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)

Abbey, I appreciate all the work you put into this but there are a few things you missed. Not all oils are keto friendly. Vegetable oils are a huge no-no which was not mentioned. Regular mayo usually contains soybean oil which should be avoided. You also missed that foods with preservatives are a no-no which excludes some cheeses (you said enjoy all the cheese you like). Processed sliced cheese or pre-shredded cheese in a bag at the grocery store contains preservatives. Ever notice how shredded cheese in a bag never sticks to itself but when you shred your own cheese it sticks? Preservatives. Most nuts are okay but peanuts are a legume and should be consumed in very small amounts or avoided altogether. Don’t go crazy either, nuts do have carbs. I don’t eat more than a half cup a day of salted almonds. That said, you could have mentioned that getting salted nuts is ideal as you do excrete more salt and other minerals in your urine (eating keto is diuretic so attention must be paid to salt, potassium, magnesium, etc. as you did mention) so finding simple ways to add salt and other minerals is helpful. I also take a multi-vitamin daily. You mentioned you cannot do high intensity workouts. You are not supposed to do high intensity workouts as elevating your heart rate too high actually stops the fat burning process in your body. Your heart rate should be 180 beats minus your age +/- 5 beats depending on fitness level. A 40 year old obese person shouldn’t go over 135 beats/min during a workout as that is the optimal fat burning window. Higher than that and your body reverts to storing fat reserves thinking it will run out if it keeps this pace. Which bring me to metabolism. Its been long believed a high metabolism is good. A high metabolism leads to more hunger (because you’re burning glucose faster), ingesting more food, and typically gaining more weight. Slowing your metabolism down AND teaching your body to consume slow burning ketones instead of quick burning glucose puts less stress on your liver mainly and on your body in general. There’s a lot more but this is getting long so I’ll finish with this. You said this diet focuses on quantity of food and not quality. This is confusing to me….wouldn’t organic and grass-fed meats, be of better quality than non-organic and grain fed meat? (they feed animals grains to fatten them up….shouldn’t that be a huge warning sign for us?). Is food without preservatives not better quality than food with preservatives? Aren’t beverages with no sugar or artificial sweeteners of better quality than sugar/artificial sweetener-filled beverages? I’ve never seen any keto advocate advise ignoring quality foods, in fact its quite the opposite.
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.
Studies are emerging that ketogenic diets (in conjunction with other treatments) can either reverse progressive brain disorders or help repair the damage. These include traumatic brain injuries and neurodegenerative diseases like Alzheimer’s and Parkinson’s. The Wahl’s Protocol also utilizes this benefit of the ketogenic diet to help repair neurological damage from multiple sclerosis.
It’s important we distinguish between the process of ketoacidosis seen in type 1 diabetes and this ketosis that so many people on the keto diet are striving for. If someone with diabetes lacks enough insulin and/or does not eat enough carbohydrates, they risk entering a state known as ketoacidosis. For those with uncontrolled diabetes, this can increase the levels of ketones in the blood, increasing the acidity of the blood, and potentially leading to a coma or even death. In ketosis for a healthy individual, the level of ketones in the blood never reaches these crazy high levels so it’s generally safe for the average healthy individual.

Thankfully, a few keto variations have been developed that are a little more flexible, and easier to stick with long-term. The traditional or standard ketogenic diet puts your body into ketosis: In this metabolic state, you burn fat (rather than carbs) as your primary fuel source, and that promotes fat loss. On a modified keto diet, your body will go in an out of ketosis, but still shed weight and body fat. Check out the guide below to see how each of the four keto diet types work. 

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 >


Many people on a ketogenic diet report sleeping much deeper, says Pamela Ellgen, a personal trainer and author of Sheet Pan Ketogenic. However, during the adjustment period (the first three to five days after you start keto), you may experience insomnia or difficulty staying asleep. This will end once your body adjusts to ketosis and burning stored fat. Then, you may find you’re able to sleep longer, sleep deeper, and feel more relaxed and rested when you wake up. Here are 15 things you need to know before starting the keto diet.
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.
I, too, am finding the keto diet to be beneficial. My weight is moving down. My recent A1c was 5.7. I am consistently below 90 each morning when I check my blood. I am learning to adapt my cooking to the needs of maintaining this way of eating. I have incorporated walking because now I FEEL like it. I don’t feel deprived. I feel empowered. No medications for diabetes!
"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.)
I have been on a low carb keto diet for more than a year. As T2DM my A1C dropped from 9% to 5.4% & I discontinued meds. All my lipids improved even with ample healthy saturated fat. More than a year now so I wonder why this would be a short term improvement when its obvious that I will not go back to a high A1C and taking 3 diabetes medications including sulphonylureas. It is clear from this article that you lack the necessary experience that would be gained from wholeheartedly trying the diet or monitoring patients doing it properly like me. I would be probably be facing my first amputation if I believed the negativity in your article. So for people with diabetes who may be dissuaded by your article. Ignore it and take back your health by restricting carbs (<25 g a day) or as low as you reasonably can below 130g while being satisfied that you are getting adequate nutrition.
With fats being my main source of calories, my body and energy levels have never been better. When I educated myself on it and understood the science behind it, it was clear to see why my joints started feeling better, and ailments started to go away. I now have more “oil” lubricating my cells so they’re more receptive/flexible/malleable to the nutrients in my foods. People can loose weight very fast, but honestly the first 10lbs or so is a lot of water weight so that’s really nothing to write home about.
Those with mental health conditions have higher rates of physical illness and premature mortality, with life spans shortened by 13 to 30 years. People with mental health conditions also have higher rates and worse outcomes for chronic conditions such as diabetes, cardiovascular disease, and cancer. Years lived with disability for mental and substance use disorders increased 45% from 1990 to 2013 worldwide – during the same time that the incidence of obesity and the diabetes exploded.
So yes, the ketogenic diet is safe for diabetics. However, they still need to be closely monitored because diabetes medications including insulin, blood pressure, and beta blockers will have to be adjusted down when following a ketogenic diet. Therefore, the diabetic should do this with supervision from a doctor who is up to date with the nutritional literature.
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