An article published in the New York Times in 2018 explores the use of a keto diet and diabetes type 1. The article points out how many diabetes experts will not recommend low-carb diets for type 1 diabetics, especially if they are children, due to concerns over hypoglycemia as a result of carb restriction and the possibility of this having a negative effect on a child’s growth.

🙌🙌 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.
At the core of the classic keto diet is severely restricting intake of all or most foods with sugar and starch (carbohydrates). These foods are broken down into sugar (insulin and glucose) in our blood once we eat them, and if these levels become too high, extra calories are much more easily stored as body fat and results in unwanted weight gain. However, when glucose levels are cut off due to low-carb intake, the body starts to burn fat instead and produces ketones that can be measured in the blood (using urine strips, for example).
Changes in blood lipid levels. By changing the carb and fat content of your diet, your cholesterol levels will change. The current research indicates that cholesterol levels should improve while you are on the keto diet. However, the increased fat consumption can also send cholesterol into unhealthy ranges for some people, especially those who are already struggling with familial hypercholesterolemia.
Foods that are emphasized as part of an alkaline keto diet include non-starchy vegetables, raw foods, green juices, lean proteins and lots of healthy fats. Foods that are high in sugar, carbs and acidic that should be avoided include: added sugar, high-sodium foods, processed grains, too much meat and animal protein, milk and dairy products, alcohol and caffeine.
"Keto is not a great long-term diet, as it is not a balanced diet," Nancy Rahnama, M.D., M.S., an internal medicine and bariatric specialist, told Reader's Digest. "A diet that is devoid of fruit and vegetables will result in long-term micronutrient deficiencies that can have other consequences. The keto diet can be used for short-term fat loss, as long as it is under medical supervision."
Good article. A friend at work is stating this diet and of course being new at it, he is quite the Zealot. I have been into nutrition and exercise for over 40 years (57 years old now). I have tried s few different eating philosophies (I never use the word the word diet. Negative connotation and dieting isn’t good the way most practice it.). Eating Keto style and the logic behind it aren’t too different than some others. And you pointed out many of the misconceptions about cholesterol and triglycerides ect. For about the last 20 plus years I have pretty much followed a “Zone” type diet. 40% carbs, 30% fat, 30% protein. And I always get weird looks at the 30% fat part. Well, I’m 57 with 7% body fat. Not bad for and old guy. I work out and I supplement with protein as I lift weights. It’s worked well. The ratios may be different, but the emphasis on vegetable carbs and good fats are the key to either way to eat. There were only a couple things that kinda struck me as something that made me go hmmmmm. Using the Inuit people isn’t a good example really. They have evolved some different physical features over hundreds of years than we have. And there is no evidence if ketosis occurring in examination. And somehow when you mention eating large amounts of animal fat, just hit me as counterintuitive. It’s a much different fat than an avocado. Finally, and this is just me, I love fruit. True it’s probably less efficient, but its good, sweet, and beats the hell outta donuts for your health. It fulfills the reward need many of us have. I also feel if God put it on the earth naturally, it’s got a place in our food source. I’ve had a philosophy about excersise that’s served me well. What’s the best exercise? The one that you’ll do regularly. Get up and move and find out what works for your own body. It applies to good too. If you feel deprived or for various reasons can’t stay on the supposed best food program, what good is it? But if you stay with more natural and Balanced foods that usually leads to more energy then more and regular excerise. Check in. It looks like it’s been 2 years since you wrote this. I’d live to hear how your 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.
Test for allergies and intolerances. For suspected allergies and intolerances, It is best to try an allergy test and an elimination diet that removes all common allergens and intolerances (wheat, eggs, fish, dairy, nuts, peanuts, shellfish, soy, and nightshade vegetables) for a period of time (3-4 weeks). If you are noticing positive changes and want to start adding these foods back into your diet, choose one at a time and tread slowly. Take note of how you feel. If you are still feeling great, move onto the next one. If at any time you experience adverse reactions to a certain food, chances are you have an allergy or intolerance to it.

Wait, what?! How could a diet rich in meat, butter, and cheese do anything but increase the chances of a heart attack? Well, the tables might be turning in defense of fat. While it’s still unclear how the keto diet impacts heart health long-term, especially for those predisposed to heart disease, research has found that the keto diet may help improve triglyceride, HDL, and LDL levels, and improve overall cardiovascular risk factors. Pass the cheese, please!


This plan entails eating about 120 grams of protein per day (or four 4-ounce servings of meat, fish or poultry) and around 130 grams of fat per day. Carbs are still restricted to less than 10% of daily calories. But many people find this modified keto diet easier to follow, because it allows you to eat more protein and less fat than the standard keto diet. The caveat is that this approach may not result in ketosis, because like carbs, protein can be converted into glucose for fuel. But the high-protein keto diet will generally result in weight loss.

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.
Despite its explosive popularity, there’s a lot of confusion about what the ketogenic (keto) diet really is. “Many people think they’re following a keto diet when they’re really just consuming a low-carbohydrate diet,” says Patti Urbanski, MEd, RD, CDE, a certified diabetes educator with St. Luke’s Hospital in Duluth, Minnesota. “So one person’s ‘keto diet’ may look very different than another’s.” 

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.


It sounds as if you may have been following a very strict keto protocol. I’m not, and have not followed a ketogenic diet, but am interested in it. I’ve been reading up on it a bit on the blog called Mark’s Daily Apple.* I’ve been following it for several years now, even before Mark tried keto. Based on some of his blog post, both keto related and otherwise, it seems that women do better with slightly more carbs than men. He’s written several blog post specifically for women, including one called 7 Keto Tips for Women, which you may want to read. https://www.marksdailyapple.com/7-keto-tips-for-women/ Then there is this one Where I Part Ways with the Popular Keto Movement https://www.marksdailyapple.com/where-i-part-ways-with-the-popular-keto-movement/ Perhaps the problem wasn’t the keto diet in and of itself, but that you went too low carb for you. It’s worth considering. I’ve also found this site to be pretty interesting https://peterattiamd.com/ Here’s a link to his section on keto https://peterattiamd.com/category/ketosis/ He followed a ketogenic diet for a number of years, though as of 2016 was no longer ketogenic, but definitely eating lower carb than most. (That is under Articles, on the drop down menu, click on Personal.)
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.

Casual chronic keto is at some risk of those same side effects. Sure, there are sporadic anecdotal cases where there appears (so far) to be no harm, but these are not large population RCTs. The KD-in-epilepsy data is closer to being RCT data. There being no ancestral case for chronic keto, we need to learn what we can from the formal studies (and sure, endeavor to separate the ailment, med and diet effects).
"Keto is not a great long-term diet, as it is not a balanced diet," Nancy Rahnama, M.D., M.S., an internal medicine and bariatric specialist, told Reader's Digest. "A diet that is devoid of fruit and vegetables will result in long-term micronutrient deficiencies that can have other consequences. The keto diet can be used for short-term fat loss, as long as it is under medical supervision." 

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.

Luckily today, we do not have to treat any type of diabetes with this barbaric method. There are so many healthy food options for most people today in modern society. In America, most of us are blessed to have access to healthy food options. I did see the research that Dr. Westman has completed at Duke University and did reference one of his articles above (reference #7 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1325029/). I have no doubt the diet works, I’ve done it and lost weight really fast, so I know from firsthand experience that it works. You will lose weight which will have wonderful effects on every aspect of your health. The problem I have is, can anyone go the rest of their life without consuming anything white EVER? Do you think every author of all those books actually does that? I would offer to put them all on a lie detector to prove that they haven’t lived 40 years without consuming one white thing or one fruit or anything with sugar in it. My question is, what quality of life do they really have if they have? I for one will NOT be giving up my or my family’s birthday cake!
It sounds damning, but before you stop eating beef and lamb, check out the details. The non-red meat diet differed from the red meat diet in many ways. The non-red meat dieters weren’t just avoiding red meat; they also ate way more fruits, vegetables, eggs, cheese, and soy than the meat eaters. The researchers failed to control all other aspects of the diet, instead focusing only on the meat.

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.
Additionally, you may find it difficult to eat adequate calories on a daily basis because fat is so filling. Some people even opt to fast for several hours each day. While this may help with weight loss, your body needs those calories for proper maintenance. Without them, it may turn to burning muscle for energy, and that can accelerate muscle loss.

We recently published an article documenting the grim long-term effects of low-carbohydrate diets, in which we explain the evidence-based research showing that low-carbohydrate diets high in fat and protein including meat, dairy products, eggs, fish, and oil actually worsen diabetes health, increase cancer risk, increase cholesterol, increase atherosclerosis, harden blood vessels, and increase all-cause mortality.


The same is true for meat. You’ve probably been told to avoid red meat when in fact you should not. Meat is an integral part of any diet including the ketogenic diet. There is no reason to avoid it (OK you’re excused if you’ve been bitten by a lone star tick!). The ketogenic diet reduces cardiovascular risk factors and improves the lipid profile by increasing HDL and lowering triglycerides [9,10].

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.
Fat accumulation in the liver is commonly associated with prediabetes and type 2 diabetes. In serious cases, fatty liver disease can damage the liver. Doctors test for the condition by measuring levels of liver enzymes using blood tests. “These enzymes were significantly reduced after one year in the clinical patients, indicating less risk of developing fatty liver disease,” Dr. Phinney says of the diabetes study. If you’ve been told you’re at risk for fatty liver, you may want to give this diet plan a try. Before you embark on any new eating plan, arm yourself with knowledge. You’ll want to read this: 11 hidden dangers of the keto diet.
These findings were confirmed in another interesting study. Researchers compared the effects of the low-carbohydrate diet to the effects of a combination of a low-fat diet and orlistat (a weight-loss and blood pressure lowering medication) on blood pressure. The researchers stated that the low-carbohydrate dietary intervention “was more effective for lowering blood pressure.”

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.
I take thyroxine 150mgs for my underactive thyroid issue. My dose does need to be adjusted regularly. I have gradually put weight on despite eating healthily & generally avoiding fats, because of a raised Cholesterol level. I can’t take Statins either because it causes muscle problem! All in all I am at a loss. I really want to lose my excess weight (28pounds). I have started the keto diet now & it’s a way of eating totally alien to me! I’m eating foods I never eat! I’m only a week in & am having dizzy episodes but am taking the steps to stop these but now I have read that having thyroid issues I should not pursue it. I’m really devastated. Can I get around this?

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.
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.
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.
Here’s another controversial yet promising area of study: Research suggests that when patients with diabetes take on a low-carb diet (like keto), they experience improvements in insulin sensitivity by up to 75 percent, as well as a reduction in blood sugar control medications. What we aren’t sure of, however, is whether these improvements are due specifically to the effects of ketosis or to weight loss in general, so similar results could theoretically be found with any successful diet.
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.

The same goes for people with type 2 diabetes. While some preliminary research suggests the keto diet may be safe and effective for certain people with type 2 diabetes, there’s still the risk for low blood sugar, especially for those on insulin, and the keto diet omits certain food groups known to benefit those with this disease. For example, a study published in September 2016 in the journal Nutrients highlights the importance of whole grains for helping to control weight as well as episodes of high blood sugar. Whole grains are off-limits on the ketogenic diet.


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.
But beyond that, experts aren't convinced that the keto diet has any other scientifically-proven health benefits. In fact, it may have some distinct downsides. If you follow the keto diet incorrectly, for example (like by eating lots of saturated fats, versus healthy unsaturated fats), you're at risk of raising your cholesterol levels. “The best strategy to keep your heart healthy is to get as much fat as possible from unsaturated sources such as olive, avocado and canola oils, nuts, seeds, avocados, and olives," says Ansel.

But all those studies were very small, and not all research on the keto diet is as promising. One American Society for Clinical Nutrition study of 20 participants found that those on the diet didn’t lose more weight than those on a non-keto diet. But they did have fouler moods and higher levels of inflammation, which has been linked to a variety of conditions, including heart disease and cancer.
If someone tries to tell you that the Keto diet is dangerous because of high protein consumption you can pretty much stop them right there.  The calling card of the keto diet is “Low carb, moderate protein, high fat” and the recommended protein dosage usually falls between 60-120g/protein per day depending on your weight and lean body mass.  This is not a high protein diet.  Anyone eating significantly more protein than they require is probably kicking themselves out of ketosis and is therefore not following a keto diet.
Proponents of the keto diet say that when and followed precisely, it does not “starve” the body.  “A well-formulated keto diet includes all the food groups and therefore provides adequate intake of micronutrients,” says Dr. Goss. “There is ample scientific evidence from randomized clinical trials supporting the therapeutic effects of the diet in treating a number of chronic disease conditions besides epilepsy, including type 2 diabetes [node/59538], non-alcoholic fatty liver disease, even obesity.”
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.
In essence, it is a diet that causes the body to release ketones into the bloodstream. Most cells prefer to use blood sugar, which comes from carbohydrates, as the body’s main source of energy. In the absence of circulating blood sugar from food, we start breaking down stored fat into molecules called ketone bodies (the process is called ketosis). Once you reach ketosis, most cells will use ketone bodies to generate energy until we start eating carbohydrates again. The shift, from using circulating glucose to breaking down stored fat as a source of energy, usually happens over two to four days of eating fewer than 20 to 50 grams of carbohydrates per day. Keep in mind that this is a highly individualized process, and some people need a more restricted diet to start producing enough ketones.
Best animal proteins are wild salmon, tuna, trout, shellfish, red meats, and poultry. The oil, protein sources will help balance your omega 3s. You only need 70 to 80 grams of protein a day, depending on your lifestyle and your body's physical needs. Protein requirements are different for everyone. Here are some good protein sources to include in your diet.
These findings were confirmed in another interesting study. Researchers compared the effects of the low-carbohydrate diet to the effects of a combination of a low-fat diet and orlistat (a weight-loss and blood pressure lowering medication) on blood pressure. The researchers stated that the low-carbohydrate dietary intervention “was more effective for lowering blood pressure.”
"Many of the richest sources of fiber, like beans, fruit, and whole grains are restricted on the ketogenic diet," registered dietician Edwina Clark told Everyday Health. "As a result, ketogenic eaters miss out on the benefits of fiber-rich diet such as regular laxation and microbiome support. The microbiome has been implicated in everything from immune function to mental health."
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