Eating a keto diet can have some short-term health perks. But in the long run, it also has the potential to create some serious health problems. That’s why many experts say you shouldn’t attempt it on your own. “In general, if a person follows a ketogenic diet, they should only do so for a brief time and under close medical supervision,” says Hultin.
On the standard keto diet, you plan all meals and snacks around fat like avocados, butter, ghee, fatty fish and meats, olives and olive oil. You need to get about 150 grams a day of fat (the amount in nearly ¾ cup of olive oil and three times what you are likely eating now) in order to shift your metabolism so it burns fat as fuel. At the same time, you need to slash your carbs from about 300+ grams per day to no more than 50 (which is about the amount found in just one blueberry muffin). That means sticking to leafy greens, non-starchy veggies, and low-carb fruits like berries and melon. Finally, you'll eat a moderate about of protein, which is about 90 grams per day or 30 grams at each meal (think 4 ounces of meat, fish, or poultry).
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.
Another organ that plays an essential role in blood sugar regulation is the liver. It stores excess glucose as glycogen, and when glucose levels are low, glycogen is broken down to provide glucose [6]. This process is regulated by two hormones: insulin and glucagon. Insulin normally promotes glycogen synthesis and interferes with glucose release from the liver.
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.
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.
Considered a symptom of the keto flu, your breath on this diet often smells fruity at first. This is because acetone is a by-product of ketosis and is eliminated mostly through the lungs and the breath, according to a study in the journal International Journal of Environmental Research and Public Health in February 2014. Acetone is a type of ketone known for having a fruity aroma in smaller concentrations. “It’s hard to say exactly how long it will last as it depends on the person, but it’s common for someone to experience this side effect for a few weeks,” says Asche.
You increase your production of these ketones through a process called ketosis. To get and stay in ketosis, you increase your dietary fat intake while modifying protein and dramatically limiting carbohydrate consumption, and you incorporate intermittent fasting. Human adults have little need for dietary carbohydrates, and reducing intake to shift into mild ketosis can provide dramatic benefits. (5)

There are two main types of diabetes: Type 1 and Type 2. Type 2 is by far more common, accounting for 90 percent of all diabetes cases worldwide. In this type, the body does not make or does not use insulin well. It can happen to anyone but is more common in people over the age of 40, those who are overweight and inactive, those with a family history of diabetes and patients whose diets consist mainly of refined carbohydrates.


The low-carb, high-fat approach to the keto diet limits the types of foods you can have, and entire food groups are eliminated entirely. Beans, legumes, and whole grains are out, as are many fruits and vegetables. Many of these foods carry vitamins, minerals, and other nutrients you can’t get from any other source, and without them, you may start to experience nutritional deficiencies.
THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for general informational purposes only and does not address individual circumstances. It is not a substitute for professional medical advice, diagnosis or treatment and should not be relied on to make decisions about your health. Never ignore professional medical advice in seeking treatment because of something you have read on the WebMD Site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
I’ve said many times before that keto dieters tend to eat less produce, either because they don’t like it and see keto as a free pass for near-carnivory, they worry about the carbs in produce throwing them out of ketosis, or they somehow think plants are restricted on keto. These are mistakes. Common ones. You can eat plenty of produce on keto. You should eat plenty of produce on keto. Mushrooms of all kinds. Leafy greens. Cruciferous veggies like broccoli, cauliflower, bok choy. Low-carb fruits like berries. Anything fibrous.
Also, be aware that, while diet can be an extremely powerful tool to regain control over many aspects of health, diet by itself remains insufficient for full health. Just as filling up the gas tank of your car with quality gasoline helps your car run well, but other aspects of your car need attention over time (change the oil, tune-ups, new tires on occasion, etc.), so it goes with diet. We must also pay attention to vitamin D and iodine status, the potential for common endocrine disruptions such as thyroid dysfunction, efforts to cultivate bowel flora, and other issues. Focus on diet as a start, not as an end.
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.
Technically speaking, you're in ketosis when your blood ketones are higher than 0.5 mmol/L, but the optimal level for fat-burning purposes is 1.5 to 3 mmol/L. Nisevich Bede says that seasoned keto dieters report that they can actually feel a difference in this state, citing that they're less hungry and experience mental clarity once they reach ketosis.
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.
So my question to all of you is: why do most people trying to improve their health appear to not care at all about how their food choices impact the earth and the future of all our children? (Not to mention the horrific conditions that the great great majority of animals bred for food endure?) Is it because you have not been told or do not believe how bad it is (our society has many many who are in total denial about global warning, for instance), or is it because you truly don’t care?
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). 

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

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.
Those following the keto diet are advised to restrict carbohydrates to just 50 grams a day at the most, although hardcore keto dieters recommend consuming just 20 grams—about the equivalent of half a hamburger bun or a single banana. Instead, high-fat foods are prioritized, like avocados, olive oil, nuts and butter. Beef and chicken, which have no carbs, are staples of the ketogenic diet, although protein should only make up 20 percent of your daily caloric intake.  
But people who started following the keto diet noticed weight loss for a few reasons: When you eat carbs, your body retains fluid in order to store carbs for energy (you know, in case it needs it). But when you’re not having much in the carb department, you lose this water weight, says Warren. Also, it's easy to go overboard on carbohydrates—but if you're loading up on fat, it may help curb cravings since it keeps you satisfied.

I think that the experts don’t want to admit that they have been wrong all this time, They all screamed low fat/high carb which is a miserable, unsatisfying way to eat. Who wants to eat a potato with plain yogurt? Gross! She mentions that you are missing out on vital nutrients, but where is the mention that you are giving up things your body needs when you limit fats too? Keto is the only way to eat where you feel satisfied. I would eat cereal and be starving an hour later. How is that helpful? I can eat bacon and eggs (no toast), and be perfectly content for hours. It takes more food preparation, but I truly believe now that bread (whole grain or not) is the enemy of man.


Hello, I’m Abbey! I'm a Registered Dietitian (RD), an avid food and recipe writer, a TV nutrition expert and spokesperson, a YouTube host and the founder of Abbey’s Kitchen Inc. Abbey's Kitchen is a multi- faceted food and nutrition media brand developed with the goal of celebrating the pleasurable eating experience. For more information about me, check out my bio here.
And science is now catching up, this review paper on ketogenic diets   as a form of cancer therapy concluded: “Although the mechanism by which ketogenic diets demonstrate anticancer effects … has not been fully elucidated, preclinical results have demonstrated the safety and potential efficacy of using ketogenic diets.. improve responses in murine cancer models”
Changes in blood lipid levels. By changing the carb and fat content of your diet, your cholesterol levels will change. The current research indicates that cholesterol levels should improve while you are on the keto diet. However, the increased fat consumption can also send cholesterol into unhealthy ranges for some people, especially those who are already struggling with familial hypercholesterolemia.
“Keto is not a great long-term diet, as it is not a balanced diet,” says Nancy Rahnama, MD, MS, an internal medicine and bariatric specialist in Los Angeles. “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.”
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.”
What is more common throughout the history of the human race is fasting. Islamic Ramadan is a 28- to 30-day fast where food and drink are prohibited during the daylight hours. Christianity also has a strong fasting foundation, and in the Bible, Jesus fasted to have higher and clearer communication with God. Greek Orthodox Christians fast for a total of 150–200 days each year!
The low-carb diet induces ''nutritional ketosis," Dr. Saslow tells EndocrineWeb, which is not the same as ketoacidosis. Ketones are a chemical your body produces when you burn stored fat; if you are on a low-carb diet you may be ''in ketosis.'' Ketoacidosis is different; it is a life-threatening condition in which levels of ketones and blood sugar are dangerously high, which may occur in people who have poorly controlled diabetes.

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. 
Author’s note: I want to stress again the importance of consulting with your doctor before you try ketogenic dieting. The more I study this area of science, the more I realize that every individual is extremely unique when it comes to health issues and there are a ton of reasons why you should NOT go full-on keto (especially if you are prone to kidney, heart, or gallbladder issues). That being said, for many people this form of eating is life changing, and the amount of scientific research supporting a ketogenic lifestyle is significantly increasing. Subscribe to my newsletter to stay posted when I publish new articles, and I’d appreciate any and all feedback/corrections on the content I’ve written above. Thanks! (Image credit)

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.


The ketogenic diet—also known as "keto"—has become the latest big thing in weight-loss plans, touted recently by celebs like Jenna Jameson, Mama June, and Halle Berry. The diet involves cutting way back on carbohydrates, to 50 grams a day or less, to help the body achieve a state of ketosis, in which it has to burn fat (rather than sugar) for energy.

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
One of the keto side effects people may complain about is keto breath.  Although this is not quite related to the three major causes we’ve discussed so far, keto breath is something that many people experience in the early stages of keto adaptation. When you begin producing ketones, you produce them in several different forms. The ketone that is released through the breath is acetone and is responsible for the keto breath that some people experience.
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.

In this study, researchers compared the impact of a low-carbohydrate diet and three other diets on blood pressure and other measures of cardiovascular fitness in women. After the 12 month trial, all subjects who successfully completed their respective diet experienced notable reductions in body mass, triglycerides, and LDL cholesterol. Those in the low-carbohydrate diet group, however, had the best results.
“Keto diets should only be used under clinical supervision and only for brief periods,” Francine Blinten, R.D., a certified clinical nutritionist and public health consultant in Old Greenwich, Connecticut, told Healthline. “They have worked successfully on some cancer patients in conjunction with chemotherapy to shrink tumors and to reduce seizures among people suffering from epilepsy.”

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.
The problem comes when people remain ketotic for extended periods. We know with confidence that long-term ketosis poses substantial risk for health complications because thousands of children have followed ketogenic diets over the years as a means of suppressing intractable grand mal seizures unresponsive to drugs, seizures that can lead to irreversible brain damage if not stopped. A ketogenic diet reduces seizures by approximately 55%. Because seizures are a chronic problem, these kids maintain ketosis for months to years.

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.

The keto diet is known for helping people lose a few pounds very quickly, says Becky Kerkenbush, RD, a clinical dietitian at Watertown Regional Medical Center. Carbs hold on to more water than protein or fat, so when you stop eating them, your body releases all that extra H2O by making you pee more. As a result, the scale might read a few pounds lower, and you may look a bit leaner.


I recently had one of my previous cooks post that she was going to do this diet and should she start with 20 grams or 30 grams. She has been a cook in the healthcare business for about 8 years so she understands the different diets but not the physiology behind them (yet. I am trying to talk her into taking the CDM course). I told her to consult the RD at her facility before she embarks on such a trend. She won’t because all her friends posted their weight loss stories.
"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.)
Recommendations: If you have high levels of LDL particles and VLDL particles, consider adopting a carbohydrate-restricted diet. To optimize your LDL cholesterol levels, consider adopting a diet high in healthy monounsaturated fats and low-carb vegetables. Some examples of keto-friendly foods that are high in monounsaturated fats are olive oil, avocado, and macadamia nuts.
A great long-term benefit of the ketogenic diet is reduced cravings for sugar and other unhealthy foods. However, you might initially have stronger cravings for carbs during the transition period. This can last anywhere from one to two days to around three weeks. But stick it out! At the end, you’ll be pleased with the reduced, and often eliminated, cravings. 

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.


Second point, I have never tried ketogenic dieting and also I did my calculations based on a 4:1 ratio and I was amazed at how much fat I would need to consume even at my size and the foods I would have to 1. Get rid of to achieve that and 2. Add in my diet to get there and , no thank you. My heart goes out to the families with children who do have to be on this diet.
Ketoacidosis, on the other hand, is a complication of poorly managed diabetes. It results in uncontrolled production of ketone bodies that can change the pH of the blood, which can prove fatal. Ketoacidosis is more common with Type 1 diabetes rather than Type 2. It’s also important to note that the keto diet cannot cause ketoacidosis – but rather puts the body into the beneficial state of ketosis.

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Ketosis, similarly to fasting or caloric restriction, turns on a group of genes called Sirtuins. When scientists activate Sirtuins in animals, they found that these animals live longer. In addition, Sirtuins can help keep you lean and energetic during the day and sleeping well at night. More research is needed to know if this effect is the same in humans, but evidence seems strong that spending some time in ketosis is beneficial.
Another organ that plays an essential role in blood sugar regulation is the liver. It stores excess glucose as glycogen, and when glucose levels are low, glycogen is broken down to provide glucose [6]. This process is regulated by two hormones: insulin and glucagon. Insulin normally promotes glycogen synthesis and interferes with glucose release from the liver.

We have all heard of essential fatty acids (EFAs) and essential amino acids (EAAs), but have you ever heard of essential carbohydrates? No. The human body is capable of burning fat for fuel. If the body can burn fat for fuel, why would you ingest a substance (carbohydrate) that raises your blood sugar, raises your insulin levels, and makes you sick? Why would the ADA advocate the very diet that made us sick in the first place? When are they going to admit they’ve been wrong and start doing what is in the best interest of diabetics?


Thanks for this inputs. 20 years ago I gain 17 pounds a year for 5 years. I was healthy but my dr told me start diet, any diet just come back in a month I want to see you start loosing… I started Atkins and lost 7 pound in a month. She was checking my progress every six months and checking my condition. I lost 64 pounds in 3 years. Now I started eating out of control. I am eating healthy but too much… I gain 40 pound back after 20 years. Now I will start again my Atkins to take off 30 pounds…
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.
During the first few weeks of the ketogenic diet, the body has to go through the "metabolic shift," as Dr. Mauro DiPasquale calls it. While going through this, the body will experience a small degree of fatigue, brain fog, and even dehydration due to the increased water loss associated with ketoic-induced diuresis and water loss from depletion of glycogen stores.
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.
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.
Use Fat Wisely Rather Than Excessively. While the keto diet means your food choices are geared to a low carb/high fat intake, it does not mean adding fat to everything you eat. You do not need to fall for one of the most trendy keto tricks— adding a pat of butter to your coffee. This might be useful at the very beginning as you transition away from a high carb diet but should not be continued once you are past the initial shift once your body has adapted to this new eating rhythm.  Instead, listen to your body for cues. If you are feeling hungry right after a meal, you probably didn’t have enough protein or fat. When followed correctly, a keto-based meal will leave you feeling full and satiated for hours.
A keto diet has shown to improve triglyceride levels and cholesterol levels most associated with arterial buildup. More specifically low-carb, high-fat diets show a dramatic increase in HDL and decrease in LDL particle concentration compared to low-fat diets.3A study in the long-term effects of a ketogenic diet shows a significant reduction in cholesterol levels, body weight, and blood glucose. Read more on keto and cholesterol >
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