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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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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A. When you first start a ketogenic diet, you may temporarily experience flu-like symptoms such as dizziness, brain fog, irritability, stomach trouble, insomnia, and more, as your body switches from burning glucose to burning fat. These symptoms can occur for a few days up to a few weeks and are a natural reaction that you’re encouraged to push through. You can alleviate symptoms by increasing hydration, electrolytes, and natural salt consumption. Get lots of rest and exercise gently. Lastly, consuming activated charcoal binds any toxins stored in the fat you’re shedding and can reduce nasty detox symptoms.

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There have been many attempts at studying the link between type 2 diabetes and the keto diet. In one study, a strict low-carbohydrate diet was administered in obese patients with type 2 diabetes. After 14 days of being on the diet, the glucose levels of participants normalized, their hemoglobin A1C decreased from 7.3% to 6.8% and insulin sensitivity improved by 75%. Some of this study’s limitations include the short duration, the small sample size and the weak control group. In another study, 84 obese patients with type 2 diabetes were randomized to either a low-carbohydrate keto diet or a low-glycemic reduced calorie diet. At the end of the study, both groups experienced improvements in glycemic control however the low carb keto group had greater improvements in hemoglobin A1c and higher HDL levels compared to the low-glycemic group. A more recent 2017 study in the journal of Nutrition and Diabetes found that a low carbohydrate ketogenic diet for 12 months led to greater reductions in HbA1c and body weight. These results suggest that low carbohydrate interventions may be effective at improving glucose control.
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.

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I think I would be better is you would talk about how people could make the keto diet better instead of dismissing it, more emphasis should be put on eat vegetables, fermented veggies and healthy sources of fat. Those studies that showed the negatives of the keto all used man made polyunsaturated seed oil, the worst possible type pf oil that people can eat.

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One of the latest trends in weight-loss diets, the ketogenic or “keto” diet is so effective for some of its devotees that it may be here to stay. So, what exactly is this diet that you’ve heard so much — or so little — about? Simply put, a keto diet drastically reduces the amount of carbs you eat and increases the amount of healthy fats you consume. A percentage of protein is allowed. This is supposed to put your body in the metabolic state of “ketosis” where it burns fat instead of carbs. Sounds simple enough until you try to eat that way 24/7!
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.

What level of ketones indicates ketosis


Eliminating several food groups and the potential for unpleasant symptoms may make compliance difficult. An emphasis on foods high in saturated fat also counters recommendations from the Dietary Guidelines for Americans and the American Heart Association and may have adverse effects on blood LDL cholesterol. However, it is possible to modify the diet to emphasize foods low in saturated fat such as olive oil, avocado, nuts, seeds, and fatty fish.

Can I Eat Oats on Keto


There is exciting research on the role of a keto diet as a form of treatment for cancer. In one study, the use of a keto diet on patients with advanced cancer was deemed safe, and some evidence suggested it played a role in stabilizing the disease or resulting partial remission. In another study, the keto diet was used as a form of therapy for patients with malignant brain cancer. The study found that the keto diet may carry anti-tumor effects when administered in experimental animal and human brain tumors. The researchers believe this may be due to the reduction in calories, which reduces the circulating glucose needed for tumor growth. It is still unsure whether a keto diet per se plays a role in this or simply calorie restriction. All of this is to say that the research is preliminary, however still promising.
It’s important we distinguish between the process of ketoacidosis seen in type 1 diabetes and this ketosis that so many people on the keto diet are striving for. If someone with diabetes lacks enough insulin and/or does not eat enough carbohydrates, they risk entering a state known as ketoacidosis. For those with uncontrolled diabetes, this can increase the levels of ketones in the blood, increasing the acidity of the blood, and potentially leading to a coma or even death. In ketosis for a healthy individual, the level of ketones in the blood never reaches these crazy high levels so it’s generally safe for the average healthy individual.
On a ketogenic diet, your entire body switches its fuel supply to run mostly on fat, burning fat 24-7. When insulin levels become very low, fat burning can increase dramatically. It becomes easier to access your fat stores to burn them off. This is great if you’re trying to lose weight, but there are also other less obvious benefits, such as less hunger and a steady supply of energy. This may help keep you alert and focused.

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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.
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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Available research on the ketogenic diet for weight loss is still limited. Most of the studies so far have had a small number of participants, were short-term (12 weeks or less), and did not include control groups. A ketogenic diet has been shown to provide short-term benefits in some people including weight loss and improvements in total cholesterol, blood sugar, and blood pressure. However, these effects after one year when compared with the effects of conventional weight loss diets are not significantly different. [10]
First off, I will say the ketogenic diet is not for everyone for their individual health reasons. However, reading through many of the posts where it didn’t work for people I would be willing to bet 90% of the time there is an obvious reason and no offense to that person but maybe a little more research would have helped. Something as simple as consciously increasing salt intake, or taking a multi-vitamin to get the minerals you need could help. Everyone’s body is different and some people can’t eat as much cheese for example (like my wife), as others can. If you feel off, or just don’t feel right before abandoning the diet please look up your symptoms and see if there’s a simple fix. It can really be worth it.

Can I do a modified keto diet


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.
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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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!

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.
With the easy to make meals in this book, Jeremy Stone shows people how they can enjoy a variety of dishes which are both really healthy but also really tasty! This cookbook can be useful for those leading a busy work life or for those who are not completely familiar with what you need to be nutritionally ketogenic. This book is a great introduction to a diet which offers fat-burning, yet mouth-watering meals. If you, or someone you know, is just starting out on keto, this is one of the best keto cookbooks you will find. 
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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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.

Can you eat peanut butter on a keto diet


Eliminating several food groups and the potential for unpleasant symptoms may make compliance difficult. An emphasis on foods high in saturated fat also counters recommendations from the Dietary Guidelines for Americans and the American Heart Association and may have adverse effects on blood LDL cholesterol. However, it is possible to modify the diet to emphasize foods low in saturated fat such as olive oil, avocado, nuts, seeds, and fatty fish.

Can I Eat Oats on Keto


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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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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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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.
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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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.
First off, I will say the ketogenic diet is not for everyone for their individual health reasons. However, reading through many of the posts where it didn’t work for people I would be willing to bet 90% of the time there is an obvious reason and no offense to that person but maybe a little more research would have helped. Something as simple as consciously increasing salt intake, or taking a multi-vitamin to get the minerals you need could help. Everyone’s body is different and some people can’t eat as much cheese for example (like my wife), as others can. If you feel off, or just don’t feel right before abandoning the diet please look up your symptoms and see if there’s a simple fix. It can really be worth it.

Can I do a modified keto diet


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.
One of the latest trends in weight-loss diets, the ketogenic or “keto” diet is so effective for some of its devotees that it may be here to stay. So, what exactly is this diet that you’ve heard so much — or so little — about? Simply put, a keto diet drastically reduces the amount of carbs you eat and increases the amount of healthy fats you consume. A percentage of protein is allowed. This is supposed to put your body in the metabolic state of “ketosis” where it burns fat instead of carbs. Sounds simple enough until you try to eat that way 24/7!

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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