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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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.
I say thank you, Abby, for the time you spent on your research of the KETO diet. I have been wondering what all that fat intake of the KETO diet would do to your liver. It can’t be healthy! But hey, it’s a matter of preference I guess. I prefer to be healthy. Okay, I’m not obese, I’m 5’1″ with 38 lbs. According to what I’ve read online and what my health insurance says, I need to lose about 15 lbs. I’m 60 years old — so, nah– probably not happening. I may be old, but active (walking 5 miles each day, doing one workout video on Grokker daily, gardening, hiking, kayaking). I want to lose enough weight to feel better (less arthritic) when I roll my butt out of bed in the morning, but I don’t want to deprive myself from the fun of eating. I don’t do fast or fat foods. I love cooking and eating healthy (like greens and everything veggie and beans and healthy grains like quinoa, freekeh, farro, black rice) and I like my beer of and on. I can do without sweets, but I do crave cheese. Take the “likes” away, and I get grouchy. I was trying to go with a low carb diet years ago, but the brain farts that came with it where just too pronounced. My body needs carbs! As long as they’re healthy carbs, I’ll be ok. I stay away from white bread and packaged, processed foods. I cook mostly low sodium and going out to eat is a special occasion. But I do count calories overall. I started logging my food intake on http://www.cronometer.com and that has helped a lot. I can create my own recipes, incorporate them into other recipes, and it gives me an overview of all the nutrients I consumed – both for the whole day or by each food item. I can tell how many calories or sodium is in each of my recipes. When I first started logging stuff on their website, I ran across the setting for “KETO diet”, but after I saw that it required to only eat 100 mg of carbs, I clicked off that one really fast. You get more than that from 1 glass of Porter! I love dark beer and good food. Real food, not pre-packaged powders or bla-tasting boxed food. I want fresh garlic, sumac, harissa. I want spice and texture. And low fat in most foods. If I want fat, I eat real cheese like goat cheddar. But that’s a treat. As long as I stick to my rule of eating at least 500 cal less than I burn, I’m ok with losing weight slowly. I want to be healthy first. So yeah, it’s a matter of preference. And patience. 🙂 To those of you who love Keto, cause it’s fast and it works for you, by all means: stay on it! It’s your body. My body runs better with a balanced diet. And that’s my 5 cents worth. 🙂

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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This content is strictly the opinion of Dr. Josh Axe and is for informational and educational purposes only. It is not intended to provide medical advice or to take the place of medical advice or treatment from a personal physician. All readers/viewers of this content are advised to consult their doctors or qualified health professionals regarding specific health questions. Neither Dr. Axe nor the publisher of this content takes responsibility for possible health consequences of any person or persons reading or following the information in this educational content. All viewers of this content, especially those taking prescription or over-the-counter medications, should consult their physicians before beginning any nutrition, supplement or lifestyle program. 

How long can you stay in ketosis


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.

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.
Besides healthy fats like chicken thighs, olive oil, avocado oil, and high-quality bone broth, there are several specialty ingredients that you will find in many keto recipes such as keto friendly sweeteners, flours, and chocolates. There are several different sweeteners on the list, but purchasing all of them isn’t necessary. I’ve listed some of my favorite Keto Grocery List items below that you’ll need for baking, low carb bread, and keto desserts.

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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.
Noakes’s war on sugar goes back a generation, to when his father developed type-2 diabetes. Type-2 is a disease in which the body gradually loses its ability to regulate blood sugar through the production of the hormone insulin. It’s linked to genetics, but also to diet—particularly sugar and refined carbs—as well as obesity and inactivity. Diabetes experts estimate that the disease speeds up the aging process by roughly a third, damaging the body from the inside out. Too much blood sugar slowly destroys blood vessels, with results ranging from mild—early wrinkling of skin—to catastrophic: heart disease, blindness, stroke, amputations due to poor circulation, and even Alzheimer’s disease (more on that later).

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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!)
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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Our bodies are incredibly adaptive to what you put into it – when you overload it with fats and take away carbohydrates, it will begin to burn ketones as the primary energy source. Optimal ketone levels offer many health, weight loss, physical and mental performance benefits.1There are scientifically-backed studies that show the advantage of a low-carb, ketogenic diet over a low-fat diet. One meta-analysis of low-carbohydrate diets showed a large advantage in weight loss. The New England Journal of Medicine study resulted in almost double the weight loss in a long-term study on ketone inducing diets.

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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.

So for all the dangers you listed on this, my dietician prescribes this diet to everyone who comes into his office looking for weightloss, he has a stack of packets with standardized information regarding the specific diet. For what it’s worth, most of the side effects you listed, I did go through, although the sugar withdrawal was the worst, but after a couple weeks, that passed too. Now I’m on the same 1200 calorie, <20g carb, 0 sugar diet, and it feels VERY sustainable. The only thing I really miss is pizza, and even then, there are keto friendly chicken based crusts that really hit the spot. I guess one thing that sticks out to me is my doctor told me that the human body doesn't need any sugar to survive, and while he makes the distinction between simple and complex carbs, still cuts them out in a normal keto diet style (no potatoes, corn, most beans in larger quantities, etc). Should I be concerned about my doctor? He came as a referral and has a large track record of long term success with his patients.
Our dietary choices remain our most powerful ally in remaining healthy and combating disease. In Keto Diet, Dr. Josh Axe explores the emerging science that is converging around both the threat of carbohydrates and sugar as well as the powerfully salubrious benefits of a diet that augments our utilization of fat, and specifically ketones, to power our physiology. And beyond providing an in-depth exploration of this exciting science, Keto Diet provides the user-friendly tools that will allow every reader the chance to implement changes to regain and safeguard their health.
But this sort of “low-carbohydrate, high-fat” (LCHF) diet, as Noakes calls it, is still far from mainstream. It takes serious dedication to drop your daily total carb intake to below 50 grams (or 20–30g of net carbs, which are sans fiber), the equivalent of a single cup of brown rice. The USDA Dietary Guidelines were just changed in January to mention the need to limit intake of added sugars and refined carbs like bread, rice, pasta, cookies, and crackers, which spike blood sugar more rapidly than candy. Check the label of nearly any sports drink, and it’s most likely loaded with natural or added sugar. Go to the grocery store today and the labels are awash with the message of “low fat,” “no fat,” or “zero fat.”
This book has a great variety of recipes and has some good info for beginners at the start. This book deals with recipes which are typically high in fat without being fattening. The book offers a number of cooking options which helps people maintain caloric intake while still burning fat. This is because the book focuses on food which is high in healthy fat and low in carbohydrates which are converted into unhealthy fat. The low-carbohydrate meals in this book are wonderful for those looking to enjoy delicious, yet healthy meals. As we know, food that is high in fat is often made out to be unhealthy and will typically not be included in weight-loss cookbooks.

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Jade, congratulations for your keto approach! I’ve had lots of sugar cravings & binging and keto was my solution for “cooling down” and getting back on track. I am also very careful with animal fat and I tend to get the fats from other sources – at least until further notice. I have also made a list of super-foods as I like to call them, vegetables high in micronutrients and low in carbs and also others high in fiber. I actually managed to search these foods in the USDA database and rank them from top to bottom, depending on the micronutrient. This way I know how to get the richest foods that are less calorie dense. I could say I’ve had some revelations along the way.

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.

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.

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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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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.

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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“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.
I think you should take some of your own advice…you are being judgmental and thinking your diet will work for everyone. Look at the scientific facts; your body’s life blood is carbohydrates, the bread of life. Simple carbohydrates are what is killer to American society. Any diet that cuts out junk food like greasy potato chips and ice cream and cake will make you lose weight, not rocket science. Where do you think your body is getting fuel from? Muscle mass! It has to use that because you are depriving it of fuel! Why go on extreme diets when all you need to do is practice portion control and get up off the couch and walk around?

Hi, I am trying to do as much research as I can for my daughter and myself. My 19 year old daughter has been diabetic for 13 years and I am quite nervous about altering our diets without the approval of her medical team but they are not always on board with alternative lifestyles. I would love to follow your journey so she can see all the benefits you have gotten since you started.


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.
I’m a Registered Dietitian, and I greatly appreciate your overview. I will admit, I felt the exact same as yourself, but I decided to research it further, and then go on it to test it, and I have to admit, it has changed my view of it completely. I believe as dietitians, instead of telling our clients it’s a fad, educate them on how to do it successfully as a lifestyle and not as a fad. I believe that is the key. I highly recommend “What the Fat” book written by both a Registered Dietitian and professor. Great job going into the science and research. https://whatthefatbook.com/product/what-the-fat/

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I disagree with you. A calorie deficit leading to weight loss for YOU should be not accepted as a reasonable method for ALL. Also, a 5% weight loss is enough to show improvements in blood pressure, blood sugar and lipids. It doesn’t mean the ketosis caused it, but rather the reduction in weight which could just be from the calorie deficit. Additionally, if you enjoy carbs occasionally then you are not in ketosis and could be following a modified low carb diet. Using evidenced-based research findings is not spouting off guidelines- it is science. And when you’re dealing with hundreds, thousands and millions of different individuals each presenting with their own unique set of risks, genetics, behaviors and history -that must be taken into consideration for any weight management plan. It is more complicated than how you presented it above. Also, I don’t believe Abbey is calling it a “fad diet” but she is explaining that the specific ketogenic diet plan that is being described in mainstream media is a current trend, which is undeniable. It is such a trend that there is no long term research study yet because that is how new to the scene it is. 

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