If the liver is resistant to insulin, that's a bad sign for the rest of the body and could mean there's an increased risk of developing type 2 diabetes, the researchers said. What's more, these results are concerning because overweight patients seeking to reduce their risk of type 2 diabetes by following a ketogenic diet could unintentionally be increasing their risk for developing the disease, at least in the first few days of their diet. 
My understanding of keto diets is that they eliminate starches and starchy vegetables but that eating non-starchy vegetables is encouraged. Therefore there is no reason why you should be constipated or have bowel flora dysbiosis due to lack of soluble fibre. In fact on this keto diet kids would get more fibre than kids on the normal diet of pizza, pasta and similar junk that passes for the SAD.
What about fruits and vegetables? All fruits are rich in carbs, but you can have certain fruits (usually berries) in small portions. Vegetables (also rich in carbs) are restricted to leafy greens (such as kale, Swiss chard, spinach), cauliflower, broccoli, Brussels sprouts, asparagus, bell peppers, onions, garlic, mushrooms, cucumber, celery, and summer squashes. A cup of chopped broccoli has about six carbs.
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
Dr. Campos, it is unfortunate that you retain the medical community’s negative stance on the ketogenic diet, probably picked up in medical school when you studied ketoacidosis, in the midst of an obesity and type II diabetes epidemic that is growing every year, especially among populations who will never see the Harvard Health Letter. The medical community has failed in reversing this trend, especially among children, and the public is picking up the tab, in the form of higher health insurance premiums to treat chronic metabolic diseases which doctors cannot cure. The ketogenic diet does not bid its adherents to eat unhealthy processed meats, and the green leafy vegetables that it emphasizes are important in a number of nutritional deficiencies. People lose weight on the ketogenic diet, they lose their craving for sugar, they feel more satiety, they may become less depressed, their insulin receptors sensitivity is improved, and these are all the good outcomes you fail to mention. There is a growing body of research which demonstrates the neuroprotective effects of the ketogenic diet to slow cancer progression, as well as diseases like Parkinson’s and Alzheimer’s, for which there are no effective medical treatments. Please respect your patients by providing them with evidence-based medical outcomes, not opinions.

Yes. The ketogenic diet is very healthy. As a matter of fact, it comes with lots and lots of health benefits which we have already looked at. Even though this diet comes with a few side effects, it comes with a lot more health benefits ranging from providing more energy to helping with weight loss and controlling blood sugar. In all, the ketogenic diet is a very healthy diet.
Let me introduce myself. My name is Mark Sisson. I’m 63 years young. I live and work in Malibu, California. In a past life I was a professional marathoner and triathlete. Now my life goal is to help 100 million people get healthy. I started this blog in 2006 to empower people to take full responsibility for their own health and enjoyment of life by investigating, discussing, and critically rethinking everything we’ve assumed to be true about health and wellness...
Our body needs some time to get used to ketones being elevated in the blood stream to begin using them effectively and efficiently for cellular energy.  By consuming an exogenous ketone supplement, you get the body adapted to ketones faster and using them as an energy source before the body has built the metabolic machinery to produce its own ketones effectively.
3. Lower levels of physical performance; when you have just started taking a keto diet, you will likely notice limitations in your physical performance. However, this is just your body adapting to the diet. As you continue with the diet and your body gets used to it, this side effect will go away and your strength and persistence will get back to normal again.
Another earlier study published in the journal, Nutrition and Metabolism, finds that both a low-glycemic index, reduced-calorie diet and a low-carbohydrate, ketogenic diet can improve glycemic control, encourage weight loss, and reduce or eliminate the need for diabetic medication over a 24-week period with the lower carbohydrate keto diet being “most effective for improving glycemic control.”

It’s only dangerous to not get enough carbs at each meal if one is taking too much meds or insulin for the amount of carbs they are eating! Restricting carbohydrates doesn’t lead to hypoglycemia unawareness, but having lots of lows and lots of highs will (and decreasing insulin and carbs leads to way fewer highs and fewer lows, or at least it can). On the other hand, being in ketosis does make low blood sugars less negative as an experience. I still feel my lows just fine, but they are less of an emergency because my brain still works (feeding on ketones) and by body doesn’t freak out and release tons of adrenaline that then makes me want to eat a house. Mind you, I still wake up and know immediately if I’m low, I know from experience and how it feels in my head and body but without the crazy shakes. This is not unawareness but it is less reactive.


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.
Con: Results can vary depending on how much fluid you drink. By drinking more water, you dilute the concentration of ketones in the urine and thus a lower level of ketones will be detected on the strips. The strips don’t show a precise ketone level. Finally, and most importantly, as you become increasingly keto-adapted and your body reabsorbs ketones from the urine, urine strips may become unreliable, even if you’re in ketosis.
In fact, the diet first gained popularity in the 1920s when it was discovered to have benefits for children suffering from extreme epilepsy. Now, researchers are conducting studies to determine whether it could have benefits for any number of disorders, including the treatment of ALS, Alzheimer’s disease, brain tumors, traumatic brain injury, diabetes, weight loss, polycystic ovary syndrome, glaucoma, Parkinson’s disease, narcolepsy, and some cancers.
Glucose is stored in your liver and released as needed for energy. However, after carb intake has been extremely low for one to two days, these glucose stores become depleted. Your liver can make some glucose from amino acids in the protein you eat via a process known as gluconeogenesis, but not nearly enough to meet the needs of your brain, which requires a constant fuel supply.
Other potential culprits, Dr. Ede notes, are grains and legumes, which not only interfere with absorption of brain-healthy nutrients but are also high in lectins and other factors that may pose risks to brain health. Cutting out refined carbohydrates, refined oils, grains and legumes through the low-carb high-fat (LCHF) or ketogenic diet may improve mental health, just as doing so can reverse diabetes and promote weight loss, she notes. 
Ketosis is different, because, when in the state of ketosis, the brain will prefer ketones over glucose. For the dieter this is good! The body will not have to break down protein for energy. In turn the body will be forced to use its fat reserves, a.k.a. your love handles, for its energy. This is why a low-carb diet is such a good method of dieting.
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-
Often these children who have trouble gaining *don’t feel good* when eating, so they aren’t interested in eating much.  In the case of underweight children who crave refined carbs, the dopamine hit they get from eating the simple sugars may override enough of the discomfort of eating, making these nutrient-void foods the only ones they accept.  In addition, if their gut flora is off balance, the gut flora may be sending signals to the brain to keep consuming simple starches and sugars.
Balance your fat. Saturated fat has received a terrible rap in the literature, but that doesn’t mean it’s the only fat you should consume. Look to the fatty acid ratios of ruminants like beef and lamb—or your own adipose tissue—for guidance. They have about equal amounts of saturated and monounsaturated fat with a small amount of PUFA. Mix up the butter and cream with olive oil and avocado oil.
Because SO much brain development and growing happens in 0-5, I think that having an abundance of calories, even if they are stored as fat for a while, is a good problem to have.  More often than not, a growth spurt, picking up a new fascination with a sport or activity, and normal development will even out children’s weight as they approach school age.
Hey there! I started on the keto diet fully a few days ago but have been slowly working my way into for a couple weeks; eliminating . I have unspecified/other specified bipolar and have already spoken with my doctor about starting this diet. She said she recommends it fully. Today, I feel tired, foggy and I’ve had a headache for two days in a row. My mood is lower than I would like but being bipolar, I can’t really tell if its that or keto. There really aren’t many articles for keto and bipolar and I was wondering if you know of anyone with this condition and doing keto?
The keto diet involves a very high consumption of dietary fats, and very low carbohydrate consumption. Through these nutritional changes, the body reduces its use of glucose for fuel, and increasingly uses ketones (derived from fats). The diet was first used to control epileptic seizures, but there is growing body of research showing positive effects on Alzheimer’s disease, Parkinson’s disease, traumatic brain injury, inflammation1, and diabetes.

"If you're going to do keto, there's a better and a worse way to do it," registered dietician Kim Yawitz told Everyday Health. "Loading your plate with meats, and especially processed meats, may increase your risk for kidney stones and gout... High intake of animal proteins makes your urine more acidic and increases calcium and uric acid levels. This combination makes you more susceptible to kidney stones, while high uric acid can increase your risk for gout."


These findings were backed up in a 2012 study which had obese diabetics follow a ketogenic diet for 12 months. The researchers found lower fasting glucose levels, improved cholesterol markers and improved HA1c readings. Remember, carbs and glucose are not required when on a ketogenic diet, as stable, clean burning energy is sourced from fat. This makes controlling blood sugar levels near foolproof.
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.
Thanks for reading Roxanne! You could try the following: eating more frequently, using MCT oils, consuming plenty of salts, and potentially using an HPA axis supporting formula such as adapt-strong: https://store.drjockers.com/products/adapt-strong we also have an awesome magnesium lotion with melatonin that could be helpful in this case: https://store.drjockers.com/products/magnesium-lotion-goodnight-with-melatonin
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.
I’m desperate to find some answers~I have no history of sensitivity to anything, no allergies. I understand allergies can happen at any time. I started the Keto diet and in a one month time I had four separate episodes of my tongue swelling~each episode worse than the one before. I LOVED this diet~felt great, handled it with ease. The last episode almost put me in the hospital~my tongue was so swollen it was coming out of my mouth making it difficult to swollen and breath. I had no choice but to narrow it down to Ketosis. All the foods were the same that I have eaten all my life. No new meds. The last episode I took 2 Benadryl and pulled myself out of Ketosis with consuming a Dr.Pepper, and 2 pieces of white toast. I was terrified. Everyone on Facebook in all these Keto sites tell me it has nothing to do with Ketosis….but I’ve tried literally everything I consumed when a was on that WOE and I’ve had no reaction in days. My body feels horrible, I have no energy, my entire body aches. I want back on the Keto diet because my body was responding really well to it~except for my tongue.
One of the keto researches commented, (I think it was Steve Phinney) that change will come about only because enough of the the public will be become educated about this and will demand that the ADA change their recommendations because those recommendations are just wrong. What is the proof they are wrong? If you eat 45-60 g of carb daily, you will continue to have diabetes, and the epidemic will continue as it has for the last 25 years.
Metabolic Syndrome Limited research, including a study published in November 2017 in the journal Diabetes & Metabolic Syndrome: Clinical Research & Reviews, has suggested that adults with metabolic disease following keto shed more weight and body fat compared with those on a standard American diet, which is heavy in processed food and added sugars. (6)
In these cases, exogenous ketones can be powerful. Exogenous ketones are a supplement that can be used to supply the body with a source of ketones that require almost no processing by the digestive tract and liver. This makes them great not only for helping someone get into ketosis, but also as a quick energy source and performance enhancer for brain and body.

“It’s unhealthy and unsustainable,” they say. “How can a high-fat diet help you lose weight? It’s dangerous for the heart, increases the risk of ketoacidosis, leads to poor mineral intake and electrolyte imbalance,” they say. But the ketogenic diet has a well-established history of aiding in disease treatment. It has been used to help people with epilepsy (especially children) since the early 1900’s, and more recently, it has been used to manage type-2 diabetes (since it lowers the need for insulin therapy).1
Finding keto-friendly foods can be difficult at social gatherings — so consider bringing your own snacks. “If I know the restaurant where I’m meeting my family or friends, I usually look through the menu in advance and see if there’s something I can eat,” says Lele. “Salads are generally safe, with ranch or another low-carb dressing and a non-marinated protein. There are a lot of hidden carbs in restaurant food!”
Because weight loss can have such a dramatic positive impact for those struggling with type 2 diabetes, most of the diets prescribed to diabetics focus on weight loss. The ketogenic diet is no exception, and often leads to substantial weight loss and improved body composition. It’s also interesting to note that the ketogenic diet may contribute to a greater preservation of muscle mass during weight loss than other diets.
In the brain, there are some parts that can only take glucose to burn for fuel, which is usually derived from carbohydrates. However, when the body is on a ketogenic diet, the body will enter ketosis, which is a process that produces proteins called ketones from fatty acids in the liver. The brain can surprisingly also take in these special ketones to function. Past studies have shown that children affected with epilepsy who are on this diet have a 50% lower chance of reducing seizures. 16% of that group have also shown to be seizure free. This diet is for individuals with Parkinson’s disease and Alzheimer’s to see if ketogenic diets can also help.
Constipation is the rule–as virtual elimination of dietary carbohydrates also means virtual elimination of prebiotic fibers that nourish bowel flora. Over time, this leads to metabolic distortions including a drop in HDL cholesterol, rise in triglycerides, rise in small LDL particles that lead to heart disease, rise in insulin resistance and blood sugar, rise in blood pressure, even if these parameters initially improved on the diet. This is also due to dysbiosis and lack of prebiotic fibers. While this has not yet been tracked in children, in adults we can expect that these distortions in bowel flora will, over time, also lead to heightened inflammation (bowel and elsewhere), diverticular disease (.e.g., diverticulitis), and colorectal cancer. Yes: prolonged ketosis can add substantially to risk for colon cancer. Other peculiar gastrointestinal complications of prolonged ketosis have also been observed, such as protein-losing enteropathies.
Protein: A typical recommended keto protein intake is between one and 1.5 grams per kilogram of your ideal body weight. To convert pounds to kilograms, divide your ideal weight by 2.2. It’s important to note that Kidney Disease: Improving Global Outcomes (KDIGO) recommends that adults with diabetes limit their protein intake to less than one gram per kilogram of body weight each day and that adults with chronic kidney disease avoid protein intake greater than 1.3 grams per kilogram per day.
Participants completed take-home food records (4 consecutive days, including a weekend) collected at baseline and at weeks 2, 8, and 16 during the study. Participants were given handouts with examples of how to complete the records. A registered dietician analyzed the food records using a nutrition software program (Food Processor SQL, ESHA Research, Inc., Salem, OR).

Weight loss is the primary reason my patients use the ketogenic diet. Previous research shows good evidence of a faster weight loss when patients go on a ketogenic or very low carbohydrate diet compared to participants on a more traditional low-fat diet, or even a Mediterranean diet. However, that difference in weight loss seems to disappear over time.
It's really the trans fats that you'll want to avoid completely. "Trans fats are highly processed, and heated to a point where they create free radicals in the body, which increase your risk of cancer.," she says, "Trans fats are found in hydrogenated oils (be on the lookout for this form of fat listed on the ingredients), and these are mostly used in the preparation of processed crackers and packaged foods."

Most anyone who has struggled with keto side effects or just hasn’t felt good on a ketogenic diet stands to benefit greatly from exogenous ketones during the adaption phase and beyond.  Additionally, for people who have poor liver or gallbladder function, have poor mitochondrial health, or have never tried a ketogenic diet; the process of producing ketones can be stressful.

The problem is: it flies in the face of the way we have been taught. Our society (as an American), and our medical community, have preached for years that FAT is bad, and you should limit it. However, recent FACTS beg to differ. So many people rail against the keto diet because they just feel that it can’t be good…after all, you eat so much fat on it, it can’t be good for you! Facts are facts…they don’t care about your feelings. Fat is not the enemy. Sugar is.
Coal, on the other hand, burns evenly, and continues to burn for hours. Not only that, but it is fairly simple to adjust the amount of coal you burn to keep the house nice and warm, but not hot, for extended periods of time. The only problem is, it is kind of a hassle to get it to start burning at first (again, in the analogy we are assuming you are simply trying to light bare coal on fire, no aids). But once it is started, maintaining it is no sweat. So what is the solution? You use a tiny bit of kerosene, which lights easy and burns hot, to get the coals started (we need a few carbs, but not much).
Metabolic Syndrome Limited research, including a study published in November 2017 in the journal Diabetes & Metabolic Syndrome: Clinical Research & Reviews, has suggested that adults with metabolic disease following keto shed more weight and body fat compared with those on a standard American diet, which is heavy in processed food and added sugars. (6)
“You can spend two hours in the gym but ruin it with a bad meal,” said Sowers. “Incorporating all the food groups in proportioned sizes throughout the day is the best way to not only lose weight, but to also control appetite. Restaurants are also making it easier to eat healthier with calorie counts on the menu. Now people are able to make mindful choices when they go out to eat.”
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.)
The bottom line? If you’re thinking about trying the ketogenic diet, run it by your doctor first — regardless of any preexisting health conditions. And consult a registered dietitian nutritionist (find one at EatRight.org) to find a nutrition professional who can work with you to create a meal plan you can stick to. People with kidney disease or a history of disordered eating should avoid the diet, and people with type 1 diabetes may want to avoid it, as well. If you have risk factors for heart disease, you’ll want to speak with your doctor before considering the diet.
What about heart health and the keto diet? Previous older schools of nutrition would purport that a diet rich in fats (specifically saturated fats) would be detrimental for heart health, but more recent research suggests that saturated fat is not as bad as previously believed.  There is actually a tiny little bit of evidence that a keto diet may improve triglyceride, HDL and LDL levels. Like here and here. An even more recent study found that a keto diet improved triglyceride, HDL and LDL levels. We’ll definitely have to wait to see how that research unfolds because there is definitely a lot of competing elements at play.
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!

Let’s talk about a keto side effect that may not be so sexy: constipation. “Many of the richest sources of fiber, like beans, fruit, and whole grains are restricted on the ketogenic diet,” says Clark. “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.” Indeed, in a long-term study in the Journal of Pediatrics in April 2015, constipation was noted as a very common side effect in children receiving ketogenic diets for epilepsy treatment.
"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.)
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