You can absolutely be in ketosis and eat 50g of net carbs a day. Maybe not everyone, but many people can maintain ketosis at that level of carb if fat/protein intake is OK. I have experienced this myself, and tested with blood keto meter. It would be interesting to test people who have been on the WB diet to see how me many are also in ketosis. I would bet a significant portion cycles into ketosis very regularly, and some are ketotic most of the time.
On the flip side, hypos can be an issue, especially early on…and if you treat them too aggressively, they could knock you out of ketosis. I remember my first 3 weeks on keto, my CGM trend line hugged a blood sugar of around 80.  It was glorious, but I had to reduce insulin substantially through trial and error and felt like I was low every five seconds.

A ketogenic diet elevates the levels of ketone bodies in the system—these are the byproducts of the body breaking down fat for energy when carbohydrates are in short supply, a process called ketosis. The average American gets most of their energy from glucose, which comes from carbs and sugars. When you’re in ketosis, though, your body goes into hyper fat-burning mode, also using up stored body fat, which is why it’s effective as a weight-loss strategy.  
If you want to successfully lose weight with a Ketogenic weight loss program…successful meaning you lose weight and learn how to keep it off…then a Keto Diet is NOT another do-it-yourself, magazine of the month yo-yo diet trend. Ketogenic Diets are based on the science of weight loss and how human physiology responds to sugar, carbohydrates, insulin and fat storage.
Thank you for this comment. It is truth! I keep telling people about this diet. It is literally the best diet I have ever been on. I can eat good food, I feel full, my weight is dropping, I feel better and I can actually feel the difference. While it is great for a professional to be skeptical of emerging diet trends (and lets face it, most diet trends are garbage peddled by snake oil salesmen), this one actually has science from some prestigious institutions behind it, not a marketing scheme.

Our body needs some time to get used to ketones being elevated in the blood stream to begin using them effectively and efficiently for cellular energy.  By consuming an exogenous ketone supplement, you get the body adapted to ketones faster and using them as an energy source before the body has built the metabolic machinery to produce its own ketones effectively.


Related to this research, some serious attention has been given to ketogenic dieting and Alzheimers Disease. Scientists have discovered increased cognition and enhanced memory in adults with impairments in these areas, and a growing body of research shows improvement at all stages of dementia. Ketosis has been shown to be effective against Parkinson’s disease as well.
“When you start the keto diet, you lose sodium and other electrolytes in the urine due to reductions in insulin,” says Yawitz. “This is a major contributor to symptoms of keto flu.” So it’s important to replenish sodium through the diet, especially if you exercise or sweat a lot. “This can help ward off more serious side effects that are seen with long-term sodium deficiencies,” says Yawitz. These include lethargy and confusion — and in extreme cases, seizures, coma, and death, according to the Mayo Clinic.
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.
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.
“Muscle loss on the ketogenic diet is an ongoing area of research,” says Edwina Clark, RD, a dietitian in private practice in San Francisco. “Small studies suggest that people on the ketogenic diet lose muscle even when they continue resistance training. This may be related to the fact that protein alone is less effective for muscle building than protein and carbohydrates together after exercise.” Meanwhile, according to a small study published in March 2018 in the journal Sports, people following the keto diet for three months lost about the same amount of body fat and had about the same muscle mass changes as people following normal diets. Yet the folks on keto did lose more leg muscle.
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Thank you for your objective review of the Keto Diet. I am not overweight but decided to try the Keto lifestyle because I have a lot of inflammation issues, including asthma and osteoarthritis. I had also been experiencing uncomfortable intestinal issues. I have been following the Keto lifestyle for 4 1/2 weeks, and I feel so much better- especially my stomach! I am eating a ton of leafy greens, broccoli and cauliflower. I am also enjoying Brussel sprouts, whole avacados and zucchini. I think the reason this is working well for me is because my body chemistry loves all the vegetables, good fats and protein. I also think that taking away sugar has had a big impact on how I feel. I’m just not eating grains and sugar. lots more veggies, berries, and consciously incorporating healthy fat. My stomach is flat again, and I have no more bloating or constipation. I have only lost 5 pounds, but I think my system is clean and operating better than it has in years. My point is that every person’s body chemistry is different. The Keto lifestyle seems to be what My body needed to feel my best. I did experience “the Keto flu” about a week into it, but it was short lived. I think that to be successful it is really important to eat a wide variety of veggies and good fats every day.
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.
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.
Researchers who set out to review the current state of research as it relates to the ketogenic diet published their results in the highly respected European Journal of Clinical Nutrition. Their comprehensive evaluation showed that the ketogenic diet held promise in a vast array of medical conditions and is promising results in other conditions, such as:
Try to be patient. Although some people get into ketosis relatively quickly, it can take others a while. Unfortunately, people who are insulin resistant often have a longer journey. Put in a solid month of consistent keto eating, and try to ramp up your physical activity, if possible. Within four weeks, you should definitely be in ketosis and experiencing its benefits.
But all those studies were very small, and not all research on the keto diet is as promising. One American Society for Clinical Nutrition study of 20 participants found that those on the diet didn’t lose more weight than those on a non-keto diet. But they did have fouler moods and higher levels of inflammation, which has been linked to a variety of conditions, including heart disease and cancer.
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.
As CDE’s, we individualize our recommendations for each of our patients. One person’s diet may not be appropriate for another person. For example, a six foot 6 inch tall man weighing 220 lbs of mainly muscle, who exercises 2 hours per day at the gym cannot have the same number of carbs per meal as a petite 5 foot 1 inch 75 year old lady who does not exercise.
The bottom line? If you’re thinking about trying the ketogenic diet, run it by your doctor first — regardless of any preexisting health conditions. And consult a registered dietitian nutritionist (find one at EatRight.org) to find a nutrition professional who can work with you to create a meal plan you can stick to. People with kidney disease or a history of disordered eating should avoid the diet, and people with type 1 diabetes may want to avoid it, as well. If you have risk factors for heart disease, you’ll want to speak with your doctor before considering the diet.
At this point, I’m searching for the secret sauce that will allow me to follow Wheatbelly or Keto or any other low carb diet, but not develop any health problems. When you have 80 lbs to lose, it’s discouraging to be told that you can’t be on the only diet that has ever worked for more than a few months. I’ll need a year or more just to get to goal weight.
Eating in a restrictive way can be socially isolating, Brown says. "You may avoid parties and other gatherings because you may worry about what food will be available for you, or even what foods may tempt you. Having to plan and control what you are eating so closely may lead to increased anxiety and stress. And who doesn't want to enjoy a beer with a friend or a piece of cake on your birthday?" As you probably know, emotional well-being and physical health are closely linked, which is all the more reason to choose foods that make you feel good both mentally and physically. If keto does that for you, great! But if it doesn't, know you're not alone. 

As far as the the Ketogenic Diet goes, it is a very personal decision between you and hopefully your physician. I would just recommend working closely with your physician for all the recommended lab tests to make sure you remain healthy while on the diet. That’s really the goal of any “diet” anyway, right? To get healthy? This is why we normally always recommend moderation with everything…moderation in the foods you eat along with moderate amounts of exercise equals a healthy lifestyle that will prevent diabetes or help you control your diabetes if you already have it.
Congratulations to you!! Keep up the good work. And, I have to say again, choosing the keto way of life as a type one diabetic is a lot easier than one would think, right?!. It is so rewarding, as you point out, and actually quite easy (lose the carb cravings and enjoy eating everything that you can!). I honestly feel more FREEDOM eating this way than I did eating the other way for 20 years and I love the normal sugars and better energy. Also the decrease in inflammation is awesome.

The keto diet has a massive fan base that has grown at least in part due to the popular Netflix documentary The Magic Pill, which touts a trove of promising keto health benefits. But the fact of the matter is that most of the studies on the keto diet are premature. Meaning: They’re in small populations of humans, or they’re in rats. (And you are very different from a rat.)

Familial Hypercholesterolemia. Familial hypercholesterolemia is a condition where one or more of the genes for the LDL receptor are defective, making it more difficult for them to clear cholesterol from the blood. If a person with familial hypercholesterolemia is then put on a high-fat diet, they will become even more vulnerable to heart disease as the increased saturated fat and cholesterol content of the diet provokes higher cholesterol levels. To counteract these genetic vulnerabilities, it is may be best to follow a low to moderate fat diet with plenty of whole foods, fiber, monounsaturated fats, polyunsaturated fats (especially omega 3s), and limited saturated fats. This, as well as a lifestyle that prioritizes physical activity, stress relief practices, and plenty of sleep, should keep their cholesterol levels under control.


It’s important to note, however, that most of the research is being done on diseases and disorders, not specifically weight loss. That doesn’t mean there hasn’t been evidence of weight loss as a benefit of the eating pattern, just that the studies performed specifically for the benefits for long-term weight loss are limited. There’s anecdotal evidence out there, of course, but there was evidence of weight loss associated with a low-fat diet in the '90s… until that farce came falling down around our collective shoulders as the long-term evidence came rolling in to the contrary.
A ketone body (KB) is a byproduct formed during the conversion of fatty acids to fuel. Some fatty acids are oxidized by the liver for energy production. Others can be partially oxidized to form the substrate acetoacetate, which is then converted to beta-hydroxybutyric acid; collectively, these are termed ketone bodies. Ketones can be used by all tissue containing mitochondria, which includes muscle and the brain.

Second point, I have never tried ketogenic dieting and also I did my calculations based on a 4:1 ratio and I was amazed at how much fat I would need to consume even at my size and the foods I would have to 1. Get rid of to achieve that and 2. Add in my diet to get there and , no thank you. My heart goes out to the families with children who do have to be on this diet.
Starting on a ketogenic diet can influence your exercise performance in multiple ways, both positive and negative. During the first 1-2 weeks (the “adaption period,” which I will get back to later), you will most likely see a decrease in energy and athletic performance across the board while your body adjusts to the new diet. This is perfectly normal and should NOT be a cause for concern or make you abandon the diet.
Skin conditions like eczema, acne, and psoriasis are often rooted in chronic inflammation or autoimmunity. Often, inflammatory processes unnecessarily attack different structures of the skin which results in various conditions. For example, acne is associated with inflammation of the sebaceous glands in the skin whereas eczema is generalized inflammation of the skin cells.
Type 2 diabetes is not a chronic and progressive disease if one removes the offending factors from their diet, namely sugar, flour and seed oils. This is imperative because it accomplishes two things; it removes the factors causing and exacerbating the disease, as well as replace them with nourishing foods that also regulate appetite. With nourishing food, a stable appetite and having removed the disease factors, this disease will not progress but regress.
But your heart health might depend on what you actually eat. Research published in the New England Journal of Medicine suggests that low-carb diets based mostly on plant sources of fat and protein (like avocados or nuts) can lower heart disease risk by 30 percent. But those benefits didn’t hold for people who ate mostly animal-based proteins and fats. (Think: bacon, butter, and steak.)
Click here to join my newsletter and I’ll keep you posted when I get new articles up (FYI: as a heads up, I also write about entrepreneurship and web development. I started writing about fat metabolism and ketogenic dieting here at KetoSchool out of pure hobby interest, as there are relatively few resources out there that teach the underlying science).
John Staughton is a traveling writer, editor, and publisher who earned his English and Integrative Biology degrees from the University of Illinois in Champaign, Urbana (USA). He is the co-founder of a literary journal, Sheriff Nottingham, and calls the most beautiful places in the world his office. On a perpetual journey towards the idea of home, he uses words to educate, inspire, uplift and evolve.
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