Both states are normal to the human body, although many people live without experiencing a state of ketosis. In traditional hunter-gatherer lifestyles, people regularly cycled in and out of ketosis. Most of these cultures lacked consistent access to carbohydrates. In seasons where carbs were unavailable, or when food was very scarce, blood sugar levels would plummet.
I started Keto 100 days ago after seeing numerous family members losing a lot of weight and inches. They are getting good blood results from their doctors too. I did some research before I started and found many pro’s and con’s but decided the pro’s out weighed the con’s as long as my medical team approves. I have lost 22lbs but more important I’m down many percentage points in body fat (17.35% total now) during this time and have just received the most amazing blood work results I’ve had in years, I’m 60 years old. I told my nurse practictioner and my cardiologist how I’m eating and my N.P. said she doesn’t know enough about it but wants to know all I could tell her and my cardiologist said different diets work for different people but keep doing what I’m doing, they both just want to keep monitoring my progress with blood work and followups. I really feel the best I’ve been in a long while. When I reach a body fat percetage I’m comfortable with I might boost my carbs up to 50grams per day and decrease the fats a bit. My cardiologist says I don’t care what you eat on Friday night but the rest of the week be very mindful of your diet and blood work never lies. I can live with that.
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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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So where did the ketogenic diet come from? Interestingly enough, this fad diet didn’t spark from a celebrity endorsement or some guy missing a medical license. There’s evidence of the keto diet being used back in the early 1920s to treat severe childhood epilepsy and it’s still being used today for that purpose. Research suggests that the production of ketones may influence neurotransmitter activity in neurons allowing for a reduction in seizure attacks. A recent Cochrane Review demonstrated a 30-40% reduction in seizures compared with non-keto diet controls. One thing to keep in mind, however (which is a theme when discussing the keto diet) is that it’s generally difficult to adhere to and difficult to tolerate for a lot of people. In other words, people go on it and then come off it pretty damn quick.
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.
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.
DEXA scans are proven to be the most accurate measurement of body fat. They’re commonly available at gyms and some doctor offices when requested. If you don’t have access to this, you can always go the old-fashioned route and use a good quality caliper. The last resort is using a guide to visually estimate – this can sometimes be a little bit inaccurate, so try to over estimate your body fat percentage.
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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. 
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I like the list of health benefits you talk about here. But I seriously reject most of the side effects you claim without any basis. The only real risk that all keto dieters face, is constipation. I never encountered it, as I drink ample water and ate ample vegetables until I got sick with the flu and dehydrated. But that’s easily manageable. As with any diet, you should have your doctor regularly monitor your blood pressure, cholesterol, and other blood panel stats.
I also want to add that I absolutely agree with your verdict! As a type 1 diabetic who has experienced the sickening feeling of ketones’ presence, and known about the dangers of ketoacidosis since childhood, the concept of this diet for weight loss has always rubbed me the wrong way and struck me as a bit off (although I know ketosis is a different thing and is alright for the body, its extreme form is ketoacidosis, after all). I also have seen the diet, used for weight loss, cause dramatic results that then rebounded afterwards. I understand it is an incredible revelation in treating some epileptic individuals, and I see how it makes sense and can be helpful for type 2 diabetics or pre-diabetics. But as for a weight-management diet, like with everything else in life, I think we should strive balance. And enjoying summer peaches!
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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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I think every body responds to diets differently. What works for one person doesn’t work for another. There is not true, standard diet that’s one-size-fits-all. My sister eats a diet of mostly carbs and very little protein – and she functions just fine on this. Personally, even a moderate amount of carbs gives me brain fog, fatigue, irritability, and bloat.
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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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.
Abbey, I appreciate all the work you put into this but there are a few things you missed. Not all oils are keto friendly. Vegetable oils are a huge no-no which was not mentioned. Regular mayo usually contains soybean oil which should be avoided. You also missed that foods with preservatives are a no-no which excludes some cheeses (you said enjoy all the cheese you like). Processed sliced cheese or pre-shredded cheese in a bag at the grocery store contains preservatives. Ever notice how shredded cheese in a bag never sticks to itself but when you shred your own cheese it sticks? Preservatives. Most nuts are okay but peanuts are a legume and should be consumed in very small amounts or avoided altogether. Don’t go crazy either, nuts do have carbs. I don’t eat more than a half cup a day of salted almonds. That said, you could have mentioned that getting salted nuts is ideal as you do excrete more salt and other minerals in your urine (eating keto is diuretic so attention must be paid to salt, potassium, magnesium, etc. as you did mention) so finding simple ways to add salt and other minerals is helpful. I also take a multi-vitamin daily. You mentioned you cannot do high intensity workouts. You are not supposed to do high intensity workouts as elevating your heart rate too high actually stops the fat burning process in your body. Your heart rate should be 180 beats minus your age +/- 5 beats depending on fitness level. A 40 year old obese person shouldn’t go over 135 beats/min during a workout as that is the optimal fat burning window. Higher than that and your body reverts to storing fat reserves thinking it will run out if it keeps this pace. Which bring me to metabolism. Its been long believed a high metabolism is good. A high metabolism leads to more hunger (because you’re burning glucose faster), ingesting more food, and typically gaining more weight. Slowing your metabolism down AND teaching your body to consume slow burning ketones instead of quick burning glucose puts less stress on your liver mainly and on your body in general. There’s a lot more but this is getting long so I’ll finish with this. You said this diet focuses on quantity of food and not quality. This is confusing to me….wouldn’t organic and grass-fed meats, be of better quality than non-organic and grain fed meat? (they feed animals grains to fatten them up….shouldn’t that be a huge warning sign for us?). Is food without preservatives not better quality than food with preservatives? Aren’t beverages with no sugar or artificial sweeteners of better quality than sugar/artificial sweetener-filled beverages? I’ve never seen any keto advocate advise ignoring quality foods, in fact its quite the opposite.
To start with you don’t really need to worry about macros. Just eat when you’re hungry and stop when you’re full. An air fryer is awesome for keto! If you don’t like the juices toss them, you can always add butter or oil for more fat. If you find that you’re getting hungry or craving carbs add some type of healthy fat to your meals, otherwise keep doing what you’re doing. Thanks for stopping by!
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Fats are an important staple of any keto diet. But it’s the quality of your dietary fat that matters.Saturated fats like coconut oil and grass-fed butter are excellent options for cooking. Oils like extra virgin oil are best reserved for unheated uses, like homemade salad dressings. Nuts and seeds make great snacks, or your can sprinkle them on salads and other veggie dishes. Just watch your nut intake. While they’re high in many healthy fats, some of them also contain a lot of carbs.
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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!)
Not long after he got the news, he happened to receive an e-mail about a book title The New Atkins for a New You, and realized he recognized many of the authors’ names on the cover, which belonged to respected exercise experts Stephen Phinney, M.D., Ph.D; Jeff Volek, Ph.D., R.D.; and Eric Westman, M.D. They argued that the late Dr. Robert Atkins, who famously promoted a low-carb, high-fat diet in the 1980s—and was routinely lampooned for promoting eggs, bacon, and cheese as healthy foods that worked great for weight loss—had been right all along. The professors backed up their position with more than 50 new dietary studies and an action plan for getting lean and maintaining weight loss. Noakes says he learned more about nutrition that year than in his previous 42 years as a doctor.
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Ketogenic Diet is another excellent resource, focused on beginners and newcomers to the ketogenic diet. Written by Jeremy Stone, this book features 60 really simple recipes, that even the most modest chef can put together. With some basic knowledge of keto dieting, this book offers simple recipes which are easy to put together. More often than not, starting out what may seem like a highly restrictive diet can be very intimidating. However, this book looks to address those nerves.
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