While it's not necessarily dangerous, bad breath is a known side effect of entering ketosis. When you’re taking in a lot of fat, your liver metabolizes it and eventually converts it into smaller ketone bodies. These ketones (including acetone — yep, like nail polish remover acetone) will circulate in your body and diffuse into your lungs. Your body wants balance, so you'll exhale ketones to avoid build-up in your bloodstream. Those compounds are what cause keto breath: a metallic-tasting, somewhat stinky side effect.
The good news here is no! All the evidence points to the fact that a low carbohydrate diet actually does lower blood glucose and A1c levels and does contribute to weight loss. The problem is we do not yet have enough large studies, over enough sustained years to support evidence that people with diabetes can remain on a highly restrictive Ketogenic Diet for the rest of their life and also not have other consequences to their health.
I have multiple autoimmune diseases. I fought 4 doctors, all of whom told me that adults can’t get type 1. I finally went to the Jefferson Diabetes Center. Yup! Type 1 diabetes. I’m slender, do marathons, bp 100/60, triglyceride/HDL ratio 1.08. And I STILL fought 4 doctors because of the ADA misinformation. All it takes is a simple blood test to look at antibodies. That’s all it takes, but the test is almost never run.
The low-carb diet induces ''nutritional ketosis," Dr. Saslow tells EndocrineWeb, which is not the same as ketoacidosis. Ketones are a chemical your body produces when you burn stored fat; if you are on a low-carb diet you may be ''in ketosis.'' Ketoacidosis is different; it is a life-threatening condition in which levels of ketones and blood sugar are dangerously high, which may occur in people who have poorly controlled diabetes.
When we eat this carby kind of food multiple times per day with little time in-between meals, insulin levels are consistently high throughout the day. Over the years, cells react to this constant overflow of glucose and fat by shutting down their insulin receptors. With fewer insulin receptors, cells become less sensitive to the action of insulin. For the same amount of glucose to be taken up, the pancreas has to produce more insulin.
2 days from grains my stomach bloat was gone and I knew at that point everything this article and American diet was a lie. I’ve been on keto for over 16 months. Down 50lbs. In 6 months. I am ripped. Haven’t lost any muscle mass. I eat greens protein and healthy fat. I whole juice to get macros and yes I add watermelon or berries fo palatability purposes. I still eat carbs just healthy choices. I’ve become carb tolerant.. your liver will produce all glucose without ever eating 1 carb. This is biased and poor representation of keto lifestyle. When your starving and no carbs to choke keto will still thrive on either or fuel.
Articles and information on this website may only be copied, reprinted, or redistributed with written permission (but please ask, we like to give written permission!) The purpose of this Blog is to encourage the free exchange of ideas. The entire contents of this website is based upon the opinions of Dave Asprey, unless otherwise noted. Individual articles are based upon the opinions of the respective authors, who may retain copyright as marked. The information on this website is not intended to replace a one-on-one relationship with a qualified health care professional and is not intended as medical advice. It is intended as a sharing of knowledge and information from the personal research and experience of Dave Asprey and the community. We will attempt to keep all objectionable messages off this site; however, it is impossible to review all messages immediately. All messages expressed on The Bulletproof Forum or the Blog, including comments posted to Blog entries, represent the views of the author exclusively and we are not responsible for the content of any message.
The following measurements were made every other week: anthropometric and vital sign measurements; urine testing for ketones; and assessment for hypoglycemic episodes and other symptomatic side effects. Weight was measured on a standardized digital scale while the participant was wearing light clothes and shoes were removed. Skinfold thickness was measured at 4 sites – the average of 2 measurements at each site was entered into an equation to calculate percent body fat . Waist circumference was measured at the midpoint between the inferior rib and the iliac crest using an inelastic tape; 2 measurements were averaged in the analysis. Blood pressure and heart rate were measured after the participant had been seated quietly without talking for 3 minutes. Certified laboratory technicians assessed urine ketones from a fresh specimen using the following semi-quantitative scale: none, trace (up to 0.9 mmol/L [5 mg/dL]), small (0.9–6.9 mmol/L [5–40 mg/dL]), moderate (6.9–13.8 mmol/L [40–80 mg/dL]), large80 (13.8–27.5 mmol/L [80–160 mg/dL]), large160 (>27.5 mmol/L [160 mg/dL]). Hypoglycemic episodes and symptomatic side effects were assessed by direct questioning of the participant and by self-administered questionnaires.
I came here to say similar things, OP. Whoever wrote this article obviously has an agenda and is conveniently over-looking evidence and stories from people like you. I especially like the part where she claims keto isn’t sustainable because “Oh My God, I can’t not like eat bread, like for the rest of my life, lol” and “YOU’LL GAIN ALL THE WEIGHT BACK IMMEDIATELY IF YOU HAVE A CHEAT DAY!!” This article was a great laugh. I came here to get educated but am quickly learning you can’t always believe what a random dietician says on the internet. Happy KETO and congrats on your success!
I know a few people who struggle with keeping on the low carb diet and staying in ketosis. They introduced me to a exogenous drink called keto/os that is a natural energy drink that contains ketones. It gets you into ketosis within an hour!!! This can be tested in the blood and they showed me the results and it works!!! Not only that but it dropped their blood sugars as well. I am now on the product myself for other reasons but just thought I would share it. Let me know if you want more info.
According to Dr. Sarah Hallberg, an advocate of diabetes reversal with dietary intervention, low-carb diets are the only ones that can possibly reverse this disease. Most studies examining the possibility of diabetes reversal focus on general exercise and reducing calorie intake. Nonetheless, these studies found that lifestyle changes normalize beta cell functioning, meaning reversal is possible.
Thank you Dr Jockers! I recently came across your website and i absolutely love what you do. I am an advanced practice nurse and just started a part time keto coaching practice.I am already amazed by the changes i see in my clients. Do you have by chance a training program for keto coaches. If not, is there one out there that you recommend? Thank you in advance.
Lazy keto diet: Last but not least, the Lazy keto diet often gets confused with dirty keto … but they’re different, as the “lazy” refers to simply not carefully tracking the fat and protein macros (or calories, for that matter). Meanwhile, the one aspect that remains strict? Not eating over 20 net carb grams per day. Some people find this version less intimidating to start with or end with … but I will caution that your results will be less impressive.
In a survey of both children and adults, researchers found that a very low carbohydrate diet promotes “exceptional glycemic control” in those with type 1 diabetes mellitus. When it comes to type 2 diabetes, the Journal of American Medical Association recently published a review examining the effective use of the ketogenic diet in those with type 2 diabetes.
Of all the high-carbohydrate foods that are eliminated in the low-carb ketogenic diet cutting out wheat products — bread, cereals, baked goods, pasta — may be the most significant for mental health disorders. It has been known for more than 50 years that an associate appears to exist between wheat consumption and symptoms for some people with schizophrenia.
I suffered through a year on 20 grams of carbs per day and it was the worst year of my life. Yep, I lost weight, but at my current weight of 130 lbs and eating 30 carbs per meal and remaining in a prediabetes state for 15 years, I am healthy AND happy now. None of us know the long term effects of most of what is offered to us…medications, diet drinks, processed foods, restrictive diets. The point I was trying to make was eating healthier, more natural foods will be better in the long run, I believe we all have the common sense to agree on that, even if we can’t agree on how many carbs we will eat!
Type 1 diabetes is not caused by insulin resistance, but it still makes sense to lower the need for insulin. Because type 1 diabetics hardly produce any insulin, they rely on external insulin when following a standard high-carb diet. Through carb restriction, a ketogenic diet decreases the need for insulin. In some type 1 diabetics, their insulin production is sufficient when following a ketogenic diet. Others still need to inject insulin, but much less than on a high-carb diet. Overall, it is much easier to control blood sugar levels with injected insulin on a ketogenic diet because blood glucose raises only mildly after meals.
More and more studies show that low-carb diets are an effective way to lose weight: A 2018 report out of Framingham State University found that after five months on a low-carb, high-fat diet, overweight adults burned about 250 more calories daily than people who ate a high-carb, low-fat diet. The keto diet in particular has a number of famous adherents, including Halle Berry, Katie Couric and Gwyneth Paltrow. Kourtney Kardashian blogged about doing keto, calling it “a really positive experience.” And keto-friendly recipes, snacks and meal plans have proliferated in the past few years.
The keto diet may also be beneficial for adults with epilepsy, though the Epilepsy Foundation notes that it’s less frequently recommended for this group because it is so restrictive and difficult to stick with. (1) One study, published in May 2016 in the journal Epilepsy & Behavior, found the diet reduced the frequency of seizures for many study participants, 7 percent of whom were seizure-free at the four-year mark. (2) And though it wasn’t the goal for this study, nearly 20 percent of the participants lost weight while following the diet.
Keto has become synonymous with low carb, but as you have just read, reaching ketosis is much more complex than just eating fewer carbs. Healthy, young active people are taking up ‘the keto diet’ recreationally without any clinical reason in an attempt to lose weight, drop body fat, get a six-pack, or just to follow a trend their friends have taken up.
"Most of the work in this field is still pre-clinical, meaning it's been conducted in animal models," Angela Poff, a research associate in the Department of Molecular Pharmacology and Physiology at the University of South Florida, told U.S. News & World Report. "It's been done in various cancer types, but most of the work has been done in brain cancer specifically. But there's very little clinical data all around. There's some case reports and very small preliminary clinical studies in small groups of patients, usually very late-stage patients with various types of cancers. So in the clinical realm, which is the most important in telling us whether this is going to be useful, we have a long way to go."
At the first visit, participants were instructed how to follow the LCKD as individuals or in small groups, with an initial goal of ≤20 g carbohydrate per day. Participants were taught the specific types and amounts of foods they could eat, as well as foods to avoid. Initially, participants were allowed unlimited amounts of meats, poultry, fish, shellfish, and eggs; 2 cups of salad vegetables per day; 1 cup of low-carbohydrate vegetables per day; 4 ounces of hard cheese; and limited amounts of cream, avocado, olives, and lemon juice. Fats and oils were not restricted except that intake of trans fats was to be minimized. Participants were provided a 3-page handout and a handbook  detailing these recommendations. Participants prepared or bought all of their own meals and snacks following these guidelines.
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
Our bodies are incredibly adaptive to what you put into it – when you overload it with fats and take away carbohydrates, it will begin to burn ketones as the primary energy source. Optimal ketone levels offer many health, weight loss, physical and mental performance benefits.1There are scientifically-backed studies that show the advantage of a low-carb, ketogenic diet over a low-fat diet. One meta-analysis of low-carbohydrate diets showed a large advantage in weight loss. The New England Journal of Medicine study resulted in almost double the weight loss in a long-term study on ketone inducing diets.
In the study, the researchers fed mice a ketogenic diet for several days and expected to find a favorable outcome — perhaps weight loss or another indication of improved health. Instead, they found that the liver began resisting insulin almost immediately and the mice were unable to regulate their blood sugar levels after only three days on the diet. (Insulin resistance, meaning that cells in the body don't respond to insulin, is a key characteristic of type 2 diabetes.)
Here’s the tricky part: There’s no definite answer for how much protein you’d have to eat before you run into trouble. “It really depends on how much protein a person is consuming versus how much they need, as well as the health of their kidneys at baseline,” Hultin says. That’s why it can be helpful to speak with a nutritionist or doctor who can help you tailor your diet before going keto.
Although we love them to death, our Mom’s typically have zero authority on the subject. When Mom heard you were going on a ketosis diet the first thing she did was head to google hell bent on finding any information about the dangers of the diet. Sure enough, 10 pages into google she found what she was looking for… Never mind the first 9 pages filled with information about the safety and merits of the diet.
A huge concern with the keto diet is the maintenance and potential loss of muscle mass. Many people will just think: hey, dummy, then just eat more protein. However, some research has shown that even if your protein intake remains constant, a low carb diet may promote muscle loss. A study from the Netherlands confirmed these findings. In the study, participants were given three diets (high carb, moderate carb, low carb) and moderate protein. The study found that those following a low carb diet experienced increased muscle breakdown. This is because when we eat carbohydrates, we produce insulin which promotes muscle growth. This is why athletes depend on carbohydrates (along with protein) to fuel their performance. When we eat carbs, the insulin release “unlocks” our muscles to let the protein in so it can do its job at building our muscles. So, when we skip the carbs all together, muscle glycogen stores get depleted, we lose out on those muscle building opportunities. Forget about high intensity training. A depleted glycogen store also means our workouts will suffer because we just don’t have enough oil left in the tank. This was a again suggested in the recent review looking at many ketogenic studies. The studies found that there was greater lean body mass loss in the ketogenic groups compared to the other diets being studied.
Several recent studies indicate that a low-carbohydrate diet is effective at improving glycemia. A few studies have shown that in non-diabetic individuals, low-carbohydrate diets were more effective than higher carbohydrate diets at improving fasting serum glucose [13,14] and insulin [6,14-16], and at improving insulin sensitivity as measured by the homeostasis model . One of these studies also included diabetic patients and noted a comparative improvement in hemoglobin A1c after 6 months (low fat diet: 0.0 ± 1.0%; low carbohydrate diet: -0.6 ± 1.2%, p = 0.06)  and 12 months (low fat diet: -0.1 ± 1.6%; low carbohydrate diet: -0.7 ± 1.0%, p = 0.019) duration . In a 5-week crossover feeding study, 8 men with type 2 diabetes had greater improvement in fasting glucose, 24-hour glucose area-under-the-curve (AUC), 24-hour insulin AUC, and glycohemoglobin while on the low-carbohydrate diet than when on a eucaloric low-fat diet . In a 14-day inpatient feeding study, 10 participants with type 2 diabetes experienced improvements in hemoglobin A1c and insulin sensitivity as measured by the euglycemic hyperinsulinemic clamp method . Hemoglobin A1c also improved in an outpatient study of 16 participants who followed a 20% carbohydrate diet for 24 weeks .
Prior to the advent of exogenous insulin for the treatment of diabetes mellitus in the 1920's, the mainstay of therapy was dietary modification. Diet recommendations in that era were aimed at controlling glycemia (actually, glycosuria) and were dramatically different from current low-fat, high-carbohydrate dietary recommendations for patients with diabetes [1,2]. For example, the Dr. Elliot Joslin Diabetic Diet in 1923 consisted of "meats, poultry, game, fish, clear soups, gelatin, eggs, butter, olive oil, coffee, tea" and contained approximately 5% of energy from carbohydrates, 20% from protein, and 75% from fat . A similar diet was advocated by Dr. Frederick Allen of the same era .
Obesity Compared with those on a typical low-calorie diet, obese individuals on a very-low-calorie ketogenic diet lost more weight and inflammatory visceral (belly) fat in one study, published in December 2016 in the journal Endocrine. (9) It may also help preserve lean body mass during weight loss, according to an article published in February 2018 in the journal Nutrition & Metabolism. (10)
Hey Edwin, I personally have been following one for years with no issues. I cycle out once every 1-2 weeks with a higher carb day using low glycemic carb sources like root vegetables. One of the keys for me has been keeping it simple and finding ways to use staple ingredients (such as avocados and coconut products) to make a variety of recipes.Check out this article for some examples https://drjockers.com/ketogenic-avocado-recipes/
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.
"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."
No Pete, this is not true. What you have mentioned is based on the seven country epidemiological study done by Ancel Keys in the 1970s. This entire study was based on flawed science. Ancel Keys cherry picked the data that supported his argument for the foundation for his hypothesis. Although this hypothesis was never backed by scientific evidence the mainstream medical system took it as gospel in creating standards for the health professionals.
The one important caveat: Eating keto also ups the risk for diabetic ketoacidosis, a life-threatening condition where fat gets broken down too fast and causes the blood to become acidic. It’s much more common in people with type 1 diabetes, but if you have type two and are eating keto, talk with your doctor about what you should be doing to diminish your risk.
The most important thing that diabetics have to learn is that there is no reason to avoid fat, not even saturated fat. It is not saturated fat that causes arteriosclerosis and heart disease, but an excess of refined carbohydrates like sugar and flour. Seed oils are implicated in the disease although by other mechanisms that involve damaged lipids and mitochondrial toxins.
Bulk buy and cook. If you’re someone who doesn’t like to spend a lot of time in the kitchen, this is the best of both worlds. Buying your food at bulk (specifically from wholesalers) can reduce the cost per pound tremendously. Plus, you can make ahead food (bulk cook chicken thighs for pre-made meat, or cook entire meals) that are used as leftovers, so you spend less time cooking.
And that’s the kicker -- most people “going keto,” may not actually be following a true ketogenic diet since it’s hard to know for sure if your body’s in ketosis. Mancella explains that the only formal and valid method of determining if your body is in ketosis is if there are ketone bodies being excreted in your urine. “There are strips for purchase at local drug stores that are available to determine this,” she says. “Otherwise, we’re not actually sure if we’re in ketosis, and we’re just following a ‘low carbohydrate’ diet.”
I lived the last 10 years with this disease and a mentality of “Well all those other people around me are eating and drinking this stuff, so I want to be normal like them” I’m lucky that mentality didnt kill me. I’ve had A1C of 12, bad cholestoral in the high 600s and triglycerides of almost 2000. And yes, the author is right, our lives are ridiculously built around food. That’s why we have an obesity epidemic in this country. I am the only person I know that eats healthy. Everywhere I went for the last 10 years I was surrounded by food and drink. Oh well. Moderation is only the key for people with good genes. For people like me, sacrifice is the key. I don’t want a normal life anymore. Excuse my vulgarity, but I want energy, six pack abs, and a hard dick again. This disease wrecked my life and I’m never going back there again.
A keto diet has shown to improve triglyceride levels and cholesterol levels most associated with arterial buildup. More specifically low-carb, high-fat diets show a dramatic increase in HDL and decrease in LDL particle concentration compared to low-fat diets.3A study in the long-term effects of a ketogenic diet shows a significant reduction in cholesterol levels, body weight, and blood glucose. Read more on keto and cholesterol >