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.
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.
Look, keto is simple. Please stop complicating it. You can honestly eat any food and stay in ketosis as long as you eat less than 25-50 grams of carbs a day. If you are an athlete you can eat up to 100 carbs per day. No food, I repeat NO FOOD is a keto food. Like hummus? Eat it! Like pineapple? Eat it! Unless you have a metabolic disease that causes your body to be super sensitive to sugar you can eat pretty much any whole food and remain in ketosis. 
Even at what I now refer to my ignorant age of 20 years old — before Atkins became a household word— I remember a nutritionist telling me how the body works, and then telling me I needed to eat carbs and I recall thinking “wait a minute — if my body needs to use the carbs I consume before it begins to dip into my stored fat— why on earth is she TELLING me to eat so many carbs?”

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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. 

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It may be because all we have ever known is what we have been told by the FDA or who are the people in our country that tell you what you should eat. Do you realize how much money is in the grain , corn and sugar business in this country? A lot more than you can imagine. Bottom line I think its money telling people what they should eat. I’m gonna try the diet and see if it helps me. Thx for letting me voice my opinion.

The walking around part is not true in my experience, exercise alone will not help an obese person. I’ve been doing Keto and most things I’ve read have come true, I found this article to be unbiased. I will say this however, I agree I too have been eating many green veggies and the bad stuff I do use I use very little for flavor (like bacon) what I found that is utterly ridiculous on the part of the folks that did the diet rankings was saying Keto was unsustainable. The way I feel from being on Keto is insanely well. I want to keep eating this way! Unsustainable its the only diet I can do intermittent fasting on. I was type 2….
I’ve lost 30 pounds in 2 months, I feel better than I ever have, energy levels are up, my skin issues have cleared up, and I am training to run a 5k with my 14 year old. This is the only diet I’ve tried that has been easy to stick to. For me I could never do a diet if I didn’t like the food. Not a chance I could go vegan. Anyone reading this I strongly suggest you do your own research. No offense to the writer but nobody should only look to one opinion as the be all and end all on any topic. Mark Sisson is an amazing resource, has been eating keto for a long time and *gasp* is a marathon runner. On Netflix check out The Magic Pill for some eye opening stuff. Just do as much research as you can before either jumping in or dismissing it. There are some amazing and delicious foods that are keto-friendly, you just gotta put in the time to find them. Keto is not just a diet, it’s a lifestyle that includes proper exercise (to avoid loss of muscle mass among many other health benefits), stress management and proper sleep. Be informed.

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Keto for Women, my third paperback, delves into what the keto diet is (and is not) and how women can reap the many health benefits by using a targeted method specifically designed for their bodies. You’ll be shown why hormone imbalances cause many of the negative symptoms you experience and what keto foods and protocols will work best to remedy those. By showing you how to understand your body, you will be empowered to find solutions that are right for you as an individual and stay in control each step of the way.

Since the ideal protein intake is fixed based on your lean mass and activity level and your net carbs intake is specified by you, the only macronutrient that needs adjusting is the fat intake. Your fat intake is used to adjust the calorie intake. The more fat, the more calories. Typically, you adjust fat so that you reach but not exceed your target calories.

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.

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.
Today we are sharing this extensive Keto Food List and FREE printable Keto Grocery List. If you scroll down to the bottom, you will find links to purchase some keto food products that you may have a hard time finding in your local grocery store. When I first started keto, I had a hard time figuring out what I could and couldn’t eat, which is why I decided to create this huge list for you!

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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.

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Hi Danielle, it’s all about learning to read labels and the nutrition label before purchasing something! I also double heck the ingredients before I buy packaged products. I also have an ongoing list of approved veggies that I keep in my phone so that I know what I can buy and the variety I can buy so I don’t get in a food funk! Definitely let me know how I can help further! Like posting a label guide? Complete veggie list? Let me know! 

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Consider buying your meat in bulk. This will save you lots of money if you know where to get family-sized packages of meat. When you buy meat in large quantities, you can also cook it in bulk as well. Taking the time a few days per week to cook meat makes it simple to follow the keto plan. You can cook your meat beforehand and have it ready to go when you need it. You can purchase ground beef, chicken pieces, small steaks and even seafood in bulk.

I did the Keto diet for 26 days. I’m not really what anyone would consider overweight but did lose 11 pounds. My heart rate is out of control. My resting heart rate is 98 and my blood pressure is above high. I’m actually a little scared. I loved the diet and being on it, but as someone who always had optimal blood pressure and pulse before and great endurance for intense workouts, I’d say the diet has destroyed that. I wish I’d have known before. I didn’t take magnesium, potassium or salt drops like so many told me I should have been doing. (Didn’t realize this before) In my opinion, if you need to do that to stay alive on a diet it isn’t safe! I have lost weight in much healthier ways before without needing to supplement to stay alive. I am now working on getting my heart rate down at the age of 33 and 145 pounds. Such a ridiculous outcome. Diet fail!

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A: The amount of weight you lose is entirely dependent on you. Obviously adding exercise to your regimen will speed up your weight loss. Cutting out things that are common “stall” causes is also a good thing. Artificial sweeteners, dairy, wheat products and by-products (wheat gluten, wheat flours, and anything with an identifiable wheat product in it).

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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.
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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Also, plan for modifications to the meals for other people in your home. You wonít be able to make totally different meals for yourself and your family for the long term. The best approach is to use the main meat dish for your meal for the entire family and then a carbohydrate side dish for your family. For example, if you are eating meatloaf you can add half a potato for the other members of your family.

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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.


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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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!


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!

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.

Hi, I think Keto is a great starting point. I am almost 60 years old and finally feel good, no fogginess or sluggishness. For the first time I have no hippy handles and my tummy is flatter – no bloating or puffiness and I feel more energetic. I have only been doing Keto for about 4 weeks. I am so happy with the results!! I will continue for another 8 weeks or so then I will add more foods back in BUT moderation is key. I will slowly up my healthy carbs and find what is good for me. Happy days everyone!!! =)


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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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.

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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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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.
Thank you for the information on the pros and cons of the keto diet. I have heard so much about it, a lot of people in my age group (55-65) are on it and have had success. I have NOT had the success that everyone else has had, I lose 7 gain back 2. Lose 3, gain back 4. I work out almost every day during my lunch break, which gives me only about 20 minutes of fast hard sweat. I have to wonder if this diet is NOT working for me because of this. I follow the dietary guidelines very strictly and I have experienced the effects of it, such as constipation, stinky pee and stinky breath. People tell me that by week 5 you should start to see a dramatic drop in weight. Not so for me, but then, I had the same issue when I was on weight watchers. The weight loss is so slow that I tend to just give up. I will stay with it for another month, but if I continue to see no real drop in weight, I am just going to assume that it is the wrong diet plan for me.

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I have to thank you for presenting a more rational view of keto than I have seen presented by other dietitians. However I am a Type 1 diabetic, and ahem, also a registered dietitian and since finding keto a year ago would not have any reservation in guiding a pt, especially a diabetic, to eat keto. I find the diet far less restrictive than a vegetarian or vegan diet, and food cravings have completely been eliminated. I’m far more satiated when I eat and I have no problem adhering to this way of eating. The fact that dietitians advise eating 45-60 g CHO per meal to a diabetic (someone who essentially has a carb intolerance) is absolutely ludicrous to me. As a T1D I’m off the blood sugar roller coaster, no longer have dangerous lows and have achieved an A1c of 5.1, which means no long-term complications. I think the main fear in the mainstream media comes from that F word–fat. With the dawn of the low-fat era in the 1960s, sugar and carb consumption skyrocketed, fat consumption plummeted and what happened as a result? Yes, that’s right, rates of overweight and obesity skyrocketed. Insulin is the body’s primary fat storage hormone and carb consumption triggers insulin. The reason a keto diet works for weight loss (more than just water weight from loss of glycogen stores) is because insulin levels stay low, which allows for the mobilization of fat.
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.
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.
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.
In 2014 — for the first time — I discovered a low carb diet called Ideal Protein. It’s different from Keto in that you also keep a low fat intake as well. I can’t speak for Keto as I’ve not done it personally, but I lost 80 pounds on Ideal Protein in 5 months. It fit into my life as a busy mom and returning college student because I didn’t have to spend hours at the gym. I just ate low carb and moderate protein.

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The only time I wasn’t hungry was on ketosis. I ate meat, healthy fats, nuts, non carb-y veggies. Dropped the diabetes medicine, blood pressure med, and got rid of the brain fog. You didn’t mention the role of inflamation in cholesterol danger. I asked my doctor to test that instead of cholesterol, and when he saw the test results he said I did not need my cholesterol tested.
Meanwhile, Noakes continues preaching that the right kinds of fats—the ones our bodies evolved to process, like animal fat and butter, olive and coconut oil (but not vegetable oils like corn oil and soybean oil)—are extremely healthy. Noakes titled his 2012 autobiography Challenging Beliefs, and, at age 67, he’s publicly waging a war against carbs and sugar from his Twitter account, @ProfTimNoakes, where he chimes in every few hours and has churned out more than 27,000 tweets since 2012.
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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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.

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As you walk around the store, stick to the outer edges. The outer aisles have the freshest food. Think about your neighborhood grocery store. Most often the deli, the meat counter, and the produce section are all along the sides of the store with the packaged items in the aisles. Once you add more carbohydrate grams to your daily limit, you can start to experiment with low-carb packaged foods.

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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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Let's find out your body fat percentage. Based on your height and weight, your body fat percentage might be around %. The most accurate measurement would be a DEXA. Skin fold measurement with a good caliper is also pretty accurate. The easiest way is to just estimate it from some comparison pictures. More: 1, 2, 3, 4. You can also try this calculator but that can be inaccurate.
When you eat foods high in carbohydrates and fat, your body naturally produces glucose. Carbohydrates are the easiest thing for the body to process, and therefore it will use them first – resulting in the excess fats to be stored immediately. In turn, this causes weight gain and health problems that are associated with high fat, high carbohydrate diets (NOT keto).
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/
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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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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It is now a mainstream dietary regime used wih the intent to reduce weight as it is safe for most people, but one should be especially aware of going ketogenic if one takes diabetes medicine, medication for high blood pressure or is breastfeeding. Typical foods include cheese, eggs, fish and seafood, natural fats, meet, vegetables that grow above ground. The key to maintaining the diet is low carb intake - usually with the goal of eating less than 50 grams or even less than 20 grams of carbohydrates per day. The fewer the carbs, the better, usually. Things to avoid include: fruit, potatoes, pasta, beer, bread, soda, chocolate, candy, donuts, etc.

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