Our dietary choices remain our most powerful ally in remaining healthy and combating disease. In Keto Diet, Dr. Josh Axe explores the emerging science that is converging around both the threat of carbohydrates and sugar as well as the powerfully salubrious benefits of a diet that augments our utilization of fat, and specifically ketones, to power our physiology. And beyond providing an in-depth exploration of this exciting science, Keto Diet provides the user-friendly tools that will allow every reader the chance to implement changes to regain and safeguard their health.

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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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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.

Don’t be afraid of a banana. Do be afraid of going over your carbs and calories. The same person that will write a hate comment about banans not being keto will sit and eat 10 handfuls of nuts. Guess what, just because you think nuts are a “keto food” you are eating waaaaaayyyyy more calories than you need and you will not lose weight. Keto is not a miracle diet. The laws of science still apply. 

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Today, the ketogenic diet is the world’s fastest growing diet, and with good reason. When practiced correctly, it has been proven to burn fat, reduce inflammation, fight cancer, balance hormones and gut bacteria, improve neurological diseases, and even increase lifespan. Unfortunately, many people remain unaware of several key factors that are crucial to the diet’s success, setting them up for frustration, failure and relapse.

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Another thing we know about diets and weight loss is that the results are not easily maintained. I’ve written about this in depth with regards to the participants on the Biggest Loser. This was evident in a study  analyzing 31 long term studies on dieting, which found 2/3 of dieters put back the weight they lost. Other research has reported the failure rate may be as high as 95%. This isn’t specific to the keto diet but rather, any diet that is restrictive and unrealistic may be nearly impossible to sustain.
A huge concern with the keto diet is the maintenance and potential loss of muscle mass. Many people will just think: hey, dummy, then just eat more protein. However, some research has shown that even if your protein intake remains constant, a low carb diet may promote muscle loss. A study from the Netherlands confirmed these findings. In the study, participants were given three diets (high carb, moderate carb, low carb) and moderate protein. The study found that those following a low carb diet experienced increased muscle breakdown. This is because when we eat carbohydrates, we produce insulin which promotes muscle growth. This is why athletes depend on carbohydrates (along with protein) to fuel their performance. When we eat carbs, the insulin release “unlocks” our muscles to let the protein in so it can do its job at building our muscles. So, when we skip the carbs all together, muscle glycogen stores get depleted, we lose out on those muscle building opportunities. Forget about high intensity training. A depleted glycogen store also means our workouts will suffer because we just don’t have enough oil left in the tank. This was a again suggested in the recent review looking at many ketogenic studies. The studies found that there was greater lean body mass loss in the ketogenic groups compared to the other diets being studied.

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Slow cooking is also great for those who aren’t comfortable using a stove or an oven as slow cookers typically need minimal preparation and food is all prepared in one pot. This is also a great alternative to other books which typically rely on standard cooking infrastructure such as a stovetop. So, if you are a fan of the crockpot or simply looking to expand your ketogenic cooking repertoire, this is one of the best keto cookbooks you will find.

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My biggest beef with this diet is that it focuses on how much and what you can eat and less about the quality of the food you eat. A recent 2018 study found that people who focused on eating plenty of vegetables and whole foods and less on counting calories and limiting food groups, lost a significant amount of weight over the course of a year. This continues to echo the notion that the key to successful weight loss is diet QUALITY and not QUANTITY. And now, there’s research that actually supports that!
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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Sleep enough – for most people at least seven hours per night on average – and keep stress under control. Sleep deprivation and stress hormones raise blood sugar levels, slowing ketosis and weight loss a bit. Plus they might make it harder to stick to a keto diet, and resist temptations. So while handling sleep and stress will not get you into ketosis on it’s own, it’s still worth thinking about.
A: The amount of weight you lose is entirely dependent on you. Obviously adding exercise to your regimen will speed up your weight loss. Cutting out things that are common “stall” causes is also a good thing. Artificial sweeteners, dairy, wheat products and by-products (wheat gluten, wheat flours, and anything with an identifiable wheat product in it).

Noakes’s war on sugar goes back a generation, to when his father developed type-2 diabetes. Type-2 is a disease in which the body gradually loses its ability to regulate blood sugar through the production of the hormone insulin. It’s linked to genetics, but also to diet—particularly sugar and refined carbs—as well as obesity and inactivity. Diabetes experts estimate that the disease speeds up the aging process by roughly a third, damaging the body from the inside out. Too much blood sugar slowly destroys blood vessels, with results ranging from mild—early wrinkling of skin—to catastrophic: heart disease, blindness, stroke, amputations due to poor circulation, and even Alzheimer’s disease (more on that later).


I’ve lost 30 pounds in 2 months, I feel better than I ever have, energy levels are up, my skin issues have cleared up, and I am training to run a 5k with my 14 year old. This is the only diet I’ve tried that has been easy to stick to. For me I could never do a diet if I didn’t like the food. Not a chance I could go vegan. Anyone reading this I strongly suggest you do your own research. No offense to the writer but nobody should only look to one opinion as the be all and end all on any topic. Mark Sisson is an amazing resource, has been eating keto for a long time and *gasp* is a marathon runner. On Netflix check out The Magic Pill for some eye opening stuff. Just do as much research as you can before either jumping in or dismissing it. There are some amazing and delicious foods that are keto-friendly, you just gotta put in the time to find them. Keto is not just a diet, it’s a lifestyle that includes proper exercise (to avoid loss of muscle mass among many other health benefits), stress management and proper sleep. Be informed.
I’m throwing in the towel but will continue working out as I LOVE it. I am going to eat sensible, keep up the weight training and see how it goes. I feel like I gave it a good run but if I haven’t seen results in 90 days I don’t feel this is the best way to eat for my body. I’m curious if anyone else has had lack luster results like mine while being diligent with a strick KETO diet.

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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 throwing in the towel but will continue working out as I LOVE it. I am going to eat sensible, keep up the weight training and see how it goes. I feel like I gave it a good run but if I haven’t seen results in 90 days I don’t feel this is the best way to eat for my body. I’m curious if anyone else has had lack luster results like mine while being diligent with a strick KETO diet.

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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!)

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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.
Once the medical community acknowledged the keto diet’s effectiveness in reducing seizure episodes, they decided to look further and study its impact on neurological diseases in general. Neurological diseases share a common problem – a deficiency in energy production. Ketones provide that energy for normal brain cell metabolism, and may even be a more efficient   when the body is in starvation mode. When patients were put on the keto diet, the number of mitochondria (energy powerhouse) in brain cells increased. Ketones may also act as an antioxidant by inhibiting the formation of reactive oxidant species, which is why they may have promising effects in the treatment of certain cancers in conjunction with chemotherapy.

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When you consider what excessive consumption of carbohydrates (and I do consider the RDA of 250g excessive) do to the human body I find it kind of sad that nutritionists still by and large pedal carbs as a hugely necessary forerunner to being a functioning human. The sugar industry pedalled the “fat is bad” lie for decades and the introduction of low fat foods duped millions of people into becoming obese. A lot of people still don’t get, for instance, the difference between blood cholesterol and dietary cholesterol.

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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!

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?


Fats are an important staple of any keto diet. But it’s the quality of your dietary fat that matters.Saturated fats like coconut oil and grass-fed butter are excellent options for cooking. Oils like extra virgin oil are best reserved for unheated uses, like homemade salad dressings. Nuts and seeds make great snacks, or your can sprinkle them on salads and other veggie dishes. Just watch your nut intake. While they’re high in many healthy fats, some of them also contain a lot of carbs. 

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And glucose is not the preferred fuel of the brain, because fat is. It is just super easy to get glucose from all the garbage carbs that are available 24/7. When you can eat a high fat diet and cause cancer to go into remission, then no it is not glucose that any part of the body prefers. It is fat. Sugar (carbs) feeds cancer and ill health. Fat improves health.
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.
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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Why not just rest on the opinion that it is not a fad diet and has been around for a long time as a diet that works for some people. Some of our youth on reddit may be doing it because they have diabetes (like my Son) Many of these kids are getting this from the poor American diet and low activity because of computers and phones. So if they can take a break from that and try to take an active and creative interest in this diet (which is a good diet for some) then why not just be respectful of that. My Sons doctor put him on this diet, we are doing it as a family and loving it! His blood sugar is normal after 1 1/2 months and we have all lost weight. BTW most if not all the foods you tried I would def eat! ???? There is def some concern about doing this way of eating carefully and making sure we are in balance with our nutrients. We have cheat meals once a week, so not feeling deprived at all!
There are numerous benefits that come with being on keto: from weight loss and increased energy levels to therapeutic medical applications. Most anyone can safely benefit from eating a low-carb, high-fat diet. Below, you’ll find a short list of the benefits you can receive from a ketogenic diet. For a more comprehensive list, you can also read our in-depth article here >
What about heart health and the keto diet? Previous older schools of nutrition would purport that a diet rich in fats (specifically saturated fats) would be detrimental for heart health, but more recent research suggests that saturated fat is not as bad as previously believed.  There is actually a tiny little bit of evidence that a keto diet may improve triglyceride, HDL and LDL levels. Like here and here. An even more recent study found that a keto diet improved triglyceride, HDL and LDL levels. We’ll definitely have to wait to see how that research unfolds because there is definitely a lot of competing elements at play.
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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If you stick to g of carbs, g protein, and g fat, you will eat kcal and lose kg (lbs) in the first month. Keep in mind that your body weight can fluctuate by ±2kg (±4lbs) on any given day from water weight and what's in your stomach. Recalculate your macro ratio once a month! Changes in body composition have a large influence on the recommendations and weight loss.

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Thanks for the great article! As a fellow dietitian I think its challenging to stay on top of the fads and weight loss trends. The way I see it is that there are two types of ketogenic diets – lifestyle (for weight loss) and therapeutic for some of the medical conditions you mentioned above. Bottom line, the ketogenic diet is not a “natural” diet and there are serious associated side effects. I believe that people following the diet need to be supported by a team of medical professionals to ensure adequate monitoring.
I did the Keto diet for 26 days. I’m not really what anyone would consider overweight but did lose 11 pounds. My heart rate is out of control. My resting heart rate is 98 and my blood pressure is above high. I’m actually a little scared. I loved the diet and being on it, but as someone who always had optimal blood pressure and pulse before and great endurance for intense workouts, I’d say the diet has destroyed that. I wish I’d have known before. I didn’t take magnesium, potassium or salt drops like so many told me I should have been doing. (Didn’t realize this before) In my opinion, if you need to do that to stay alive on a diet it isn’t safe! I have lost weight in much healthier ways before without needing to supplement to stay alive. I am now working on getting my heart rate down at the age of 33 and 145 pounds. Such a ridiculous outcome. Diet fail!

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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.
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.

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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.

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“Net carbs” and “impact carbs” are familiar phrases in ketogenic diets as well as diabetic diets. They are unregulated interchangeable terms invented by food manufacturers as a marketing strategy, appearing on some food labels to claim that the product contains less “usable” carbohydrate than is listed. [6] Net carbs or impact carbs are the amount of carbohydrate that are directly absorbed by the body and contribute calories. They are calculated by subtracting the amount of indigestible carbohydrates from the total carbohydrate amount. Indigestible (unabsorbed) carbohydrates include insoluble fibers from whole grains, fruits, and vegetables; and sugar alcohols, such as mannitol, sorbitol, and xylitol commonly used in sugar-free diabetic food products. However, these calculations are not an exact or reliable science because the effect of sugar alcohols on absorption and blood sugar can vary. Some sugar alcohols may still contribute calories and raise blood sugar. The total calorie level also does not change despite the amount of net carbs, which is an important factor with weight loss. There is debate even within the ketogenic diet community about the value of using net carbs.

Meat – Unprocessed meats are low carb and keto-friendly, and organic and grass-fed meat might be even healthier. But remember that keto is a high-fat diet, not high protein, so you don’t need huge amounts of meat. Excess protein (more than your body needs) is converted to glucose, making it harder to get into ketosis. A normal amount of meat is enough.

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Hi Danielle, it’s all about learning to read labels and the nutrition label before purchasing something! I also double heck the ingredients before I buy packaged products. I also have an ongoing list of approved veggies that I keep in my phone so that I know what I can buy and the variety I can buy so I don’t get in a food funk! Definitely let me know how I can help further! Like posting a label guide? Complete veggie list? Let me know!

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Two years ago, LeBron James famously lost 25 pounds and upped his late-game endurance by cutting carbs and sugars from his diet. Tim Ferriss, the author of the Four-Hour self-improvement book series, followed a strict keto diet to cure his Lyme disease, and performs a long multi-day fast every four months as a means, he says, of pushing ketosis further and starving incipient pre-cancerous cells of sugar (more on that later). Last summer, Sami Inkinen, the ultrafit co-founder of real estate juggernaut Trulia, rowed with his wife from California to Hawaii in record time on a keto diet, to promote high-fat eating and raise awareness about the dangers of too much sugar. The Keto Diet, say its ardent supporters, is a natural way to literally reprogram your metabolism and transition to an upgraded operating system. You’ll ultimately feel better and perform better, and your body fat will plummet.

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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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