This was very confusing and disappointing to read from Dr. D. Wheatbelly IS ketogenic. In fact, I got kidney stones while following it, along with some other weird symptoms like hair loss and very cold hands and feet. Granted I was probably dehydrated and lacking in some nutrients……but still. I never had those issues while following SAD. On SAD I never worried about drinking enough water or whether I was getting the right scientifically controlled combination of vitamins, minerals, pro/pre biotics. Never had to eat a raw potato or, dear God, a hard, chalky, green banana (who can do that for life? No one). I never got a kidney stone (or the other mentioned symptoms) on SAD. And they all went away when I stopped doing Wheatbelly. Very disappointing because I was losing weight on Wheatbelly and have gained it all back. Anyway, the diets are very similar. If you restrict carbs the way Dr. D says you should…. for life, you will be in ketosis long term.
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.
The keto diet also appears to help induce autophagy, which helps clear damaged cells from the body, including senescent cells that serve no functional purpose but still linger inside tissues and organs. In animal studies when rats are put on the ketogenic diet, autophagic pathways are created that reduce brain injury during and after seizures. (21)
Financial disclosures: There were no conflicts of interest reported except for Dr Bernstein who has received royalties for books on the management of diabetes (which were used by members of the online social media group surveyed in this study). Dr. Hallberg who holds stock options and receives research support from Virta Health, and consulting fees from Atkins. Dr. Rhodes is the site principal investigator in clinical trials for pediatric type 2 diabetes that are sponsored by Merck and AstraZeneca. Dr. Westman has an ownership interest in companies using low-carbohydrate principles, and he receives royalties for books related to low-carbohydrate diets. Dr. Ludwig has received royalties from books on nutrition and obesity; and Dr. Galati is author of Eating Yourself Sick: How to stop obesity, fatty liver, and diabetes from killing you and your family (2018).

 Ketones are a cellular “superfuel” and one in particular – beta-hydroxybutyrate (BHB) – drives powerful, beneficial processes. Beta-hydroxybutyrate is important for the regulation of important genes, inflammation regulation, immune system activity, and even antioxidant function. This important ketone is one of the fundamental reasons the keto diet is so beneficial.
The keto diet is a low-carb, high-fat dietary regimen which has been linked to improvements in insulin sensitivity and higher rates of weight loss — both positive factors in managing type 2 diabetes. Lowering carb intake induces a metabolic state known as ketosis, through which the body produces ketones which burn fat — rather than carbohydrates — for energy.
One of the keto side effects people may complain about is keto breath.  Although this is not quite related to the three major causes we’ve discussed so far, keto breath is something that many people experience in the early stages of keto adaptation. When you begin producing ketones, you produce them in several different forms. The ketone that is released through the breath is acetone and is responsible for the keto breath that some people experience.
Now, there’s even evidence that a low-carb, high-fat regimen (as the keto diet is) helps you live longer, compared to a low-fat diet. In a study by the medical journal The Lancet that studied more than 135,000 adults from 18 countries, high carbohydrate intake was associated with higher risk of total mortality, whereas total fat and individual types of fat were related to lower total mortality. Total fat and types of fat were not associated with cardiovascular disease, myocardial infarction or cardiovascular disease mortality.
Known primarily as a weight-loss diet, a ketogenic approach will allow your body to use higher-quality food sources for energy, and store less fat. When it comes to carbohydrates, any excess calories will be stored as fat for future use. This will only result in weight gain, and lower energy levels, particularly after the initial sugar rush of energy from simple carbohydrates. More protein in the body will also kickstart the metabolism, which will increase fat-burning potential, particularly if you are eating high-quality fats as a part of the ketogenic diet.
This concept was previously unthinkable as modern nutritional science was led to believe that the body’s metabolism relied on gluconeogenesis to create ATP as energy for the body’s metabolic processes. Glycogen derives from dietary carbohydrate intake, so by removing it from the diet, nutritionists expected devastating health results to emerge in practitioners of the diet.
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.
In the last 15 years, about two dozen studies have been conducted on low-carb diets and all of the studies came out with one conclusion – the Ketogenic diet works! It is a much healthier and more effective option for weight loss compared with any high-carb calorie restricted diet. This article explores the numerous health benefits of ketogenic diet in addition to weight loss.

Even if you don't have a history with eating disorders, keto can still leave some people (although certainly not everyone!) with negative feelings around food. "For the vast majority of people, keto is not sustainable, meaning they don't stick with it for more than a few months," Brown says. "Not 'succeeding' with this diet and returning to one's usual eating habits can trigger feelings of guilt and failure." Those two feelings can actually trigger disordered eating in some people in the worst-case scenario, says Brown. (Also, We Seriously Need to Stop Thinking of Foods As "Good" and "Bad")
By going on a ketogenic diet, you are far more likely to increase your level of fiber intake, primarily through fruits and non-starchy vegetables. This increase in dietary fiber will help aid digestive health by promoting peristaltic motion and easing the passage of bowel movements. This can lower your risk of indigestion, constipation, diarrhea, bloating, cramping, gastric ulcers and even colorectal cancer.
Two years in and I am this exact same story. I do agree that if one is not insulin resistant or diabetic and has normal insulin response there are other less restrictive diets that will work. I would also add that people fail and drop out of almost EVERY diet program for one reason or another so that argument is null and void. I am under a doctor’s care and am healthier than I have been in years. My only dietary “sin” is artificial sweeteners and I am not looking back! I have not cheated at all on high carb foods and am rarely even tempted. It is doable if your motivation is there and you have support which is true for any kind of life altering decision.
You would be surprised how many people do read the comments. I wouldn’t say the article is crap. You are excited about keto because you have heard about it yesterday, or last week, or last month or last year or 2 years ago or 5 years ago or may be you were born in 20’s-30’s when it all started but I doubt you were born in 20’s-30’s because your language would differ a lot.
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Examples include non-starchy fruits and vegetables such as leafy greens, mushrooms, bell peppers, and berries. The trace minerals and vitamins found in grains can also be obtained at higher percentages in good-quality meats and dairy products. Moreover, compounds such as phytates and tannins in grains hinder the bioavailability of several minerals.13

Type 2 diabetes is not a chronic and progressive disease if one removes the offending factors from their diet, namely sugar, flour and seed oils. This is imperative because it accomplishes two things; it removes the factors causing and exacerbating the disease, as well as replace them with nourishing foods that also regulate appetite. With nourishing food, a stable appetite and having removed the disease factors, this disease will not progress but regress.
People With a History of Eating Disorders Going on a strict diet that eliminates food groups could trigger a relapse if you have a personal history of having an eating disorder. And while there’s a growing popularity in treating binge eating disorder (BED) with keto, experts strongly advise against it. Treatment of BED requires regular, adequate food intake without restriction, says Sumner Brooks, MPH, RDN, a certified eating disorder dietitian in Portland, Oregon.

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.
Second point, I have never tried ketogenic dieting and also I did my calculations based on a 4:1 ratio and I was amazed at how much fat I would need to consume even at my size and the foods I would have to 1. Get rid of to achieve that and 2. Add in my diet to get there and , no thank you. My heart goes out to the families with children who do have to be on this diet.
I’m in ketogenesis now – 3 weeks in. Lost over 10kg. Protein shakes. Great. But what I wanted to add was that i’m Diabetic (2) and quite badly so. I was Injecting insulin twice a day – Novomix (part immediate, part slow acting). But since I went into keto, my blood sugar has been steady between 5-9, normal range. No injections needed. And no hypo attacks either – that occurs below a reading of 4, for me. This is NOT a cure of course – it’s directly related to low carb intake. But I do wonder if discontinuing insulin is partly responsible for my improvement in alertness, activity level and so on. Magnesium tabs, 1000 units twice a day, have also been helpful – I suffer leg and foot cramps due to spinal arthritis – but they had worsened until I upped the dose.
Controlling your blood sugar levels helps you control your cravings, Dr. Burrows says. “When we are not on a sugar roller coaster from processed carbohydrates, most people make better food choices because they are not looking for their next hit of food,” she says. You may also find you’re able to go longer periods without eating, he says. Intermittent fasting is a common practice among dieters who’ve been eating keto for a while. Learn how one woman totally kicked her sugar habit by trying the keto diet.
Hello, I’m Abbey! I'm a Registered Dietitian (RD), an avid food and recipe writer, a TV nutrition expert and spokesperson, a YouTube host and the founder of Abbey’s Kitchen Inc. Abbey's Kitchen is a multi- faceted food and nutrition media brand developed with the goal of celebrating the pleasurable eating experience. For more information about me, check out my bio here.

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.
Examples include non-starchy fruits and vegetables such as leafy greens, mushrooms, bell peppers, and berries. The trace minerals and vitamins found in grains can also be obtained at higher percentages in good-quality meats and dairy products. Moreover, compounds such as phytates and tannins in grains hinder the bioavailability of several minerals.13
This means that instead of generating tons of ketones from the very beginning, most people experience hypoglycemia for a period of time. With hypoglycemia comes a disruption in cortisol signaling which is what accounts for the HPA axis dysfunction. Finally, HPA axis dysfunction leads to an increase in secretion of minerals from the body in the urine.

Celiac disease is another condition with a very well established link to psychiatric and neurologic conditions. It is estimated that one to two of every 100 people has celiac disease, an immune disorder in which the ingestion of gluten in wheat, rye and barley destroys the lining of the small intestine, leading to a wide array of health problems. Another six out of every 100 people may have non-celiac gluten sensitivity, which while not having evidence of damage to the lining of their small intestine nevertheless can experience a wide range of health issues, including mental health issues.
Adding salt to food might be new to you, since most people are used to being told to limit salt intake. However, when you’re eating a ketogenic diet of less than 60 carbohydrates each day, you’ll need to make up for this loss of salt. That being said, those with high blood pressure who take medication should check with their doctors before making a change.
First off, make sure that you’re eating real and organic foods. It’s best to steer clear of processed products and foods that contain excessive amounts of sugar, starch and trans fat, since they obviously won’t do your health any good. You should also avoid foods that contain high amounts of carbohydrates, such as milk, as they may cause you to consume more than the allotted amount of carbs that you need for a day.
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.
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.
I recently had one of my previous cooks post that she was going to do this diet and should she start with 20 grams or 30 grams. She has been a cook in the healthcare business for about 8 years so she understands the different diets but not the physiology behind them (yet. I am trying to talk her into taking the CDM course). I told her to consult the RD at her facility before she embarks on such a trend. She won’t because all her friends posted their weight loss stories.
While there have not been large studies that show the relationship between the ketogenic diet and cancer, we will be publishing a case study about that topic. The author failed to comment that pediatric patients with epilepsy are on the diet for usually about 2 years with no harmful effects. Before the false studies about heart disease and fat, the low carb diet was a respected way to lose weight. Studies into our metabolism show we can use both fat and carbohydrate as fuel. So stepping away from our high carb diet- I am sorry to say that we eat more carbs since the 70s with most of it processed and we now use high fructose corn syrup to sweeten products and we have a wide spread childhood obesity problem. If cholesterol is a concern try plant sterols and stenals to block cholesterol from the receptors in the body. So much more can be said about a keto diet than this article states
I’m discouraged to see that nowhere in the article nor in the comments is there a mention of a diet’s best fit to genetics. Consider if someone is an APOE E2 carrier and/or has certain polymorphisms of the APO5 gene. These are quite rare in Okinawa but much more prevalent in the USA (12% of the population). According to a number of well-designed studies, these genetic characteristics point to a higher fat, lower carbohydrate diet as beneficial and even a “moderate” carb diet as problematic.
First off, make sure that you’re eating real and organic foods. It’s best to steer clear of processed products and foods that contain excessive amounts of sugar, starch and trans fat, since they obviously won’t do your health any good. You should also avoid foods that contain high amounts of carbohydrates, such as milk, as they may cause you to consume more than the allotted amount of carbs that you need for a day.
After reading that article I have to say that the “USC experts” are full of it. It’s the usual scare stuff that the mainstream docs and dietitians trot out to attempt to discredit LCHF and keto diets. There’s no reason why a keto diet should be any worse for bone health than any other diet provided it has adequate calcium, phosphate and Vit K2 and you have good Vit D levels. As for the recommendations of dietitians – eat lots of healthywholegrains and “vegetable” oils but no saturated fats – we know what the long-term results are of that: diabetes, heart disease and osteoporosis.
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.
The low-carb, high-fat approach to the keto diet limits the types of foods you can have, and entire food groups are eliminated entirely. Beans, legumes, and whole grains are out, as are many fruits and vegetables. Many of these foods carry vitamins, minerals, and other nutrients you can’t get from any other source, and without them, you may start to experience nutritional deficiencies.
Traditionally, in the sports nutrition field, we talk about the importance of timing carbohydrate and fluid intake on improving sports performance. For some time now, research has been looking at the role of very low carbohydrate diets on sports performance. Trailblazers in keto and sports performance research like Dr. Stephen Phinney have been conducting studies in this area since the 80s. In one of his studies, the glycogen stores of cyclists on a keto diet were not completely depleted and lipid oxidation was increased. Researchers concluded that the body was able to adapt to the lack of carbohydrates and preserve what was needed to use the fat as fuel.  However, based on the VO2 max breath test, since the body was attempting to preserve the carbohydrate during the exercise, it appears that the intensity of the exercise was limited. In a more recent study, off-road cyclists following a keto diet experienced small improvements, but still not significant enough to make strong conclusions.

3. Ketone bodies are NOT a better source of energy than glucose. Your body uses SO much more energy just to MAKE ketone bodies. Basically, your cells take in fats and turn these into Acetyl CoA in the mitochondria. In a NORMAL cell, this acetyl CoA would go through the Citric Acid Cycle and onto the Electron Transport Chain, making energy that can be used by ALL of your cells. ( In a cell that is in the state of Ketosis (AKA Starvation), the acetyl CoA is not used for the citric acid cycle, but is instead used to make the ketone bodies. The ketone bodies then make their way to the brain. Not to mention, gluconeogenesis is also occurring (at depleted rates at this point …. you know, because you’re running out of those scary glycogens.) And remember, gluconeogenesis is also energetically expensive, along with the production of ketone bodies. So all in all, you are losing energy by resorting to Ketosis.
The keto diet is a low-carb, high-fat dietary regimen which has been linked to improvements in insulin sensitivity and higher rates of weight loss — both positive factors in managing type 2 diabetes. Lowering carb intake induces a metabolic state known as ketosis, through which the body produces ketones which burn fat — rather than carbohydrates — for energy.
However, the complete opposite occurred, practitioners began to lose excess body fat, feel healthier, and in some cases, issues of diabetes even began to subside. Nutritionists began to study the effect of a fat-based diet and its impact on human health, years later; the modified ketogenic diet emerged from the research and had been used with success in modern society.
In a study of 51 obese people using an extremely low fat low calorie diet (just one gram of fat a day!) the gallbladder was examined by ultrasound before the diet and after one and two months. After one month four of the 51 participants had developed new gallstones. After two months more than one in four (13 people) had new gallstones! This on an almost fat free diet. Three participants needed to have their gallbladder removed during the study.
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.

I have patients that have lost tons of weight on keto. They do go off some meds. I also have people who eat a moderate amount of good carbohydrates, and they have lost tons of weight, and been taken off meds, had improved markers, even reversal. I think both approaches work, as I have seen in practice. Many people cannot stay on a keto diet forever. I for one, prefer to have some carbohydrates. I try to pick the right ones. If this works for you, then just be sure to have some medical supervision, which it sounds as though you are doing.
Low carb, high fat diets have been used for centuries by doctors when working with obese patients. William Banting published the widely popular booklet titled ‘Letter on Corpulence Addressed to the Public’ in 1863. In this booklet he explained how he had slimmed down by eating a diet high in fat void of carbs. The Banting diet was used for decades by individuals looking to lose weight.

The keto diet cuts your daily carbohydrates to less than 20 grams; for people with diagnosed diabetes, this may help them manage the condition. A one-year study found that putting people with type 2 diabetes into ketosis dramatically improved their blood sugar control. Also, reports study author Steve Phinney, MD, PhD, chief medical officer of Virta Health, a type 2 diabetes reversal treatment, “Patients were able to lose on average 12 percent of their body weight, about 31 pounds.” Doctors want you to know these 13 things about the keto diet.
This is where dietary fats come into play: depleted glucose reserves leads to the production of ketone bodies that are used as an alternative energy source, especially by the central nervous system, including the brain which has high energy demands. In order to get enough fat and limit carbs, the keto diet includes plenty of foods like meats, eggs, oils, cheeses, fish, nuts, butter, seeds and fibrous vegetables.
The initial weight loss is usually short-lived as carbohydrates hold onto fluid in the body. Beyond that, we need fat on our bodies in order to function and survive. Fat is essential and plays a vital role in many basic physiological functions of our body. This notion of ‘burning’ as much fat off our bodies as we can can be downright dangerous because biologically, we need fat. Having too little body fat can lead to issues such as:
"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.)
Once the body gets used to manufacturing ketones as the main energy substrate, the body actually has more energy than it previously had, and you won't have to be fighting through all those low-blood-sugar crashes your high-carb meals previously gave you. Additionally, hydration should be an area of high priority, especially before, during, and after exercise.
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.

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.


I started on a strict keto diet one year ago, and it has been the easiest diet I have ever been on. I was prediabetic before the diet, and now am not. My triglycerides are lower ( in normal range) and my good cholesterol is high. I am at lower than normal risk for heart disease because of my cholesterol ratios. I was not overweight to start with, am not now….and have not changed my weight at all. So the good effects are due solely to the diet change and not weight loss, which the author implies throughout the article that it is the weight loss that causes the good effects….not so. I am a veterinarian and believe in good medicine. This diet makes sense biochemically for those with diabetes or prediabetes.
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.

The only difficulty with some of these studies is that they tend to have small sample sizes, like this one that only has five cyclist participants and the data was largely skewed by the fact that only ONE cyclist experienced a large enhancement of exercise capacity after the keto diet. Their studies also tend to be short term. Back in 2014, Phinney and scientist Tim Noakes wrote an editorial that stated that in the past 31 years, there have only been a handful of studies measuring sports performance and low carb diets. Out of a total of 11, only 3 found exercise improvements.
If you are pregnant or are nursing, you should not follow a Ketogenic diet. You will not receive enough of the recommended carbohydrates, vitamins and nutrients necessary for yourself and your growing baby on this diet. Your obstetrician will recommend how many carbohydrates you should consume per meal and for snacks during each phase of your pregnancy. They will likely refer you to a Certified Diabetes Educator for nutritional counseling as well. Please check out The Diabetes Council’s FAQ’ About Gestational Diabetes for all your gestational diabetes related questions. 

While people can argue back and forth about the role carbohydrates play in a healthy lifestyle, no one is going to say packaged snack foods are healthy. This is one of the areas where the ketogenic diet definitely succeeds because it eliminates the opportunity to eat highly processed foods, which are made almost entirely from sugar and other refined carbs. In a review published in the European Journal of Clinical Nutrition, the authors highlighted a number of studies showing a ketogenic diet can significantly improve insulin sensitivity for those with type 2 diabetes. They went so far as to say, “results have been nothing short of miraculous.”

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.”
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