the Atkins diet is the former emphasizes healthier keto fats, less overall protein and no processed meat (such as bacon) while having more research to back up its efficacy.
For the ketogenic eating plan, participants were instructed to reduce non-fiber-containing carbohydrates to between 20 and 50 grams a day, with no calorie restriction. The group following the plate method were told to eat their meals on a nine-inch plate, filling half of it with non-starchy vegetables (eg, greens, peppers, broccoli, carrots), ¼ of the plate with whole grains (eg, brown rice, sweet potatoes, whole wheat bread) and adding lean protein (eg, skinless chicken, turkey, fish, and seafood) to the last quarter of the plate.1
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.
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)
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