There are numerous benefits that come with being on keto: from weight loss and increased energy levels to therapeutic medical applications. Most anyone can safely benefit from eating a low-carb, high-fat diet. Below, you’ll find a short list of the benefits you can receive from a ketogenic diet. For a more comprehensive list, you can also read our in-depth article here >

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Here are a few of the most common side effects that I come across when people first start keto. Frequently the issues relate to dehydration or lack of micronutrients (vitamins) in the body. Make sure that you’re drinking enough water (close to a gallon a day) and eating foods with good sources of micronutrients. To read more on micronutrients, click here >

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Following a very high-fat diet may be challenging to maintain. Possible symptoms of extreme carbohydrate restriction that may last days to weeks include hunger, fatigue, low mood, irritability, constipation, headaches, and brain “fog.” Though these uncomfortable feelings may subside, staying satisfied with the limited variety of foods available and being restricted from otherwise enjoyable foods like a crunchy apple or creamy sweet potato may present new challenges.
Hi. I have been on the keto diet for 6 weeks and have not lost any weight but even more concerning, my gerd is much worse. I’m taking ppi’s just to stay on the diet. Constipation which has always been an issue for me is now much worse, hello laxatives! For these reasons, I have decided to go back to a more balanced diet leaning towards vegetarian. Keto works for some, I’m not one of them. I appreciate your info.

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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.

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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.
This way of eating is a lifestyle and it has never failed, because we are all the same. The only variations are peoples environments/ temperature and food availability. Of course if someone lives in Siberia they will not eat the same as someone who lives in Phillipines; and not everyone has access to the healthiest environment and the healthiest cleanest food.

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And by pink salt I mean pink Himalayan mineral salt. I sprinkle this stuff on everything! On my food, in my water – you name it, pink salt is in it. Not only does it make my food taste AMAZING, but the benefits of pink salt are insane, especially when it comes to Keto flu. Pink Himalayan salt contains up to 84 different minerals, a fantastic source of magnesium (almost 80% of people are deficient in!), promotes a healthy PH balance, helps regulate blood sugar levels (this is huge for Keto and staying in ketosis), and helps regulate the body’s natural sleep cycle.
What about heart health and the keto diet? Previous older schools of nutrition would purport that a diet rich in fats (specifically saturated fats) would be detrimental for heart health, but more recent research suggests that saturated fat is not as bad as previously believed.  There is actually a tiny little bit of evidence that a keto diet may improve triglyceride, HDL and LDL levels. Like here and here. An even more recent study found that a keto diet improved triglyceride, HDL and LDL levels. We’ll definitely have to wait to see how that research unfolds because there is definitely a lot of competing elements at play.
Thats a lie. I hear this from keto cultists all the time. They constantly have to defend that they eat tons of veggies. They do, tons of the same 5 veggies. Lost 3 lbs in 5 months on keto. Lost 10 lbs on IF in 10 days. The constapation and constant craving for carbs…which never go away (another keto lie, carb crave never goes away) stay away from this diet…in 10 yrs we’re gonna see people dropping like flies from heart attacks!!
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).

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No, you won’t need every single item on a keto grocery list at any time. Instead, a list is simply a guideline to help you to make the best food choices while you are shopping for keto foods. You don’t need to stock every single kind of nut butter, oils, sweeteners, etc. Pick the ones that you like the most, and stock those as needed. Then, you can build your keto pantry over time.

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I’m very glad I found a common sense expert to help sort through some of this Keto fog. I watched “The Magic Pill” which got me curious about a few things. Does their argument that eating Keto is the way to go because our ancestors ate this way and were healthy have any validity? The Paleo diet seems to use this argument too but Paleo is not Keto – or so I read.

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A. When you first start a ketogenic diet, you may temporarily experience flu-like symptoms such as dizziness, brain fog, irritability, stomach trouble, insomnia, and more, as your body switches from burning glucose to burning fat. These symptoms can occur for a few days up to a few weeks and are a natural reaction that you’re encouraged to push through. You can alleviate symptoms by increasing hydration, electrolytes, and natural salt consumption. Get lots of rest and exercise gently. Lastly, consuming activated charcoal binds any toxins stored in the fat you’re shedding and can reduce nasty detox symptoms.
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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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.
The 30-Day Ketogenic Cleanse offers a step-by-step guide to approaching what some may see as a lifestyle change. The day by day guide is highly informative as each day’s diet is broken into its constituent parts. This further informs readers as to how their day-to-day diet is working to nourish and improve their body. The book breaks down what it takes to go into a ketogenic state while staying healthy and enjoying truly delectable food. From our standpoint, this really is a great resource and truly one of the best keto cookbooks out there. 

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Total carbs is not a precise indicator of the carb content of a food. When you see “total carbs” on a food label, the number beside it represents the cumulative total of grams of dietary fiber, sugar, and sugar alcohol that are in that food item or beverage. Net carb content, on the other hand, relates to the carb content of the food that is digested at four calories per gram and impacts your ketones levels.

Meat – Unprocessed meats are low carb and keto-friendly, and organic and grass-fed meat might be even healthier. But remember that keto is a high-fat diet, not high protein, so you don’t need huge amounts of meat. Excess protein (more than your body needs) is converted to glucose, making it harder to get into ketosis. A normal amount of meat is enough.
Hi Julie, thank you for stopping by. As someone who has been on this diet for over three years, I can tell you that eventually, you will be able to add more fruits into your diet. Remember that once you reach your goal weight you will be in maintenance mode and will have more food options. You may find that bananas cause you to crave sweets and may never eat them again, but I loved adding fruits back in my diet!
I’ve had many people ask for a Keto Grocery List. At first, I was hesitant because I am a picky eater and tend to stick to the same foods over and over. I know that most people eat a larger variety of foods than I do. At the same time, when I was researching Keto Grocery Lists, so many seemed overwhelming and included many foods that even after almost a year of following a Keto Diet I have never used.

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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. 

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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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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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i like the comments of people who are better off now after being on Keto, but what they never say is what were they doing BEFORE keto? eating like shit? no exercise? unhealthy lifestyle? THAT is the big part of the equation – if you went from a terrible diet to keto then OF COURSE you’re going to be better off, lose weight and feel better. maybe its not the keto, maybe its just the removal of garbage food?
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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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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Been doing keto since Dec. 26, 2018. I started for weight loss but got a few bonuses so far. Haven’t had a hotflash since starting, sleep so much better, brain fog gone and more energy! I’m perimenopause. I researched a lot before starting…realized the SAD way of eating is horrible. Carbs and sugar are not necessary. Dr. Phinny and Dr. Volek have the science behind this on YouTube (videos). Quite eye opening.
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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A ketogenic diet may be an option for some people who have had difficulty losing weight with other methods.  The exact ratio of fat, carbohydrate, and protein that is needed to achieve health benefits will vary among individuals due to their genetic makeup and body composition. Therefore, if one chooses to start a ketogenic diet, it is recommended to consult with one’s physician and a dietitian to closely monitor any biochemical changes after starting the regimen, and to create a meal plan that is tailored to one’s existing health conditions and to prevent nutritional deficiencies or other health complications. A dietitian may also provide guidance on reintroducing carbohydrates once weight loss is achieved.
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!
While I do appreciate the amount of research that went into this article, I need to weigh in here— no pun intended. I am a 44 year old woman who suddenly and inexplicably gained a lot of weight at about age 20 and pretty much (albeit a few bouts of massive dieting and exercising) have remained fat until the age of 42. I had always been thin without having to give my lifestyle much thought before my sudden weight gain — so I have spent the last 20+ years becoming pretty proficient on learning how the body uses fuel. I have had success losing great amounts of weight a few times in my life — twice reducing my calories the “nutritional counseling” way — using the old school and outdated food pyramid and tons of exercise. It took literally having to spend hours and hours at the gym — being miserably hungry all the time — only to achieve slow progress at the scale. Months and months I would spent this way only to gain the weight right back the minute that I let go of the reins. I’m always hearing about “sustainable lifestyle changes” from you nutritionists— an I believe in daily exercise — but that lifestyle was completely unsustainable in the long term which is why so many people are unsuccessful.
The problem is the SAD diet (Standard American Diet) and eat less move more advice. Tell that to a baby boomer with a hi bmi. Keto if done properly allows over weight people a way to lose weight without having to do hours in a gym. It is recomended to do a 15 minute walk now and then to keep a level of fitness. The weight is coming off even if one doesnt excercise. No sugar highs and lows, no cravings of carbs. Easier to do intermittent fasting to break plateus. Having the control over food and not being a slave to it. Reduction in sugar levels. The chance of autophahy. No brain fog. The chance to reverse type 2 diabetes. We have an obesity problem world wide. Yes you do have bad breath. Yes you can get constipated. Shall I stop because of a couple of negatives. Both negatives are treatable. The keto wave is coming. Empowering people to take control of thier own bodies by controlling thier insulin levels by keeping all sugar derivied products to a low level. The food companies drug companies are worried.
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.

This is a great list of Keto foods. I also try to choose higher quality food sources when they are available and my budget permits, such as grass fed meats and Kerry Gold butter, wild caught seafood, cage free eggs, and organic produce and oils as much as possible. When I travel and eat out, these higher quality options are generally less accessible, if at all. So I don’t sweat it. I just go with the flow. We just have to do what we can when we can. 🙂 Best wishes to all on your personal wellness journey!


The BMR is simply a number of calories we burn while our bodies are at rest and from eating and digesting food. Together they form what’s known as TDEE, or total daily energy expenditure. This is the keto calculator’s estimate for your total calories burned per day. If you use a heart rate monitor or third party software to monitor your calories, you can use the custom input in the activity level section for an even more accurate macro profile.
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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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.

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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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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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Fish are great for keto diets because they offer heart-healthy omega-3 fatty acids, and you can dress them up in so many ways. While fish and seafood can be a great choice when dining out, make sure you order with no breading and try to find out exactly what they use to cook and season them. Did you know that black pepper has carbohydrates? It does indeed, which is why it is so important to make sure you know what’s being added to it.
“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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The keto diet is amazing! I’ve been on it for 15 months now. I maintain 20 grams or less carbs a day. I lost 60 pounds in less than 3 months and have maintained that loss. My triglycerides and cholesterol numbers are far better than average. My blood pressure normalized within a month and I no longer take mesds. I have a heart condition called PVC and am off all meds for that as the symptoms are no longer a bother. Those symptoms, as well as blood glucose numbers, decreased considerably within 2 weeks. It is the most beneficial “diet” I’ve ever used. It is a lifestyle that I 100% support. It is sustainable long term. I go to the gym daily. I am now 50 and have better energy than ever and feel far better than I did in my 30s and 40s.

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