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.
The ketogenic diet has been shown to produce beneficial metabolic changes in the short-term. Along with weight loss, health parameters associated with carrying excess weight have improved, such as insulin resistance, high blood pressure, and elevated cholesterol and triglycerides. [2,7] There is also growing interest in the use of low-carbohydrate diets, including the ketogenic diet, for type 2 diabetes. Several theories exist as to why the ketogenic diet promotes weight loss, though they have not been consistently shown in research: [2,8,9]

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I recently went to a walk in lab and found that I have high cholesterol and I am pre-diabetic. However, I am well on my way to healing my body with nutrition and supplements. I was able to reverse all my pre-diabetic symptoms in a few days (brain fog, blurry vision, thirst, frequent urination) and I have amazing energy and mental clarity now. I’m losing weight without hunger or counting calories. I eat low carb produce, poultry, fish, nuts and dairy. I believe that the key to avoid diabetes is to drastically reduce or eliminate grains, sugar and any type of processed food or cured meat from your diet. For cholesterol, I take plant sterols/stanols before meals and tumeric & black pepper, fish and flax oil. I believe that everyone who eats meat should take plant sterols (Try Minute Maid Heart Smart OJ!). It is the ultimate preventative, because it is not usually not possible to reduce your cholesterol enough with diet and exercise alone.

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 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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This said, I do prefer low-carb balance compared to SAD. I can speculate a lot about SAD and about the non-discrimination of different carbs – like, lactose vs. fructose. It is only my opinion, that fructose has its value in the nutrition (black bears get body fat for hibernation eating fruits) yet somehow we miss to notice that naturally fructose had been available in humans’ diet only seasonally, while nowadays juices of all kinds are available year-round; not to mention fructose additives to sugar-rich products. And yes, fructose is addictive, and yes, this is part of the evolution for 200 thousand years of humans.

Hi Leigh, I like to inform myself before I make my arguments, so I try to do as much research as possible. Same goes for when I was looking into the keto diet. I’m so glad you’ve seen improvements with the keto diet. I still believe that for the majority of people, the keto diet has its side effects and may not be successful. If it helps some people, then I’m glad!
Abbey, I appreciate the article, it’s helped me come to a decision on KETO. I’ve been on KETO for over 3 months, I’m a woman of 55 and post menopausal with a good 40 lbs of fat to lose. I work out 3-5 per week at an intense level doing cardio, HIIT and weight training and I have NOT lost any weight (ok, a single pound). I am in Ketosis most of the time (testing often) and I’ve been eating 1,200 to 1,300 cals per day. My carb intake around 15-20 grams per day, Fat around 90 grams and protein was about 45 grams until I increased it after learning I had lost muscle mass confirmed on a SECA scale.
A meta-analysis of 13 randomized controlled trials following overweight and obese participants for 1-2 years on either low-fat diets or very-low-carbohydrate ketogenic diets found that the ketogenic diet produced a small but significantly greater reduction in weight, triglycerides, and blood pressure, and a greater increase in HDL and LDL cholesterol compared with the low-fat diet at one year. [10] The authors acknowledged the small weight loss difference between the two diets of about 2 pounds, and that compliance to the ketogenic diet declined over time, which may have explained the more significant difference at one year but not at two years (the authors did not provide additional data on this).
A: The most common ways to track your carbs is through MyFitnessPal and their mobile app. You cannot track net carbs on the app, although you can track your total carb intake and your total fiber intake. To get your net carbs, just subtract your total fiber intake from your total carb intake. I have written an article on How to Track Carbs on MyFitnessPal.
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.
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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I appreciate your approach to the keto diet it is the most unbiased I’ve seen. I decided to take a more mindful approach to the keto diet. I took the allotted carbohydrates and decided to count the net carbohydrates. I researched the most healthy vegetables highest in nutrition value and antioxidants and use those for my net carbohydrate allowance. Then using my lean muscle mass calculated the necessary amount of protein using the healthiest options like lean chicken breast fish with no bacon and no fatty Meats. I decided to get my fat grams from avocado olive oil and coconut oil. Monitored my micronutrients and supplemented them as necessary to reach the daily requirement. Using a vegetables I attempt to get the highest fiber possible and supplement the rest. I’ve changed my concept of what is cheating on a diet to indulging in fresh pineapple and watermelon raspberries blueberries and blackberries. Grains have always caused problems with feeling bad gastric bloating and water gain for me. So it was not difficult to decide to leave those off research the nutrition and a tip to substitute. as far as gaining all the weight back if you return to the diet that got you overweight you can only expect to get it back. A calorie Surplus will put on weight. As I near my goal I will increase the carbohydrates using the healthy foods I have grown accustomed to to achieve the highest level of carbohydrates that does not have me regain the fat. Because remember my protein intake was based on my muscle mass. As I follow the diet I am mindful of the behavior changes choices that caused me to gain weight and there is no getting off the diet there is only bringing balance to the macronutrients. If dietitians everywhere find my Approach unhealthy that is their opinion they have a right to. I’m using this strict limited diet initially for the weight loss success as a positive reinforcer while modifying my behavior using the healthiest food choices. Which does not include heavy cream butter and fatty Meats.

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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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This article covers everything I’ve read about the diet. They’re still testing it on Alzheimer’s I believe so I’m interested in seeing complete results of that study as neurological diseases are somewhat like cancer in being able to find cures for them. I do believe our bodies genetic makeup has more to do with optimal diets. Though I wonder how many are doing keto thinking it will prevent disease? Because there are no studies on that from what I’ve seen, though prevention and diet seem to not have any long-term studies completed.
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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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.
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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Steven has over 10 years of experience in online media industry at various positions throughout the editorial cycle. Because of his interest in presenting scientific knowledge to the general public as well as providing a platform for information dissemination, Steven decided to bring together a team of like-minded individuals and started Top Health Journal.

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This is of course just an overview of what you can eat, but these are things I’m most likely going to pick up from the grocery store. I also didn’t want to include crazy expensive specialty items like Erythritol for beginners. I think we all get excited about making our favorite junk foods in the style of our diets right away. This is fine…but it can be very expensive, time consuming and exhausting. Stick with the basics, especially when first starting out!

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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:
A study of 89 obese adults who were placed on a two-phase diet regimen (6 months of a very-low-carbohydrate ketogenic diet and 6 months of a reintroduction phase on a normal calorie Mediterranean diet) showed a significant mean 10% weight loss with no weight regain at one year. The ketogenic diet provided about 980 calories with 12% carbohydrate, 36% protein, and 52% fat, while the Mediterranean diet provided about 1800 calories with 58% carbohydrate, 15% protein, and 27% fat. Eighty-eight percent of the participants were compliant with the entire regimen. [12] It is noted that the ketogenic diet used in this study was lower in fat and slightly higher in carbohydrate and protein than the average ketogenic diet that provides 70% or greater calories from fat and less than 20% protein.
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.
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.

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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.

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I can buy clothes off the rack. Better than being obese. My brain is sharper. I get more stuff done. I don’t sit around. I feel like I can feel the fat melting off. I have trouble sometimes eating enough. After 40 years if being very obese on and off, I think I am better off. I hope to use it when I need it after I reach my goal. The blood tests will prove it.
When it comes to meat, there’s not much to avoid. You should always make sure to purchase meat with fat and void lean cuts, as this will not help you lose weight. Remember, fat is your friend. Fat is needed, so your body has fat to burn and not sugar. When you are on a low carb diet, you are not fueling your body with sugar, so make sure you eat plenty of fat. If you don’t have fat to burn, your body will start burning glucose (even if you have fat stores). Your body needs to know that it never has to worry about not having enough fat.
2 days from grains my stomach bloat was gone and I knew at that point everything this article and American diet was a lie. I’ve been on keto for over 16 months. Down 50lbs. In 6 months. I am ripped. Haven’t lost any muscle mass. I eat greens protein and healthy fat. I whole juice to get macros and yes I add watermelon or berries fo palatability purposes. I still eat carbs just healthy choices. I’ve become carb tolerant.. your liver will produce all glucose without ever eating 1 carb. This is biased and poor representation of keto lifestyle. When your starving and no carbs to choke keto will still thrive on either or fuel.
Abbey, I appreciate the article, it’s helped me come to a decision on KETO. I’ve been on KETO for over 3 months, I’m a woman of 55 and post menopausal with a good 40 lbs of fat to lose. I work out 3-5 per week at an intense level doing cardio, HIIT and weight training and I have NOT lost any weight (ok, a single pound). I am in Ketosis most of the time (testing often) and I’ve been eating 1,200 to 1,300 cals per day. My carb intake around 15-20 grams per day, Fat around 90 grams and protein was about 45 grams until I increased it after learning I had lost muscle mass confirmed on a SECA scale.

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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!
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.
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.
What I did: I didn’t count grams or calories, but rather estimated well. I have a history of anorexia, so there’s no way in hell I was going to start counting calories again. I didn’t want to trigger my dormant brain pathways for obsessive, exacting analysis about calories. I used a Ketonix breath analyzer or a blood meter (this one is recommended) to measure my ketone levels.

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.
I have found eating low-carb, high-fat to be easier than other diets because I feel satiated, and I have good energy and feel warm (I usually feel cold in the winter). I can also skip snacking because I don’t get “hangry”. I totally understand if it’s not for everyone; people are different with different genetic expressions, and their bodies will respond in different ways. But if you’re going to give it a try, it make take a couple of weeks before your body is adapted to burning fat instead of glucose. Make sure to get enough salt, and eat lots of vegetables (if you don’t like spinach salad, roasted cauliflower or fired mushrooms, this diet may not be for you).
If you are looking to put your health on a new track, these books can help you renovate your life. Whether you are dealing with weight issues, or other health concerns such as Type-2 diabetes, autoimmune disorders, depression, Alzheimer’s, or some other gut and brain health related issues, you will be able to find value in any of these keto books on our list.
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.

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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.

Studies found that endurance performance, whether it was anaerobic or aerobic was impaired or maintained with a ketogenic diet. This is still a complicated area to study, since majority of studies used in this review had small sample sizes, no control group or were very short in duration (no more than six weeks). Because of this, it is still unclear whether endurance performance is enhanced or impaired with a ketogenic diet.

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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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Let’s face it: a ketogenic diet is not the easiest diet to follow — or understand! This is why we love books that simplify the process, like Keto Made Easy: 100+ Easy Keto Dishes Made Fast to Fit Your Life. You don’t have to miss out on your favorite foods with these easy-to-follow, easy-to-make recipes from this popular food blogger duo. It also has five meal plans for different kinds of keto diets, including vegetarian. A Bible for many keto dieters, Leanne Vogel’s The Keto Diet Book: The Complete Guide to a High-Fat Diet not only boasts 125 recipes but also is a great resource chock full of information to answer your every question about this sometimes perplexing diet. We love that it has five 28-day meal plans, taking the stress out of planning every meal for weeks or even months on end.

Hi Leigh, I like to inform myself before I make my arguments, so I try to do as much research as possible. Same goes for when I was looking into the keto diet. I’m so glad you’ve seen improvements with the keto diet. I still believe that for the majority of people, the keto diet has its side effects and may not be successful. If it helps some people, then I’m glad!
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.

“These diets are so unsustainable and in the long term, just not worth it!” Most definitely in your opinion. I did a LOT of research on Keto before I started it in 2009. I lost 130lbs. It’s not a diet, it’s changing the way you think about food and fuel for your body. And once you do that you understand food freedom. I eat mostly Keto but if I want a beer and a piece of Watermelon I will let myself have one. True it’s not for everyone, not everyone has the willpower to control what they put in their mouth. We tend to reward ourselves with food instead of using it what its for, nourishment and fuel. It’s why our country is dying of obesity. Awesome that a size 10 women can put what she wants in her mouth everyday, exercise, and it not affect her weight but guess what, you are becoming the minority.


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.

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