Other experts say the long-term accumulation of ketones could be harmful. “Those ketones are emergency fuel sources, and we’re not meant to run on them long-term,” says Kristen Kizer, a registered dietitian at Houston Methodist Hospital. “Ketones are negatively-charged molecules, which means they’re acidic. When you build up ketone bodies in your system, you’re building up acid. One of the ways your body buffers acid is by pulling calcium from your bones.” Kizer also notes that the diet isn't very balanced and involves a very high intake of animal products, which generally do not protect against cancer, diabetes, or other diseases.
• Potassium: With the approved list of foods being so brief, you might not be getting in enough fruits and veggies on keto. One of the biggest impacts? A potassium deficiency—and all of the lovely constipation and muscle cramps that accompanies it. Aim to up your intake of foods like spinach, avocado, tomatoes, kale and mushrooms to get your potassium fix.
The classic ketogenic diet is a very low-carb diet plan that was originally designed in the 1920s for patients with epilepsy by researchers working at Johns Hopkins Medical Center. (1) Researchers found that fasting — avoiding consumption of all foods for a brief period of time (such as with intermittent fasting), including those that provide carbohydrates — helped reduce the amount of seizures patients suffered, in addition to having other positive effects on body fat, blood sugar, cholesterol and hunger levels. (2)
Alison Moodie is a health reporter based in Los Angeles. She has written for numerous outlets including Newsweek, Agence France-Presse, The Daily Mail and HuffPost. For years she covered sustainable business for The Guardian. She holds a master’s degree from Columbia University’s Graduate School of Journalism, where she majored in TV news. When she's not working she's doting on her two kids and whipping up Bulletproof-inspired dishes in her kitchen.
During week 1 (and sometimes week 2) your body is transitioning to this whole new metabolic state, and there may be some initial side effects.  These are collectively known as the "keto flu".  The good thing is that if you don't take them for granted and think you're "superman" and that your body will be different, you can easily prevent these symptoms.
“Your liver produces ketones all the time, but the rate depends on carbohydrate and protein intake,” says Jeff Volek, Ph.D., R.D., a professor of human sciences at Ohio State University. When the majority of your diet is made up of of carbs and protein, ketogenesis slows. Replacing carbs and protein with fat will put your body into ketosis, thus ramping up ketone production. This takes about three days to induce.
So people saying that – despite the lack of scientific support – likely have a financial reason to say it. Some of these products are sold under something like a multi-level marketing arrangement, so sales people are entirely paid based on commission. For example, the company Prüvit sells drinkable ketones, called KETO//OS with a multi-level marketing structure.
[iv] Hussein M Dashti, MD PhD FICS FACS, Thazhumpal C Mathew, MSc PhD FRCPath, Talib Hussein, MB ChB, Sami K Asfar, MB ChB MD FRCSEd FACS, Abdulla Behbahani, MB ChB FRCS FACSI PhD FICS FACS, Mousa A Khoursheed, MB ChB FRCS FICS, Hilal M Al-Sayer, MD PhD FICS FACS, Yousef Y Bo-Abbas, MD FRCPC, and Naji S Al-Zaid, BSc PhD. "Long-term effects of a ketogenic diet in obese patients"
But what does the science say? Results are mixed. In one Spanish study of 20 obese adults, participants were put on a low-calorie keto diet and lost an average of 40 pounds over four months. Another small experiment had a similar outcome. In a six-month Experimental & Clinical Cardiology study of 83 obese adults, those on the keto diet lost an average of 33 pounds, while lowering their bad (LDL) cholesterol levels and increasing their good (HDL) cholesterol.
When you’re first getting started, it can be helpful to use a blood or breath ketone meter.  What these meters do is measure the amount of ketones (the energy source your body is switching to) in your blood or your breath.  Knowing those amounts and seeing how they increase or decrease depending on what you’re eating daily can often be a motivating and helpful indicator of the transition occurring in your body.

On a ketogenic diet, your entire body switches its fuel supply to run mostly on fat, burning fat 24-7. Insulin levels become very low, and fat burning increases dramatically. It becomes easy 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.
Reduced hunger. Many people experience a marked reduction in hunger on a keto diet. This may be caused by an increased ability of the body to be fueled by its fat stores. Many people feel great when they eat just once or twice a day, automatically ending up doing a form of intermittent fasting. This saves both time and money, while also speeding up weight loss.
The recipes themselves are divided into smoothies and breakfasts, appetizers and snacks, fish and poultry, meats, veggies and sides, desserts, and staples. Each individual recipe gives an overall "keto quotient" (how close it fits the idea balance of fats, carbs, and protein) as well as what each serving contains in calories and the fats, carbs, and protein for those servings. This makes life a lot easier if you are using a phone or tablet app to keep an eating record.

Achieving ketosis is a pretty straightforward, but it can seem complicated and confusing with all of the information out there.4If you want to learn more about ketosis and the scientific process around it, you can visit a very in-depth discussion about on Dr. Peter Attia’s website. Here’s the bottom line on what you need to do, ordered in levels of importance:
You should know that the side effects of a ketogenic diet are still being studied. In addition, there have not been significant studies for long term dieters.  There are plenty of people that have used the diet long term (10+ years) and very happy with it.  It is up to the unique individual, so regular checkups with your doctor are recommended to check that "everything looks good".
The ketogenic diet — a high-fat and very low-carb eating plan — can be tough to start. After all, it’s likely a radical departure from the way you’re eating now (a typical standard American diet is high in carbohydrates and processed foods). But many people are trying the keto diet, which puts your body in a state of ketosis. That's what happens when your body’s carb-burning switch flips to a fat-burning one, a change that can cause weight loss and has even been credited with controlling diabetes. (1)

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