This is a helpful article. But there are some inaccurate things too. I have type two diabetes and use a keto genie diet to lose weight (45# so far). I was able to get my cholesterol down, Triggs down, and my A1C to 6! I went off and followed a Mediterranean diet for a year. I gained back 15# and my diabetes got worse. So I am back on keto. I am using a closer to Mediterranean keto both then and now.
The keto diet involves getting up to 80 percent of daily calories from sources of healthy fat, a significant change for most of her patients who were accustomed to running on carbs, caffeine and sugar for energy. It became clear that something else had to be adjusted in order to prevent the side effects associated with the keto diet. This is when she came up with the idea to focus on restoring alkalinity first and foremost.

Test ketones in the late morning or afternoon. Blood and urine ketones are usually lowest right after waking up. Try testing later on, preferably a few hours after eating. Even if you’re only in ketosis for a portion of the day, you’re still getting some benefits, as discussed in this talk by Dr. Steve Phinney: Achieving and maintaining nutritional ketosis.

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.


Well… what are many people on a Keto diet trying to do? Lose weight right?  I would guess that prior to discovering the Keto diet many of these people were caught in the trap of low fat dieting.  This lead to months or years of low fat intake and consequentially low gallbladder activity.  The gallbladder wasn’t needed to digest fat and so it sat idle and stones were more likely to form.  Once they made the shift to a ketogenic lifestyle and their fat consumption increased upwards of 1000%, the gallbladder kicked into high gear.  If the previous period of low fat dieting had caused stone formation they are going to have to deal with flushing those stones out now while on a high fat Keto diet.
Con: Results can vary depending on how much fluid you drink. By drinking more water, you dilute the concentration of ketones in the urine and thus a lower level of ketones will be detected on the strips. The strips don’t show a precise ketone level. Finally, and most importantly, as you become increasingly keto-adapted and your body reabsorbs ketones from the urine, urine strips may become unreliable, even if you’re in ketosis.
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.

Your body uses the carbohydrates you eat for energy, so if we restrict how many carbohydrates we eat, the body has to get its fuel source from fat. A byproduct of this fat burning state are ketones which are produced; this is called nutritional ketosis. You can determine if you are in this fat burning state by purchasing urine ketone testing strips from your local pharmacy.
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.”
Also, diabetics should not undertake the diet without medical supervision. “Trying a ketogenic diet has the power to drastically and quickly lower blood glucose levels,” says Santos-Prowse. “If a person with diabetes is taking blood glucose-lowering medications, their doctor needs to be on board to help with adjusting or stopping the medications as needed.”
Sleep enough – for most people at least seven hours per night on average – and keep stress under control. Sleep deprivation and stress hormones raise blood sugar levels, slowing ketosis and weight loss a bit. Plus they might make it harder to stick to a keto diet, and resist temptations. So while handling sleep and stress will not get you into ketosis on it’s own, it’s still worth thinking about.
Here’s why. All of these effects take time, but a reasonable explanation as to why the keto diet leads to rapid weight loss is due to the loss of water weight. One of the concerns with the keto diet is the loss of muscle mass and the depletion of glycogen stores. Glycogen, which stores our glucose, also stores water, so when stores are depleted, we flush out excess water. In other words, that rapid weight loss isn’t fat, it’s just water.
Switching from a high-carb diet to a very-low-carb diet lowers insulin levels in your body. This is not only healthy but also one of the primary goals of a ketogenic diet. When insulin levels are very low, your liver begins converting fat into ketones, which most of your cells can use in place of glucose. When your body is mainly using ketones and fat for energy, you’re in a state of ketosis.

Type 2 diabetics may be on a range of medications that only treat symptoms, have serious side-effects and leave root causes unaddressed. Medications like Metformin may still make sense to use while reversing diabetes with a ketogenic diet. However, most if not all drugs like insulin and sulfonylureas can and should be discontinued. A note of caution though, changing doses or discontinuing medications is something you should do with the help of your doctor (or at the keep them informed).
Walking, stretching, or doing gentle yoga or other mind-body exercise should be fine and may even help you feel better. But when your body is already under stress from trying to adapt to a new fuel system, don’t place an additional burden on it by attempting any type of strenuous workout. Take it easy for the first few weeks and then slowly increase your exercise intensity.
There are occasional instances of cardiomyopathies (heart muscle diseases, heart failure) and sudden cardiac death–The immediate causes are unclear, though at least some cases are due to severe selenium deficiency. The picture is muddied by the fact that some kids were fed large quantities of corn oil in past as a means of maintaining ketosis. Nonetheless, it suggests further uncertainties with prolonged ketosis.

This effect can also be demonstrated by researchers at Kraft Foods, published in the American Journal of Clinical Nutrition. For 12 weeks one group ate a low fat, calorie restricted date, and the other ate a low-carb, high-fat diet without restriction… other than low carb of course. After 12 weeks, the low-fat group lost 5.5 pounds and the low-carb group lost 10.8 pounds.
It’s a fairly common scene for new keto dieters. Aubrey Marcus recently referenced a highly-disturbing stat that 25% of physicians still equate consuming dietary cholesterol with increased blood cholesterol, an association that has been unequivocally refuted by recent science. But before you accept AHA-sanctioned diet advice, determine if there’s actually a problem.
Compared to other diets, the keto diet actually has positive effects on appetite control. A major reason that people tend to lose weight and reduce their risk for certain diseases on the KD is because ketosis causes a decreased appetite, thanks to lowering hunger hormones such as ghrelin. It does this even while not negatively affecting levels of leptin, another hormone that regulates appetite, food intake and body weight. Having adequate leptin levels signals to the body that its energy needs are being met and makes weight loss possible.
Recently, four studies have re-examined the effect of carbohydrate restriction on type 2 diabetes. One outpatient study enrolled 54 participants with type 2 diabetes (out of 132 total participants) and found that hemoglobin A1c improved to a greater degree over one year with a low-carbohydrate diet compared with a low-fat, calorie-restricted diet [5,6]. Another study enrolled 8 men with type 2 diabetes in a 5-week crossover outpatient feeding study that tested similar diets [7]. The participants had greater improvement in glycohemoglobin while on the low-carbohydrate diet than when on a eucaloric low-fat diet. The third study was an inpatient feeding study in 10 participants with type 2 diabetes [8]. After only 14 days, hemoglobin A1c improved from 7.3% to 6.8%. In the fourth study, 16 participants with type 2 diabetes who followed a 20% carbohydrate diet had improvement of hemoglobin A1c from 8.0% to 6.6% over 24 weeks [9]. Only these latter three studies targeted glycemic control as a goal, and two of these were intensely-monitored efficacy studies in which all food was provided to participants for the duration of the study [7,8]. Three of the studies [6,8,9] mentioned that diabetic medications were adjusted but only one of them provided detailed information regarding these adjustments [9]. This information is critical for patients on medication for diabetes who initiate a low-carbohydrate diet because of the potential for adverse effects resulting from hypoglycemia.
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.
Registered dietitian Julie Stefanski is based in York and has specialized in the ketogenic diet for more than a decade. She also advocates for anyone starting keto, especially individuals who have not seen a doctor in more than a year, to first see a physician and/or registered dietitian to have their lab work checked and monitored. She also notes there are certain medications that cannot be used while on a ketogenic diet.  
What is more common throughout the history of the human race is fasting. Islamic Ramadan is a 28- to 30-day fast where food and drink are prohibited during the daylight hours. Christianity also has a strong fasting foundation, and in the Bible, Jesus fasted to have higher and clearer communication with God. Greek Orthodox Christians fast for a total of 150–200 days each year!
My son started the Keto Diet (not perfectly) with the ok of his Dr and a Different Oral Chemo at the same time. Last Tuesday an MRI indicated no new growth or no new tumors. We don’t know if the new Chemo, Keto diet, lots of prays or what has stopped the tumors from growing.I found your site after looking for possible adverse reactions to Keto Diets, and appreciate your research. His platelets are low now and never have been low before. This is stopping the next Chemo treatment. I understand that being on Chemo for 12 months could have created the low platelets and now the possibility that the Keto Diet could also be causing low platelets is frustrating. They will do a new blood test Tuesday to see if the platelets have increased. Any suggestions about how if possible to increase the platelets on the Keto Diet would be helpful.
To avoid the overload of stress, I find my relief by being the person at the origin of my son’s quality of life. I am not a doctor, a pharmacist, or a research person. I am just Max’s mother. For almost 15 years I have been using food to treat the adverse side effects of his syndrome. Angelman Syndrome (AS) is one of many neurological disorders that can be treated with therapeutic diets.
Yes. The ketogenic diet is very healthy. As a matter of fact, it comes with lots and lots of health benefits which we have already looked at. Even though this diet comes with a few side effects, it comes with a lot more health benefits ranging from providing more energy to helping with weight loss and controlling blood sugar. In all, the ketogenic diet is a very healthy diet.
Ketoacidosis, on the other hand, is a complication of poorly managed diabetes. It results in uncontrolled production of ketone bodies that can change the pH of the blood, which can prove fatal. Ketoacidosis is more common with Type 1 diabetes rather than Type 2. It’s also important to note that the keto diet cannot cause ketoacidosis – but rather puts the body into the beneficial state of ketosis.
Yes you can lose fat on a low carb because it’s just another low calorie diet. How do I know this? I’ve done low carb, (Atkins, etc) high carb, (Slimming Word) moderate carb etc and log my food and was shocked each time to see they were all low calorie. After the initial week or so the rate of fat loss is same as any other diet. It’s calories in calories out. Simple. It’s what some call indirect deficit diet placing silly restriction, rules can eat must eat etc. and of course you lose weight but nothing to do with low carb. It works because it’s a low calorie diet.
Eating cholesterol has very little impact on the cholesterol levels in your body. This is a fact, not my opinion.  Anyone who tells you different is, at best, ignorant of this topic.  At worst, they are a deliberate charlatan. Years ago the Canadian Guidelines removed the limitation of dietary cholesterol. The rest of the world, especially the United States, needs to catch up.
You work out for a few months and get in shape and fall back to the old habits because you were not conditioned mentally, only physically. Physical fitness is only a part of journey, fitness is over 75% percent mental. Gyms, nutritionists, and personal trainers give most people a temporary Band-Aid but never address the actual issue. The 3-Week Ketogenic Diet includes secret mindset strategies to make your journey so much easier.
Although many proponents recommend this high fat version of Keto for weight loss, it first gained notoriety as a treatment method for Epilepsy. Going as far back as the 1920’s, medical professionals have recommended high fat Keto Diets as a treatment method for difficult to control seizure disorders. However, a diet that includes a high percentage of fats as part of its eating program increases the daily caloric intake. More calories means slower fat loss. Therefore, the higher calorie count is why this Ketogenic Diet type is considered a slower weight loss model for dieters and is why the Ideal Protein Protocol is a more effective Keto Diet for weight loss.
You might be surprised to learn that many non-keto friendly foods are associated with a whole lot of health benefits – so by cutting them out, you forgo many of their perks. Fruit, for example, is brimming with a range of antioxidants that help to fight damage to your body’s cells. Another example is grain foods, which are associated with reduced risk of heart disease, diabetes and some cancers. Same goes for legumes, too.
If you’re wondering why iron is at risk on a meat-based diet, hear me out. Many grain foods provide a considerable amount of iron, because wholegrains naturally contain iron in their inner layer called the ‘germ’. Another reason is that some grain products can have iron added to them during manufacturing. So, once you cut grains out, your iron status could suffer, which can lead to unpleasant symptoms like tiredness and lethargy. It can even compromise your immune system.
Losing heart muscle may not be the only heart-associated risk with the keto diet, Derocha says. “If you have high blood pressure and are taking medication, the prescription mixed with the diet may cause abnormally low blood pressure test results,” Derocha says. Before you start the keto diet, she suggests you talk with your doctor to avoid low blood pressure, which can be dangerous, even deadly.
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.
“Tremendous Results”….guess that’s why the diabetes nationwide gets worse every year, because of the stellar advice your kind is giving out. I’ve been on the virta clinic for two months and already went off insulin, Janumet and Jardiance, which I’ve been on for 10 years, with blood sugars between 80 and 150. The advice you give makes people get sick slower. The ketogenic approach deals with the real issue, carbohydrate intolerance. If you are lactose intolerant you stop ingesting lactose. Type two diabetes is simply carbohydrate intolerance. Stop eating the carbs and the symptoms go away. I think you meet to cite some of the other research out there I’ve read in other books and the work the Virta Clinic has done. In my opinion you’ve cherry picked data to suit your preconceived beliefs.
Katie Wells, CTNC, MCHC, Founder and CEO of Wellness Mama, has a background in research, journalism, and nutrition. As a mom of six, she turned to research and took health into her own hands to find answers to her health problems. WellnessMama.com is the culmination of her thousands of hours of research and all posts are medically reviewed and verified by the Wellness Mama research team. Katie is also the author of the bestselling books The Wellness Mama Cookbook and The Wellness Mama 5-Step Lifestyle Detox.
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.
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