To say that the keto diet has become one of the most popular diets of recent years is a complete understatement. Case in point: There are more than one million searches on Google every month for the keto diet. It’s unique because the fad diet has captured the interest of people who want to lose weight — and there’s no shortage of reported success stories to be found.
You’re transitioning. Your body is equipped to process a high intake of carbs and a lower intake of fat. Your body needs to create enzymes to be able to do this. In the transitional period, the brain may run low on energy which can lead to grogginess, nausea, and headaches. If you’re having a large problem with this, you can choose to reduce carb intake gradually.
The keto diet is a low-carb, high-fat dietary regimen which has been linked to improvements in insulin sensitivity and higher rates of weight loss — both positive factors in managing type 2 diabetes. Lowering carb intake induces a metabolic state known as ketosis, through which the body produces ketones which burn fat — rather than carbohydrates — for energy.
I am a 7 year stroke survivor that is partially paralyzed from the stroke. I work part time and while working I walk at least 2 miles at work three to five times per week, but I can only walk 1 mph if even that speed. Which I know average speed is 3 mph when walking. I am 40 pounds overweight due to not being to do cardio workouts. I take aspirin daily as a blood thinner. I have considered getting on the keto diet. I drink sweet tea and one dr pepper per day along with coffee and water. I talked to my dr about this diet all he could tell me was he hasn’t researched it enough but knew of someone that lost weight on it. For my health I need to maintain a healthy weight and not be overweight. I have a b12 deficiency along with folic acid. I have not been taking any supplements for either.

Such great info. Husband has been seizure free 11 months. Was having 2-3 per month. Learning new and great awesome recipes. There is one side affect, I have lost 40#, our daughter, has lost 70#. However, my husband has not lost any weight. His body was at the correct weight before we started. My goal is not weight loss, that’s just lagniappe, my goal is better health. This is such an awesome journey.

Our bodies are incredibly adaptive to what you put into it – when you overload it with fats and take away carbohydrates, it will begin to burn ketones as the primary energy source. Optimal ketone levels offer many health, weight loss, physical and mental performance benefits.1There are scientifically-backed studies that show the advantage of a low-carb, ketogenic diet over a low-fat diet. One meta-analysis of low-carbohydrate diets showed a large advantage in weight loss. The New England Journal of Medicine study resulted in almost double the weight loss in a long-term study on ketone inducing diets.
Reduce daily net carb intake to less than 20 grams: Although it’s possible that you may not need to be this strict, eating fewer than 20 grams of net carbs every day virtually guarantees that you’ll achieve nutritional ketosis. What does 20 grams of carb look like? Use our visual guide to find out, or simply try our keto recipes and meal plans that limit carbs to less than 20 grams per day.
With fats being my main source of calories, my body and energy levels have never been better. When I educated myself on it and understood the science behind it, it was clear to see why my joints started feeling better, and ailments started to go away. I now have more “oil” lubricating my cells so they’re more receptive/flexible/malleable to the nutrients in my foods. People can loose weight very fast, but honestly the first 10lbs or so is a lot of water weight so that’s really nothing to write home about.
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.”
“If someone with diabetes is [taking insulin or oral type 2 meds in the sulfonylurea or meglitinide class and is] following this diet, they need to know that their blood sugar can drop really quickly, so it’s critical that they check it more frequently,” says Toby Smithson, MS, RDN, CDE, author of Diabetes Meal Planning & Nutrition for Dummies. “Don’t wait for it to happen. Meet with your doctor or diabetes educator in advance so that you can troubleshoot exactly what to do if your blood sugar drops.” If it’s an infrequent occurrence, you may be advised to treat with fast-acting glucose. But frequent lows may require medication adjustments or the addition of more carbs to your eating plan.
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.
The ketogenic diet has recently been investigated a great deal for how it may help prevent or even treat certain cancers. One study found that the ketogenic diet may be a suitable complementary treatment to chemotherapy and radiation in people with cancer. This is due to the fact that it would cause more oxidative stress in cancer cells than in normal cells.

🙌🙌 thank you for some great info! USC just had an article about Keto, saying they don’t know the impact on bone health. So I’m not sure why all these articles are written without the documentation to prove the claims. We all know too much calcium supplementation can cause problems but every Dr wants you to supplement calcium. Most people could do a lot worse than doing Keto! The SAD will cause more problems for you than eating whole, unprocessed Keto food! Sugar seems to be the real issue along with aspartame and stressful living.


Another benefit has to do with the low levels of insulin in the body, which causes greater lipolysis and free-glycerol release compared to a normal diet when insulin is around 80-120. Insulin has a lipolysis-blocking effect, which can inhibit the use of fatty acids as energy. Also, when insulin is brought to low levels, beneficial hormones are released in the body, such as growth hormone and other powerful growth factors.
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.
If you are pregnant or are nursing, you should not follow a Ketogenic diet. You will not receive enough of the recommended carbohydrates, vitamins and nutrients necessary for yourself and your growing baby on this diet. Your obstetrician will recommend how many carbohydrates you should consume per meal and for snacks during each phase of your pregnancy. They will likely refer you to a Certified Diabetes Educator for nutritional counseling as well. Please check out The Diabetes Council’s FAQ’ About Gestational Diabetes for all your gestational diabetes related questions.

I have been a type 1 diabetic for most of my life. I live a very active lifestyle of long distance running and hiking. I’ve always had a very healthy diet, but would still have those after meal blood sugar spikes that would leave me feeling unwell. I decided to try the keto diet to see how my blood sugar did It’s been amazing. I’ve cut my insulin in half and my head is clear. I no longer have the brain fog. I sleep better and have more energy. I have been doing it for a year and have no desire to go off of it.


When carbohydrate consumption is limited, your body has to use an alternate fuel source to keep your brain going. This is the general premise behind the ketogenic diet. “The ketogenic diet is a high fat diet with low carbohydrate and moderate protein content,” says Gabrielle Mancella, a Registered Dietitian with Orlando Health. “Carbohydrate is depleted to provide an alternative fuel source, known as ketones, to the brain. The body converts from burning carbohydrates to burning fats, known as ketosis.”

Achieving ketosis is a pretty straightforward, but it can seem complicated and confusing with all of the information out there.4If you want to learn more about ketosis and the scientific process around it, you can visit a very in-depth discussion about on Dr. Peter Attia’s website. Here’s the bottom line on what you need to do, ordered in levels of importance:

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.
First – let’s admit that there are several different types of diets that produce dramatic improvements in weight loss and diabetes. The vegan diet is one of them (and one which also reduces risk in most other diseases better than the others) – but it is by unquestionably by far the very best diet for the environment and the survival of the planet. High protein (high meat and/or dairy) diets are absolutely TERRIBLE for the environment and are not sustainable in any way. A vegetable diet will END world hunger because we DO have enough earth to grow enough vegetables for everyone and we definitely do NOT have enough earth for meat eaters even at current levels.
Given all the buzz, adopting a ketogenic diet may be the perfect weight loss plan, especially if you have diabetes, or want to try this approach to lose those troublesome extra pounds. After all, it’s a very low-carb meal plan that promises effective weight loss while also lowering your blood sugar to the point where you could possibly stop taking medication. By all accounts, the “keto” diet, as it’s widely known, may even reverse type 2 diabetes, at least for some lucky individuals.
If you are pregnant or are nursing, you should not follow a Ketogenic diet. You will not receive enough of the recommended carbohydrates, vitamins and nutrients necessary for yourself and your growing baby on this diet. Your obstetrician will recommend how many carbohydrates you should consume per meal and for snacks during each phase of your pregnancy. They will likely refer you to a Certified Diabetes Educator for nutritional counseling as well. Please check out The Diabetes Council’s FAQ’ About Gestational Diabetes for all your gestational diabetes related questions.
The main electrolytes affected by this process are sodium, potassium and magnesium. There are other electrolytes in your bloodstream, such as calcium and phosphorus, but their levels don’t change much on a keto diet. However, getting sodium, magnesium, and potassium in balance can help prevent against symptoms of keto flu and fix some of the side effects you may have long term. Read on to find out more about them.
Constipation is a common side effect of low-carb eating plans, including the ketogenic diet. Severely curbing your carb intake means saying goodbye to high-fiber foods like whole grains, beans, and a large proportion of fruits and vegetables, says Ginger Hultin, MS, RDN, Seattle-based nutritionist and spokesperson for the Academy of Nutrition and Dietetics.
Once ketosis is established, most people experience more stable and lower blood sugar levels. Low-carb diets can be an effective way for people with type 2 diabetes to get a handle on glycemic control—and carb monitoring has long been thought to be an effective way to control blood sugar—though one study concluded low-carb diets are not necessarily a better long-term strategy than other diets. Anecdotal evidence abounds from people with type 2 diabetes who have used the keto diet to stabilize their blood sugar and were able to quit taking their diabetes medication. But it’s not recommended that people with diabetes begin the keto diet without first talking to their doctor.
Disagree. I’ve been eating like this for ten months. I still enjoy carbs on the rare occasion but stick to a ketogenic diet most of the time. Ive lost 94lbs. I understand people lose weight in other ways but for me this worked. I eat 10x as many green vegetables as I ever have (at least 2 meals a day). My blood pressure dropped drastically in the first month. My cholesterol, triglycerides and blood sugar all normalized within the first 90 days. I don’t see any reason not to continue. I find this way of eating empowering and not restrictive. Before you call something a fad, because you obviously don’t fully understand this, you ought to read something from people other than the people you agree with. This is the problem I have with dieticians and most doctors. You don’t think for yourselves. You follow whatever the accepted guidelines are and spout them off without ever asking if they are right. It’s easier to stand with the crowd. I get that. But do not use your expertise as a means to criticize real progress. I would think as an expert your would be a proponent of what works! Have you ever been morbidly obese? Do you know what it is like to think your going to die from a heart attack at a young age? Do you know what it’s like to know your going to get type 2 if you can’t overcome your weight? Eating this way got me out of all of that and gave me my life back. Come down from the Ivory tower… Just maybe a little less judgement, a little more open minded
Known primarily as a weight-loss diet, a ketogenic approach will allow your body to use higher-quality food sources for energy, and store less fat. When it comes to carbohydrates, any excess calories will be stored as fat for future use. This will only result in weight gain, and lower energy levels, particularly after the initial sugar rush of energy from simple carbohydrates. More protein in the body will also kickstart the metabolism, which will increase fat-burning potential, particularly if you are eating high-quality fats as a part of the ketogenic diet.
Experts are split on whether the keto diet is a good idea. On the one hand, Lori Chang, registered dietitian and a supervisor at the Center for Healthy Living at Kaiser Permanente West Los Angeles, says using a “cleaner” source of energy—ketones rather than quick-burning carbohydrates—can improve mood and energy levels. When you eat refined carbohydrates or just too many carbs in general, the blood is flooded with excess insulin, Chang says. "This can lead to a blood sugar rollercoaster that stresses the body and negatively impacts energy levels and mood. When you’re in a state of ketosis, however, ketone bodies don’t require insulin to cross the blood-brain barrier, which wards off unfavorable blood sugar levels."
Now, there’s even evidence that a low-carb, high-fat regimen (as the keto diet is) helps you live longer, compared to a low-fat diet. In a study by the medical journal The Lancet that studied more than 135,000 adults from 18 countries, high carbohydrate intake was associated with higher risk of total mortality, whereas total fat and individual types of fat were related to lower total mortality. Total fat and types of fat were not associated with cardiovascular disease, myocardial infarction or cardiovascular disease mortality.
Unless you’ve already been eating a paleo or primal diet and are somewhat keto-adapted (burning ketones for fuel), it is a good idea “reset” the body in order to regain the metabolic flexibility to go into ketosis or even stay in ketosis despite eating some carbohydrates. Intermittent fasting is one efficient way to do this. During a water fast, ketosis can occur in days instead of weeks or months and often sustains for a while after the fast.
The keto diet restricts carbs so much that anyone who is on blood sugar lower medication or who has type 1 or type 2 diabetes must consult his or her doctor before making such a severe dietary change. As the body adapts to low-carb dieting, medication dosages and treatment plans will have to be revised, and blood sugar levels must be carefully monitored.
While people can argue back and forth about the role carbohydrates play in a healthy lifestyle, no one is going to say packaged snack foods are healthy. This is one of the areas where the ketogenic diet definitely succeeds because it eliminates the opportunity to eat highly processed foods, which are made almost entirely from sugar and other refined carbs. In a review published in the European Journal of Clinical Nutrition, the authors highlighted a number of studies showing a ketogenic diet can significantly improve insulin sensitivity for those with type 2 diabetes. They went so far as to say, “results have been nothing short of miraculous.”

The main role of the gallbladder is to store bile (which is made in the liver), and in turn, the role of bile is to digest fat. People assume eating a lot of fat is somehow linked to an increased risk of gallstones, which are solid deposits of cholesterol and bile that can form in the gallbladder. But most of the cholesterol in the bloodstream is made inside the body (as part of a tightly regulated process inside the liver), not derived from the diet.
The ketogenic diet is a high-fat, very-low-carb diet plan. The goal of the diet is to reach a “ketosis” state. The more restrictive you are on your carbohydrates (less than 15g per day), the faster you will enter ketosis. Once in this state, rapid weight loss begins. Research does indicate that the ketogenic diet is most effective in weight loss by reducing visceral (body) fat.
Slightly increase carbs. If you wait a few more weeks and still have trouble with the ketone smell, you might consider eating slightly more carbs to reduce the ketosis. Try increasing to between 50 and 70 grams per day. You might also try combining this with intermittent fasting, such as only eating within an 8-hour window, to maintain the benefits of ketosis without the side effect of fruity breath.
Carbohydrates help control blood sugar levels, which are of particular importance for people with diabetes. A study published in May 2018 in the journal Diabetic Medicine shows that while a keto diet may help control HbA1c levels (a two- to three-month average of blood sugar levels), the diet may also cause episodes of hypoglycemia, which is a dangerous drop in blood sugar. Echoing many registered dietitians, the Lincoln, Nebraska–based sports dietitian Angie Asche, RD, says she is “hesitant to recommend a ketogenic diet for individuals with type 1 diabetes.”

I can tell how passionate you are about this subject. As you can see on one of my reply’s above, CDE’s do not recommend the same number of carbs for every person we see; we use an individualized approach. It varies depending on the person’s height, bone structure/muscle mass, amount of weight they may need to lose (or gain) and the amount of exercise they may or may not do per day/week.
Weight loss often means feeling hungrier and fighting off more cravings, but that doesn’t always seem to be the case when you go keto. People report less hunger and a diminished desire to eat after adopting a ketogenic diet, according to an analysis of 26 studies. Experts don’t fully understand why, but it’s thought that very low carb diets could suppress the production of hunger hormones like ghrelin.
More recently, a meta-analysis was published in the Journal of Neurology that assessed the impact of the ketogenic diet in treating epilepsy. It included a total of 19 studies with a total of 1084 patients. After analyzing the data, the researchers noted that the patients who stayed on the diet had a 2.25 times greater probability of treatment success (at least a 50% reduction in seizures).

The ketogenic (or keto) diet was initially designed to treat severe epilepsy in infants and children. As an intervention diet, it was intended to be administered for short periods of time under the supervision of a medical team. Now popular for it’s rapid weight-loss side effects, the diet has moved to the mainstream public as an alternative low-carb diet.

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.


And while some fats can be healthy, there’s a risk that in following a high-fat diet, you’ll increase your intake of unhealthy trans and saturated fats. These “bad” fats are found in things like red meat, poultry skin, cheese, and butter, and can lead to an increase in LDL, or “bad” cholesterol and increased risk of heart disease. (14) This is a controversial issue, as some experts do recommend adopting a low-carbohydrate diet to lower heart disease risk. If you’re at risk or have heart disease, it’s important to speak with your doctor first about your health needs.
Wolfrum said he and his colleagues don't want to stop people from changing their diet if that's what's necessary to reach a healthy weight, but they think it's important for people to know that "the [final] verdict on the ketogenic diet is not out yet." There's still more research to be done to fully understand the long-term effects of a high-fat, low-carb diet. In the meantime, said Wolfrum, "more balanced food intake is probably the healthiest way to live."
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.
thank you Dr. Jockers for the informative article. I have hypothyroidism from 3 parathyroid cysts being removed along with 80% of my thyroid. It is under control with Levothyroxine and liathyronine. I have been on the keto diet for almost 4 weeks and am still experiencing heart palpatations, dizzyness and low energy. I have been quite strict and feel disappointed. I have Chronic Lymphocytic Leukemia and my oncologist was ok with me going on it. I feel like this diet would help me have more energy and help my overall health. Any advise would be appreciated. thank you, Inika
Also, to the author I do appreciate you stating you are bias up front, but I do get to indulge with some fruit/berries when I want. You dont give up everything forever but you learn to fit them into your macros. I have learned to make Keto ice cream and fat bombs if the urge comes along. I have learned to take keto friendly foods along to potlucks that everyone loves. Keto can be a way to follow forever but everyone has their own needs for their bodies. I am new to this but finding it easier and easier to remain keto
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