This whole post must have taken so much effort and I think it’s incredible that you do this. The issue with these diets is that people hear about it, think it sounds good and do it. No questions! We are so lucky to have dietitians like you actually laying out all the research, the good, the bad, and everything in between about these diets, so THANK YOU!
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.
With more than 200 pages of colorful, informative recipes, The Essential Keto Cookbook is, as per the title, a tome of vital food options for those following the keto diet. The authors, Louise and Jeremy Hendon, are a power couple in the field of high fat, low carb diets. Alongside each recipe, the authors have provided the full nutritional information including the carbohydrate counts, to help you keep track of what you are consuming. As part of this purchase, you will also get a fully developed meal plan to assist you in sustaining this energizing and filling diet.

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Skinfold Calipers: Skin calipers are affordable and easy to get on Amazon. Your local gym most likely has them too. A skinfold caliper works by pinching one area of your skin that folds easily (like your belly and back), in three to ten different areas of your body to measure your subcutaneous fat. That measurement is then used in a formula to calculate your body fat percentage. If you’ve never done this before, let a physician or coach do it first and teach you how to read the measurements accurately so you can do it at home next times.
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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What really killed it for me was the unrealistic restrictions of the entire day carbs count you should end up with – there is no f***ing way I can get by one full day with 20 grams of carbs and under. Just one of my meals ended up with at least 15 grams of carbs (half small onion-small red bell pepper-half cup chopped mushrooms-cup green beans), sometimes 20-25, times 4-5 meals (amature bodybuilder) and I end up with ~100 grams of carbs per day, at least.

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[…] “ANY diet, especially one that is as devastatingly restrictive as the keto diet, is likely to encourages disordered eating behaviors. I’ve written about my own experience with, and this is a pretty scary reminder of how UNHEALTHY that world can be. I’m a big believer that everything – especially carbs – can be enjoyed in moderation and the best diet is just whatever eating pattern you find most pleasurable that also meets your body’s unique needs.” [12]  […]
Sustainable is Key. Thank you for the article, it explained so much! I have been inclined to follow this diet but what has worked for me before is a diet that’s called “The AntiDiet” and is simply starting your day with fruits, while strictly separating complex carbs and proteins during lunch and dinner, and still being opened to consume all kinds of food. I had been trying the Whole30 for so long and so many times and I simply can’t, does not make sense for me and so does Keto in the sense of overloading on fats and meat. Thank you!

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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, 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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I am also a proponent of the ketogenic lifestyle. I am a healthy eater and have studied nutrition and enjoy cooking. As a person managing hypothyroidism I found losing weight by calorie restriction very difficult and it suppressed my thyroid. I continued researching and found an online site that gave me sufficient medical videos to start to understand how to be ketogenic in a healthy way.
This whole post must have taken so much effort and I think it’s incredible that you do this. The issue with these diets is that people hear about it, think it sounds good and do it. No questions! We are so lucky to have dietitians like you actually laying out all the research, the good, the bad, and everything in between about these diets, so THANK YOU!
A dirty keto diet also follows the standard keto diet but with disregard to the nutrient value or quality of the food consuming. For example, you could go to a fast food restaurant and order a bunless cheeseburger chased down with a diet soda and still be keto. This works if you’re traveling and really have no better options, but is not recommended in the long run because of a host of negative effects, such as the inflammation, cravings, increased blood pressure due to the high sodium, and bloating.

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Achieving ketosis is a pretty straightforward, but it can seem complicated and confusing with all of the information out there.4If you want to learn more about ketosis and the scientific process around it, you can visit a very in-depth discussion about on Dr. Peter Attia’s website. Here’s the bottom line on what you need to do, ordered in levels of importance:
Get Plenty of Sodium. This might sound counter to what you’ve been told before, but your body really needs sodium. It’s one of the ways that your cells transport nutrients in and out of cells. And when you stop eating processed grains and sugar, you often get much less sodium. So when you go keto, just be sure that you’re eating salt or sodium-rich foods. If not, you will often experience fatigue.

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To calculate your calorie needs, you need to enter your age, gender, height, weight and activity level which includes exercise and other physical activity. Finally, select your chosen stringency of the diet from the drop down: ketonic, moderate and liberal, with C/P/F representing the percentages of carbs, proteins and fats in the dietary mix. The ketogenic calculator will display the amount (in ounces or grams) and caloric equivalence of the carbs, proteins and fats (lipids) you need to consume per day. You should try to eat according to the macronutrients given and to spread your meals out during the day, but you should not be overly worried about getting the exact numbers each and every day and meal as small fluctuation should be OK as long as you are close to the estimate.
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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Cheese, if you can tolerate it, can also be purchased in bulk. Many stores offer store-brand cheese in large bricks. You’ll need to make sure to read the labels before you purchase any cheese. Make sure that when you eat cheese to eat some fiber (salad or raw veggies) as well. Having large blocks of your favorite cheeses on hand can make it easy to grab a quick snack between meals. 

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The Keto craze has not worked for me. My favorite websites unfortunately are full of blogs and recipes that keep reminding me to eat more fat. Unfortunately I still eat carbs. This has led to weight gain. For example, I love avocados and bacon, but being encouraged to eat more avocados and bacon while I’m still giving in to a quick sandwitch for lunch several times a week means my calorie intake is too high.

While fat isn’t forbidden on keto – I also don’t think that it makes up 80% of my diet. I wouldn’t know because exact % because I don’t count fat – but I do know that I eat too much chicken, turkey, fish, and vegetables for that to be true. Contrary to the belief of some, not every person on keto is scarfing down a pound of bacon and slathering butter on everything.

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.
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.
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.
Some negative side effects of a long-term ketogenic diet have been suggested, including increased risk of kidney stones and osteoporosis, and increased blood levels of uric acid (a risk factor for gout). Possible nutrient deficiencies may arise if a variety of recommended foods on the ketogenic diet are not included. It is important to not solely focus on eating high-fat foods, but to include a daily variety of the allowed meats, fish, vegetables, fruits, nuts, and seeds to ensure adequate intakes of fiber, B vitamins, and minerals (iron, magnesium, zinc)—nutrients typically found in foods like whole grains that are restricted from the diet. Because whole food groups are excluded, assistance from a registered dietitian may be beneficial in creating a ketogenic diet that minimizes nutrient deficiencies.
I give you points for not completely bashing the Keto diet but I have to ask you why do you think it is hard to follow? Do you tell vegans that their diet in unsustainable? I know for myself I can go to almost any restaurant and eat a keto meal the same could not be said with vegans. A properly balanced keto diet would require no vitamins or minerals (the reason for Keto “Flu”) the same can not be said for vegans, most vegans have major deficiencies and some vitamins like B12 are near impossible to obtain without supplements.

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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.
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?

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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You didn’t convert grams to calories. You must convert the grams of fat and protein to calories and then calculate your macronutrient percentages. Calorie percentages, not gram percentages, are what the recommended keto percentages are based on. Usually, once you account for the fact that one gram of fat has five more calories than one gram of protein the calorie percentages will end up being what you expect from a typical keto diet.
The low-carbohydrate diet options available in this book are also sugar-free, gluten-free, legume-free and in some cases dairy-free. While these may seem like restrictions on your diet, this book has so many delicious recipes to offer that you’ll not even miss carbohydrates or sugars, so often a major part of contemporary diets. This book also contains an in-depth list of foods which are suitable for eating when following keto. This ketogenic diet food list will help you stick to the diet while enjoying delicious food.

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I now eat healthy organic 8-10 cups of greens daily, small amounts of grass fed or organic protein and healthy fats and oils as recommended. My cravings disappeared within a few days of cutting out carbohydrates. My sugar intake was already very low. I do intermittent fasting daily without any hunger pangs. I am happily eating a main midday meal and then having a kale shake around 4pm. I am losing a healthy 1kg a week. This diet is a mood stabiliser because there are fewer insulin spikes. I do not snack and am loving the increased clarity of my mind.
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.
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.

In the first week, many people report headaches, mental fogginess, dizziness, and aggravation. Most of the time, this is the result of your electrolytes being flushed out, as ketosis has a diuretic effect. Make sure you drink plenty of water and keep your sodium intake up.6One of the fathers of keto, Dr. Phinney, shows that electrolyte levels (especially sodium) can become unbalanced with low carb intake.

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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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Such an in-depth post (and I applaud you for remaining so professional throughout some of these comments)! I’ve heard a lot about the keto diet and am glad that it does seem to work for some, but am definitely more on board with a more balanced diet. Kudos to the people it does work for though (I’ve had several patients with epilepsy who follow a ketogenic diet and it does seem to be helpful for them)!


The keto diet is high in fat, moderate protein, and low in carbs. You will avoid foods that are high in carbs, including some fruits and vegetables, most vegetable oils (like canola and corn oil) sugar, and grains, to name a few. Instead of going over all the foods to avoid, it is easier to print the keto grocery list pdf at the bottom of this post and stick to those keto foods for simplicity.
Hi Hannah! Thanks for stopping by from PJ affiliates. Actually my information is correct. Trust me, I do make mistakes from time to time, but Keto is actually a low carb, moderate protein, high fat diet. You can have fruit on Keto. That’s the great thing about Keto as long as it fits your macros and won’t throw you out of ketosis you can eat a variety of foods and you should! Natural and clean foods are great sources of vitamins and minerals that your bodies need to thrive and survive and while it’s a great idea to go easy on foods that will cause insulin spikes when you first start Keto once you reach your goal weight and entire maintence mode you can add more and more fruits and veggies. What many people don’t understand is glycemic load and glycemic index and that’s something I plan to start talking about here very soon! We aren’t paleo believe me my family wishes we were! Thanks again for the visit and if you’re interested in learning more about how we do Keto keep stopping by!

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My favorite drink is: 1/3 glass of Spicy Low Sodium V8 + 1/3 water + 1/3 DIET Tonic Water + 1 rounded tsp Stevia. Outstanding !! After I plateaued out after 35 lb loss on keto I continued to drink this and had no difficulties losing 9 additional lbs. I simply do not believe the keto prohibitions on ANY sweeteners…. they have zero carbs & calories. Exactly HOW could they effect metabolism? IMHO THEY DON’T! I don’t believe that superstition, it’s biblical.
I have never been on any kind of diet. I have never been more than 10-15lbs more than I should be. I have no health concerns. I am 55yrs. old with an enormous appetite. Almost everyone I know has been on a diet. My observation is that once you start dieting you start this yo-yo relationship with gaining and losing weight. I have counseled my children to stay away from fad diets. Moderation is enjoyable and sustainable. I love all-inclusive resorts and cruises. If I gain a bit I just cut back a bit. I don’t have a sweet tooth and I am cautious about potato chips and high fat snacks/foods. I love life, I love food in all its variety and I exercise moderately. I don’t have a gym membership. I get a little fresh air with a 30min easy jog.
Done Keto diet for over a year now. I started it due to increased liver enzymes showing a start on a path towards low-level diabetes due to being about 30 lbs overweight (229 lbs, 5’10” endomorphic, muscular build). After a year, my Cholesterol is excellent, I dropped to 192 lbs (37 lbs lost), maintained muscle mass through maintenance workouts and cardio, resting heart rate is 50bpm, EKG shows perfect results, blood pressure is excellent, and full panel of bloodwork shows zero abnormal liver enzymes.

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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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Here’s why. All of these effects take time, but a reasonable explanation as to why the keto diet leads to rapid weight loss is due to the loss of water weight. One of the concerns with the keto diet is the loss of muscle mass and the depletion of glycogen stores. Glycogen, which stores our glucose, also stores water, so when stores are depleted, we flush out excess water. In other words, that rapid weight loss isn’t fat, it’s just water.

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