Although various short-term studies examining the effect of a ketogenic diet in reducing the weight of obese patients have been carried out (10), its long-term effects in obese subjects are not known (15). Therefore, the purpose of the present study was to investigate the long-term effects of a ketogenic diet on obesity and obesity-associated risk factors in a large population of obese patients.
I think what bothered me most about the article was the way in which the writer has put her own fears about living without cake onto the shoulders of any diabetic she might treat. In the same way an epileptic might choose a life without cake in order to remain seizure free I choose a life without cake to remain “undiabetic”. I must admit that when I was researching this diet I did worry that I would not have the stamina, but the thought of going blind is a useful motivator.
But Jini’s doctor — intelligent though I’m sure he was — fell victim to the common confusion between nutritional ketosis and diabetic ketoacidosis, the latter of which being a life-threatening complication of Type 1 diabetes, where ketones are produced rapidly, overwhelming the body’s acid-base buffering system. This is a common misconception or myth about keto diets that I seek to dispel. 
Carbohydrate facts: Simple = bad, complex = good? Carbohydrates provide energy for the body, but the health benefits they offer depend on the type of carbs we consume. Complex carbs, found in brown rice, for example, contain more nutrients than simple carbs, such as white rice. Refined carbs, such as sugary drinks, are best avoided, as their nutritional value is low. Read now
Keto breath, on the other hand, is less of a side-effect and more of a harmless inconvenience (your breath literally smells like nail polish remover). Basically, when your body breaks down all that extra fat on the keto diet, it produces ketones—one of which is the chemical acetone, Keatley previously told WomensHealthMag.com. (Yes, the same stuff that's in nail polish remover.)
Bingo!! It’s all about the $. The info graphic at the very beginning is labeled Keto-Paleo. And is misleading. Contrary to popular belief the Paleo diet is plant based. It restricts carbohydrate and dairy consumption based on foods that cause an inflammatory response in the body. Keto restricts foods that cause a blood sugar spike two very different purposes. American nutrition is very obviously broken and any recommendation tied to a money making association should be taken with a grain of salt because you can bet there are $$ strings attached. Usually big Pharma funding.
Diets that focus on lowering carbohydrates and increasing fat have been associated with lower levels of “bad” cholesterol and higher levels of “good” cholesterol. Furthermore, lower triglyceride levels are typically seen in those on a ketogenic diet. A better cholesterol balance and fewer triglycerides can help to protect against plaque deposition in the arteries, which can lower your risk of atherosclerosis, heart disease, heart attacks, and stroke.
Fanatic? Someone with T2D, a disease usually claimed to be progressive and a never ending stream of problems and medications, was REVERSED. That’s something to shout from the rooftops. The drop in medication use alone, but the big pharma companies would prefer that people’s stories of reversing (well, putting it into remission) T2D get called fanatical instead of insightful.
Strict dietary restriction means we may be missing out on crucial vitamins and minerals. With the keto diet, major minerals that are missed include sodium, potassium and chloride which is why they are typically supplemented with a table salt tablet. Other vitamins that might be missed out on include vitamin D, calcium, magnesium, selenium and zinc. The lack of vitamin D and calcium puts keto dieters at risk for reduced bone health and increased risk for fractures and long term bone diseases.
What is more common throughout the history of the human race is fasting. Islamic Ramadan is a 28- to 30-day fast where food and drink are prohibited during the daylight hours. Christianity also has a strong fasting foundation, and in the Bible, Jesus fasted to have higher and clearer communication with God. Greek Orthodox Christians fast for a total of 150–200 days each year! 

The keto diet is notorious for delivering a quick initial slim down. That’s because carbs hold on to more water than protein or fat, says Becky Kerkenbush, RD, a clinical dietitian at Watertown Regional Medical Center. So when you stop eating them, all that extra H2O gets released through urination. As a result, the scale might read a few pounds lower, and you may look a bit leaner.
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.”

But this state of metabolic derangement is not actually possible in a person who can produce insulin, even in small amounts.  The reason is that a feedback loop prevents the ketone level from getting high enough to cause the change in pH that leads to the cascade of bad problems.  A person who is said to be “keto-adapted,” or in a state of nutritional ketosis, generally has beta-hydroxybutyrate levels between about 0.5 and 3.0 mM.  This is far less than the levels required to cause harm through acid-base abnormalities.


This is a helpful article. But there are some inaccurate things too. I have type two diabetes and use a keto genie diet to lose weight (45# so far). I was able to get my cholesterol down, Triggs down, and my A1C to 6! I went off and followed a Mediterranean diet for a year. I gained back 15# and my diabetes got worse. So I am back on keto. I am using a closer to Mediterranean keto both then and now.
Another one of my concerns long-term is that many people are being persuaded to remain on a ketogenic diet over a long period. In 3, 5, or 10 years, we are going to see a sharp rise in colon cancer cases. People in conventional dietary circles will then point fingers at all of us engaged in unconventional dietary advice and we will be lumped together and labeled as dangerous fads. The key is to be smarter and to view ketogenic dieting as the short-term tool/response it is, not as a solution to all health struggles.
However, the lower calorie Keto Diet also features a reduction in fats as well. In doing so, this Keto Diet accelerates fat loss and is better suited for losing weight. After all, between 2 Ketogenic Diet types, with one having a higher caloric intake than the second, which do you think would be the better choice for weight loss? Obviously the lower calorie diet. By reducing fats, your caloric intake is also reduced. As a result, the dieter’s weight loss will occur more rapidly.
In addition, recent papers within the last few years investigating the effect of ketogenic dieting on obesity conclude that it’s an extremely effective way to not only lose fat, but spare muscle loss while curbing many disorders related to obesity as well (many of which have been discussed above), including the set of symptoms and risk factors known as Metabolic Syndrome (i.e. abdominal obesity, diabetes, hypertension, and elevated cholesterol)
Another potential benefit of the ketogenic diet is that it is thought to improve insulin sensitivity5,6. Prediabetics and diabetics are often referred to as “insulin resistant” because their muscle, fat, and liver tissues do not respond properly to insulin. When the pancreas can’t meet the body’s need for insulin, excess glucose builds up in the bloodstream, contributing to diabetes and other medical conditions7.

I’ve been type 2 for about 15 years was pretty stable with diet and Metformin for 10 years. But eventually started trying more aggressive treatment like Victoza and without fail in 4 years I was on slow acting insulin. I lost weight lowered carb intake to 40mg or less in the morning my breakfast has been no carbs. People need to realize every diabetic is different you must manage it how it keeps you with good A1C levels. I myself got off insulin for a year and half but my fasting levels slowly increased again. Reversing diabetes is not possible. Reducing the effects is possible and more likely the better you monitor yourself and do what you need to do. Depending on medications or diets or counting carbs will all help but not cure the diabetes. These all are things that reduce its ability to affect your health negatively.
Some people have trouble with the concept of high-fat and a moderate amount of protein. I have to admit. It was hard for me to wrap my head around it at first. Now I have even given up artificial sugar substitutes and diet products of any kind. It's even hard for me to call this a diet. After researching this eating style, I've learned it's a way of life.
Parkinson’s Disease Because these patients are at a higher risk for dementia, researchers like Robert Krikorian, PhD, professor of clinical psychiatry and the director of the division of psychology at the University of Cincinnati College of Medicine in Ohio, are studying how inducing nutritional ketosis may be used to preserve cognitive functioning.
That doesn’t mean keto causes diabetes; it’s amazing for most diabetics. However, if your cells are great at processing fat, but suck at processing glucose or carbohydrates, you won’t be able to run at full power, and parts of your body that prefer glucose over fat — like the glial cells in your brain that handle immune function and synaptic pruning — don’t work as well over time.
Through experimentation, I have found that the best way to get into the metabolic state of ketosis is by starting off using a fairly high-fat intake with smaller amounts of protein. After your body gets into ketosis, the fat intake can be reduced and the protein intake can be increased. Keep in mind that keto-adapation takes about three weeks, so be patient!

"There is still some debate on the effects of saturated fats and what constitutes a healthy dose.  There has been quite a bit of buzz around grass-fed cows producing cream, dairy, and butter.  Ghee has been popular on the market as well, as a clarified form of butter," Ms. Zarabi says.  "It's really the trans fats that I think people need to understand and the harmful effects on the heart and cholesterol."


Increases in cholesterol levels need discussion too. We do see temporary increases in cholesterol levels often as individuals transition onto a ketogenic diet. However, when you examine lipid particle size (a more important way to look at the cardiovascular risks), the risk pattern doesn’t seem to increase with a ketogenic diet. Harvard Health has written about lipid particle size here before: http://www.health.harvard.edu/womens-health/should-you-seek-advanced-cholesterol-testing-
Carbohydrate facts: Simple = bad, complex = good? Carbohydrates provide energy for the body, but the health benefits they offer depend on the type of carbs we consume. Complex carbs, found in brown rice, for example, contain more nutrients than simple carbs, such as white rice. Refined carbs, such as sugary drinks, are best avoided, as their nutritional value is low. Read now
When carbohydrate consumption is limited, your body has to use an alternate fuel source to keep your brain going. This is the general premise behind the ketogenic diet. “The ketogenic diet is a high fat diet with low carbohydrate and moderate protein content,” says Gabrielle Mancella, a Registered Dietitian with Orlando Health. “Carbohydrate is depleted to provide an alternative fuel source, known as ketones, to the brain. The body converts from burning carbohydrates to burning fats, known as ketosis.”
I actually clicked on the story just to see if they included anything about it’s use in managing chronic migraine. I have chronic migraine, basically intractable. Nothing has helped. I’ve tried medications, meditations, and everything in between including a bunch of dietary changes. Keto is my next consideration. I’m happy to hear it helped you! Thanks for sharing
The ketogenic diet is a powerful new tool to hit the mainstream recently. This style of eating has substantial data behind it showing that it can boost fat-burning, reduce inflammation, boost cognitive performance, and more. What has not been covered quite enough are common keto side effects and how you can avoid them to make the best of this powerful eating style.
While many health care providers aren’t comfortable recommending the keto diet for people with diabetes, there’s a substantial body of research indicating that it can help with weight loss, reduce the need for medication, and even lower A1C into the non-diabetes range. It’s so effective that when researchers assigned 349 volunteers with type 2 diabetes to follow either a keto diet or a traditional diabetes eating plan (the makeup of that plan wasn’t defined in the study) for one year, they observed some powerful results. While the people on the “diabetes diet” didn’t experience any positive movement in their A1C, body weight, or medication requirements, those on the keto plan reduced their A1C from 7.6 to 6.3 percent, shed 12 percent of their body weight, eliminated their need for sulfonylurea medication, and lowered or reduced their need for insulin by 94 percent. The results were published in 2018 in the journal Diabetes Therapy.
The keto diet dates back to the 1920s, explains Michelle Hyman, MS, RD, CDN a registered dietitian at Simple Solutions Weight Loss. "The original keto diet was designed for patients with forms of epilepsy that were resistant to standard treatments. The macronutrient breakdown was designed to mimic the fasting state — which seemed to help with relieving seizures — yet provide energy and nutritions to function," Hyman says.
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.
“These diets are so unsustainable and in the long term, just not worth it!” Most definitely in your opinion. I did a LOT of research on Keto before I started it in 2009. I lost 130lbs. It’s not a diet, it’s changing the way you think about food and fuel for your body. And once you do that you understand food freedom. I eat mostly Keto but if I want a beer and a piece of Watermelon I will let myself have one. True it’s not for everyone, not everyone has the willpower to control what they put in their mouth. We tend to reward ourselves with food instead of using it what its for, nourishment and fuel. It’s why our country is dying of obesity. Awesome that a size 10 women can put what she wants in her mouth everyday, exercise, and it not affect her weight but guess what, you are becoming the minority.
Other experts say the long-term accumulation of ketones could be harmful. “Those ketones are emergency fuel sources, and we’re not meant to run on them long-term,” says Kristen Kizer, a registered dietitian at Houston Methodist Hospital. “Ketones are negatively-charged molecules, which means they’re acidic. When you build up ketone bodies in your system, you’re building up acid. One of the ways your body buffers acid is by pulling calcium from your bones.” Kizer also notes that the diet isn't very balanced and involves a very high intake of animal products, which generally do not protect against cancer, diabetes, or other diseases.
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. 

When the body's glycogen stores begin to get depleted, rates of beta-oxidation increase, resulting in the mobilization of free fatty acids from fat tissue. This is where the metabolic state of ketosis comes in. During beta-oxidation, ketone bodies are released from the liver—because they cannot be utilized by the liver—and travel to the brain to be used for fuel. The free fatty acids can then be turned into a usable energy substrate.

When your brain uses ketones for fuel, you don’t experience the same energy slumps as you do when you’re eating a lot carbs. On keto, your brain won’t start to panic, wondering when it will get its next hit of energy. When your metabolism is in fat-burning mode, your body can simply tap into its readily available fat stores for energy. The result? No more energy crashes or brain fog.


You lose weight temporarily because “if you’re not hungry every five minutes and can work on your willpower,” you won’t eat as much, Nisevich Bede says. But while some research is promising — one study published in October 2013 in the British Journal of Nutrition found that the keto diet led to greater weight loss than a low-fat diet, for example (4) — there is a lack of long-term research (greater than two years) that suggests a highly restrictive diet like keto is superior for weight loss than others, and it’s certainly not right for everyone.


Losing heart muscle may not be the only heart-associated risk with the keto diet, Derocha says. “If you have high blood pressure and are taking medication, the prescription mixed with the diet may cause abnormally low blood pressure test results,” Derocha says. Before you start the keto diet, she suggests you talk with your doctor to avoid low blood pressure, which can be dangerous, even deadly.
There are two main types of diabetes: Type 1 and Type 2. Type 2 is by far more common, accounting for 90 percent of all diabetes cases worldwide. In this type, the body does not make or does not use insulin well. It can happen to anyone but is more common in people over the age of 40, those who are overweight and inactive, those with a family history of diabetes and patients whose diets consist mainly of refined carbohydrates.
Other experts say the long-term accumulation of ketones could be harmful. “Those ketones are emergency fuel sources, and we’re not meant to run on them long-term,” says Kristen Kizer, a registered dietitian at Houston Methodist Hospital. “Ketones are negatively-charged molecules, which means they’re acidic. When you build up ketone bodies in your system, you’re building up acid. One of the ways your body buffers acid is by pulling calcium from your bones.” Kizer also notes that the diet isn't very balanced and involves a very high intake of animal products, which generally do not protect against cancer, diabetes, or other diseases.
Once you’ve stayed on keto for a couple of days, you may notice a new odor coming from your mouth that smells like overripe fruit or nail polish remover. This is an unfortunate side effect of ketosis that occurs when acetone (i.e., the primary ingredient in nail polish remover) is created as a by-product of ketone production. Unfortunately, your body can’t do much with the acetone it makes, so most of it will be excreted with each breath.
Diabetes, whether type 1 or 2, are diseases extremely susceptible to the therapeutic level effects of diets that lower insulin. If those diets are also nutrient dense, evolutionarily matched to humans and produce a more generally preferable shift in metabolism, then all the better. This sort of dietary treatment for diabetes holds great promise in their potential for helping out in other diseases like cancer, Parkinson’s and Alzheimer’s disease.
It has been found that a sugary diet is the root cause of various chronic diseases of the body. A recent study (35) showed that sugar can accelerate aging. Several recent studies (36,37) have pointed to the fact that a diet with a high glycemic load is independently associated with the development of cardiovascular diseases, type II diabetes and certain forms of cancer. Glycemic load refers to a diet of different foods that have a high glycemic index. Glycemic index is a measure of the elevation of glucose levels following the ingestion of a carbohydrate. The classification of a carbohydrate based on its glycemic index provided a better predictor of risk for coronary artery diseases than the traditional method of classification of carbohydrate into simple or complex forms (38). In other studies (38–46), it was shown that the risk of dietary glycemic load from refined carbohydrates was independent of other known risk factors for coronary diseases.
That's certainly the case with the ketogenic diet—a very low-carb meal plan—based on the findings of two recently published studies.1,2  Dr. Saslow and her team report that the individuals with type 2 diabetes who followed the keto diet lost significantly more weight than those on the low-fat diet espoused by the American Diabetic Association.1 These dieters also were able to get their hemoglobin A1c (HbA1c) below 6.5%, suggesting that some may have reversed their type 2 diabetes.1

With more people enthusiastic about the ketogenic diet comes more talk about potential adverse side effects. Upon closer examination, almost all of the complaints can be traced to a flawed approach. Granted, if you are coming to the game with significant metabolic damage from decades of carbohydrate dependency, or not paying attention to some common sense best practices, such as choosing healthy foods instead of blindly focusing on macros, you will likely struggle with something as stringent as keto.
Kidney stones are usually a sign of excess oxalates in the diet and/or Vitamin K2 deficiency. If the kids were eating a no-vegetable diet where were the oxalates coming from? If they were eating the vegetables why the constipation and dysbiosis? What were they not eating that caused a K2 deficiency? You don’t have to be on a keto diet to have kidney stones as I know only too well.

One reason it's hard to determine the exact health effects of diets is that it's often unclear whether any observed effects come from the diet or from a combination of other factors, like stress, environment or genetics. Still, that doesn't mean all the bold claims about the keto diet are wrong, but rather that you should approach them with a healthy degree of skepticism.
I’ve practiced Keto diet and nothing is wrong with me. Yes the first few months there were side effects like headache etc… but after that your gonna get smooth. Keto diet are for those people who are badly in need to get in shape like those who have obesity because no matter what the consequences are, People who have been hanging by a thread because of obesity will do everything to make all things right again and that’s why Keto diet works for me.
Type 1 diabetics, for now, nearly always need some insulin. How much they need and how effective the exogenous insulin is at controlling their blood sugars largely depends on how well they followed a well-formulated low-carb or ketogenic diet. What it comes down to is that the diet allows you to deal with the easier task: covering your basal insulin needs. Off the diet, people are faced with the harder task: covering basal insulin needs + those arising from carby foods.
Difficulty. Many experts question how long a person can realistically give up carbs. “This is a very restrictive diet that requires a drastic change in eating behaviors and even taste,” says Sandra Arevalo, MPH, RDN, CDE, a certified diabetes educator and spokesperson for the Academy of Nutrition and Dietetics. “It isn’t very practical or easy to maintain, for people both with and without diabetes.” That’s not saying you can’t stick with it, but before you commit, make a plan and set measurable goals to help you stay on track. Being prepared with the right foods can also help. Urbanski recommends making a shopping list that focuses on a few basic keto-friendly meals and snacks, so you’ll always have the right foods on hand to ensure success.
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