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weight a few times in my life — twice reducing my calories the “nutritional counseling” way — using the old school and outdated food pyramid and tons of exercise.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.
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.
When ketone bodies accumulate in the blood, this is called ketosis. Healthy individuals naturally experience mild ketosis during periods of fasting (e.g., sleeping overnight) and very strenuous exercise. Proponents of the ketogenic diet state that if the diet is carefully followed, blood levels of ketones should not reach a harmful level (known as “ketoacidosis”) as the brain will use ketones for fuel, and healthy individuals will typically produce enough insulin to prevent excessive ketones from forming. [2] How soon ketosis happens and the number of ketone bodies that accumulate in the blood is variable from person to person and depends on factors such as body fat percentage and resting metabolic rate. [3]
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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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.

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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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Consider buying your meat in bulk. This will save you lots of money if you know where to get family-sized packages of meat. When you buy meat in large quantities, you can also cook it in bulk as well. Taking the time a few days per week to cook meat makes it simple to follow the keto plan. You can cook your meat beforehand and have it ready to go when you need it. You can purchase ground beef, chicken pieces, small steaks and even seafood in bulk.
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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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.

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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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“Keto diets should only be used under clinical supervision and only for brief periods,” Francine Blinten, R.D., a certified clinical nutritionist and public health consultant in Old Greenwich, Connecticut, told Healthline. “They have worked successfully on some cancer patients in conjunction with chemotherapy to shrink tumors and to reduce seizures among people suffering from epilepsy.”
Thats a lie. I hear this from keto cultists all the time. They constantly have to defend that they eat tons of veggies. They do, tons of the same 5 veggies. Lost 3 lbs in 5 months on keto. Lost 10 lbs on IF in 10 days. The constapation and constant craving for carbs…which never go away (another keto lie, carb crave never goes away) stay away from this diet…in 10 yrs we’re gonna see people dropping like flies from heart attacks!!
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Hello, I’m Abbey! I'm a Registered Dietitian (RD), an avid food and recipe writer, a TV nutrition expert and spokesperson, a YouTube host and the founder of Abbey’s Kitchen Inc. Abbey's Kitchen is a multi- faceted food and nutrition media brand developed with the goal of celebrating the pleasurable eating experience. For more information about me, check out my bio here.

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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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I went back to school for Medical Laboratory Science which involved a lot of chemistry and physiology. I pieced together what I had learned through dieting over the years and how the body works — and I have to say that I am really waiting for the medical community — doctors and nutritionists to finally get on board with lower carb diets. If dropping 80-100 pounds isn’t successful then I don’t know what is. I don’t really care how “unhealthy” you call it because of how rapid the weight loss is. How unhealthy is being obese in the first place?
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!

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I started Keto 100 days ago after seeing numerous family members losing a lot of weight and inches. They are getting good blood results from their doctors too. I did some research before I started and found many pro’s and con’s but decided the pro’s out weighed the con’s as long as my medical team approves. I have lost 22lbs but more important I’m down many percentage points in body fat (17.35% total now) during this time and have just received the most amazing blood work results I’ve had in years, I’m 60 years old. I told my nurse practictioner and my cardiologist how I’m eating and my N.P. said she doesn’t know enough about it but wants to know all I could tell her and my cardiologist said different diets work for different people but keep doing what I’m doing, they both just want to keep monitoring my progress with blood work and followups. I really feel the best I’ve been in a long while. When I reach a body fat percetage I’m comfortable with I might boost my carbs up to 50grams per day and decrease the fats a bit. My cardiologist says I don’t care what you eat on Friday night but the rest of the week be very mindful of your diet and blood work never lies. I can live with that.

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.
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?
Both states are normal to the human body, although many people live without experiencing a state of ketosis. In traditional hunter-gatherer lifestyles, people regularly cycled in and out of ketosis. Most of these cultures lacked consistent access to carbohydrates. In seasons where carbs were unavailable, or when food was very scarce, blood sugar levels would plummet. 

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I am with you! I have been a WW member and been years without going outside of my suggested guidelines. I would lose weight, plateau, go on one of their plateau breaking diets for two weeks then have to go off and slowly gained weight again. I was teaching my body to live on less. I have been down as low as 800 kcal a day and not losing. Eat more fiber so you feel full was what I was told. Try eating 800 kcal, high fiber and see how balanced your diet is. I am eating between 1800 – 2000 kcal now and dropping 10 – 15 lbs a month on Keto. Long term diuretic user, I no longer have water retention. I am salting and using fat and I am off my blood pressure medicine. I am not hungry so I am wondering why is this not sustainable? I eat mostly carbs from vegetables, I eat a variety of meats, I eat a variety of vegetables, I feel great and my blood tests are better than they have been in 2 decades. I am starting to feel that the carb revolution is because we are told by the government what is good to eat. We all know that vegetables are good to eat but the government subsidizes corn, wheat and soy, not spinach, kale and cucumbers. Do your research, follow your hearts, do what works for you.

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First of all, don't weigh yourself more than once a week. There are natural fluctuations related to water retention and hormonal balance. If you are a woman, you will notice these fluctuations more often. If you see no movement on the scales or even if your weight goes up, it doesn't mean you are not losing fat. If you exercise, you may even see a little increase in weight, as muscles are heavier than fat. The important thing here is to concentrate on losing body fat. Don’t rely just on scales, use body tape, calipers, belts or clothes to see any changes.

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So one study looked at the long-term effects of a keto diet in obese patients and after 24 weeks, patients lost weight, reduced their total cholesterol, LDL, triglycerides and increased their HDL. Another study conducted on 132 obese patients found that the low carb (keto) group lost more weight than the low fat group while improving biomarkers like decreased triglycerides, improved insulin sensitivity, and decreased fasting glucose. This all was confirmed in a 2013 meta-analysis, 13 RCTs (1,569 participants) found that patients assigned to a very low carbohydrate diet resulted in greater weight loss compared to those assigned to a low-fat diet.

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I am on the Ketogenic diet and have lost 30 lbs. in three months. I am never hungry, have an abundance of energy and feel great. Will stay on this lifestyle for the rest of my life. Am now off medication for high blood pressure. My doctor recommended this lifestyle. Normal cells in the body use fat, glucose and ketones for energy. Cancer cells can only use glucose [sugar] as an energy source. If the cancer cells can’t get glucose for fuel they will starve and die. What better reason to get off sugar. I recently read Americans consume on average 66 lbs. of sugar per year and Canadians 88 lbs. of sugar per year. Teenage boys are consuming 138 lbs of sugar per year mainly from pop. Canada is becoming a nation of obesity and disease. People are living on processed foods, sugary cereals, sodas, fruit juices, sugary snacks etc. Look at what is in the grocery carts at the tills. When are people going to wake up? I am having so much fun with the hundreds of recipes for Keto. Have found 39 websites with delicious Keto recipes.
Traditionally, in the sports nutrition field, we talk about the importance of timing carbohydrate and fluid intake on improving sports performance. For some time now, research has been looking at the role of very low carbohydrate diets on sports performance. Trailblazers in keto and sports performance research like Dr. Stephen Phinney have been conducting studies in this area since the 80s. In one of his studies, the glycogen stores of cyclists on a keto diet were not completely depleted and lipid oxidation was increased. Researchers concluded that the body was able to adapt to the lack of carbohydrates and preserve what was needed to use the fat as fuel.  However, based on the VO2 max breath test, since the body was attempting to preserve the carbohydrate during the exercise, it appears that the intensity of the exercise was limited. In a more recent study, off-road cyclists following a keto diet experienced small improvements, but still not significant enough to make strong conclusions.

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The premise of the ketogenic diet for weight loss is that if you deprive the body of glucose—the main source of energy for all cells in the body, which is obtained by eating carbohydrate foods—an alternative fuel called ketones is produced from stored fat (thus, the term “keto”-genic). The brain demands the most glucose in a steady supply, about 120 grams daily, because it cannot store glucose. During fasting, or when very little carbohydrate is eaten, the body first pulls stored glucose from the liver and temporarily breaks down muscle to release glucose. If this continues for 3-4 days and stored glucose is fully depleted, blood levels of a hormone called insulin decrease, and the body begins to use fat as its primary fuel. The liver produces ketone bodies from fat, which can be used in the absence of glucose. [1]

People claiming huge benefits of these supplements – despite the lack of solid scientific support – may sometimes have a financial reason to believe in the supplements. Some of these products are sold under a multi-level marketing arrangement, where sales people are paid based on commission. For example, the company Prüvit sells drinkable ketones, called KETO//OS with a multi-level marketing structure.

Our bodies run well on glucose (carbs)–they give us the necessary energy we need to function on a daily basis. When our body doesn’t get enough glucose (either because we’re cutting carbs too low, OR we haven’t eaten in too long), our body kind of freaks out and looks for other forms of energy to satisfy that role. That’s where the fat comes in. Without carbs, our insulin levels drop and fat is released from our cells. The fat overwhelms the liver which turns it into ketones, our body’s second choice to carbs for energy.
My husband has been on keto for 4 months since being diagnosed with Type II diabetes, and it seems to be working very well for his blood sugar issue, his levels have all improved drastically and he has lost so much weight I’m starting to worry about his liver. In the spirit of not making his life hell, I joined him on a modified version. My version still includes fruit and milk, I just gave up added sugars, liquor, and grain flour. Mostly. I definitely haven’t lost weight the same way he has, but I am slowly and steadily losing weight, and eating potatoes or apples doesn’t seem to change that. The biggest thing is that, for the ONLY time in all the many, many times I have tried to change my eating habits, I’m not STARVING. I don’t feel horribly deprived and ready to kill a man for a cookie.

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