"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.)
You even have root vegetable and a picture of a carrot. Carrots are not part of a keto diet and as far as I have seen never were. They have 2 much sugar content and are discouraged except in very small amounts. Are you sure you tried it? Sorry. Great article in many ways but outdated in others. I don’t think people go into thinking they will “do it forever” How long can I last? I think that is missing the point entirely. So many people are getting their triglycerides down, losing weight reducing stroke possibilities lengthening their very lives. It is just not fair to not at least point out a few of these things as much as the risks you made sure to point out. albeit they are very important. How about the risks of not doing something? How about the list of people that found this and turned their lives around. Also, I know several people who have been doing keto for years.
Although studies have shown that the keto diet can reduce seizures for children with epilepsy, there is no evidence indicating that keto helps with other brain disorders or improves mental cognition, according to Harvard Health Publishing. Some studies show that keto may lower blood sugar for people with type 2 diabetes, but there is not enough long-term research to determine whether it’s safe and effective for diabetics.
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.”
I see several inconsistencies, one being a strict 20 grams or less of carbs, most Keto followers I see aim for closer to 30, and even as high as 40 per day. I also see several times in this article her opinion that you cannot get all of your essential vitamins and minerals without eating fruits, and I’m no nutritionist, but this is far from the truth. The writers hatred for this w.o.e. Presents itself early and often in this article, and because they weren’t able to successfully stay away from sweets, and other carbs, they’re attempting to scare others away as well, especially pregnant women. She admits that she’s been taught to follow the ADA’s dietary guidelines which has been proven to fail. It sadly isn’t working. She recommends consulting your physician before attempting this w.o.e., I tried that and was instructed to follow the clean eating that I had followed for the first 15 years with type 1. The 60 grams of complex carbs in meals, and 20 or so with snacks. That way allowed me to ride a dangerous daily rollercoaster, with damaging highs, and very dangerous lows. Yet my Endo was pleased with my sub 7 a1c, even though I was always tired. I’ve practiced a very healthy way of eating long before being dxd with type 1, which probably makes it easier for me to continue living this way. Ultimately, the info is out there, and those able to avoid certain foods will be rewarded with non diabetic numbers… some say big food/pharmaceutical are doing all they can to end this “fad” I’m not sure if it’s true or not, but the simple fact that there will always be those that lack enough discipline to remain in ketosis should still present them with enough clientele.

In either case, think about that for a second: Mancella says a 4% carbohydrate consumption translates to roughly 20-50 grams of carbs per day. And given that a single cup of cooked pasta contains roughly 45-grams of carbs by itself, and a single English muffin has about 30-grams of carbs, a single, poorly-planned meal could undo your efforts to achieve and maintain ketosis in a hurry.


The key of these miraculous healing effects relies on the fact that fat metabolism and its generation of ketone bodies (beta-hydroxybutyrate and acetoacetate) by the liver can only occur within the mitochondrion, leaving chemicals within the cell but outside the mitochondria readily available to stimulate powerful anti-inflammatory antioxidants. The status of our mitochondria is the ultimate key for optimal health and while it is true that some of us might need extra support in the form of nutritional supplementation to heal these much needed energy factories, the diet still remains the ultimate key for a proper balance.” 

Josh Axe, a doctor of natural medicine and clinical nutritionist, estimates that about 25% of people who try a ketogenic diet experience these symptoms, with fatigue being the most common. “That happens because your body runs out of sugar to burn for energy, and it has to start using fat,” he says. “That transition alone is enough to make your body feel tired for a few days.”
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.
Instead of thinking about the total carbs you’re eating, assess what those carbs provide to you. Do the majority of your carbs come from fruit and vegetables, with a payload of fiber and disease-fighting antioxidants? Fantastic. Or are you consuming them in the form of added sugars (cookies, candy, soda) or refined flour? If you are, you know what to do.
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.
Additionally, you may find it difficult to eat adequate calories on a daily basis because fat is so filling. Some people even opt to fast for several hours each day. While this may help with weight loss, your body needs those calories for proper maintenance. Without them, it may turn to burning muscle for energy, and that can accelerate muscle loss.

Keto is not hard to follow at all. See, this is why I took my diet and nutrition into my own hands. I have PCOS and the ketogenic diet has worked wonders for me. I’m finally pregnant at the age of 32 and after 11 years of marriage because the ketogenic diet made me lose over 100 lbs and brought my insulin resistance under control. I feel better than I’ve ever felt. Sometimes doctors don’t seem to know as much as they should, or as much as they assume they do, and that’s pretty disturbing. Just like they’re still using the old school and very inaccurate BMI charts that are just pure bs. I’ll just take care of myself outside of certain situations involving illness or injury. I’m doing great on my own.
The targeted keto diet is popular among athletes and active individuals who live a keto lifestyle but need more carbs. It allots an additional 20-30 grams of carbs immediately before and after workouts to allow for higher-intensity exercise and enhanced recovery. (The total carb count comes to 70-80 grams per day.) The best options include fruit, dairy or grain-based foods, or sports nutrition products. Because the additional carbs are readily burned off, they don't get stored as body fat.
In a pilot study, five out of seven patients trialed a keto diet for 28 days and showed marked reduction in physical symptoms. Parkinson’s attacks our human nervous system, partially as a result of an abnormal accumulation of a protein called alpha-synuclein. Research suggests that a ketogenic diet may reduce the associated cognitive and motor symptoms.Obviously, we need more research here but its an exciting finding.
Since carbohydrates do increase insulin and insulin is a storage hormone many people have made large leaps of logic to point the finger at carbohydrates as the primary cause of fat gain and obesity as opposed to overall caloric intake. They also point out that in a keto diet, carbohydrates are not being used as fuel hardly at all whereas fats become the primary fuel.
Eat micronutrient dense foods every day. The most nutrient-rich foods are pasture-raised organ meat, wild-caught sardines and salmon, and low-carbohydrate vegetables like spinach, kale, and broccoli. During early pregnancy and prior to conception, foods higher in folate, such as liver and dark leafy greens, are essential. Vitamin D (high in beef liver and sardines), iodine (high in seaweed and raw cheeses), and DHA (high in sardines and fatty fish) are essential as well.
I have been working more seriously on my health after a major health crash 5 years ago, possible Rocky Mountain Spotted Fever/Lyme. Organ functions are getting better including heart, liver and gallbladder. Pancreas is at stage 3 insufficiency. I’m concerned about a high fat, protein diet. Still have IBS and gut infections. Thinking that just bone broth and easy to digest foods might be good at this point for healing?
In addition, on the day the diet was initiated, diabetes medications were reduced – generally, insulin doses were halved, and sulfonylurea doses were halved or discontinued. Due to the possible diuretic effects of the diet soon after initiation, diuretic medications were discontinued if of low dosage (up to 25 mg of hydrochlorothiazide or 20 mg of furosemide) or halved if of higher dosage. Participants were also instructed to take a standard multivitamin and drink 6–8 glasses of water daily, and were encouraged to exercise aerobically for 30 minutes at least three times per week.
Diarrhea can also be due to a lack of fiber in the diet, says Kizer, which can happen when someone cuts way back on carbs (like whole-grain bread and pasta) and doesn’t supplement with other fiber-rich foods, like vegetables. It can also be caused by an intolerance to dairy or artificial sweeteners—things you might be eating more of since switching to a high-fat, low-carb lifestyle.
Although this may repel people away, it also provides you with a clear sign that you are on your way to reaping all the benefits of keto and ketosis. As your body continues to produce ketones, it will become more efficient at creating and using the energy-shuttling ketone bodies, beta-hydroxybutyrate and acetoacetate, which will help reduce acetone levels and normalize your breath. In the meantime, while your body is adapting to ketosis, make sure you have breath-freshening gum or spray that you can use throughout the day to cover up keto breath (if you have it).
Incidentally , there’s a very informative article on the bbc website about one of the last remaining hunter/gather societies left in the world, living in Tanzania. They have amazing gut health and no t2d. Would you like to guess at the type of diet they follow? This would be the caveman diet that the writer mentions, and yes these people might not live as long as us but the cause of death is never a lack of motivation to stay on a keto diet.
Keto has become synonymous with low carb, but as you have just read, reaching ketosis is much more complex than just eating fewer carbs. Healthy, young active people are taking up ‘the keto diet’ recreationally without any clinical reason in an attempt to lose weight, drop body fat, get a six-pack, or just to follow a trend their friends have taken up.
According to Dr. Sarah Hallberg, an advocate of diabetes reversal with dietary intervention, low-carb diets are the only ones that can possibly reverse this disease. Most studies examining the possibility of diabetes reversal focus on general exercise and reducing calorie intake. Nonetheless, these studies found that lifestyle changes normalize beta cell functioning, meaning reversal is possible.
Consider a 135-pound woman who has about 25% body fat and 100 lb of lean mass. If she follows a 2,000 calorie diet, she would be eating between 145 – 179 grams of fat, 50 grams of protein, and between 50 – 124 grams of carbohydrates (depending on her activity level). She would need to keep her carbohydrates under 50 grams a day in order to “keto-adapt” (for her body to adapt to using fat as the primary fuel).
He has been on keto diet for at least 3 years now. I think that he is some proof that yes, it does work. And it may be that some people do need keto. However, I don’t believe that everyone needs keto diet to get reversal. I have had reversal with regular ADA diet in my clinic. Not just a few! Many have reversed. However, I just want for keto dieters to find a clinical trial. We do need more information. We must understand what happens in the long term on keto diet. I personally did Atkins years ago, which was 20 grams. I had a very hard time to stay on it. I lost 20 pounds, and then I did gain it back. I just could not live without some more carbohydrates than this allowed. I don’t know about being on 60 to 70 carbs, and staying in ketosis. It seemed I was out of it at 22 carbs. Anyway, this was not for me. Maybe it is for you. No one is saying that one should never go on a keto diet, but we are wary of it. We need more science behind it. Therefore, I am just going to put this out here now. I will paste it down the page so that others may see it. They are taking participants. If you fit the criteria, please help us to get more than people’s opinion about this diet. Then we can be more positive about it, and recommend it if the science is there. Here is the link to the clinical trial. Thanks for your comments:
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.
At the core of the classic keto diet is severely restricting intake of all or most foods with sugar and starch (carbohydrates). These foods are broken down into sugar (insulin and glucose) in our blood once we eat them, and if these levels become too high, extra calories are much more easily stored as body fat and results in unwanted weight gain. However, when glucose levels are cut off due to low-carb intake, the body starts to burn fat instead and produces ketones that can be measured in the blood (using urine strips, for example).
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.

Now, I know what you are going to say, “I can take a break from the diet anytime.” What do you think happens when you take that “break”? As soon as you start consuming a normal amount of carbohydrates again, you immediately go out of ketosis or the fat burning state, and your body starts storing fat again immediately. In other words, you immediately start gaining weight. So whatever weight you lost on the diet, you gain back right away. How healthy do you think it is for your body to be in a starvation mode, then in a feeding frenzy, making up for lost time?
This was simply the best response to this article. The doctor who wrote it has no idea of the life changing benefits of keto. Bravo to you for speaking up. Congratulations on reversing your diabetes. I dont have diabetes and am not obese but I switched to keto to live a longer healthier life. I’ve never felt better. Must mention that I am 32. I want to prevent disease. Let the food be the medicine.
Your kidneys flushing out all that water is also part of the reason people see dramatic scale drops in the beginning of their keto journeys. "I wish people knew that the weight loss they will initially experience on this diet is largely due to water loss," Brown says. That means you're most likely not actually losing fat in the first couple of weeks, but instead losing water that will come back in the form of glycogen stores if and when you start eating carbs again. (BTW, Here's How to Safely and Effectively Come Off the Keto Diet.)
They have high likelihood of calcium oxalate and uric acid kidney stones–Kidney stones are uncommon in childhood, yet these kids commonly have kidney stones. The risk in an adult on a prolonged ketogenic effort is therefore high, also. Kidney stones are not benign–they are painful and can occasionally result in kidney damage (increased creatinine, urinary tract infections, etc.)
The longer you’re in ketosis, the more fat you burn. Unfortunately, you may also start to lose muscle tissue, too. While protein is considered the powerhouse muscle builder, your muscles need carbs for adequate formation and maintenance. Without those carbs, your body may start breaking down muscle. “Since your body starts to eat away at muscles as it enters ketosis, your heart, being a muscle, may also be damaged in the process,” Derocha says.

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. 


As far as the the Ketogenic Diet goes, it is a very personal decision between you and hopefully your physician. I would just recommend working closely with your physician for all the recommended lab tests to make sure you remain healthy while on the diet. That’s really the goal of any “diet” anyway, right? To get healthy? This is why we normally always recommend moderation with everything…moderation in the foods you eat along with moderate amounts of exercise equals a healthy lifestyle that will prevent diabetes or help you control your diabetes if you already have it.
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.

Researchers believe that the ketogenic diet can also help patients with schizophrenia to normalize the pathophysiological processes that are causing symptoms like delusions, hallucinations, lack of restraint and unpredictable behavior. One study found that the keto diet lead to elevated concentrations of kynurenic acid (KYNA) in the hippocampus and striatum, which promotes neuroactive activity. Some studies even point to the elimination of gluten as a possible reason for improved symptoms, as researchers observed that patients with schizophrenia tended to eat more carbohydrates immediately before a psychotic episode. (19)
If you're new to keto, watch out for hidden carbs. Generally, dairy products and nuts are a good way to meet your daily fat intake, but know that some of those items may contain more carbohydrates than you think. For example, yogurt topped with nuts may seem like a great keto-friendly snack, but a 5.3 ounce serving of plain yogurt has 12 grams of carbohydrates. Vanilla flavored yogurt has 24 grams of carbohydrates. Add an ounce of cashews, weighing in at nearly nine grams of carbs, and you’re up to 21 to 33 grams of carbs for that snack, which could knock you out of ketosis. Be sure to read nutrition labels carefully and pay careful attention to serving sizes. Track foods using a keto-specific app like Senza or KetoDiet can help you stay within your recommended daily carb intake.
Click here to join my newsletter and I’ll keep you posted when I get new articles up (FYI: as a heads up, I also write about entrepreneurship and web development. I started writing about fat metabolism and ketogenic dieting here at KetoSchool out of pure hobby interest, as there are relatively few resources out there that teach the underlying science).
The kidneys play an important role in metabolizing protein, and it’s possible that eating too much of the nutrient can have a negative impact on kidney function. While ketogenic diets are supposed to be much higher in fat than they are in protein, many keto eaters make the mistake of loading up on lots of meat, Mancinelli says. The result? You could end up eating way more protein than you actually need.

I have enough carbs in a day for all my needs. Just eating proteins alone raise the insuline level, enough for muscles preservation. And I top it with vegetables. I have more than enough. I just to be clear, I don’t think the human body is dumb enough to burn a lot of muscles when you have 100 pounds of stored fat. Why the body don’t store proteins, if it prefers that? Modern nutrition take our body – and us – for fools!
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.
The only evidence I could find for the long-term safety of a keto diet is from one 12 month trial. As a result of the study, the researchers found that overweight adults with elevated A1c that followed the keto diet experienced more significant reductions in A1c, lost more weight, and decreased their medications more than those instructed to follow a moderate-carbohydrate, calorie-restricted, low-fat diet.
Several recent studies indicate that a low-carbohydrate diet is effective at improving glycemia. A few studies have shown that in non-diabetic individuals, low-carbohydrate diets were more effective than higher carbohydrate diets at improving fasting serum glucose [13,14] and insulin [6,14-16], and at improving insulin sensitivity as measured by the homeostasis model [6]. One of these studies also included diabetic patients and noted a comparative improvement in hemoglobin A1c after 6 months (low fat diet: 0.0 ± 1.0%; low carbohydrate diet: -0.6 ± 1.2%, p = 0.06) [6] and 12 months (low fat diet: -0.1 ± 1.6%; low carbohydrate diet: -0.7 ± 1.0%, p = 0.019) duration [5]. In a 5-week crossover feeding study, 8 men with type 2 diabetes had greater improvement in fasting glucose, 24-hour glucose area-under-the-curve (AUC), 24-hour insulin AUC, and glycohemoglobin while on the low-carbohydrate diet than when on a eucaloric low-fat diet [7]. In a 14-day inpatient feeding study, 10 participants with type 2 diabetes experienced improvements in hemoglobin A1c and insulin sensitivity as measured by the euglycemic hyperinsulinemic clamp method [8]. Hemoglobin A1c also improved in an outpatient study of 16 participants who followed a 20% carbohydrate diet for 24 weeks [9].
Make things yourself. While it’s extremely convenient to buy most things pre-made or pre-cooked, it always adds to the price per pound on items. Try prepping veggies ahead of time instead of buying pre-cut ones. Try making your stew meat from a chuck roast. Or, simply try to make your mayo and salad dressings at home. The simplest of things can work to cut down on your overall grocery shopping.

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...


Josh Axe, a doctor of natural medicine and clinical nutritionist, estimates that about 25% of people who try a ketogenic diet experience these symptoms, with fatigue being the most common. “That happens because your body runs out of sugar to burn for energy, and it has to start using fat,” he says. “That transition alone is enough to make your body feel tired for a few days.”
Ketogenic diet for diabetics is a highly controversial topic, but we will break down everything here for you! As a Certified Diabetes Educator (CDE), I have to tell you from the start I will have a biased view here. Sorry, but I feel that I need to be completely honest right up front! I will however, present all the evidence that is available currently on the subject.
There are people who say that keto helps your athletic performance, and those who say it hurts it. "The literature is mixed on how an ultra low-carbohydrate diet like the keto diet affects athletic performance," says Grant Cox, C.S.C.S., head coach at Iron Tribe Fitness. But one thing is pretty clear: "A lot of it points to consistent decreases when athletes are looking for maximal power output (in weightlifting, vertical jumps, sprinting, etc.). Along the same lines, you'd be hard-pressed to put on weight and strength on such a low carbohydrate diet," he says.

While there have not been large studies that show the relationship between the ketogenic diet and cancer, we will be publishing a case study about that topic. The author failed to comment that pediatric patients with epilepsy are on the diet for usually about 2 years with no harmful effects. Before the false studies about heart disease and fat, the low carb diet was a respected way to lose weight. Studies into our metabolism show we can use both fat and carbohydrate as fuel. So stepping away from our high carb diet- I am sorry to say that we eat more carbs since the 70s with most of it processed and we now use high fructose corn syrup to sweeten products and we have a wide spread childhood obesity problem. If cholesterol is a concern try plant sterols and stenals to block cholesterol from the receptors in the body. So much more can be said about a keto diet than this article states
What is the ketogenic diet exactly? The classic ketogenic diet is a very low-carb diet plan that was originally designed in the 1920s for patients with epilepsy by researchers working at Johns Hopkins Medical Center. Researchers found that fasting — avoiding consumption of all foods for a brief period of time (such as with intermittent fasting), including those that provide carbohydrates — helped reduce the amount of seizures patients suffered, in addition to having other positive effects on body fat, blood sugar, cholesterol and hunger levels. (1)
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