By now, you've probably heard all about the ketogenic diet, the high-fat, low-carb eating style everyone's talking about. And while the benefits of keto are pretty well-known—weight loss and a suppressed appetite—the downsides are usually minimized by keto advocates. "The positive aspects of a ketogenic diet are spoken about much more than the drawbacks," says Alix Turoff, R.D., C.D.N., C.P.T., a dietitian and personal trainer.
There is one precaution with keto and children who are under their ideal weight, though, and you will need to decide if the risks outweigh the benefits – being in ketosis is a natural appetite suppressant. This will vary from person to person for how much this affects them, but if your child seems even affected by this appetite suppressant property, you may find that the GAPS or SCD diets are a better fit for healing the gut and encouraging weight gain.
An even bigger concern from my POV: Dietary supplements aren’t overseen by the FDA, meaning they’re not evaluated for safety and efficacy in the same way that food and medications are — so you may not be getting exactly what you pay for. And if you are? Well, consuming certain nutrients in supplement form versus food form can induce oxidative stress rather than treating it — and cause more harm than good to your organs.
A ketogenic diet could be an interesting alternative to treat certain conditions, and may accelerate weight loss. But it is hard to follow and it can be heavy on red meat and other fatty, processed, and salty foods that are notoriously unhealthy. We also do not know much about its long-term effects, probably because it’s so hard to stick with that people can’t eat this way for a long time. It is also important to remember that “yo-yo diets” that lead to rapid weight loss fluctuation are associated with increased mortality. Instead of engaging in the next popular diet that would last only a few weeks to months (for most people that includes a ketogenic diet), try to embrace change that is sustainable over the long term. A balanced, unprocessed diet, rich in very colorful fruits and vegetables, lean meats, fish, whole grains, nuts, seeds, olive oil, and lots of water seems to have the best evidence for a long, healthier, vibrant life.
Those following the keto diet are advised to restrict carbohydrates to just 50 grams a day at the most, although hardcore keto dieters recommend consuming just 20 grams—about the equivalent of half a hamburger bun or a single banana. Instead, high-fat foods are prioritized, like avocados, olive oil, nuts and butter. Beef and chicken, which have no carbs, are staples of the ketogenic diet, although protein should only make up 20 percent of your daily caloric intake.
WY conceived, designed, and coordinated the study; participated in data collection; performed statistical analysis; and drafted the manuscript. MF assisted with study design, performed data collection, and helped to draft the manuscript. AC analyzed the food records. MV assisted with study/intervention design and safety monitoring. EW participated in the conception and design of the study, and assisted with the statistical analysis. All authors read and approved the final manuscript.
Figuring out a diet that fuels our body’s needs and keeps us healthy without sacrificing taste is a daunting task for anyone. Factor in diabetes and this task can suddenly seem like an insurmountable obstacle overcome only by the most health-conscious fitness guru. Some diets are clearly fads, popping up into existence seemingly overnight, selling books and recipes and often food itself, only to fade into the twilight and be overtaken the next day by yet another set of guidelines by which we are to become, optimistically, the best self we can be.
You eat less than 50 grams of net carbs a day on keto. Cutting down on carbs increases your high-density lipoprotein (HDL) levels. HDL is known as the “good” cholesterol — it turns on anti-inflammatory pathways and protects your heart from disease. The keto diet also lowers blood triglycerides — fat molecules in your bloodstream. High levels of blood triglycerides are linked to coronary heart disease.
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“Despite its temporary side effects, we have always suspected that the ketogenic diet is relatively safe long term, and we now have proof,” says senior investigator Eric Kossoff, M.D., a pediatric neurologist and director of the ketogenic diet program at Hopkins Children’s. “Our study should help put to rest some of the nagging doubts about the long-term safety of the ketogenic diet,” he adds.
We do recommend everyone eat something every 4-5 hours to maintain a healthy metabolism. If your meals are more than 4-5 hours apart, a snack consisting of a protein and a carbohydrate is a great choice. The protein will help fill you up quicker and keep you feeling satisfied between meals. The protein also has a slower effect on your blood glucose than most carbohydrates, so when paired with carbohydrates, your blood sugar will not spike nearly as high. We recommend eating a protein with every meal and snack.
But the question remains, can you keep it off? Aside from the fact that it’s a pretty hard diet to keep up (ah, no birthday cake!), one large meta-analysis found that while low-carb dieters tended to lose more weight than low-fat dieters at first, the differences disappeared by the one-year mark. This may be because cutting carbs tends to reduce bloating and water weight, which may level out over time. But the bottom line on weight loss? Calorie restriction is calorie restriction. You just have to find what works best for you, and slashing carbs for fat might or might not work.
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.
…uric acid goes up promptly in the same time frame that ketones go up, but after 4–6 weeks, despite ketones staying up, uric acid starts to come back down. Based on these data and my clinical observations in thousands of patients, uric acid returns to or below pre-diet baseline within 6–12 weeks despite the person remaining is a state of nutritional ketosis.
If you do try the diet outside of medical supervision, Kizer says it’s important to test your urine with urinalysis ketone test strips to ensure your ketone levels don’t become dangerously high. Ketone urine test strips are also used by people with diabetes to determine if they’re at risk for ketoacidosis (DKA), a life-threatening complication that occurs when an individual doesn’t have enough insulin in their body. (Healthy ketosis is considered 0.5 to 3.0 mM blood ketones.)
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.
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.
It’s no secret that carbs—especially refined ones like sugary cereals, white bread and pasta, or sweet drinks—cause your blood sugar to spike and dip. So it makes sense that eating less of them can help keep things nice and even. For healthy people, this can translate to more steady energy, less brain fog, and fewer sugary cravings, Mancinelli explains.
He was wrong. Originally used for epilepsy, studies show that keto diets are far from dangerous. In fact, they benefit numerous conditions, including cancer, dementia, and overweight/obesity, and modern history only supports these claims. During the early 19th century, physicians had dramatic success implementing keto diets, yet they eventually found that prescribing drugs was much easier that than scrupulously monitoring what people ate. (1)
The data presented in the present study showed that a ketogenic diet acted as a natural therapy for weight reduction in obese patients. This is a unique study monitoring the effect of a ketogenic diet for 24 weeks. There was a significant decrease in the level of triglycerides, total cholesterol, LDL cholesterol and glucose, and a significant increase in the level of HDL cholesterol in the patients. The side effects of drugs commonly used for the reduction of body weight in such patients were not observed in patients who were on the ketogenic diet. Therefore, these results indicate that the administration of a ketogenic diet for a relatively long period of time is safe. Further studies elucidating the molecular mechanisms of a ketogenic diet are in progress in our laboratory. These studies will open new avenues into the potential therapeutic uses of a ketogenic diet and ketone bodies.
I had type 1 diabetes for 30+ yrs; CKD/ESRD x8 yrs and did peritoneal dialysis for 5 yrs before getting a kidney pancreas transplant nearly 5 years ago. Then had a below knee amputation and a rather sedentry life since-need to lose weight. Is this a safe diet for me? I am terrified of ketosis (DKA nearly killed me when i was 12 yrs old) so anything messing with stuff like that really makes me nervous. TIA!
A related clinical diet for drug-resistant epilepsy is called the medium-chain triglyceride ketogenic diet, in which MCT oil is extensively used because it’s more ketogenic than long-chain triglycerides. (13) Another dietary therapy for epilepsy called Low Glycemic Index Treatment (LGIT) was developed in 2002 as an alternative to the keto diet. LGIT monitors the total amount of carbohydrates consumed daily, and focuses on carbohydrates that have a low glycemic index.) (14)
More recently, a meta-analysis was published in the Journal of Neurology that assessed the impact of the ketogenic diet in treating epilepsy. It included a total of 19 studies with a total of 1084 patients. After analyzing the data, the researchers noted that the patients who stayed on the diet had a 2.25 times greater probability of treatment success (at least a 50% reduction in seizures).
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.
Depending on how you choose your fats, the keto diet can contain an abundance of saturated fat, which raises levels of dangerous LDL cholesterol and causes atherosclerosis, the buildup of fats and cholesterol in the arteries. If you decide to go keto, have a doctor monitor your cholesterol levels monthly to ensure you remain within a healthy range.
“Keto is not a great long-term diet, as it is not a balanced diet,” says Nancy Rahnama, MD, MS, an internal medicine and bariatric specialist in Los Angeles. “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.”
Fats produce more energy as compared to proteins or carbohydrates and this quality of theirs renders them very helpful in ensuring that the body is sufficiently energized. Since your body is using up fat for providing energy for the whole reaction system, the fat content decreases over time. This happens since the fats are not in the adipose tissues now. Instead, they are being broken up as they are ingested. This further prevents obesity.
Remember the low-fat diet craze? Back in the 1990s, we were told that swapping regular cookies and chips for those labeled "low fat" would be the ticket to easy weight loss and better health. Today, it's the opposite—a low-carb, high-fat eating plan called the ketogenic diet, or keto diet for short, is getting all the buzz. Celebrities like Halle Berry, Kim Kardashian, and Megan Fox are fans; more than 7 million Instagram posts have been tagged #keto; and upwards of 1 million people search "keto diet" on Google every month.
For my own children, I weighed them during this process and my two that were about 80 lbs both lost just under 3 pounds, and my 35-pounder lost 1.5 pounds the first 5 days. How do I know it’s water weight? Because if it was fat, they would have lost the equivalent of over 5,000 calories (my little guy) or 17,500 for my olders. There is no way they ran a calorie deficit in this amount in just 5 days ;)
While these findings are preliminary, in one study of mice, the keto diet helped reduce anxiety. The research suggests this could be due to the protective brain benefits of intake of healthy fats and low levels of sugar. A follow-up study found that mice exposed to a ketogenic diet while in utero showed less susceptibility to anxiety and depression than mice born to mothers who were not on the keto diet. Here’s what it’s really like to follow the keto diet.
Oh how I miss you, delicious high-fat smoothie 😫 🌿🌱🍃Day 15 on carnivore and I am feeling quite amazing though! 🥩 ~ UPDATE: I don’t have “recipes” I make food to taste but if I recall this was something like: -a handful of blueberries -half a carton of coconut milk -macadamia nuts -a couple glugs of @perfectketones MCT oil -some chunks of cacao butter -some chunks of coconut butter -half avocado -spinach, kale, cabbage -some ice and maybe a little water to get consistency right MUST use a badass blender (I use blendtec) -toppings: you can see them. Put what you like to eat on top.
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")
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.
Low-calorie, low-carbohydrate diets are increasingly recognized to be more satiating than low-calorie mixed diets (meaning, overall calorie intake is reduced to promote weight loss).7 Many people on the keto diet commonly experience the feeling of being more satisfied after eating, and this could contribute to weight loss–but scientists have yet to find a clear advantage of keto for weight loss when compared to any other calorie-controlled diet.
Following a ketogenic diet puts your body into a state of “ketosis,” which is a metabolic state that occurs when most of the body’s energy comes from ketone bodies in the blood, rather than from glucose from carbohydrate foods (like grains, all sources of sugar or fruit, for example). This is in contrast to a glycolytic state, where blood glucose (sugar) provides most of the body’s fuel (or energy).
Wondering how many carb foods you can eat and still be “in ketosis”? The traditional ketogenic diet, created for those with epilepsy consisted of getting about 75 percent of calories from sources of fat (such as oils or fattier cuts of meat), 5 percent from carbohydrates and 20 percent from protein. For most people a less strict version (what I call a “modified keto diet”) can still help promote weight loss in a safe, and often very fast, way.
Jalali says people following the diet have the best chance of keeping the weight off if they stay on it long term. And that’s not always easy to accomplish. The weight may come back if you go back to your regular eating habits. And regaining weight may lead to other negative effects. “Chronic yo-yo dieting appears to increase abdominal fat accumulation and diabetes risk,” notes Clark.
A recent pilot study put five patients on the ketogenic diet (less than 20 grams per day of carbohydrate). At the end of six months, the average weight loss was 28 pounds (but this wasn’t the most surprising finding). Each patient underwent a liver biopsy, and four of the five patients had a reduction in liver fat, inflammation, and fibrosis. However, this is a small pilot study that also used supplements, so the results are not conclusive. What does the rest of the research say?
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.
The crazy thing is it is not hard, if it matters. Sure I can see it being hard for someone who does it to lose weight, then when they get closer to their ideal, they want to have treats, etc. Well, for a type one diabetic there’s no end in sight, this is it, and it’s a relatively complication free life (many people reverse their complications when they bring their A1C down to normal) vs. one with inevitable complications. So, perhaps it was too hard for you after a year (you didn’t say, but I assume you are not a type one diabetic), but that is a choice you can make. Not I.
Finally, a feasibility study was done on 10 cancer patients in 2012. All patients followed a ketogenic diet for 28 days after exhausting every other cancer treatment option. The results of the study found that 1 had a partial remission of their cancer, 5 stabilized and 4 continued progressing. It’s important to remember that these individuals had tried all other forms of cancer treatment. 60% of these individuals then stalled or improved their cancer rates by following a ketogenic diet for 4 weeks.
I think you should take some of your own advice…you are being judgmental and thinking your diet will work for everyone. Look at the scientific facts; your body’s life blood is carbohydrates, the bread of life. Simple carbohydrates are what is killer to American society. Any diet that cuts out junk food like greasy potato chips and ice cream and cake will make you lose weight, not rocket science. Where do you think your body is getting fuel from? Muscle mass! It has to use that because you are depriving it of fuel! Why go on extreme diets when all you need to do is practice portion control and get up off the couch and walk around?
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.
In a March 2018 blog post, Dr. Ede provides a range of very helpful tips for anyone already on mood-altering or psychiatric medications who want to try a ketogenic diet, such as how to talk with your psychiatrist or mental-health provider and what laboratory metabolic tests the doctor should order to help monitor your response to the diet. Most importantly, she provides details about some specific medications — notably specific antipsychotic medications, anticonvulsant medications, and lithium — that should be carefully monitored.
If you are seeking fat loss but do not want to follow a strict ketogenic diet, you will be pleased to know that this study found that the weight loss benefits came purely from a low carb diet – whether it was ketogenic or not. If you need help transiting to a lower carb diet, be sure to download my free diet plan or better yet, be sure to view the most effective way to lose fat and keep it off on this page.
"Electrolyte imbalances can also be common if keto followers aren't aware of hydration needs," Turoff says. It's important to stay hydrated on keto, she says, especially in the beginning. "As you limit carbohydrates, your body produces less insulin, and glycogen stores (how carbs are stored) in the muscles and liver are depleted. For every 1 gram of glycogen that's depleted, you lose about 3 grams of water." This causes the kidneys to flush out more water, and along with it, electrolytes your body needs like magnesium, calcium, sodium, and potassium. "Imbalanced electrolytes can lead to muscle cramps, irregular heartbeat, fatigue, cognitive distortions, and lack of body temperature control," Turoff says. Some people may also be more likely to get kidney stones while on keto due to inadequate hydration, according to Turoff. (PS: These Are the Hydration Tips Every Fit Girl Needs.)
One of the most-cited worries about the keto diet is the long-term impact it may have on heart health—especially because people with diabetes are at greater risk for heart disease. In the small Diabetic Medicine study that found people with type 1 improved their A1Cs on a keto diet, participants had higher triglycerides and LDL (“bad”) cholesterol. This raises concerns about the diet’s longer-term heart health implications, as do the results of research published last year in The Lancet. That study followed more than 15,000 adults for 25 years and found that people who consumed less than 40 percent of their calories from carbohydrates were significantly more likely to die from heart disease than those whose diets contained 50 to 55 percent of calories from carbs—especially if the foods that replaced those carbs were rich in animal fats and proteins.
Tammy, just because someone follows a keto diet doesn’t mean they can’t have their sweet treats. There are dozens of websites with hundreds of keto sweet treats and “fat bombs” made with stevia or other natural non-caloric sweeteners which will not raise blood sugars. One of my favorites is Keto Mocha Mousse https://www.ruled.me/keto-mocha-mousse/ which has 5 g net carbs per servings. We don’t have to be deprived on keto.
The ketogenic diet may seem like the latest weight-loss craze, but it’s actually been around for nearly a century. Developed in the 1920s, this ultra-low-carb, high-fat eating plan was originally used to treat seizures in people with epilepsy. Today, it’s getting some serious attention for an entirely different reason. “There’s growing research showing that the ketogenic diet is effective for managing blood sugar in people with diabetes,” says William Yancy, MD, program director at the Duke Diet and Fitness Center in Durham, North Carolina. “However, because we don’t have studies [lasting] longer than two or three years, we don’t know what can happen with regard to complications over longer periods of time.”
Eating a keto diet can have some short-term health perks. But in the long run, it also has the potential to create some serious health problems. That’s why many experts say you shouldn’t attempt it on your own. “In general, if a person follows a ketogenic diet, they should only do so for a brief time and under close medical supervision,” says Hultin.
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.
Yancy has seen similar results in his practice. “Carbohydrate intake is the main driver of blood sugar. So if you’re able to lower blood sugar by reducing carbohydrate intake, then you may be able to reduce diabetes medication,” he says. “We’ve seen people come off of hundreds of units of insulin just by changing the way they eat, and that can happen really quickly, in just a few weeks.”
Depriving the body of dietary carbohydrates for a period, long enough to deplete the body of its glycogen reserves, produces a ketogenic state. This depletion typically takes three to seven days to occur. During this time, you will notice that your energy level becomes consistently diminished as your body consumes energy with no new source of fuel added. You will also find that you begin to drop water-weight, as glycogen is bound to water and then excreted.
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.