I’ve just spent two weeks on keto, joined a very popular Facebook group in the process and thought I’d finally found the answer! I feel like crap! I’ve lost 8 lbs. but am so bloated and constipated as well. The more I read the postings in the group, the more freaked out I became, guzzling pickle juice and drinking salt water to balance electrolytes, everything slathered in cheese and fat and heavy cream. The baking recipes are garbage! These people must be terrible cooks to begin with because the waffles and pancakes they are raving over taste like garbage, a waste of time and ingredients. They dole out advice on vitamin and mineral supplementation as if they are doctors. Very scary. My jaw dropped open at the posting about hair loss, and everyone saying oh don’t worry, it eventually goes away. So here I am, Monday morning of a brand new week trying to formulate a plan that will work for me. I think for many of us, we are so desperate to lose weight that it’s easy to get caught up into these diet plans.

Thank you for the information on the pros and cons of the keto diet. I have heard so much about it, a lot of people in my age group (55-65) are on it and have had success. I have NOT had the success that everyone else has had, I lose 7 gain back 2. Lose 3, gain back 4. I work out almost every day during my lunch break, which gives me only about 20 minutes of fast hard sweat. I have to wonder if this diet is NOT working for me because of this. I follow the dietary guidelines very strictly and I have experienced the effects of it, such as constipation, stinky pee and stinky breath. People tell me that by week 5 you should start to see a dramatic drop in weight. Not so for me, but then, I had the same issue when I was on weight watchers. The weight loss is so slow that I tend to just give up. I will stay with it for another month, but if I continue to see no real drop in weight, I am just going to assume that it is the wrong diet plan for me.

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I understand your reservations on this diet (I was once the same way), however I encourage you to take a deep look into the mechanisms of the diet, and maybe give it a try for yourself. Give it 90 days. Read any number of books on it with an open mind (Keto Clarity is a great one and is a quick read) and perhaps you may find it challenges you to second guess the dietitian dogma that is pushed by the AND.

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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.

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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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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.
Thanks for the great and helpful information about the Ketogenic diet .Since the last 4 years I’m on a keto diet I’m very happy,feeling a lot more healthy and I have lost a lot of weight.During that time I did quite few mistakes mainly due to misinformation so I highly recommend everyone who is really interested in keto diet to read this first https://tinyurl.com/y7xp7c6u 

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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!
Hi. I have been on the keto diet for 6 weeks and have not lost any weight but even more concerning, my gerd is much worse. I’m taking ppi’s just to stay on the diet. Constipation which has always been an issue for me is now much worse, hello laxatives! For these reasons, I have decided to go back to a more balanced diet leaning towards vegetarian. Keto works for some, I’m not one of them. I appreciate your info.

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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.

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.
Some shellfish like oysters and mussels contain some carbohydrates, so take that into consideration when eating out. The easiest thing to do is PLAN. Before you go out, find the restaurant’s menu and nutrition info if possible (if not just read the menu carefully and don’t be afraid to ask questions). This is just another reason to make sure you are using My Fitness Pal to calculate your meals, and if you have the app, you can add them while you wait for your food!

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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?”
A great little book with some really simple, quick and easy recipes. This is ideal for beginners and newcomers to the diet or those who don’t have much experience preparing their own meals. Often it can be quite daunting for those looking to begin the keto diet, and as such, this is a really helpful book as recipes are broken down into easy-to-follow, step-by-step guides. As part of breaking down the ketogenic diet, this book also looks at the nutritional information which is available in each recipe to ensure that you know exactly what you are putting into your body when you make these meals.

Such a thorough article. Thank you! I have a friend who swears by the KETO diet. However, I’m of the same thinking as you are, that cutting out or eating next to nil of any food group, is not what God meant. Discipline in portion size, and perhaps not combining certain food groups (proteins with heavy carbs is a not best for our digestive system), but both can be eaten when not combined, hence no cutting out of any food group. Thanks again!
Since the ideal protein intake is fixed based on your lean mass and activity level and your net carbs intake is specified by you, the only macronutrient that needs adjusting is the fat intake. Your fat intake is used to adjust the calorie intake. The more fat, the more calories. Typically, you adjust fat so that you reach but not exceed your target calories.
No, you won’t need every single item on a keto grocery list at any time. Instead, a list is simply a guideline to help you to make the best food choices while you are shopping for keto foods. You don’t need to stock every single kind of nut butter, oils, sweeteners, etc. Pick the ones that you like the most, and stock those as needed. Then, you can build your keto pantry over time.

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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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No, you won’t need every single item on a keto grocery list at any time. Instead, a list is simply a guideline to help you to make the best food choices while you are shopping for keto foods. You don’t need to stock every single kind of nut butter, oils, sweeteners, etc. Pick the ones that you like the most, and stock those as needed. Then, you can build your keto pantry over time.

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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/

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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 “unlimited amounts of protein and fat” does NOT work, for me. Instead, I have to carefully restrict total daily calories and mix in “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 not-hydrogenated no-added-sugar seven-nut butter, walnuts, avocado and lots of water and soups, it helps me avoid constipation. The other benefit is that I have become a careful label reader and I am often surprised at how much sugar is added to packaged foods.
But for evidence of the Keto Diet’s more immediate effects, Noakes brings up South African athlete Bruce Fordyce, 60, who won the country’s biggest ultramarathon, the 56-mile Comrades, a record nine times. He ate high-carb his whole life, eventually putting on weight and becoming insulin resistant. Recently, though, he switched to a high-fat diet—and has regained his former waistline and dramatically improved his marathon times. Little by little, according to Noakes, we’re learning. “This is the single most important health intervention we can make as doctors,” he says. “And as nations.”

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Disagree. I’ve been eating like this for ten months. I still enjoy carbs on the rare occasion but stick to a ketogenic diet most of the time. Ive lost 94lbs. I understand people lose weight in other ways but for me this worked. I eat 10x as many green vegetables as I ever have (at least 2 meals a day). My blood pressure dropped drastically in the first month. My cholesterol, triglycerides and blood sugar all normalized within the first 90 days. I don’t see any reason not to continue. I find this way of eating empowering and not restrictive. Before you call something a fad, because you obviously don’t fully understand this, you ought to read something from people other than the people you agree with. This is the problem I have with dieticians and most doctors. You don’t think for yourselves. You follow whatever the accepted guidelines are and spout them off without ever asking if they are right. It’s easier to stand with the crowd. I get that. But do not use your expertise as a means to criticize real progress. I would think as an expert your would be a proponent of what works! Have you ever been morbidly obese? Do you know what it is like to think your going to die from a heart attack at a young age? Do you know what it’s like to know your going to get type 2 if you can’t overcome your weight? Eating this way got me out of all of that and gave me my life back. Come down from the Ivory tower… Just maybe a little less judgement, a little more open minded

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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

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