When you eat foods high in carbohydrates and fat, your body naturally produces glucose. Carbohydrates are the easiest thing for the body to process, and therefore it will use them first – resulting in the excess fats to be stored immediately. In turn, this causes weight gain and health problems that are associated with high fat, high carbohydrate diets (NOT keto).
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
A recent pilot study put five patients on the ketogenic diet (less than 20 grams per day of carbohydrate). At the end of six months, the average weight loss was 28 pounds (but this wasn’t the most surprising finding). Each patient underwent a liver biopsy, and four of the five patients had a reduction in liver fat, inflammation, and fibrosis. However, this is a small pilot study that also used supplements, so the results are not conclusive. What does the rest of the research say?
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)

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.


More good news: Snacks are totally allowed (and I'm not just talking about carrot sticks). There are plenty of packaged options out there designed for keto fans. FATBAR is one of them. These snack bars have 200 calories, 16 grams of fat, and four grams of net carbs. They're also plant-based and are made with almond or cashew butter, cocoa butter, coconut, pea protein, sunflower seeds, and chia seeds.


Studies are emerging that ketogenic diets (in conjunction with other treatments) can either reverse progressive brain disorders or help repair the damage. These include traumatic brain injuries and neurodegenerative diseases like Alzheimer’s and Parkinson’s. The Wahl’s Protocol also utilizes this benefit of the ketogenic diet to help repair neurological damage from multiple sclerosis.
To understand what the keto diet is, you have to understand a little about how your body generates and uses energy for daily activity. All day, every day, your body undertakes a series of chemical processes (together referred to as metabolism) to break down and use a combination of carbohydrates and fats to produce energy. The energy produced is used for everything -- from breathing to brushing your teeth to running to catch a taxi. Your body is burning fuel constantly just to sustain basic life function. And while your body is always burning a combination of fats and carbohydrates, your brain’s primary fuel source is carbohydrates… and your brain requires a surprising amount of energy to get you through each day.
The only difficulty with some of these studies is that they tend to have small sample sizes, like this one that only has five cyclist participants and the data was largely skewed by the fact that only ONE cyclist experienced a large enhancement of exercise capacity after the keto diet. Their studies also tend to be short term. Back in 2014, Phinney and scientist Tim Noakes wrote an editorial that stated that in the past 31 years, there have only been a handful of studies measuring sports performance and low carb diets. Out of a total of 11, only 3 found exercise improvements.
At this point, I’m searching for the secret sauce that will allow me to follow Wheatbelly or Keto or any other low carb diet, but not develop any health problems. When you have 80 lbs to lose, it’s discouraging to be told that you can’t be on the only diet that has ever worked for more than a few months. I’ll need a year or more just to get to goal weight.
Like the stress response, ketosis is a natural, physiological adaptation designed for short-term responses. In other words, an acute stress response to some danger or threat that involves increased adrenaline and cortisol release, increased heart rate and blood pressure, and heightened alertness is normal and can even save your life. But, if the stress response becomes chronic, as it may with divorce, prolonged caretaking of an impaired child or demented adult, PTSD, financial struggles, etc., then the stress response can have terrible health implications that include increased risk for Alzheimer’s dementia, heart disease, dysbiosis, inflammation, diabetes, and cancer. The same applies to ketosis: Acutely, ketosis is a normal physiological adaptation that serves us during periods of carbohydrate or calorie deprivation. Chronically, however, peculiar things happen with consequences that range from constipation, to selenium deficiency and cardiomyopathies, to colon cancer.
Hey Edwin, I personally have been following one for years with no issues. I cycle out once every 1-2 weeks with a higher carb day using low glycemic carb sources like root vegetables. One of the keys for me has been keeping it simple and finding ways to use staple ingredients (such as avocados and coconut products) to make a variety of recipes.Check out this article for some examples https://drjockers.com/ketogenic-avocado-recipes/
I have patients that have lost tons of weight on keto. They do go off some meds. I also have people who eat a moderate amount of good carbohydrates, and they have lost tons of weight, and been taken off meds, had improved markers, even reversal. I think both approaches work, as I have seen in practice. Many people cannot stay on a keto diet forever. I for one, prefer to have some carbohydrates. I try to pick the right ones. If this works for you, then just be sure to have some medical supervision, which it sounds as though you are doing.
Here’s why. All of these effects take time, but a reasonable explanation as to why the keto diet leads to rapid weight loss is due to the loss of water weight. One of the concerns with the keto diet is the loss of muscle mass and the depletion of glycogen stores. Glycogen, which stores our glucose, also stores water, so when stores are depleted, we flush out excess water. In other words, that rapid weight loss isn’t fat, it’s just water.
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
“What many diabetics aren’t aware of, is that it is the fat that is the problem when it comes to type 2 diabetes. Nearly 100 years ago, healthy volunteers were split into two groups – half were fed a fat-rich diet, and the other half on a carb-rich diet. Within just two days, the fatty diet groups’ glucose intolerance skyrocketed to amounts twice as high as those fed a carbohydrate-rich diet (9).
Recently, four studies have re-examined the effect of carbohydrate restriction on type 2 diabetes. One outpatient study enrolled 54 participants with type 2 diabetes (out of 132 total participants) and found that hemoglobin A1c improved to a greater degree over one year with a low-carbohydrate diet compared with a low-fat, calorie-restricted diet [5,6]. Another study enrolled 8 men with type 2 diabetes in a 5-week crossover outpatient feeding study that tested similar diets [7]. The participants had greater improvement in glycohemoglobin while on the low-carbohydrate diet than when on a eucaloric low-fat diet. The third study was an inpatient feeding study in 10 participants with type 2 diabetes [8]. After only 14 days, hemoglobin A1c improved from 7.3% to 6.8%. In the fourth study, 16 participants with type 2 diabetes who followed a 20% carbohydrate diet had improvement of hemoglobin A1c from 8.0% to 6.6% over 24 weeks [9]. Only these latter three studies targeted glycemic control as a goal, and two of these were intensely-monitored efficacy studies in which all food was provided to participants for the duration of the study [7,8]. Three of the studies [6,8,9] mentioned that diabetic medications were adjusted but only one of them provided detailed information regarding these adjustments [9]. This information is critical for patients on medication for diabetes who initiate a low-carbohydrate diet because of the potential for adverse effects resulting from hypoglycemia.
In order for this process of fat breakdown to ‘work’, the protein content must be kept low enough to prevent gluconeogenesis. So, just because you are eating a low carbohydrate diet, does not mean you are in ketosis. It is important to note here, that this nutritional ketosis is different from ketoacidosis, which is the setting of low blood pH level that occurs in people with diabetes and can be very dangerous.

Oh Mike, I just cried when I read this. Jesus…you are right on so many different levels. For you, this sacrifice is a total game changer. It’s changing every aspect of your life and yes I am very happy you were brave enough to divulge the erectile dysfunction (ED) issue also. It’s one of the biggest (no pun intended lol) issues for teens and men and the reason they get on board quickly with getting back on track! Once they learn their high blood sugars are the actual cause of the ED, they are extremely relieved and happy to learn any way to lower their blood glucose levels!

The majority of scientists believe the exact opposite. They believe that it was our high fat content in our foods in the caveman days that caused the evolution of man intellectually. The human brain seems to thrive on fat, which might explain Keto’s potential when it comes to neurological impairments like epilepsy, and now studies are being done on patients with autism, and alzheimers. One of the most common side effects people seem to claim to experience is mental clarity and improved focus.


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.
The relation between a high fat diet and cancer is not conclusive. Recent epidemiological studies (17,58–60) could not explain a specific causal relationship between dietary fat and cancer. It has been found that altered energy metabolism and substrate requirements of tumour cells provide a target for selective antineoplastic therapy. The supply of substrates for tumour energy metabolism can be reduced by dietary manipulation (eg, ketogenic diet) or by pharmacological means at the cellular level (eg, inhibitors of glycolysis or oxidative phosphorylation). Both of these techniques are nontoxic methods for controlling tumour growth in vivo (61). Sugar consumption is positively associated with cancer in humans and test animals (58–61). This observation is quite logical because tumours are known to be enormous sugar absorbers. It has also been found that the risk of breast cancer decreases with increases in total fat intake (16). Further studies on the role of a ketogenic diet in antineoplastic therapy are in progress in our laboratory.
The word “keto” often has negative associations for people living with diabetes, especially Type 1. DKA, diabetic ketoacidosis, is a life-threatening condition arising when the body produces too many ketones. So how does entering ketosis deliberately through a conscientious diet differ from entering it accidentally? The answer has to do with the level of ketones, the former causing “regulated and controlled production” and the latter causing an overabundance.

The ketogenic diet is a high-fat, adequate-protein, low-carbohydrate diet that in medicine is used primarily to treat difficult-to-control (refractory) epilepsy in children. The diet forces the body to burn fats rather than carbohydrates. Normally, the carbohydrates contained in food are converted into glucose, which is then transported around the body and is particularly important in fueling brain function. However, if little carbohydrate remains in the diet, the liver converts fat into fatty acids and ketone bodies. The ketone bodies pass into the brain and replace glucose as an energy source. An elevated level of ketone bodies in the blood, a state known as ketosis, leads to a reduction in the frequency of epileptic seizures.[1] Around half of children and young people with epilepsy who have tried some form of this diet saw the number of seizures drop by at least half, and the effect persists even after discontinuing the diet.[2] Some evidence indicates that adults with epilepsy may benefit from the diet, and that a less strict regimen, such as a modified Atkins diet, is similarly effective.[1] Potential side effects may include constipation, high cholesterol, growth slowing, acidosis, and kidney stones.[3]
But what does the science say? Results are mixed. In one Spanish study of 20 obese adults, participants were put on a low-calorie keto diet and lost an average of 40 pounds over four months. Another small experiment had a similar outcome. In a six-month Experimental & Clinical Cardiology study of 83 obese adults, those on the keto diet lost an average of 33 pounds, while lowering their bad (LDL) cholesterol levels and increasing their good (HDL) cholesterol.
There are various ways to practice intermittent fasting on keto, including some that are less likely to trigger side effects like fatigue or cravings. Crescendo fasting gives you a break from fasting throughout your week, but is still very helpful for achieving the benefits of IMF. Dr. Cabeca and other experts, such as Amy Shah, M.D., advise their patients to check their urinary ketone levels (using ketone strips) and to aim for testing positively for ketones about three days per week.
The research on ketogenic diets also suggests you'll need to take a multivitamin to get enough minerals, calcium and vitamin D — most of which are readily available in plant-based foods. One keto-specific example: Not getting enough selenium, an immune-boosting antioxidant found in plant foods, can cause cardiomyopathy, a hardening of the heart muscle leading to heart failure.
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’
Ok, let’s break this down. So with this study you have a decent number of participants…I would love to see 1000, but 105 is certainly better than 20. Many ages, races and socioeconomic backgrounds were represented. There were a closer number of males versus females included in the study. Lastly, they were followed for a longer period of time, a full year.
In another study on women, researchers confirmed that the ketogenic diet resulted in favorable changes in LDL particles consistent with lower cardiovascular disease risk. However, the total LDL cholesterol did not change. This is why it is important to test the levels of different LDL particles. Looking at the LDL number itself may be misleading, especially on the ketogenic diet.
Related to this research, some serious attention has been given to ketogenic dieting and Alzheimers Disease. Scientists have discovered increased cognition and enhanced memory in adults with impairments in these areas, and a growing body of research shows improvement at all stages of dementia. Ketosis has been shown to be effective against Parkinson’s disease as well.
Over 8–10 mmol/l: It’s normally impossible to get to this level just by eating a keto diet. It means that something is wrong. The most common cause by far is type 1 diabetes, with severe lack of insulin. Symptoms include feeling very sick with nausea, vomiting, abdominal pain and confusion. The possible end result, ketoacidosis, may be fatal and requires immediate medical care. Learn more
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Several comprehensive studies and meta-analyses have demonstrated that after a few months or even a year of a low carb diet versus a moderate/high carb diet, there are no significant differences in the amount of weight lost (2,3,4,5).  I will say, however, most of these diets are NOT keto and are simply lower carb (i.e. 20%).  Also, long-term effects (beyond 1 year) are not often studied due to budgetary constraints, so interpret results as you wish.
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.”
Note: Are you a vegetarian or vegan and want to go on a ketogenic diet? It’s still possible! Just keep in mind that the dietary restrictions can sometimes be a little bit intense. Make sure to plan ahead and prepare to aid your success. To help out, we’ve published articles (with 7 day meal plans included) for both the vegetarian ketogenic diet and the vegan ketogenic diet.
Lorraine Turcotte,  a metabolism researcher at the USC Dornsife College of Letters, Arts and Sciences, said that although it’s less trendy, long-term healthy eating is the tried-and-true solution. She’s not sure why people prefer “difficult dietary manipulations than to say ‘I’m just going to eat moderately — a well balanced diet, lots of fruits and vegetables.’”
When a person goes off the ketogenic diet and regains much of their original weight, it’s often not in the same proportions, says Kizer: Instead of regaining lean muscle, you’re likely to regain fat. “Now you’re back to your starting weight, but you no longer have the muscle mass to burn the calories that you did before,” she says. “That can have lasting effects on your resting metabolic rate, and on your weight long-term.”
2 days from grains my stomach bloat was gone and I knew at that point everything this article and American diet was a lie. I’ve been on keto for over 16 months. Down 50lbs. In 6 months. I am ripped. Haven’t lost any muscle mass. I eat greens protein and healthy fat. I whole juice to get macros and yes I add watermelon or berries fo palatability purposes. I still eat carbs just healthy choices. I’ve become carb tolerant.. your liver will produce all glucose without ever eating 1 carb. This is biased and poor representation of keto lifestyle. When your starving and no carbs to choke keto will still thrive on either or fuel.
if this is true how did humans survive before agriculture? high carbohydrate foods simply didn’t exist in abundance before the agriculture age. Hundreds of thousands of years of evolution where humans would hunt for their food, and in between hunting eat whatever berries grew nearby….going days at a time or even weeks without food our bodies HAD to evolve into a state where they could conserve and store it’s energy then supply us with that energy burst for when that deer wandered by. Ketones are that energy source. Glucose simply doesn’t last long enough for us to survive and still have the energy to hunt. A little over 10,000 years of agriculture cannot undo hundreds of thousands of years of evolution.
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).
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