A: The most common ways to track your carbs is through MyFitnessPal and their mobile app. You cannot track net carbs on the app, although you can track your total carb intake and your total fiber intake. To get your net carbs, just subtract your total fiber intake from your total carb intake. I have written an article on How to Track Carbs on MyFitnessPal.
Reynolds, AN. "Comment on 'An Online Intervention Comparing a Very Low-Carbohydrate Ketogenic Diet and Lifestyle Recommendations Versus a Plate Method Diet in Overweight Individuals with Type 2 Diabetes: A Randomized Controlled Trial." Journal of Medical Internet Research. 2018; 20(5):e180, May 2018. Available at: http://www.jmir.org/2018/5/e180/  Accessed May 4, 2018.
On a “strict” (standard) keto diet, fats typically provides about 70 percent to 80 percent of total daily calories, protein about 15 percent to 20 percent, and carbohydrates just around 5 percent. However, a more “moderate” approach to the keto diet is also a good option for many people that can allow for an easier transition into very low-carb eating and more flexibility (more on these types of plans below).
So rather than giving one-size-fits-all dietary advice or weaponizing the word “balanced” it might be better if the medical community suggested that there are Individual differences that need to be considered. This might also help those lay folk who have had success with one dietary lifestyle or another also realize that what’s valid for them may not be good advice for others.
Ok. I have MCT oil. It’s day six. I got a metallic taste in my mouth last night (day 5), and have had 2 hypoglycemia attacks over night (took small amount of OJ and some 2 tbsp of flaxseed meal with half & half). Slowly felt better throughout the day. Bought just about all the adrenal support products you recommend this a.m. My main issue since last night: my heart has been pounding, non stop. I read it might be cortisol induced reflexive hypoglycemia or something? I’ve never been diagnosed with adrenal exhaustion, but I am noticing tiredness and weight gain (I’m 47). So, the adrenal exhaustion perhaps is self diagnosed (I’m know, so annoying for a physician to hear! I hate saying it myself). But, I’m wondering, if I’m just perimenopausal instead, should I continue on keto? If so, will the heart pounding resolve after a certain time? (Days? Weeks?) Plesse excuse how long this is. Just trying to anticipate questions.
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.

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.


This article is a perfect example of the misinformation regarding diabetes and insulin resistance. The authors stance against the ketogenic diet is a simple, “its just too hard, I cant live without fruit.” She projects her lack of willpower to her audience. Ketogenic diets are a great way to reduce insulin levels and get to the root of the problem.

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)

You may be able to tell that you're in ketosis by a change in your breath (many report halitosis, or bad breath, due to higher levels of the ketone acetone coursing through the body). Others experience the keto flu for anywhere from one day to two weeks as the body cranks up the ketones. Symptoms of the keto flu are very similar to the influenza virus, including nausea, fatigue, vomiting and diarrhea. Hydrating well and starting slowly can reduce your risk for this.
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 seeing thousands of patients now for years and from personal experience, I still believe it comes down to staying away from processed foods and cooking at home whenever possible. Eating a variety of fresh fruits, vegetables, proteins, and fiber. Also, cutting out any sugary liquid calories; staying away from sodas, juices and the infamous sweet tea! Keeping stress levels under control and incorporating exercise into your routine will also be key to breaking through challenging times when you are having trouble with continued weight loss.
The modified ketogenic diet emerged in the late nineties as a re-work of the original ketogenic diet. The original ketogenic diet was inspired by the Atkins diet of the early to mid-nineties that saw practitioners eliminate any form of carbohydrates from their food intake. These practitioners relied solely on fat and protein as their macro nutrients.
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.

One argument against the consumption of a high fat diet is that it causes obesity. The major concern in this regard is whether a high percentage of dietary fat promotes weight gain more than a low percentage of fat intake. Because fat has a higher caloric density than carbohydrate, it is thought that the consumption of a high fat diet will be accompanied by a higher energy intake (31). On the contrary, recent studies from our laboratory (12) and many other laboratories (24,32–34) have observed that a ketogenic diet can be used as a therapy for weight reduction in obese patients.

If you’re wondering about the difference between ketosis and diabetic ketoacidosis, you’re not alone. “The word ketone is scary for most people with type 1 diabetes because they relate ketones to diabetic ketoacidosis,” says Patti Urbanski, MEd, RD, CDE, a certified diabetes educator with St. Luke’s Hospital in Duluth, Minnesota. “But with the ketogenic diet, we’re talking about a much lower level of ketones.”
Keto decreases inflammation and improves brain function — so much so that Alzheimer’s patients who switch to a keto diet actually begin to recover their brain function, which up until now was unheard of.[20][21][22][23][24] So there’s that. (Dale Bredesen and Mark Hyman have discussed these on the Bulletproof Radio podcast. Check out Dale’s episode here, and Mark’s here.)  
Is the keto diet safe for diabetics? Most research shows that yes, it is. However, even though the KD can help reduce insulin resistance while someone adheres to the diet’s principles and strictly limits their carb intake, these positive effects may be short-lasting. Results from some animal studies show that insulin resistence/glucose intolerance may potentially be increased once carbs are reintroduced back into the diet.
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.
A well-balanced keto diet includes enough fat so that you are not hungry after a meal, can go for several hours without eating, and have ample energy. Make sure to increase your intake of fat at the start of your keto journey until your body adapts to using fat and ketones for most of its energy needs. Once you’re fat adapted, let your appetite guide you in cutting back on fat a bit until you reach the point where you can easily maintain the balance between hunger and satiety.

You’re transitioning. Your body is equipped to process a high intake of carbs and a lower intake of fat. Your body needs to create enzymes to be able to do this. In the transitional period, the brain may run low on energy which can lead to grogginess, nausea, and headaches. If you’re having a large problem with this, you can choose to reduce carb intake gradually.
I must note here, that as a nutrition professional who has worked in pediatrics and seen children who must follow this diet, it is incredibly challenging for both the child and family. Most people who must follow this diet for therapeutic medical reasons have trouble actually reaching ketosis with diet alone, and need to drink poor-tasting formula drinks to keep their carb-to-fat ratio in tight control. Many of these individuals must follow this way of eating to survive or have any sort of quality of life.
I actually clicked on the story just to see if they included anything about it’s use in managing chronic migraine. I have chronic migraine, basically intractable. Nothing has helped. I’ve tried medications, meditations, and everything in between including a bunch of dietary changes. Keto is my next consideration. I’m happy to hear it helped you! Thanks for sharing
A ketogenic diet also has been shown to improve blood sugar control for patients with type 2 diabetes, at least in the short term. There is even more controversy when we consider the effect on cholesterol levels. A few studies show some patients have increase in cholesterol levels in the beginning, only to see cholesterol fall a few months later. However, there is no long-term research analyzing its effects over time on diabetes and high cholesterol.
Reduces mitochondrial free radial production, which decreases oxidative stress. Research demonstrates that the ketogenic diet reduces free radical levels in the brain. Furthermore, studies in cardiac tissue have suggested that ketones reduce oxidative stress, a pathogenic process implicated in many disorders ranging from atherosclerosis (plaque in the arteries) to other diseases more specific to the nervous system.

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.
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.
The ketogenic diet is a low-carb, high-fat diet, similar to a number of popular diets such as the Atkin’s diet. It is primarily known as a weight-loss diet, as it can help boost the metabolism and speed up the burning of calories. While many people think of a high-fat diet as being unhealthy, it is all about the type of fats that you consume. In a ketogenic diet, for example, your protein intake will be quite high, rather than having a carb-heavy diet. Both carbs and fats can be used by the body for energy, but when fat is the primary source of energy metabolism, the body enters a state known as ketosis.
Our bodies run well on glucose (carbs)–they give us the necessary energy we need to function on a daily basis. When our body doesn’t get enough glucose (either because we’re cutting carbs too low, OR we haven’t eaten in too long), our body kind of freaks out and looks for other forms of energy to satisfy that role. That’s where the fat comes in. Without carbs, our insulin levels drop and fat is released from our cells. The fat overwhelms the liver which turns it into ketones, our body’s second choice to carbs for energy.
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.
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