I think I would be better is you would talk about how people could make the keto diet better instead of dismissing it, more emphasis should be put on eat vegetables, fermented veggies and healthy sources of fat. Those studies that showed the negatives of the keto all used man made polyunsaturated seed oil, the worst possible type pf oil that people can eat.
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Available research on the ketogenic diet for weight loss is still limited. Most of the studies so far have had a small number of participants, were short-term (12 weeks or less), and did not include control groups. A ketogenic diet has been shown to provide short-term benefits in some people including weight loss and improvements in total cholesterol, blood sugar, and blood pressure. However, these effects after one year when compared with the effects of conventional weight loss diets are not significantly different. 
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Anyways, I am feeling so much better without the weight, my sleep apnea is gone, my blood glucose is lower and the edema in my legs is gone. But I do have concerns about the saturated fat, my HDL/LDL and I do not like the “nail polish breath”. Once I reach my goal, I plan to transition to more of a Mediterranean style diet but still with logging and I hope to be able to keep the weight off.
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DEXA (Dual-Energy X-Ray Absorptiometry): If you can afford it, a DEXA scan will give you the most accurate results. A DEXA is an X-ray treatment that measures body composition and can detect bone mineral density, lean body mass, and fat mass with great accuracy. However, they can only be done on a health facility and a comprehensive session can cost up to $160.
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This whole post must have taken so much effort and I think it’s incredible that you do this. The issue with these diets is that people hear about it, think it sounds good and do it. No questions! We are so lucky to have dietitians like you actually laying out all the research, the good, the bad, and everything in between about these diets, so THANK YOU!
It may be because all we have ever known is what we have been told by the FDA or who are the people in our country that tell you what you should eat. Do you realize how much money is in the grain , corn and sugar business in this country? A lot more than you can imagine. Bottom line I think its money telling people what they should eat. I’m gonna try the diet and see if it helps me. Thx for letting me voice my opinion.
A study of 89 obese adults who were placed on a two-phase diet regimen (6 months of a very-low-carbohydrate ketogenic diet and 6 months of a reintroduction phase on a normal calorie Mediterranean diet) showed a significant mean 10% weight loss with no weight regain at one year. The ketogenic diet provided about 980 calories with 12% carbohydrate, 36% protein, and 52% fat, while the Mediterranean diet provided about 1800 calories with 58% carbohydrate, 15% protein, and 27% fat. Eighty-eight percent of the participants were compliant with the entire regimen.  It is noted that the ketogenic diet used in this study was lower in fat and slightly higher in carbohydrate and protein than the average ketogenic diet that provides 70% or greater calories from fat and less than 20% protein.
Great post, Abbey!! Thank you for taking the time to write this and share it with us! This diet may work in some cases as you pointed out but i find it very dangerous, eventhouh i’m not a dietician. I tried it and i felt horrible. I felt depressed, constipated, pain in my right side which i think was my gallbladder. Couldn’t sleep, terrible breath. AWFUL!!
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There are so many tricks, shortcuts, and gimmicks out there on achieving optimal ketosis – I’d suggest you don’t bother with any of that. Optimal ketosis can be accomplished through dietary nutrition alone (aka just eating food). You shouldn’t need a magic pill to do it. Just stay strict, remain vigilant, and be focused on recording what you eat (to make sure your carb and protein intake are correct).
I’m a Registered Dietitian, and I greatly appreciate your overview. I will admit, I felt the exact same as yourself, but I decided to research it further, and then go on it to test it, and I have to admit, it has changed my view of it completely. I believe as dietitians, instead of telling our clients it’s a fad, educate them on how to do it successfully as a lifestyle and not as a fad. I believe that is the key. I highly recommend “What the Fat” book written by both a Registered Dietitian and professor. Great job going into the science and research. https://whatthefatbook.com/product/what-the-fat/
Skinfold Calipers: Skin calipers are affordable and easy to get on Amazon. Your local gym most likely has them too. A skinfold caliper works by pinching one area of your skin that folds easily (like your belly and back), in three to ten different areas of your body to measure your subcutaneous fat. That measurement is then used in a formula to calculate your body fat percentage. If you’ve never done this before, let a physician or coach do it first and teach you how to read the measurements accurately so you can do it at home next times.
Fortunately, I read your post before I watched your video. I am considering trying the Keto diet and am looking for honest, scientific, and wise counsel about it. Your research seems to be pretty thorough, though missing some facts, but still decent information. I feel like I can make an informed decision based on what I read, plus have a good direction for more research. However, after watching your juvenile and exaggerated video, based on the weirdest things (possibly ONE person actually eats) that “Keto Dieters eat,” I’m not sure what I think of your post. The video completely undermines your believability as a “dietician.” If someone told you they ate dog poop for breakfast, would you have tried that? Come on. Professionalism goes a long way. As a dietician, I would think you would be shooting for credibility. Aside from “seriously pissing off” your viewers, you killed your own voice of credibility.
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.
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All I know is that by cutting out foods like bread, that have arguably no nutritional value whatsoever, I’ve lost fat weight and have been able to retain (and grow) muscle through workouts. Not only that, but I am markedly stronger, and I don’t suffer any effects of malnutrition. I don’t want to be one of these people that despite eating a “balanced diet” simply gets fatter as they get older, because of how carbs screw up your insulin resistance levels and cause your body to store fat (particularly visceral fat in men) where it isn’t needed.
Look, keto is simple. Please stop complicating it. You can honestly eat any food and stay in ketosis as long as you eat less than 25-50 grams of carbs a day. If you are an athlete you can eat up to 100 carbs per day. No food, I repeat NO FOOD is a keto food. Like hummus? Eat it! Like pineapple? Eat it! Unless you have a metabolic disease that causes your body to be super sensitive to sugar you can eat pretty much any whole food and remain in ketosis.
I also want to add that I absolutely agree with your verdict! As a type 1 diabetic who has experienced the sickening feeling of ketones’ presence, and known about the dangers of ketoacidosis since childhood, the concept of this diet for weight loss has always rubbed me the wrong way and struck me as a bit off (although I know ketosis is a different thing and is alright for the body, its extreme form is ketoacidosis, after all). I also have seen the diet, used for weight loss, cause dramatic results that then rebounded afterwards. I understand it is an incredible revelation in treating some epileptic individuals, and I see how it makes sense and can be helpful for type 2 diabetics or pre-diabetics. But as for a weight-management diet, like with everything else in life, I think we should strive balance. And enjoying summer peaches!
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To calculate your calorie needs, you need to enter your age, gender, height, weight and activity level which includes exercise and other physical activity. Finally, select your chosen stringency of the diet from the drop down: ketonic, moderate and liberal, with C/P/F representing the percentages of carbs, proteins and fats in the dietary mix. The ketogenic calculator will display the amount (in ounces or grams) and caloric equivalence of the carbs, proteins and fats (lipids) you need to consume per day. You should try to eat according to the macronutrients given and to spread your meals out during the day, but you should not be overly worried about getting the exact numbers each and every day and meal as small fluctuation should be OK as long as you are close to the estimate.
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Having said that, there are also studies suggesting that long term carbohydrate restriction diets (aka. the keto diet) may result in fast short term weight loss but people gain it all back in the long term. An RCT put 63 individuals on a low-fat diet or a low carb diet, and the study found the low carb dieters lost more weight compared to the low fat group by month 3 and 6, but that the weight loss evened out by month 12. This was confirmed by a Meta-analysis which found that while low-carbers lost more weight than low-fat dieters but the differences disappeared by the one year mark.
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Abbey, I appreciate the article, it’s helped me come to a decision on KETO. I’ve been on KETO for over 3 months, I’m a woman of 55 and post menopausal with a good 40 lbs of fat to lose. I work out 3-5 per week at an intense level doing cardio, HIIT and weight training and I have NOT lost any weight (ok, a single pound). I am in Ketosis most of the time (testing often) and I’ve been eating 1,200 to 1,300 cals per day. My carb intake around 15-20 grams per day, Fat around 90 grams and protein was about 45 grams until I increased it after learning I had lost muscle mass confirmed on a SECA scale.
This is of course just an overview of what you can eat, but these are things I’m most likely going to pick up from the grocery store. I also didn’t want to include crazy expensive specialty items like Erythritol for beginners. I think we all get excited about making our favorite junk foods in the style of our diets right away. This is fine…but it can be very expensive, time consuming and exhausting. Stick with the basics, especially when first starting out!
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I think that the best way to feed is with a Keto diet, this consists of eating the maximum amount of protein and healthy foods rich in fat such as fish, meat, avocado, eggs, cheese and fruits, while carbohydrates are restricted as cereals, flours, legumes, vegetables and fruits. This produces a weight loss more quickly than when resorting to a habitual diet. Here is a link with more information of rapid loss weight. https://tinyurl.com/ketoloseweight
I’m very glad I found a common sense expert to help sort through some of this Keto fog. I watched “The Magic Pill” which got me curious about a few things. Does their argument that eating Keto is the way to go because our ancestors ate this way and were healthy have any validity? The Paleo diet seems to use this argument too but Paleo is not Keto – or so I read.
While I do appreciate the amount of research that went into this article, I need to weigh in here— no pun intended. I am a 44 year old woman who suddenly and inexplicably gained a lot of weight at about age 20 and pretty much (albeit a few bouts of massive dieting and exercising) have remained fat until the age of 42. I had always been thin without having to give my lifestyle much thought before my sudden weight gain — so I have spent the last 20+ years becoming pretty proficient on learning how the body uses fuel. I have had success losing great amounts of weight a few times in my life — twice reducing my calories the “nutritional counseling” way — using the old school and outdated food pyramid and tons of exercise. It took literally having to spend hours and hours at the gym — being miserably hungry all the time — only to achieve slow progress at the scale. Months and months I would spent this way only to gain the weight right back the minute that I let go of the reins. I’m always hearing about “sustainable lifestyle changes” from you nutritionists— an I believe in daily exercise — but that lifestyle was completely unsustainable in the long term which is why so many people are unsuccessful.
Thermal Effect of Activity, also known as Activity Level, determines additional energy expenditure due to moving around and exercising. According to Lyle McDonald, broadly speaking, there are 5 categories / activity levels. We readjusted the multipliers from Lyle McDonald's book to better reflect different activity levels that work for most people.
Thank you for your objective review of the Keto Diet. I am not overweight but decided to try the Keto lifestyle because I have a lot of inflammation issues, including asthma and osteoarthritis. I had also been experiencing uncomfortable intestinal issues. I have been following the Keto lifestyle for 4 1/2 weeks, and I feel so much better- especially my stomach! I am eating a ton of leafy greens, broccoli and cauliflower. I am also enjoying Brussel sprouts, whole avacados and zucchini. I think the reason this is working well for me is because my body chemistry loves all the vegetables, good fats and protein. I also think that taking away sugar has had a big impact on how I feel. I’m just not eating grains and sugar. lots more veggies, berries, and consciously incorporating healthy fat. My stomach is flat again, and I have no more bloating or constipation. I have only lost 5 pounds, but I think my system is clean and operating better than it has in years. My point is that every person’s body chemistry is different. The Keto lifestyle seems to be what My body needed to feel my best. I did experience “the Keto flu” about a week into it, but it was short lived. I think that to be successful it is really important to eat a wide variety of veggies and good fats every day.
I do want to point out an inaccuracy in your description of ketoacidosis. If a Type 1 diabetic “and/or does not eat enough carbohydrates,” they will not enter a state of ketoacidosis. It is the opposite. Ketoacidosis can occur if a diabetic consumes carbs without having enough insulin to allow the body to use glucose for energy. In contrast, not eating enough carbohydrates for insulin that was already injected causes hypoglycemia.