Thank you SO much for your blog post. My niece went into Ketoacidosis recently and I compared it to what a former RN in my neighborhood has been doing & recommending to everyone (& they believe her because she used to be a nurse, but definitely NOT a Dietitian). Anyway, after reading, I learned they are completely different, however if a healthy person does test for ketones in their blood, what are acceptable levels? (This same nurse tests for ketone levels). I appreciate how much work you put into this write-up and honest feedback! (I work with 2 RDs who agree with you!)

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The volumes of knowledge on display here make this book a mainstay in the field of ketogenic dieting.  This also makes it a really great option for anyone who’s interested in this high-fat diet. While this book is a superb document for anyone looking to enjoy the keto diet, don’t be scared as there is nothing too crazy in here! One of the best keto cookbooks for anyone just starting out and looking to learn the ropes.

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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/
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. 

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There is not one “standard” ketogenic diet with a specific ratio of macronutrients (carbohydrates, protein, fat). The ketogenic diet typically reduces total carbohydrate intake to less than 50 grams a day—less than the amount found in a medium plain bagel—and can be as low as 20 grams a day. Generally, popular ketogenic resources suggest an average of 70-80% fat from total daily calories, 5-10% carbohydrate, and 10-20% protein. For a 2000-calorie diet, this translates to about 165 grams fat, 40 grams carbohydrate, and 75 grams protein. The protein amount on the ketogenic diet is kept moderate in comparison with other low-carb high-protein diets, because eating too much protein can prevent ketosis. The amino acids in protein can be converted to glucose, so a ketogenic diet specifies enough protein to preserve lean body mass including muscle, but that will still cause ketosis.

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Hi Julie, thank you for stopping by. As someone who has been on this diet for over three years, I can tell you that eventually, you will be able to add more fruits into your diet. Remember that once you reach your goal weight you will be in maintenance mode and will have more food options. You may find that bananas cause you to crave sweets and may never eat them again, but I loved adding fruits back in my diet!
However, from personal experience, I can say that the diet is not optimal for athletes (as this article points out). I personally lost strength on all of my lifts at the gym and felt light headed and weak when I tried to do any physical activity. That’s why I think that is good for couch surfers and desk jockeys that don’t work out and need to lose weight.

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When you approach your normal body weight, the weight loss will slow. Just remember, a “normal” body weight differs from person to person depending on our genetics and environmental exposures and may not fit what we see in the popular media. The weight loss won’t go on forever. As long as you follow the advice to eat when you are hungry, you will eventually stabilize your weight.

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The biggest thing I’m trying to find out more about is the state of Ketosis. Is being in Ketosis a good thing? Does the brain need Ketones? If so would supplements help? Some studies such as: https://www.ncbi.nlm.nih.gov/pubmed/19664276/ seem to say maybe. Would you take Ketone supplements or put yourself into Ketosis as a way to increase your brain health – prevent from developing horrible diseases such as Alzheimers?
i like the comments of people who are better off now after being on Keto, but what they never say is what were they doing BEFORE keto? eating like shit? no exercise? unhealthy lifestyle? THAT is the big part of the equation – if you went from a terrible diet to keto then OF COURSE you’re going to be better off, lose weight and feel better. maybe its not the keto, maybe its just the removal of garbage food?
Keto for Women, my third paperback, delves into what the keto diet is (and is not) and how women can reap the many health benefits by using a targeted method specifically designed for their bodies. You’ll be shown why hormone imbalances cause many of the negative symptoms you experience and what keto foods and protocols will work best to remedy those. By showing you how to understand your body, you will be empowered to find solutions that are right for you as an individual and stay in control each step of the way.
Meanwhile, military researchers are focused on keto diets as well, believing soldiers could operate optimally on fewer, denser meals. Currently, the Defense Advanced Research Projects Agency, the Department of Defense, and NASA are all running ketogenic experiments. NASA believes the diet will be important in manned missions to Mars because it protects against higher levels of radiation in space by increasing the brain’s resilience to stress. Plus, “the energy density of a ketogenic diet is higher, so you have to carry less weight,” says D’Agostino.
Secondly, glucose is not the only source of energy for your body. The entire point of the Keto diet is that the body can use fat as a fuel source. Yes, you’ll still need glucose for certain things, but you eat protein and a minimal amount of carbs. The great majority of your energy needs are met by ketones. I don’t dismiss the concerns about accessing muscle for glucose, and I’d be interested in studies involving low intensity weight training on Keto to see if it helps with muscle retention. I think you’d probably have to carefully manage your protein levels as well.
The walking around part is not true in my experience, exercise alone will not help an obese person. I’ve been doing Keto and most things I’ve read have come true, I found this article to be unbiased. I will say this however, I agree I too have been eating many green veggies and the bad stuff I do use I use very little for flavor (like bacon) what I found that is utterly ridiculous on the part of the folks that did the diet rankings was saying Keto was unsustainable. The way I feel from being on Keto is insanely well. I want to keep eating this way! Unsustainable its the only diet I can do intermittent fasting on. I was type 2….
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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Truly Dr. Colbert is also a reputable source for more thorough science and modification of previous Keto extremes. The statements about Keto diets with dairy everyday are not true…I am a 66 year old professional (University trained) and have found medical people often very unknowledgable or partially knowledgeable which may be worse. I ask you Abbey to dig deeper…meet Dr. Colbert-not a quack and more in depth than your overview. Personally I am finding switch to more green’s and low glycemic vegetables and fruits with healthy fats, occasional dairy and healthy protein; a way of life that is helping our whole family. Please watch The Magic Pill…the help for family’s caught in old thinking from poor science (ie. Alex Keys) and with autism etc. and so much modern disease is in itself, motivation to search out more truth.

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With the high intake of fat, are we concerned about the high intake of cholesterol? YEP. A study using the keto diet as a form of treatment for epileptic seizures in children found that after 6 months of administering the diet, triglyceride levels increased, total cholesterol levels increased, and HDL and LDL increased. These results suggest that over time, a keto diet may lead to an increased risk of hypercholesterolemia and hypertriglyceridemia. In the same ten-year study, 40% of patients developed hypertriglyceridemia and 29% of patients experienced hypercholesterolemia. So, if heart disease runs in your family, you may want to bow out now.
Wow..Keto is the hardest diet in the history of diets to follow. Lets just mention the fact you need to be a mathmatician to follow the macro…or is it micro…of eating 20 g…oh wait is it 50g of carbs…which is it? And what does 75 percent fat intake entail? Can i drink a cup of olive oil and thats a percent of fats for the day? And how many cal. A day are you allowed? Nowhere is that ever discussed.

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It is now a mainstream dietary regime used wih the intent to reduce weight as it is safe for most people, but one should be especially aware of going ketogenic if one takes diabetes medicine, medication for high blood pressure or is breastfeeding. Typical foods include cheese, eggs, fish and seafood, natural fats, meet, vegetables that grow above ground. The key to maintaining the diet is low carb intake - usually with the goal of eating less than 50 grams or even less than 20 grams of carbohydrates per day. The fewer the carbs, the better, usually. Things to avoid include: fruit, potatoes, pasta, beer, bread, soda, chocolate, candy, donuts, etc. 

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As you walk around the store, stick to the outer edges. The outer aisles have the freshest food. Think about your neighborhood grocery store. Most often the deli, the meat counter, and the produce section are all along the sides of the store with the packaged items in the aisles. Once you add more carbohydrate grams to your daily limit, you can start to experiment with low-carb packaged foods.
Adequate protein intake and developing ketosis are both critical for maximising fat loss and sparing muscle mass during the ketogenic diet. However, it will take up to 3 weeks before your body gets keto-adapted (in some cases even more). During the initial phase of the ketogenic diet, nitrogen losses may occur if your daily net carbs intake is very low. When your carbohydrate intake goes down, your body converts body protein into glucose. Since about 16% of protein is nitrogen, you may lose muscle mass which will cause a decrease in your metabolic rate. This could have a negative impact on fat loss. For example, if your carbs intake is close to zero, you you may have to eat more protein (aka protein sparing modified fast). Keep in mind this applies to zero carbohydrate intake which means it does not affect most people following the ketogenic diet.
I tried the ketogenic diet and it really helped me even out my energy levels and I don’t grave sugar anymore. I had issues absorbing my B vitamins. I had high candida and l-acidophylis levels. I was also addicted to sugar. I started this 3 years ago, and since about a year ago, I’ve added fruit. Now I enjoy a little rice and potatoes as well. I even had a bite of chocolate cake and didn’t die. I started out at 112, lost 10 pounds within a month and have slowly gained most of it back. I am happy I did it, but I will be more confident to add more carbs, although it will mostly be in the form of more fruit and starchy veggies. Thanks for your article.

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.

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So where did the ketogenic diet come from? Interestingly enough, this fad diet didn’t spark from a celebrity endorsement or some guy missing a medical license. There’s evidence of the keto diet being used back in the early 1920s to treat severe childhood epilepsy and it’s still being used today for that purpose. Research suggests that the production of ketones may influence neurotransmitter activity in neurons allowing for a reduction in seizure attacks. A recent Cochrane Review demonstrated a 30-40% reduction in seizures compared with non-keto diet controls. One thing to keep in mind, however (which is a theme when discussing the keto diet) is that it’s generally difficult to adhere to and difficult to tolerate for a lot of people. In other words, people go on it and then come off it pretty damn quick.
Here’s what you got wrong…Keto is about a balanced fat and protein diet with very low carbs and high nutritional content. No one on keto shoots for an 80% fat intake, that’s just impossible to achieve and isn’t what keto is about. I targeted 110g of protein and 90g of fat in a day … and under 20g of carbs. I ate a lot of leafy/dark green vegetables and got most of my carbs from other veggies and fruits like tomatoes, onions, and berries (with a high GI). This is what most people target, a 40/40/10 ratio of protein, fat, carbs … but the common misconception is that the fat amount is a goal, whereas it’s a limit. The protein is more important to a healthy body, but the fat teaches the body to release/produce the ketones in the bloodstream.
A systematic review of 26 short-term intervention trials (varying from 4-12 weeks) evaluated the appetites of overweight and obese individuals on either a very low calorie (~800 calories daily) or ketogenic diet (no calorie restriction but ≤50 gm carbohydrate daily) using a standardized and validated appetite scale. None of the studies compared the two diets with each other; rather, the participants’ appetites were compared at baseline before starting the diet and at the end. Despite losing a significant amount of weight on both diets, participants reported less hunger and a reduced desire to eat compared with baseline measures. The authors noted the lack of increased hunger despite extreme restrictions of both diets, which they theorized were due to changes in appetite hormones such as ghrelin and leptin, ketone bodies, and increased fat and protein intakes. The authors suggested further studies exploring a threshold of ketone levels needed to suppress appetite; in other words, can a higher amount of carbohydrate be eaten with a milder level of ketosis that might still produce a satiating effect? This could allow inclusion of healthful higher carbohydrate foods like whole grains, legumes, and fruit. [9]
Depending on the info that you enter into our keto calculator, you will get different ratios of fat, protein, and carbs. In general, carbs should remain low because they will prevent you from entering into ketosis and getting all of the benefits of the keto diet. By limiting carb consumption to this degree, many people will lose a considerable amount of water weight as well.
Bulk buy and cook. If you’re someone who doesn’t like to spend a lot of time in the kitchen, this is the best of both worlds. Buying your food at bulk (specifically from wholesalers) can reduce the cost per pound tremendously. Plus, you can make ahead food (bulk cook chicken thighs for pre-made meat, or cook entire meals) that are used as leftovers, so you spend less time cooking.

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I say thank you, Abby, for the time you spent on your research of the KETO diet. I have been wondering what all that fat intake of the KETO diet would do to your liver. It can’t be healthy! But hey, it’s a matter of preference I guess. I prefer to be healthy. Okay, I’m not obese, I’m 5’1″ with 38 lbs. According to what I’ve read online and what my health insurance says, I need to lose about 15 lbs. I’m 60 years old — so, nah– probably not happening. I may be old, but active (walking 5 miles each day, doing one workout video on Grokker daily, gardening, hiking, kayaking). I want to lose enough weight to feel better (less arthritic) when I roll my butt out of bed in the morning, but I don’t want to deprive myself from the fun of eating. I don’t do fast or fat foods. I love cooking and eating healthy (like greens and everything veggie and beans and healthy grains like quinoa, freekeh, farro, black rice) and I like my beer of and on. I can do without sweets, but I do crave cheese. Take the “likes” away, and I get grouchy. I was trying to go with a low carb diet years ago, but the brain farts that came with it where just too pronounced. My body needs carbs! As long as they’re healthy carbs, I’ll be ok. I stay away from white bread and packaged, processed foods. I cook mostly low sodium and going out to eat is a special occasion. But I do count calories overall. I started logging my food intake on http://www.cronometer.com and that has helped a lot. I can create my own recipes, incorporate them into other recipes, and it gives me an overview of all the nutrients I consumed – both for the whole day or by each food item. I can tell how many calories or sodium is in each of my recipes. When I first started logging stuff on their website, I ran across the setting for “KETO diet”, but after I saw that it required to only eat 100 mg of carbs, I clicked off that one really fast. You get more than that from 1 glass of Porter! I love dark beer and good food. Real food, not pre-packaged powders or bla-tasting boxed food. I want fresh garlic, sumac, harissa. I want spice and texture. And low fat in most foods. If I want fat, I eat real cheese like goat cheddar. But that’s a treat. As long as I stick to my rule of eating at least 500 cal less than I burn, I’m ok with losing weight slowly. I want to be healthy first. So yeah, it’s a matter of preference. And patience. 🙂 To those of you who love Keto, cause it’s fast and it works for you, by all means: stay on it! It’s your body. My body runs better with a balanced diet. And that’s my 5 cents worth. 🙂

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Secondly, glucose is not the only source of energy for your body. The entire point of the Keto diet is that the body can use fat as a fuel source. Yes, you’ll still need glucose for certain things, but you eat protein and a minimal amount of carbs. The great majority of your energy needs are met by ketones. I don’t dismiss the concerns about accessing muscle for glucose, and I’d be interested in studies involving low intensity weight training on Keto to see if it helps with muscle retention. I think you’d probably have to carefully manage your protein levels as well.

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This said, I do prefer low-carb balance compared to SAD. I can speculate a lot about SAD and about the non-discrimination of different carbs – like, lactose vs. fructose. It is only my opinion, that fructose has its value in the nutrition (black bears get body fat for hibernation eating fruits) yet somehow we miss to notice that naturally fructose had been available in humans’ diet only seasonally, while nowadays juices of all kinds are available year-round; not to mention fructose additives to sugar-rich products. And yes, fructose is addictive, and yes, this is part of the evolution for 200 thousand years of humans.

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When I first started my keto experience, I didn’t have much fruit. I would occasionally have one strawberry or 1/4 cup of frozen fruit, but I kept it to a minimum. Now, the good news is that fruit sugar is different than white sugar. First of all, the fruit has fiber in it. Unlike eating white sugar which goes straight into the bloodstream and is combated with insulin spikes, the fiber in fruit is harder to digest, so it doesn’t cause your body to react in the same way. So a little fruit can be a good thing.

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Thank you SO much for your blog post. My niece went into Ketoacidosis recently and I compared it to what a former RN in my neighborhood has been doing & recommending to everyone (& they believe her because she used to be a nurse, but definitely NOT a Dietitian). Anyway, after reading, I learned they are completely different, however if a healthy person does test for ketones in their blood, what are acceptable levels? (This same nurse tests for ketone levels). I appreciate how much work you put into this write-up and honest feedback! (I work with 2 RDs who agree with you!)
So if the diet you dietitian maintain so much is so amazing where are the studies about the SAD diet and why are there so many overweight people if everyone is following the SAD diet and overweight. Honestly keto is the most amazing thing that ever happened to me after trying the SAD diet for 15 years and constantly gaining weight with no weight loss at all. I find the review you did full of guess work and no actual research.

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Louella you are absolutely wrong. It’s actually funny to me that this dietitian talks about the keto diet to such an extent but neither you nor her ever mention Gluconeogenesis. Yes your brain has specific areas that can only use glucose, but the human body is a wonderful thing and can use a few different substrates to synthesize glucose without you ever having to eat it yourself. Look up Gluconeogenesis. Your body has the ability to convert the amino acids you find in protein into usable glucose for your brain. The fact that you don’t know this shows me how uneducated you are about the ketogenic diet in general. Perhaps you should read up on the subject before you start trying to sound like a scientist who clearly has no idea what she is talking about. Thanks.

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While I admittedly struggled after going off the diet (they have some high protein, low carb,good tasting premade foods that I no longer had access to) with what to eat, I at least had better knowledges of HOW to eat and have been able to maintain my weight loss since. For the first time ever, I realized that I couldn’t eat the “food pyramid” suggested amount of carbs if I wanted to maintain a healthy weight. I even began running because I was thin enough to do so. What people who have never been fat before don’t understand is how much being fat holds us back from trying new things. If only there was a way to get people to quickly and easily lose the weight so they could be successful at dieting and discover such things (tongue in cheek).

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I tried the ketogenic diet and it really helped me even out my energy levels and I don’t grave sugar anymore. I had issues absorbing my B vitamins. I had high candida and l-acidophylis levels. I was also addicted to sugar. I started this 3 years ago, and since about a year ago, I’ve added fruit. Now I enjoy a little rice and potatoes as well. I even had a bite of chocolate cake and didn’t die. I started out at 112, lost 10 pounds within a month and have slowly gained most of it back. I am happy I did it, but I will be more confident to add more carbs, although it will mostly be in the form of more fruit and starchy veggies. Thanks for your article.

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Truly Dr. Colbert is also a reputable source for more thorough science and modification of previous Keto extremes. The statements about Keto diets with dairy everyday are not true…I am a 66 year old professional (University trained) and have found medical people often very unknowledgable or partially knowledgeable which may be worse. I ask you Abbey to dig deeper…meet Dr. Colbert-not a quack and more in depth than your overview. Personally I am finding switch to more green’s and low glycemic vegetables and fruits with healthy fats, occasional dairy and healthy protein; a way of life that is helping our whole family. Please watch The Magic Pill…the help for family’s caught in old thinking from poor science (ie. Alex Keys) and with autism etc. and so much modern disease is in itself, motivation to search out more truth.
Meanwhile, Noakes continues preaching that the right kinds of fats—the ones our bodies evolved to process, like animal fat and butter, olive and coconut oil (but not vegetable oils like corn oil and soybean oil)—are extremely healthy. Noakes titled his 2012 autobiography Challenging Beliefs, and, at age 67, he’s publicly waging a war against carbs and sugar from his Twitter account, @ProfTimNoakes, where he chimes in every few hours and has churned out more than 27,000 tweets since 2012.

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First of all, I can’t deny the fact that people will lose weight on a keto diet. Here’s why. First of all, you’re eliminating a major food group. When you do that, you limit your food options and most likely your food intake, so it’s not rocket science that you’ll likely lose weight. Second, most people on a low carb diet tend to increase their protein intake in the absence of carbs and there is some evidence that consuming higher amounts of protein may have some weight loss benefits. The large recent study mentioned above also looked at fat loss and found that individuals following a keto diet lost about the same weight as individuals following a different diet when they ate the SAME amount of calories. However, the studies found that individuals on the keto diet tended to lose body weight quicker.


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.
I have found eating low-carb, high-fat to be easier than other diets because I feel satiated, and I have good energy and feel warm (I usually feel cold in the winter). I can also skip snacking because I don’t get “hangry”. I totally understand if it’s not for everyone; people are different with different genetic expressions, and their bodies will respond in different ways. But if you’re going to give it a try, it make take a couple of weeks before your body is adapted to burning fat instead of glucose. Make sure to get enough salt, and eat lots of vegetables (if you don’t like spinach salad, roasted cauliflower or fired mushrooms, this diet may not be for you).

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I tried the ketogenic diet and it really helped me even out my energy levels and I don’t grave sugar anymore. I had issues absorbing my B vitamins. I had high candida and l-acidophylis levels. I was also addicted to sugar. I started this 3 years ago, and since about a year ago, I’ve added fruit. Now I enjoy a little rice and potatoes as well. I even had a bite of chocolate cake and didn’t die. I started out at 112, lost 10 pounds within a month and have slowly gained most of it back. I am happy I did it, but I will be more confident to add more carbs, although it will mostly be in the form of more fruit and starchy veggies. Thanks for your article.

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This was one of the most well researched and balances pieces on keto I’ve read. Nice work! However, your statement of “Carbohydrates make up the life blood of our body’s ability to function” is just not true. Carbs are not an essential nutrient. Since human bodies can convert fat to use as fuel, no amount of carbs are necessary. Also, the diet isn’t as restrictive as you make it out to be. I think that perception stems from the idea that everything we eat has to be amazing, delicious etc. Food is fuel, its health benefits should outweigh the temper tantrums of our tastebuds.

I am Keto proponent. I have been through muscle cramps when missing greens while riding my bike for 100 km in 5.5 hours (and I am going on 64!) Getting kale and spinach and parsley is a must, getting the fruit whole is a must. Consumption of “good” fats like coco, olive, avocado oils definitely does not hurt. Consumption of meat – and of organs, yes, organs – is very important. And finally, monitoring the body reaction and measuring ketones and glucose helps; I am doing observations regularly. What about G=4.2 and K=.3 in the morning? It is not ketogenic state per se, but in the morning my muscles do not need much fuel, and my frontal cortex and red blood cells need only minimum glucose. What about G=5.4 and K=3.6 in the third hour of bike ride, with acetone in the breath high and ketone disposal in urine very low? What about post-exercise levels of G=4.4 and K=1.2, with almost no acetone in breath and urine levels going sky-high because the body needs not ketones any more?

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Not long after he got the news, he happened to receive an e-mail about a book title The New Atkins for a New You, and realized he recognized many of the authors’ names on the cover, which belonged to respected exercise experts Stephen Phinney, M.D., Ph.D; Jeff Volek, Ph.D., R.D.; and Eric Westman, M.D. They argued that the late Dr. Robert Atkins, who famously promoted a low-carb, high-fat diet in the 1980s—and was routinely lampooned for promoting eggs, bacon, and cheese as healthy foods that worked great for weight loss—had been right all along. The professors backed up their position with more than 50 new dietary studies and an action plan for getting lean and maintaining weight loss. Noakes says he learned more about nutrition that year than in his previous 42 years as a doctor.

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The ketogenic diet has recently become very popular, and many food companies want to cash in by putting a “ketogenic” or “low carb” label on a new product. Be very cautious of special “keto” or “low-carb” products, such as pastas, chocolate bars, energy bars, protein powders, snack foods, cakes, cookies and other “low carb” or “ketogenic” treats. Read all labels carefully for natural low carb ingredients. The fewer ingredients the better.
I’ve lost lots of weight on the keto diet (over 100lbs) so the comment about the weight losses being water is just absurd. And I can sustain it quite easily as long as I have the right foods in the house – just like any dietary ha it you want to maintain. The Mediterranean diet was just ranked as the #1 diet, but I bet if there were Oreos in the house, I couldn’t maintain that diet either. The “low fat” diet that we’ve all been told is so good for us is not based on sound science. It’s based on the lipids theory from the 1930s and has since been denounced due to the researcher’s omittence of any data that didn’t fit his desired model. Also, the idea that somehow because you’re eliminating a macronutrient (carbs are not a food group), you’re also reducing food intake overall, and THAT’S the reason for weight loss, is utterly false. I eat WAY more on the keto diet than I ever did when I wasn’t paying attention. My brain, body, emotions, and weight all run better on ketones than they ever did on glycogen. I actually believe that ketosis is probably the way we were designed (or evolved) to operate. Think about it… agriculture (growing carbs for eating) is only something we’ve done in the last 10,000 years. Before that, we’d eat meat all fall, winter, spring, and early summer, then gorge ourselves on carbs in the late summer to store up fat, and then do it all over again in the fall. Just because we have access to an abundance of carbs doesn’t mean that’s how we are meant to live. And for hose who think that only eating meat is horribly bad for you, look at the Inuits, the aborigines, and other people groups around the world, who until the west interrupted with colonization and exploration, loved solely on high fat animal products. And guess what, they were healthier before we showed them how easy and tasty bread was.

Thank you SO much for your blog post. My niece went into Ketoacidosis recently and I compared it to what a former RN in my neighborhood has been doing & recommending to everyone (& they believe her because she used to be a nurse, but definitely NOT a Dietitian). Anyway, after reading, I learned they are completely different, however if a healthy person does test for ketones in their blood, what are acceptable levels? (This same nurse tests for ketone levels). I appreciate how much work you put into this write-up and honest feedback! (I work with 2 RDs who agree with you!)

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Jade, congratulations for your keto approach! I’ve had lots of sugar cravings & binging and keto was my solution for “cooling down” and getting back on track. I am also very careful with animal fat and I tend to get the fats from other sources – at least until further notice. I have also made a list of super-foods as I like to call them, vegetables high in micronutrients and low in carbs and also others high in fiber. I actually managed to search these foods in the USDA database and rank them from top to bottom, depending on the micronutrient. This way I know how to get the richest foods that are less calorie dense. I could say I’ve had some revelations along the way.

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The keto diet also has an impact on our hormonal levels. Many studies have looked at whether the state of ketosis suppresses our appetite through the actions of leptin and ghrelin. A 2013 study found that after patients lost weight on a keto diet, our hunger hormone (ghrelin) was altered and suppressed. A systematic review also concluded that the state of ketosis appears to be a plausible explanation for the suppression of appetite. So this the keto diet may be good for dieters who can’t stand the discomfort of hunger. Finally, the keto diet also may have an impact on our stress hormone, cortisol. This was demonstrated in a Harvard study where the keto diet resulted in an increase in cortisol in individuals following a very low carb keto diet. High levels of cortisol is associated with insulin resistance, cardiovascular disease and may promote fat accumulation.

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Even at what I now refer to my ignorant age of 20 years old — before Atkins became a household word— I remember a nutritionist telling me how the body works, and then telling me I needed to eat carbs and I recall thinking “wait a minute — if my body needs to use the carbs I consume before it begins to dip into my stored fat— why on earth is she TELLING me to eat so many carbs?”

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This article covers everything I’ve read about the diet. They’re still testing it on Alzheimer’s I believe so I’m interested in seeing complete results of that study as neurological diseases are somewhat like cancer in being able to find cures for them. I do believe our bodies genetic makeup has more to do with optimal diets. Though I wonder how many are doing keto thinking it will prevent disease? Because there are no studies on that from what I’ve seen, though prevention and diet seem to not have any long-term studies completed.
Today makes 3 months since I started Keto and I have lost 43 lbs. The way it works for me is by using a meal logging App and sticking to it daily and trying to reach the macronutrient goal percentages as closely as possible. In addition, I have found that, for me, “unlimited amounts of protein and fat” does NOT work for me. I have to carefully restrict total daily calories and mix it “intermittent fasting” with lots of hydration to get the ketosis going. I also find that if I can eat low-carb high fiber greens like arugula, celery, non-peanut no-added-sugar seven-nut butter, walnuts, avocado and lots of water and soups, it helps me avoid constipation. I am feeling so much better without the weight, my sleep apnea is gone and 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”. I have also read many articles on Keto and most are either “all in” or “no way” so I would like to thank you for the “balanced discussion” in this article. It must have taken lots of effort for a nutritionist to examine Keto in a balanced, objective style. Thanks again.

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Since adopting my current way of eating, I became much less “skinny fat” and have been able to increase muscle tone by doing less than 1 hour of exercise a day. All I’ve had to do is cut out foods like bread and pizza, and I still get my necessary fibre from breakfast cereals, veg, or rye crackers. I’m still able to meet my calorie goal so fundamentally I’m not doing damage to my body; it’s not a fad diet.
I disagree with you. A calorie deficit leading to weight loss for YOU should be not accepted as a reasonable method for ALL. Also, a 5% weight loss is enough to show improvements in blood pressure, blood sugar and lipids. It doesn’t mean the ketosis caused it, but rather the reduction in weight which could just be from the calorie deficit. Additionally, if you enjoy carbs occasionally then you are not in ketosis and could be following a modified low carb diet. Using evidenced-based research findings is not spouting off guidelines- it is science. And when you’re dealing with hundreds, thousands and millions of different individuals each presenting with their own unique set of risks, genetics, behaviors and history -that must be taken into consideration for any weight management plan. It is more complicated than how you presented it above. Also, I don’t believe Abbey is calling it a “fad diet” but she is explaining that the specific ketogenic diet plan that is being described in mainstream media is a current trend, which is undeniable. It is such a trend that there is no long term research study yet because that is how new to the scene it is.
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).
The findings below have been limited to research specific to the ketogenic diet: the studies listed contain about 70-80% fat, 10-20% protein, and 5-10% carbohydrate. Diets otherwise termed “low carbohydrate” may not include these specific ratios, allowing higher amounts of protein or carbohydrate. Therefore only diets that specified the terms “ketogenic” or “keto,” or followed the macronutrient ratios listed above were included in this list below. In addition, though extensive research exists on the use of the ketogenic diet for other medical conditions, only studies that examined ketogenic diets specific to obesity or overweight were included in this list. (This paragraph was added to provide additional clarity on 5.7.18.)

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