One of the most-cited worries about the keto diet is the long-term impact it may have on heart health—especially because people with diabetes are at greater risk for heart disease. In the small Diabetic Medicine study that found people with type 1 improved their A1Cs on a keto diet, participants had higher triglycerides and LDL (“bad”) cholesterol. This raises concerns about the diet’s longer-term heart health implications, as do the results of research published last year in The Lancet. That study followed more than 15,000 adults for 25 years and found that people who consumed less than 40 percent of their calories from carbohydrates were significantly more likely to die from heart disease than those whose diets contained 50 to 55 percent of calories from carbs—especially if the foods that replaced those carbs were rich in animal fats and proteins.
Produced by the liver, cholesterol is also derived from our diet. People often assume eating foods rich in cholesterol will raise cholesterol levels and increase the likelihood of a heart attack. But it’s more complicated than that. Cholesterol-rich foods feature heavily in the keto diet (butter, eggs, red meat); but there are two types of cholesterol. “Bad” LDL cholesterol (think L = lethal) is linked to clogging of the arteries. “Good” HDL cholesterol (think H = healthy) clears cholesterol from the blood.
To lower your heart risks while following a keto diet, be mindful of the types of fats you’re eating. “Most nutritionists encourage people to get their fat from heart-healthy mono- and polyunsaturated fats,” Urbanski says. So even though going keto may sound like a license to load up on bacon and butter, reach for unsaturated fats from foods such as olives, nuts, seeds, and avocados, and olive, canola, and nut oils.
“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.”  

One reason it's hard to determine the exact health effects of diets is that it's often unclear whether any observed effects come from the diet or from a combination of other factors, like stress, environment or genetics. Still, that doesn't mean all the bold claims about the keto diet are wrong, but rather that you should approach them with a healthy degree of skepticism.


To be clear, most of the hype you’ll hear about how the ketogenic diet can ward off cancer is taking things too far. While there is a fair amount of research regarding cancer, studies have been limited to animals. One review published in Redox Biology highlighted some of them, indicating promising results for colon, gastric, and prostate cancers. Maybe more interesting are the few case studies involving human subjects. Bear in mind, we’re talking about a handful of people. In these cases, implementing a ketogenic diet seemed to halt disease progression.
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.
The Ketogenic Diet is a low carbohydrate diet, consisting initially of less than 20 carbohydrates per day. Not per meal, yes, you heard me correctly, per day. It is not for the faint of heart and yes I am writing from experience. Of course I have tried it! Hasn’t everybody in America at some point who has wanted to lose weight? Does it work you ask? Of course it does! The problem is how long can you keep it up?
"On a ketogenic diet, your intake of fruits and vegetables is extremely limited, and we all know how important the fiber, vitamins, minerals, and other compounds in fruits and veggies are," says Libby Parker, R.D., a dietitian who specializes in treatment and prevention of eating disorders. It's true: There are a lot of healthy but high-carb foods you can't eat on the ketogenic diet. That's one of the reasons keto is usually pretty low in fiber, which isn't so great long-term. "Fiber is not only protective against many gastrointestinal cancers, it is also a big factor in fullness and weight loss," Parker explains. "Furthermore, constipation is very common on low-fiber diets like the keto diet." (That said, These Healthy, High-Fat Foods Can Help You Feel Full Longer.)
By now, most of us have heard about the ketogenic diet. Whether it's because of the benefits of eating high-fat and low-carb, or because you can eat cheese all day long, it's officially become one of the hottest diets of the year. It may not be easy to cut out all the carbs, but emerging research suggests that eating fat can actually help burn fat. So, for anyone trying to lose weight, you may find it worth the carb cut. Beyond weight loss, recent research has found some other serious health benefits of keto that may impact your life later on. Let's take a look at what the research has to say.
The keto diet is NOT what you seem to picture. I laughed at your description as I was eating lamb chops, cauliflower rice, broccoli, followed by cheesecake. How deprived I was! You should relook at what the diet really is. By the way, my cardiologist highly recommends keto. Most people see a drastic decrease in their triglyceride/HDL ratio. Looking at total cholesterol or LDL alone is 20 years out of date! Even the AHA has caught up, and now says that it’s NOT how heart health should be judged.
Often these children who have trouble gaining *don’t feel good* when eating, so they aren’t interested in eating much.  In the case of underweight children who crave refined carbs, the dopamine hit they get from eating the simple sugars may override enough of the discomfort of eating, making these nutrient-void foods the only ones they accept.  In addition, if their gut flora is off balance, the gut flora may be sending signals to the brain to keep consuming simple starches and sugars.
"Muscle loss on the ketogenic diet is an ongoing area of research," Clark told Everyday Health. "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."

But wait, there’s one loophole. Have polycystic ovary syndrome (PCOS)? Then the keto diet may help regulate your periods. “Women with PCOS have high insulin levels, which cause sex hormone imbalances,” notes Yawitz. In a small study published in the journal Nutrition & Metabolism, subjects with PCOS following a ketogenic diet for six months noted improvements in their menstrual cycles — and a small number of women became pregnant, overcoming previous infertility obstacles. “This study was very small, so we can’t make recommendations for all women with PCOS based on its findings,” says Yawitz. “And really, any diet that leads to weight loss should help in PCOS.”

Common complications of diabetic ketoacidosis include very low blood sugar, or hypoglycemia, and swelling of the brain (cerebral edema). As such, when a person is in ketoacidosis, there is such a high level of ketones produced that can push a person into cardiac arrest (heart attack) or kidney failure. Hence, the very important reason for taking occasional keto breaks go give your body a bit more nourishing carbs. 


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In part, keto diet weight loss is a real thing because high-fat, low-carb diets can both help diminish hunger and boost weight loss through their hormonal effects. As described above, when we eat very little foods that supply us with carbohydrates, we release less insulin. With lower insulin levels, the body doesn’t store extra energy in the form of fat for later use, and instead is able to reach into existing fat stores for energy.
There is nothing inherently difficult about following a ketogenic diet. We have many patients who do this very easily over many years. The metabolic benefits significantly outway any perceived challenges from limiting particular food types. Uptake would be far more widespread if nutrition professionals left their predujical opinions of SFA’s behind. Finally, given the expertise in Ketogenic Diets at Harvard, Dr David Ludwig, for one springs to mind, I am surprised the author did not avail themselves of the local expertise.
These types of back-and-forth weight fluctuations can contribute to disordered eating, Kizer says, or can worsen an already unhealthy relationship with food. “I think this diet appeals to people who have issues with portion control and with binge eating,” she says. "And in many cases, what they really need is a lifestyle coach or a professional counselor to help them get to the bottom of those issues."

“Suddenly and drastically reducing carbohydrates sets your body up for a double whammy of sorts,” says Yawitz. “The brain’s favorite fuel is glucose, which is most easily created from carbohydrates. In very-low-carb diets, the brain has to adjust to using ketones from digested fats for energy. To add to this discomfort, your kidneys release more electrolytes as insulin levels fall.” Additionally, your total body water decreases as carbohydrates become depleted on a keto diet, notes Clark. The result? What’s known as the keto flu, which could cause constipation, nausea, headache, fatigue, irritability, cramps, and other symptoms. Don’t fret, though: Many of these symptoms are short term and should last only a few days to weeks. Make sure to drink plenty of water to help your body cope with these symptoms. And call your doctor if symptoms — especially nausea — are prolonged, advises Yawitz.
🙌🙌 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.
“Rapid, significant weight loss is a common side effect of the keto diet because of the water losses that occur as carbohydrate stores are depleted,” says Clark. In a study in the American Journal of Clinical Nutrition, obese men following a modified version of the ketogenic diet, with high protein and low carbs, lost about 14 pounds in one month, compared with the control group, which lost about 10 pounds on a high-protein, medium-carb diet.
Given all the buzz, adopting a ketogenic diet may be the perfect weight loss plan, especially if you have diabetes, or want to try this approach to lose those troublesome extra pounds. After all, it’s a very low-carb meal plan that promises effective weight loss while also lowering your blood sugar to the point where you could possibly stop taking medication. By all accounts, the “keto” diet, as it’s widely known, may even reverse type 2 diabetes, at least for some lucky individuals.
Polycystic ovary syndrome (PCOS) is the most common endocrine disorder, and it affects women of reproductive age. Symptoms include obesity, hyperinsulinemia and insulin resistance. A pilot study took 11 women through 24 weeks of a low-carbohydrate ketogenic diet (20 grams or less per day). Among the five who completed the study, they lost 12 percent of their weight on average and reduced fasting insulin by 54 percent. Additionally, two women who previously experienced infertility problems became pregnant. (6)
“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.
Losing essential micronutrients is another concern raised by keto diet skeptics. People say eating a diet based on fat and protein from animal sources means losing those micronutrients found in higher-carb grains, legumes, fruits, and vegetables. Some also claim low-carb diets contain too little fiber, and thus may cause long-term constipation. That’s inaccurate.

There are people who say that keto helps your athletic performance, and those who say it hurts it. "The literature is mixed on how an ultra low-carbohydrate diet like the keto diet affects athletic performance," says Grant Cox, C.S.C.S., head coach at Iron Tribe Fitness. But one thing is pretty clear: "A lot of it points to consistent decreases when athletes are looking for maximal power output (in weightlifting, vertical jumps, sprinting, etc.). Along the same lines, you'd be hard-pressed to put on weight and strength on such a low carbohydrate diet," he says.


Constipation is the rule–as virtual elimination of dietary carbohydrates also means virtual elimination of prebiotic fibers that nourish bowel flora. Over time, this leads to metabolic distortions including a drop in HDL cholesterol, rise in triglycerides, rise in small LDL particles that lead to heart disease, rise in insulin resistance and blood sugar, rise in blood pressure, even if these parameters initially improved on the diet. This is also due to dysbiosis and lack of prebiotic fibers. While this has not yet been tracked in children, in adults we can expect that these distortions in bowel flora will, over time, also lead to heightened inflammation (bowel and elsewhere), diverticular disease (.e.g., diverticulitis), and colorectal cancer. Yes: prolonged ketosis can add substantially to risk for colon cancer. Other peculiar gastrointestinal complications of prolonged ketosis have also been observed, such as protein-losing enteropathies.
Often caused by lymph node removal or damage due to cancer treatment, lymphedema occurs because there’s a blockage in the lymphatic system and results in the swelling in leg or arm. A 2017 study involved patients who suffered from obesity and lymphedema and who embarked on a 18-week ketogenic diet. Weight and limb volume was significantly reduced. (5)
In part, keto diet weight loss is a real thing because high-fat, low-carb diets can both help diminish hunger and boost weight loss through their hormonal effects. As described above, when we eat very little foods that supply us with carbohydrates, we release less insulin. With lower insulin levels, the body doesn’t store extra energy in the form of fat for later use, and instead is able to reach into existing fat stores for energy.
By now, most of us have heard about the ketogenic diet. Whether it's because of the benefits of eating high-fat and low-carb, or because you can eat cheese all day long, it's officially become one of the hottest diets of the year. It may not be easy to cut out all the carbs, but emerging research suggests that eating fat can actually help burn fat. So, for anyone trying to lose weight, you may find it worth the carb cut. Beyond weight loss, recent research has found some other serious health benefits of keto that may impact your life later on. Let's take a look at what the research has to say.
"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.
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.
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.
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.
A great long-term benefit of the ketogenic diet is reduced cravings for sugar and other unhealthy foods. However, you might initially have stronger cravings for carbs during the transition period. This can last anywhere from one to two days to around three weeks. But stick it out! At the end, you’ll be pleased with the reduced, and often eliminated, cravings.
In the brain, there are some parts that can only take glucose to burn for fuel, which is usually derived from carbohydrates. However, when the body is on a ketogenic diet, the body will enter ketosis, which is a process that produces proteins called ketones from fatty acids in the liver. The brain can surprisingly also take in these special ketones to function. Past studies have shown that children affected with epilepsy who are on this diet have a 50% lower chance of reducing seizures. 16% of that group have also shown to be seizure free. This diet is for individuals with Parkinson’s disease and Alzheimer’s to see if ketogenic diets can also help.
Resistant starches can be included as part of a ketogenic diet or as a supplement because it has minimal effects on blood sugar, so it doesn’t disrupt the state of ketosis. Resistant starches not only feed good bacteria in the gut but can also get fermented into substances that are beneficial for health. (Read this post to learn more about the health benefits of resistant starches and how to use them.)
Unlike some restrictive eating plans, the ketogenic diet actually has some wiggle room. Authority Nutrition highlights four different variations, which allow varying proportions of fat, protein, and carbs. No matter which variation someone chooses, they can expect to eat a lot of meat, fish, eggs, dairy, and nuts. It’s time to take a closer look at some of the health benefits of the ketogenic diet.
Often these children who have trouble gaining *don’t feel good* when eating, so they aren’t interested in eating much.  In the case of underweight children who crave refined carbs, the dopamine hit they get from eating the simple sugars may override enough of the discomfort of eating, making these nutrient-void foods the only ones they accept.  In addition, if their gut flora is off balance, the gut flora may be sending signals to the brain to keep consuming simple starches and sugars.
The level of total cholesterol showed a significant decrease from week 1 to week 24 (Figure 3). The level of HDL cholesterol significantly increased (Figure 4), whereas LDL cholesterol levels significantly decreased with treatment (Figure 5). The level of triglycerides decreased significantly after 24 weeks of treatment. The initial level of triglycerides was 2.75±0.23 mmol/L, whereas at week 24, the level decreased to 1.09±0.08 mmol/L (Figure 6). The level of blood glucose significantly decreased at week 24. The initial blood glucose level and its level at the eighth, 16th and 24th week were 7.26±0.38 mmol/L, 5.86±0.27 mmol/L, 5.56±0.19 mmol/L and 5.62±0.18 mmol/L, respectively (Figure 7). The changes in the levels of urea (Figure 8) and creatinine (Figure 9) were not statistically significant.

Carbs turn into glucose (aka sugar) in the body. Eating too many carbs causes your blood sugar to spike. When you switch from carbs to fat for energy, you stabilize your blood sugar. Keto can be particularly beneficial for diabetics, who have high blood glucose levels. The keto diet may even cure diabetes — many diabetics are able to come off their medication when switching to keto. Find out more about keto and blood sugar here.


Regarding keto diets specifically, studies have proven this method to be more effective than moderate protein diets in lowering blood glucose, promoting weight loss and lowering HbA1c in patients with Type 2 diabetes. A growing number of clinicians now agree that low-carb diets can effectively treat this disease. The fact remains: these diets remain controversial and contradict dietary guidelines, so they are not very often discussed or recommended in the clinical setting.
With diabetes, the goal is to first lower your insulin levels so that your blood sugar and triglycerides normalize. Nutrita provides you with the insulin index that allows you to avoid the most insulinogenic foods and replace them with nutrient dense options lower on the insulin index. The insulin index alone can be a bit confusing because fish can cause you to secrete quite a bit of insulin, but your body compensates with other hormones like glucagon, unlike what happens when eating a donut or a pizza.
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.
I have been working more seriously on my health after a major health crash 5 years ago, possible Rocky Mountain Spotted Fever/Lyme. Organ functions are getting better including heart, liver and gallbladder. Pancreas is at stage 3 insufficiency. I’m concerned about a high fat, protein diet. Still have IBS and gut infections. Thinking that just bone broth and easy to digest foods might be good at this point for healing?
Once ketosis is established, most people experience more stable and lower blood sugar levels. Low-carb diets can be an effective way for people with type 2 diabetes to get a handle on glycemic control—and carb monitoring has long been thought to be an effective way to control blood sugar—though one study concluded low-carb diets are not necessarily a better long-term strategy than other diets. Anecdotal evidence abounds from people with type 2 diabetes who have used the keto diet to stabilize their blood sugar and were able to quit taking their diabetes medication. But it’s not recommended that people with diabetes begin the keto diet without first talking to their doctor.

Adherence to a keto diet food list isn’t always great, though. A review published in January 2015 in the Journal of Clinical Neurology found that only 45 percent of participants were able to follow the approach as prescribed. “The poor compliance was attributed to side effects, social isolation, and cravings,” says Yawitz. And some people in the study “reported the diet simply wasn’t helping them lose weight,” she adds. Brissette agrees with this line of thinking. “In my opinion, the keto diet isn't sustainable and takes the joy and fun out of eating,” she says.


Losing essential micronutrients is another concern raised by keto diet skeptics. People say eating a diet based on fat and protein from animal sources means losing those micronutrients found in higher-carb grains, legumes, fruits, and vegetables. Some also claim low-carb diets contain too little fiber, and thus may cause long-term constipation. That’s inaccurate.
Instead of thinking about the total carbs you’re eating, assess what those carbs provide to you. Do the majority of your carbs come from fruit and vegetables, with a payload of fiber and disease-fighting antioxidants? Fantastic. Or are you consuming them in the form of added sugars (cookies, candy, soda) or refined flour? If you are, you know what to do.
WOW. I guess I must be a very special, highly motivated patient then. I, of course, would never have said that about myself. My high motivation is trying to get over the hatred of food that being Diabetic gave me. I don’t feel that way anymore, and am finally happy cooking, again. (My doctor DID tell me exactly that, BTW. Even to the extent of telling me to not include the tsp of agave that I was having in my coffee once a day because sugar is sugar.)
Dr. Cabeca came up with the concept of combining an alkaline diet with a keto diet after weighing the benefits of very low-carb eating on one hand, with some of the negative feedback she was receiving from clients on the other. Although many of her clients experienced weight loss quickly and reliably while reducing their intake of carbs, many also reported dealing with side effects like nausea, fatigue and constipation due to the keto diet.
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.
In one study they were testing the endurance of the Mice by giving on group MCTs in their daily food, and the other group of mice LCTs. The study lasted for 6 weeks. The total swimming time until exhaustion was measured, and at first there was no difference. As the weeks went by, those fed MCTs quickly began to out-perform the others and continued to improve throughout the testing period.

You lose weight temporarily because “if you’re not hungry every five minutes and can work on your willpower,” you won’t eat as much, Nisevich Bede says. But while some research is promising — one study published in October 2013 in the British Journal of Nutrition found that the keto diet led to greater weight loss than a low-fat diet, for example (4) — there is a lack of long-term research (greater than two years) that suggests a highly restrictive diet like keto is superior for weight loss than others, and it’s certainly not right for everyone.
Hi, I think Keto is a great starting point. I am almost 60 years old and finally feel good, no fogginess or sluggishness. For the first time I have no hippy handles and my tummy is flatter – no bloating or puffiness and I feel more energetic. I have only been doing Keto for about 4 weeks. I am so happy with the results!! I will continue for another 8 weeks or so then I will add more foods back in BUT moderation is key. I will slowly up my healthy carbs and find what is good for me. Happy days everyone!!! =)

They have high likelihood of calcium oxalate and uric acid kidney stones–Kidney stones are uncommon in childhood, yet these kids commonly have kidney stones. The risk in an adult on a prolonged ketogenic effort is therefore high, also. Kidney stones are not benign–they are painful and can occasionally result in kidney damage (increased creatinine, urinary tract infections, etc.)
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