Healthy fats are crucial on a ketogenic diet, but people who have been following the official dietary advice don’t know what healthy fats are. In short: all natural fats that you find in fish, meat, nuts, olives, coconut, and full-fat raw dairy products are healthy for diabetics. On the other hand, oxidized seed oils and the trans fats in margarine should be avoided. Learn more about good fats vs bad fats here.


More good news: Snacks are totally allowed (and I'm not just talking about carrot sticks). There are plenty of packaged options out there designed for keto fans. FATBAR is one of them. These snack bars have 200 calories, 16 grams of fat, and four grams of net carbs. They're also plant-based and are made with almond or cashew butter, cocoa butter, coconut, pea protein, sunflower seeds, and chia seeds.
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.

Dr. Campos, it is so discouraging to see that you disparage the ketogenic diet based on your assumption that it is very heavy in poor quality processed meats. No diet that relies on processed foods can be viewed as “healthy”. Become better informed by getting up to speed with what Jeff Volek, RD, PhD, calls a “well-formulated ketogenic diet.” Also, learn more about the potential of the diet to slow cancer progression (my specialty). You owe it to your patients who are depending on you for advice. Present them with facts, not opinions.

The data presented in the present study showed that a ketogenic diet acted as a natural therapy for weight reduction in obese patients. This is a unique study monitoring the effect of a ketogenic diet for 24 weeks. There was a significant decrease in the level of triglycerides, total cholesterol, LDL cholesterol and glucose, and a significant increase in the level of HDL cholesterol in the patients. The side effects of drugs commonly used for the reduction of body weight in such patients were not observed in patients who were on the ketogenic diet. Therefore, these results indicate that the administration of a ketogenic diet for a relatively long period of time is safe. Further studies elucidating the molecular mechanisms of a ketogenic diet are in progress in our laboratory. These studies will open new avenues into the potential therapeutic uses of a ketogenic diet and ketone bodies.
A second counterintuitive approach to healing the gut for children who are having a hard time gaining is to encourage a nice long ‘fast’ over night.  When the gut is less full, and the body can digest the food that’s in there completely and then it can repair an inflamed or leaky gut better.   If the gut is inflamed, food may be passing right through without being absorbed.  In addition, growth hormone raises during periods of fasting.
Clinical improvement was observed in Alzheimer’s patients fed a ketogenic diet, and this was marked by improved mitochondrial function. (15) In fact, a European Journal of Clinical Nutrition study pointed to emerging data that suggested the therapeutic use of ketogenic diets for multiple neurological disorders beyond epilepsy and Alzheimer’s, including headaches, neurotrauma, Parkinson’s disease, sleep disorders, brain cancer, autism and multiple sclerosis. (16)
To say that the keto diet has become one of the most popular diets of recent years is a complete understatement. Case in point: There are more than one million searches on Google every month for the keto diet. It’s unique because the fad diet has captured the interest of people who want to lose weight — and there’s no shortage of reported success stories to be found.
Reduced hunger. Many people experience a marked reduction in hunger on a keto diet. This may be caused by an increased ability of the body to be fueled by its fat stores. Many people feel great when they eat just once or twice a day, and may automatically end up doing a form of intermittent fasting. This saves time and money, while also speeding up weight loss.
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.

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.
In order to transition and remain in this state, aiming for about 30–50 net grams is typically the recommended amount of total carbs to start with. This is considered a more moderate or flexible approach but can be less overwhelming to begin with. Once you’re more accustomed to “eating keto,” you can choose to lower carbs even more if you’d like (perhaps only from time to time), down to about 20 grams of net carbs daily. This is considered the standard, “strict” amount that many keto dieters aim to adhere to for best results, but remember that everyone is a bit different.
Since the state of ketosis forces cells to rely on ketones and to use the mitochondria for energy, ketosis feeds healthy cells while starving cancer cells. This especially seems to be true against some of the most deadly and incurable cancers. Researchers like Dr. Dom D’Agostino are also researching the role of ketosis and fasting in improving the outcomes and reducing the side effects of existing cancer treatments.
An article published in the New York Times in 2018 explores the use of a keto diet and diabetes type 1. The article points out how many diabetes experts will not recommend low-carb diets for type 1 diabetics, especially if they are children, due to concerns over hypoglycemia as a result of carb restriction and the possibility of this having a negative effect on a child’s growth.

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.


Casual chronic keto is at some risk of those same side effects. Sure, there are sporadic anecdotal cases where there appears (so far) to be no harm, but these are not large population RCTs. The KD-in-epilepsy data is closer to being RCT data. There being no ancestral case for chronic keto, we need to learn what we can from the formal studies (and sure, endeavor to separate the ailment, med and diet effects).


Ketogenic diet for diabetics is a highly controversial topic, but we will break down everything here for you! As a Certified Diabetes Educator (CDE), I have to tell you from the start I will have a biased view here. Sorry, but I feel that I need to be completely honest right up front! I will however, present all the evidence that is available currently on the subject.
I’ve been type 2 for about 15 years was pretty stable with diet and Metformin for 10 years. But eventually started trying more aggressive treatment like Victoza and without fail in 4 years I was on slow acting insulin. I lost weight lowered carb intake to 40mg or less in the morning my breakfast has been no carbs. People need to realize every diabetic is different you must manage it how it keeps you with good A1C levels. I myself got off insulin for a year and half but my fasting levels slowly increased again. Reversing diabetes is not possible. Reducing the effects is possible and more likely the better you monitor yourself and do what you need to do. Depending on medications or diets or counting carbs will all help but not cure the diabetes. These all are things that reduce its ability to affect your health negatively.
If not treated or reversed, dehydration can lead to acute kidney injury, Dr. Rahnama says. That’s not the only way the keto diet can put your kidneys at risk, however. “Kidney stones or damage to the kidney may also be a side effect,” Grace Derocha, RD, a certified diabetes educator and certified health coach at Blue Cross Blue Shield of Michigan says. High levels of nitrogen created by excess protein can also increase pressure in your kidneys. This can lead to the formation of more stones and damage your kidney cells.
The ketogenic diet typically reduces carbohydrate intake to less than 50 grams per day — and calls for increased protein and fat intake, according to a review published in August 2013 in the European Journal of Clinical Nutrition. Roughly speaking, on keto you’ll get 70 to 80 percent of your calories from fat, about 20 percent from protein, and as little as 5 percent from carbs.
Note that as a general rule it’s easier to err on the low side, and if your blood glucose goes a bit high you can take more insulin later if needed. That’s OK. If instead you overdose and get low sugar that is potentially far more dangerous. You’ll also have to quickly eat or drink more carbohydrates, and that obviously reduces the effect of the low-carb diet.
By now, you've probably heard all about the ketogenic diet, the high-fat, low-carb eating style everyone's talking about. And while the benefits of keto are pretty well-known—weight loss and a suppressed appetite—the downsides are usually minimized by keto advocates. "The positive aspects of a ketogenic diet are spoken about much more than the drawbacks," says Alix Turoff, R.D., C.D.N., C.P.T., a dietitian and personal trainer.
Every reduced-calorie diet is catabolic, meaning the diet can cause you to lose muscle. 'This is largely due to the fact that you are consuming less energy, so your body relies on other tissue (i.e., protein) to serve as an energy source. Added to that, some dieters do copious amounts of aerobic exercise when dieting, which can cause further breakdown of muscle. The brain can also call on protein to create more glucose for energy needs—a process called gluconeogenesis.

I would love to join a study! Could you recommend where to go to find one? I have done 30 or less total carbs a day for almost 2 years and feel great. I have NEVER EVEN ONCE gone over 40 total so I do follow it and I do not cheat on high carb foods, although I do occasionally over-eat on low carb foods resulting in a bit over 30 maybe 1 -2 times a month. I do feel that time will provide more support and think that the medical community should educate on this as another alternative. It isn’t for everyone because it is a bit more problematic if a person does fall of the straight and narrow too often but it can be done!


Having said that, there are also studies suggesting that long term carbohydrate restriction diets (aka. the keto diet) may result in fast short term weight loss but people gain it all back in the long term. An RCT put 63 individuals on a low-fat diet or a low carb diet, and the study found the low carb dieters lost more weight compared to the low fat group by month 3 and 6, but that the weight loss evened out by month 12. This was confirmed by a Meta-analysis which found that while low-carbers lost more weight than low-fat dieters but the differences disappeared by the one year mark.
Kidney stones are mineral deposits in the kidneys. They can be caused by multiple things–including dehydration, high sodium intake, family history, and excessively high consumption of protein (> 200g per day). A true ketogenic diet is low-carb, moderate-protein, and high-fat. So there’s no solid evidence that protein consumption at levels seen in a typical ketogenic diet could cause kidney stones.
If you do try the diet outside of medical supervision, Kizer says it’s important to test your urine with urinalysis ketone test strips to ensure your ketone levels don’t become dangerously high. Ketone urine test strips are also used by people with diabetes to determine if they’re at risk for ketoacidosis (DKA), a life-threatening complication that occurs when an individual doesn’t have enough insulin in their body. (Healthy ketosis is considered 0.5 to 3.0 mM blood ketones.)
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.

Clinical improvement was observed in Alzheimer’s patients fed a ketogenic diet, and this was marked by improved mitochondrial function. (15) In fact, a European Journal of Clinical Nutrition study pointed to emerging data that suggested the therapeutic use of ketogenic diets for multiple neurological disorders beyond epilepsy and Alzheimer’s, including headaches, neurotrauma, Parkinson’s disease, sleep disorders, brain cancer, autism and multiple sclerosis. (16)
It's important to note that the drop-out rate was substantial and reports of symptomatic hypoglycemia 1-5 episodes) were experienced by 69% of those in the study. The mean carbohydrate intake was 35 grams (+/- 15) daily. Based on self-reported results, the change in HbA1c was -1.45% (+/- 1.04, P < 0.001) with an average HbA1c of 7.2%  associated with greater hypoglycemia; yet, these results are comparable to other study findings. The average blood glucose levels were 104 mg/dL (+/- 16). 2  Final lipid profiles were mixed. The results were similar for adults and children.
It's important to note that the drop-out rate was substantial and reports of symptomatic hypoglycemia 1-5 episodes) were experienced by 69% of those in the study. The mean carbohydrate intake was 35 grams (+/- 15) daily. Based on self-reported results, the change in HbA1c was -1.45% (+/- 1.04, P < 0.001) with an average HbA1c of 7.2%  associated with greater hypoglycemia; yet, these results are comparable to other study findings. The average blood glucose levels were 104 mg/dL (+/- 16). 2  Final lipid profiles were mixed. The results were similar for adults and children.

"If you're going to do keto, there's a better and a worse way to do it," registered dietician Kim Yawitz told Everyday Health. "Loading your plate with meats, and especially processed meats, may increase your risk for kidney stones and gout... High intake of animal proteins makes your urine more acidic and increases calcium and uric acid levels. This combination makes you more susceptible to kidney stones, while high uric acid can increase your risk for gout."


Until recently, ketosis was viewed with apprehension in the medical world; however, current advances in nutritional research have discounted this apprehension and increased public awareness about its favourable effects. In humans, ketone bodies are the only additional source of brain energy after glucose (23,24). Thus, the use of ketone bodies by the brain could be a significant evolutionary development that occurred in parallel with brain development in humans. Hepatic generation of ketone bodies during fasting is essential to provide an alternate fuel to glucose. This is necessary to spare the destruction of muscle from glucose synthesis.
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.
Hormonal shifts. By restricting carbs, you will change the balance of glucagon and insulin. This will cause many changes throughout the body, especially regarding the function of your thyroid and adrenal glands. Most people can handle these changes without any issues, but there are a select few that may struggle to adapt without increasing their carb intake.
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.
In the mid-1990s, Hollywood producer Jim Abrahams, whose son's severe epilepsy was effectively controlled by the diet, created the Charlie Foundation to promote it. Publicity included an appearance on NBC's Dateline programme and ...First Do No Harm (1997), a made-for-television film starring Meryl Streep. The foundation sponsored a multicentre research study, the results of which—announced in 1996—marked the beginning of renewed scientific interest in the diet.[1]
At the core of the classic keto diet is severely restricting intake of all or most foods with sugar and starch (carbohydrates). These foods are broken down into sugar (insulin and glucose) in our blood once we eat them, and if these levels become too high, extra calories are much more easily stored as body fat and results in unwanted weight gain. However, when glucose levels are cut off due to low-carb intake, the body starts to burn fat instead and produces ketones that can be measured in the blood (using urine strips, for example).
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