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.

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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.
Since our body isn’t used to using ketones, we tend to feel flu-like when in ketosis. Lots of brain fog, fatigue, headaches, nausea and poor endurance. You also get bad smelling breath, sweat and pee from the acetone (a byproduct of fat metabolism). Sexy? Not so much. Thankfully, if you are in ketosis long enough, a lot of people report that most of these side effects start to go away.
I’m new to all Keto…trying desperately to loose weight…besides giving up sweets (which completely understand) need to know if hummus is okay…and what I gather from the extensive info I’m guessing like everything in life, the key is balance… too much fat? Hi calories? Do we have to worry about cholesterol in nutritional labels? Again thanks for the great information

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/


Hello, I’m Abbey! I'm a Registered Dietitian (RD), an avid food and recipe writer, a TV nutrition expert and spokesperson, a YouTube host and the founder of Abbey’s Kitchen Inc. Abbey's Kitchen is a multi- faceted food and nutrition media brand developed with the goal of celebrating the pleasurable eating experience. For more information about me, check out my bio here.
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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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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Louella you are absolutely wrong. It’s actually funny to me that this dietitian talks about the keto diet to such an extent but neither you nor her ever mention Gluconeogenesis. Yes your brain has specific areas that can only use glucose, but the human body is a wonderful thing and can use a few different substrates to synthesize glucose without you ever having to eat it yourself. Look up Gluconeogenesis. Your body has the ability to convert the amino acids you find in protein into usable glucose for your brain. The fact that you don’t know this shows me how uneducated you are about the ketogenic diet in general. Perhaps you should read up on the subject before you start trying to sound like a scientist who clearly has no idea what she is talking about. Thanks.

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This article just goes to show that NOBODY knows wtf they are talking about… For example first saturated fat is bad… years later they “find out” it is healthy… but maybe not? How can there be 2 opposing sides (with intelligent minds on each), about something as simple as what a human should eat?! My doctor told me to try the keto diet to help weight loss and improve my blood lab results. I’m only 2 weeks in but this is the easiest diet ive ever had in my life! I love everything I eat! I doubt our ancestors thrived off pasta, soda, candy, and all the processed boxed garbage the American diet consists of today. Their bread was nothing like the crap bread in stores now either. Fruit and starchy veggies are ok to eat however only in moderation. I’m just fed up with how nutritionist and scientists cant make up their mind about what a healthy diet is.
It’s important we distinguish between the process of ketoacidosis seen in type 1 diabetes and this ketosis that so many people on the keto diet are striving for. If someone with diabetes lacks enough insulin and/or does not eat enough carbohydrates, they risk entering a state known as ketoacidosis. For those with uncontrolled diabetes, this can increase the levels of ketones in the blood, increasing the acidity of the blood, and potentially leading to a coma or even death. In ketosis for a healthy individual, the level of ketones in the blood never reaches these crazy high levels so it’s generally safe for the average healthy individual.
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]
There have been many attempts at studying the link between type 2 diabetes and the keto diet. In one study, a strict low-carbohydrate diet was administered in obese patients with type 2 diabetes. After 14 days of being on the diet, the glucose levels of participants normalized, their hemoglobin A1C decreased from 7.3% to 6.8% and insulin sensitivity improved by 75%. Some of this study’s limitations include the short duration, the small sample size and the weak control group. In another study, 84 obese patients with type 2 diabetes were randomized to either a low-carbohydrate keto diet or a low-glycemic reduced calorie diet. At the end of the study, both groups experienced improvements in glycemic control however the low carb keto group had greater improvements in hemoglobin A1c and higher HDL levels compared to the low-glycemic group. A more recent 2017 study in the journal of Nutrition and Diabetes found that a low carbohydrate ketogenic diet for 12 months led to greater reductions in HbA1c and body weight. These results suggest that low carbohydrate interventions may be effective at improving glucose control.

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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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.
Depending on the info that you enter into our keto calculator, you will get different ratios of fat, protein, and carbs. In general, carbs should remain low because they will prevent you from entering into ketosis and getting all of the benefits of the keto diet. By limiting carb consumption to this degree, many people will lose a considerable amount of water weight as well.

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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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“Keto diets should only be used under clinical supervision and only for brief periods,” Francine Blinten, R.D., a certified clinical nutritionist and public health consultant in Old Greenwich, Connecticut, told Healthline. “They have worked successfully on some cancer patients in conjunction with chemotherapy to shrink tumors and to reduce seizures among people suffering from epilepsy.”
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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!!! =)

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

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.
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. 
“Keto diets should only be used under clinical supervision and only for brief periods,” Francine Blinten, R.D., a certified clinical nutritionist and public health consultant in Old Greenwich, Connecticut, told Healthline. “They have worked successfully on some cancer patients in conjunction with chemotherapy to shrink tumors and to reduce seizures among people suffering from epilepsy.”

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Jeremy Hendon grew up in Georgia, studied at Emory and UC Berkeley, and practiced law for 6 years in LA and NYC. For much of his life, Jeremy was overweight and unable to consistently find a way to get healthy. That’s a big part of the reason why he co-founded Louise’s foods, 2 health magazines, KetoSummit.com, and now CoBionic.com. He’s also co-authored multiple books, had his products featured on national TV, and has lived in 9 different countries over the last 5 years. You can find him on Facebook or LinkedIn.

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I’ve just spent two weeks on keto, joined a very popular Facebook group in the process and thought I’d finally found the answer! I feel like crap! I’ve lost 8 lbs. but am so bloated and constipated as well. The more I read the postings in the group, the more freaked out I became, guzzling pickle juice and drinking salt water to balance electrolytes, everything slathered in cheese and fat and heavy cream. The baking recipes are garbage! These people must be terrible cooks to begin with because the waffles and pancakes they are raving over taste like garbage, a waste of time and ingredients. They dole out advice on vitamin and mineral supplementation as if they are doctors. Very scary. My jaw dropped open at the posting about hair loss, and everyone saying oh don’t worry, it eventually goes away. So here I am, Monday morning of a brand new week trying to formulate a plan that will work for me. I think for many of us, we are so desperate to lose weight that it’s easy to get caught up into these diet plans.
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.

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Slow cooking is also great for those who aren’t comfortable using a stove or an oven as slow cookers typically need minimal preparation and food is all prepared in one pot. This is also a great alternative to other books which typically rely on standard cooking infrastructure such as a stovetop. So, if you are a fan of the crockpot or simply looking to expand your ketogenic cooking repertoire, this is one of the best keto cookbooks you will find.

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