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The struggle as a prescriber is that you have to follow the “standard of care,” lest you open yourself up to a lawsuit. So I talk to my patents about what “the” recommendations are, and then I talk to them bout what the evidence says and what my experience says. Plain and simple, patient’s trust the government’s recommendations and can’t wrap their head around the idea of not eating carbs because they have learned their entire lives that the body “needs” carbs to survive.
Many people on a ketogenic diet report sleeping much deeper, says Pamela Ellgen, a personal trainer and author of Sheet Pan Ketogenic. However, during the adjustment period (the first three to five days after you start keto), you may experience insomnia or difficulty staying asleep. This will end once your body adjusts to ketosis and burning stored fat. Then, you may find you’re able to sleep longer, sleep deeper, and feel more relaxed and rested when you wake up. Here are 15 things you need to know before starting the keto diet.
I told the nurse that I would not take the medications, and I would manage it with diet. She looked at me skeptically, and said “I would not recommend that.”. They had me scheduled for a follow up in a month and a half, so I told her that I would do my own thing for that time, and if my numbers did not improve, we could discuss the medication further.
Once the medical community acknowledged the keto diet’s effectiveness in reducing seizure episodes, they decided to look further and study its impact on neurological diseases in general. Neurological diseases share a common problem – a deficiency in energy production. Ketones provide that energy for normal brain cell metabolism, and may even be a more efficient   when the body is in starvation mode. When patients were put on the keto diet, the number of mitochondria (energy powerhouse) in brain cells increased. Ketones may also act as an antioxidant by inhibiting the formation of reactive oxidant species, which is why they may have promising effects in the treatment of certain cancers in conjunction with chemotherapy.
It wasn’t until my waist started pushing 35 inches that I decided I needed to do something. That something just happened to be a slight change in life style. I gave up eating processed carbs, i.e. cereals, bread, rice, pasta, pizza, beer (yes pizza And Beer!), and continued eating such things as meat, nuts, cheese, vegetables. Foregoing the processed carbs is really not that much of a loss when you consider the benefits. The impact of processed food industry didn’t hit America til the early part of the 20th century. And I dare say that it had anything to do with increasing longevity. I’ve been living a ketogenic life style for about six months and plan to continue. But for those of you thinking that its a quick fix, I’m inclined to say that, in my case, your wrong. This wasn’t exactly quick a fix. It took all of those six months to reduce my waist size to a leaner 33 inches. I’d like to think that I’m not done yet. I drink half my body weight in ounces of water (nothing to do with the ketogenic life style, but thought i’d mention it). I’m far from hungry, don’t see a down side to this, and I’m looking forward to my yearly physical and blood work results. I’m glad that I stepped outside the normal dieters box.
The good news is, if you’re a generally healthy adult, you can probably tolerate the keto diet. “It’s likely appropriate and safe for almost everyone,” says Robert Santos-Prowse, a Clinical Dietitian and the author of The Ketogenic Mediterranean Diet and The Cyclical Ketogenic Diet. “Ketosis is a natural metabolic state that everyone has spent some time in at some point in their lives. It has been proven to be most useful for weight loss and diabetes management, but it could provide benefit for some athletes and also might prove to be useful for many disease states including some cancers and forms of neurodegeneration.”
There is a reason why we store hundreds of thousands of calories in the form of fat in our body and only about 2000 calories in the form of glucose (with only a small amount of this useable by the brain). The reason is simple - The body prefers fat as its fuel source. Mark Sisson explains this in his article ‘A metabolic Paradigm Shift, or Why Fat is the Preferred Fuel for Human Consumption’.

“Suddenly and drastically reducing carbohydrates sets your body up for a double whammy of sorts,” says Yawitz. “The brain’s favorite fuel is glucose, which is most easily created from carbohydrates. In very-low-carb diets, the brain has to adjust to using ketones from digested fats for energy. To add to this discomfort, your kidneys release more electrolytes as insulin levels fall.” Additionally, your total body water decreases as carbohydrates become depleted on a keto diet, notes Clark. The result? What’s known as the keto flu, which could cause constipation, nausea, headache, fatigue, irritability, cramps, and other symptoms. Don’t fret, though: Many of these symptoms are short term and should last only a few days to weeks. Make sure to drink plenty of water to help your body cope with these symptoms. And call your doctor if symptoms — especially nausea — are prolonged, advises Yawitz.
“Tremendous Results”….guess that’s why the diabetes nationwide gets worse every year, because of the stellar advice your kind is giving out. I’ve been on the virta clinic for two months and already went off insulin, Janumet and Jardiance, which I’ve been on for 10 years, with blood sugars between 80 and 150. The advice you give makes people get sick slower. The ketogenic approach deals with the real issue, carbohydrate intolerance. If you are lactose intolerant you stop ingesting lactose. Type two diabetes is simply carbohydrate intolerance. Stop eating the carbs and the symptoms go away. I think you meet to cite some of the other research out there I’ve read in other books and the work the Virta Clinic has done. In my opinion you’ve cherry picked data to suit your preconceived beliefs.
In another study looking at ketogenic diets as a treatment for cancer,5 this research team concluded, “based on the results of rigorous preclinical and clinical studies performed thus far, the KD would appear to be a promising and powerful option for adjuvant therapy for a range of cancers. Cancer-specific recommendations await the findings of randomized controlled clinical trials.”
According to Dr. Cabeca, “Fasting is a key aspect of a healthy diet and has many anti-aging effects.” In particular Dr. Cabeca recommends fasting to women during or after menopause due to it’s anti-aging effects. For example, a 2016 study published in the Journal of the American Medical Association found that when women went 12.5 hours between dinner and breakfast (a common form of fasting), the overnight fast seemed to help improve immune system functioning to the point that it reduced their risk for breast cancer. (03) 
We all have different meanings for “quality of life” for me it means feeling good, with energy, no bloating, no heartburn, on my weight, normal glucose levels… for you it means having “white stuff” to eat, enjoy it while you eat it and then feeling bad about it, ’cause if you’re a diabetes educator you know (or at least you should) the harm it does to your body! I’m glad no one believed this biased article! It means everyone out there know what is real and what is not…
Diabetes is said to be a ‘progressive, chronic’ disease – incurable, in other words. Recently, case reports and clinical studies have accumulated claiming diabetes reversal with a low-carb or ketogenic diet. Many will debate if ‘reversal’ is the right term since adding in sugar and flour will bring their diabetes back. Nevertheless, there remains no doubt that people with diabetes benefit from these kinds of diets [1]. For diabetics, both type 1’s and type 2’s, a well-formulated low-carb or ketogenic diet should be the first line of lifestyle treatment.
More and more studies show that low-carb diets are an effective way to lose weight: A 2018 report out of Framingham State University found that after five months on a low-carb, high-fat diet, overweight adults burned about 250 more calories daily than people who ate a high-carb, low-fat diet. The keto diet in particular has a number of famous adherents, including Halle Berry, Katie Couric and Gwyneth Paltrow. Kourtney Kardashian blogged about doing keto, calling it “a really positive experience.” And keto-friendly recipes, snacks and meal plans have proliferated in the past few years.
Ketogenic diets are not for everyone. There are some people who should be very careful with the ketogenic diet, or at least should not do it without medical supervision. While I understand not many mainstream doctors will be well versed in the ketogenic diet, there are online services that can pair you with a primary care doctor who understands keto in detail.

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.

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.


The walking around part is not true in my experience, exercise alone will not help an obese person. I’ve been doing Keto and most things I’ve read have come true, I found this article to be unbiased. I will say this however, I agree I too have been eating many green veggies and the bad stuff I do use I use very little for flavor (like bacon) what I found that is utterly ridiculous on the part of the folks that did the diet rankings was saying Keto was unsustainable. The way I feel from being on Keto is insanely well. I want to keep eating this way! Unsustainable its the only diet I can do intermittent fasting on. I was type 2….
…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.

It’s the same with a keto way of eating: there is a ton of research and studies out there, and we KNOW that it works. Sure, more studies will come, and the new information will help us refine it, and we will learn how it specifically affects certain individuals in different ways…but the truth about the basics of it are all there, in the open, for all to see.

"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."

The truth is, I could have drank all the water in the world, and it wouldn’t have solved the problem, because the diet kept me from holding it. I was on the diet approximately six months when it started happening, with warning signs, in retrospect, a month before. When I wrote my story on a blog, I was contacted by a law firm who wanted to investigate my story, because they had a few other clients with similar experiences. I declined their services.


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.
From an outpatient clinic, we recruited 28 overweight participants with type 2 diabetes for a 16-week single-arm pilot diet intervention trial. We provided LCKD counseling, with an initial goal of <20 g carbohydrate/day, while reducing diabetes medication dosages at diet initiation. Participants returned every other week for measurements, counseling, and further medication adjustment. The primary outcome was hemoglobin A1c.
Inadequate calories: Keto’s satiating qualities are a double-edged blade. They help us eat less and lose body fat without really even trying, but they can also sometimes lead us to eat too little. This can cause a reaction in your body to slow down metabolic function and make you feel generally less energetic at rest. One solution is to cycle periods of generally increased caloric intake, and increased intake of nutritious carbs by default. This suggestion is totally different from the suggestion to engage in purposeful carb refeeds, where you binge on nutrient-devoid carbs in the name of a cheat day. This is never advised for any reason.

Controls glucose and reduces diabetic symptoms. In a randomized study of overweight adults with type 2 diabetes, the participants were divided into two groups. The first group followed a 32-week ketogenic diet program while the second group followed the conventional low-fat, diabetes diet plan. At the end of the study, the ketogenic diet group improved their glycemic control and lost more weight than the other group. The research showed that the ketogenic diet improved the participants’ blood glucose levels while also reducing the need for insulin.


The ketogenic diet may seem like the Jekyll to the Hyde-like low-fat craze of the 1990s. The bulk of current research finds that the middle ground between the two extremes is more beneficial for overall health. Make it easy for yourself: Eat at least two servings a week of fatty fish (salmon, sardines, mackerel) and cook with a variety of quality fats (olive oil, canola oil, avocado oil) throughout the week.

Ketosis and fasting also activates an anti-aging cellular cleanup process called autophagy (auto = self, phagy = eat). Autophagy is when a cell eats its own defective parts in order to recycle nutrients and keep the different parts functioning like new. In addition, autophagy can protect against neurodegenerative diseases, viral and bacteria infections, and cancers.
As per heartburn, studies done have shown that a ketogenic diet can have beneficial effects for those who have Non Alcoholic Fatty Liver Disease. A 2006 paper published in the Journal of Digestive Diseases and Sciences found that ‘Six months of a low-carbohydrate, ketogenic diet led to significant weight loss and histologic improvement of fatty liver disease’

Seek Nutritional Ketosis, Not Higher Ketone Levels. To gain the most benefit from this diet, you’ll want to aim for a level of ketosis between 1.5-3.0 mol/L on a blood ketone meter. You’ll be there when you are eating well-designed meals that carry you through to the next meal without hunger or other adverse symptoms (ie, nausea, insomnia, crankiness, inability to exercise). Higher ketone levels suggest you have more circulating ketones in your blood but don’t confuse this with efficient fat burning, which is the goal of this diet.
A number of studies suggest keto can disrupt the balance of good and bad bacteria in your GI tract (a condition called dysbiosis) due to high saturated fat intake and eating less fiber. Diets lacking in prebiotic fiber decrease probiotic, "friendly" bacteria as a result. Since the GI tract is considered the "bodyguard" of your immune system, this may impact your gut-brain connection, immune function, and chronic disease risk.
Keto is often suggested for children who suffer from certain disorders (like Lennox-Gastaut syndrome or Rett syndrome) and don’t respond to seizure medication, according to the Epilepsy Foundation. (1) They note that keto can decrease the number of seizures these children have by half, with 10 to 15 percent becoming seizure-free. In other cases, it may also help patients reduce the dose of their medication.
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