Don’t be afraid of a banana. Do be afraid of going over your carbs and calories. The same person that will write a hate comment about banans not being keto will sit and eat 10 handfuls of nuts. Guess what, just because you think nuts are a “keto food” you are eating waaaaaayyyyy more calories than you need and you will not lose weight. Keto is not a miracle diet. The laws of science still apply. 

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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.
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.
Such a thorough article. Thank you! I have a friend who swears by the KETO diet. However, I’m of the same thinking as you are, that cutting out or eating next to nil of any food group, is not what God meant. Discipline in portion size, and perhaps not combining certain food groups (proteins with heavy carbs is a not best for our digestive system), but both can be eaten when not combined, hence no cutting out of any food group. Thanks again!
My husband has been on keto for 4 months since being diagnosed with Type II diabetes, and it seems to be working very well for his blood sugar issue, his levels have all improved drastically and he has lost so much weight I’m starting to worry about his liver. In the spirit of not making his life hell, I joined him on a modified version. My version still includes fruit and milk, I just gave up added sugars, liquor, and grain flour. Mostly. I definitely haven’t lost weight the same way he has, but I am slowly and steadily losing weight, and eating potatoes or apples doesn’t seem to change that. The biggest thing is that, for the ONLY time in all the many, many times I have tried to change my eating habits, I’m not STARVING. I don’t feel horribly deprived and ready to kill a man for a cookie.
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 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.
For example, if we told you to eat 50 total carbs rather than 20-30 grams of net carbs, you could be eating anywhere between 0 and 50 grams of net carbs. At 0 grams of net carbs, most people will get into ketosis within the first week and experience deeper levels of ketosis as the weeks progress. On the other hand, while eating 50 grams of net carbs per day, many people will struggle to get into ketosis and sustain higher ketone levels.
I am on the Ketogenic diet and have lost 30 lbs. in three months. I am never hungry, have an abundance of energy and feel great. Will stay on this lifestyle for the rest of my life. Am now off medication for high blood pressure. My doctor recommended this lifestyle. Normal cells in the body use fat, glucose and ketones for energy. Cancer cells can only use glucose [sugar] as an energy source. If the cancer cells can’t get glucose for fuel they will starve and die. What better reason to get off sugar. I recently read Americans consume on average 66 lbs. of sugar per year and Canadians 88 lbs. of sugar per year. Teenage boys are consuming 138 lbs of sugar per year mainly from pop. Canada is becoming a nation of obesity and disease. People are living on processed foods, sugary cereals, sodas, fruit juices, sugary snacks etc. Look at what is in the grocery carts at the tills. When are people going to wake up? I am having so much fun with the hundreds of recipes for Keto. Have found 39 websites with delicious Keto recipes.
The medical community is failing their patients by continuing to shove the food pyramid in their faces. Let them lose weight in a manner that works best for them — and let them lose it fast so they see results. Im sick of hearing “it’s a lifestyle change” because diets themselves are not meant to be lifestyle changes — they are meant to be a period of weight loss. Show them the lifestyle changes AFTER they lose the weight necessary to become healthy again. How I see it — where people fail and where you are failing them — is not helping them to realistically lose the weight in the first place and then in not teaching them how to maintain their lifestyle using realistic macros guidelines to do so.

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.
My submission is, that a healthy body – liver, pancreas, kidneys – know how to maintain the right balance and produce or dispose of fuel, either glycogen or ketones as needed. I disagree that glucose is the favorite fuel, it is only the easy fast fuel for the body, which has one great advantage – PERFORMANCE! Both muscle and brain, fast performance is fueled by carbs. But, for ENDURANCE, it is ketones which are the best fuel, and moreover, burning ketones leaves less waste to be disposed off. I think that for athletes, the challenge is how to find the right performance-endurance balance.
Before I went into ketosis and before I cared anything about keto meals chicken was a staple in our home. While I do love all things chicken, I have found that going the boneless skinless route can sometimes get old, boring, and you lose some of the fat. Remember that you don’t have to choose lean meats anymore. Can you still eat it? Of course, but you need to try to dress it up with fat anytime you can. This low carb poultry list isn’t exhaustive, but I think it’s enough to get you started.

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I think lumping Keto diets in with other carb restriction diets is wrong. The reason (I’ve read) is that if you cut carbs somewhat, the body eventually responds by lowering the resting metabolic rate and you start gaining, but when you cut carbs to nothing (either in keto or fasting) the body keeps the metabolic rate high. It’s a survival mechanism, in a famine, we need energy to find food.

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Basically, in the context of dieting, dieters can either jack up dietary protein to cover the increased carbohydrate requirements of dieting or simply eat slightly more carbohydrates to provide them directly. Both have the same end-result. 15-50 grams per day limits the body’s need to break down protein and will allow protein requirements to be set lower than a diet providing essentially zero carbohydrates per day.
The only difficulty with some of these studies is that they tend to have small sample sizes, like this one that only has five cyclist participants and the data was largely skewed by the fact that only ONE cyclist experienced a large enhancement of exercise capacity after the keto diet. Their studies also tend to be short term. Back in 2014, Phinney and scientist Tim Noakes wrote an editorial that stated that in the past 31 years, there have only been a handful of studies measuring sports performance and low carb diets. Out of a total of 11, only 3 found exercise improvements.

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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Thermal Effect of Activity, also known as Activity Level, determines additional energy expenditure due to moving around and exercising. According to Lyle McDonald, broadly speaking, there are 5 categories / activity levels. We readjusted the multipliers from Lyle McDonald's book to better reflect different activity levels that work for most people.
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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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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