[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"

We add collagen peptides to our coffee every morning because it’s beneficial for healthy joints, skin, hair, etc. If you use collagen peptides or want to add it to your diet after talking with your health care professional, we recommend Naked Nutrition Collagen Peptides Protein Powder. This product is grass-fed and pasture-raised, and is GMO free, dairy free, soy free, gluten free, and free of growth hormones.


There are several medical studies — such as two conducted by the Department of Radiation Oncology at the Holden Comprehensive Cancer Center for the University of Iowa, and the National Institutes of Health’s National Institute of Neurological Disorders and Stroke, for example — that show the ketogenic diet is an effective treatment for cancer and other serious health problems. (12)
As far as fruits are concerned, most berries are low in carbs and can be consumed from time to time, and in limited amounts. These include raspberries, strawberries, and blackberries. Blueberries are a bit higher in carbs and should be eaten sparingly. Most other fruits, however, have too many carbs in just one serving, so it is best to avoid them.

The keto diet isn’t new, and it’s been around for nearly a century. It was originally developed to treat people with epilepsy. In the 1920s, researchers found that raised levels of ketones in the blood led to fewer epileptic seizures in patients. The keto diet is still used today to treat children with epilepsy who don’t respond well to anti-epileptic drugs.[2] 

In a state of ketosis, your body breaks fat down in the liver and converts it into ketones to be used for energy. Fat doesn't generate an insulin response, so insulin levels remain stable. This makes it much harder to store excess fat, and easier to tap into body fat stores for energy. Not only will this allow you to maintain your weight, but it will greatly encourage weight loss.
Christopher D. Gardner, PhD; Alexandre Kiazand, MD; Sofiya Alhassan, PhD; Soowon Kim, PhD; Randall S. Stafford, MD, PhD; Raymond R. Balise, PhD; Helena C. Kraemer, PhD; Abby C. King, PhD, “Comparison of the Atkins, Zone, Ornish, and LEARN Diets for Change in Weight and Related Risk Factors Among Overweight Premenopausal Women,” JAMA. 2007;297(9):969-977. http://jama.jamanetwork.com/art icle.aspx?articleid=205916.
This is one reason why tracking your food intake should be a priority. There are apps like Cronometer, MyFitnessPal, and LoseIt! that allow you to record all your foods for the day, and each has a large database of fresh foods, packaged foods, and restaurant meals, plus you can enter in your own recipes. This way you can know exactly what macro- and micro-nutrients you’re getting, with no guess work.
Going into nutritional ketosis by following a ketogenic diet is one of the most radical but highly beneficial lifestyle changes you can make to improve your health. As with most dietary changes, always remember to listen to your body. If you feel any side effects other than the ones listed above, then necessary adjustments to your food intake may be needed.
Hi Emily, I was also really nervous about the amount of fat when I first started too! Just trust it, give it a couple of weeks to work its magic and then you will definitely feel more comfortable! I actually used a couple of online calculators for macros and took the average of what they all said. When starting keto, remember your net carbs should be under 20 grams, so use that as a guideline when calculating the rest of your macros. Let me know if you need anything else!

Absolutely Steve. I love ranch salad dressing, cheese, cream cheese, steak, shrimp, and some vegetables. I am making “fakery” to satisfy my sweet tooth. (Fakery is baking using almond or coconut flour instead of wheat and white flour, and Swerve sweetener instead of sugar (made with Erythritol which has no impact on GI and is good for your teeth) I am over half way to my goal already. Thank you for your article. I appreciate your dedication, knowledge and sharing with the world. (and your cute animal gifs)
The first tip to get back to losing weight is to boost the amount of calories you are consuming. Say you’re eating 1200 calories per day. Overtime, your body down-regulates so it just needs about 1000 calories per day to maintain basal function. Therefore, the amount of calories that used to help you lose weight is now only helping you maintain your current weight. So, by boosting your calories, you are actually boosting your metabolism and you may even notice some weight loss in the days after your caloric increase.
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.
• Restricted ketogenic diet — As mentioned earlier, a ketogenic diet can be an effective weapon against cancer. To do this, you need to be on a restricted ketogenic diet. By restricting your carbohydrate and calorie intake, your body loses glycogen and starts producing ketones that your healthy cells can use as energy. Because cancer cells cannot use these ketones, they starve to death.12
The transition is rougher for some people than others, though it’s worth it to KCKO, or Keep Calm and Keto On. Once you’re keto-adapted, weight loss becomes easier, your body feels like it moves more smoothly, your energy levels and appetite are easily regulated, and your thoughts are clear and fast. Performance in the gym also begins to improve at this stage, since it sometimes suffers during the adaptation period.
Aside from the various keto-friendly foods mentioned in this article, you may be wondering if there are other options that may help support your ketogenic diet. If you find that the ketogenic diet is limiting when you start out, don't worry. There's actually a lot you can add to your diet that's "keto" as long as consumption is controlled. Here are some commonly asked questions:
Drink lots of water. If you aren’t consuming enough water then the organs in your body can’t function properly. There is no point in eating right if your body can’t do what it is supposed to with the foods. Drinking plain water can get tiring so I like to either use MiO in my water (this kind also helps to replenish electrolytes) or I’ll turn to a detox water to change things up.
For people with diabetes, rapidly rising ketone levels can signal a health crisis that requires immediate medical attention. When there is an absence or not enough of the hormone insulin (or the body is too resistant to insulin to allow it to drive glucose into the cells for energy), the body cannot use glucose for fuel. Insulin helps ferry glucose to our cells and muscles for energy. Instead, in this case, the body resorts to burning stored fat for energy through the process of ketosis, leading to a buildup of ketones in the body.
At the core of the classic ketogenic diet is severely restricting intake of all or most foods with sugar and starch (carbohydrates). These foods are broken down into sugar (insulin and glucose) in our blood once we eat them, and if these levels become too high, extra calories are much more easily stored as body fat and results in unwanted weight gain. However, when glucose levels are cut off due to low-carb dieting, the body starts to burn fat instead and produces ketones that can be measured in the blood (using urine strips, for example).
Certain studies suggest that ketogenic diets may “starve” cancer cells. A highly processed, pro-inflammatory, low-nutrient diet can feed cancer cells causing them to proliferate. What’s the connection between a high-sugar diet and cancer? The regular cells found in our bodies are able to use fat for energy, but it’s believed that cancer cells cannot metabolically shift to use fat rather than glucose. (11)

The macronutrient ratios for the keto diet can range between 65-90% fat, 5-25% protein, 4-10% carbohydrates depending on the person. Those are actually pretty large ranges, so they deserve an explanation.  There are a lot of details that come into play to calculate your macros for ketosis including your current weight, target weight, exercise frequency, and more.


Bonnie J. Brehm, Randy J. Seeley, Stephen R. Daniels, and David A. D’Alessio, “A Randomized Trial Comparing a Very Low Carbohydrate Diet and a Calorie-Restricted Low Fat Diet on Body Weight and Cardiovascular Risk Factors in Healthy Women,” The Journal of Clinical Endocrinology & Metabolism: Vol 88, No 4; January 14, 2009. http://press.endocrine.org/doi/full/10.1210/jc.2002-021480.
Historically, a targeted ketogenic diet consists of limiting carbohydrate intake to just 20–30 net grams per day. “Net carbs” is the amount of carbs remaining once dietary fiber is taken into account. Because fiber is indigestible once eaten, most people don’t count grams of fiber toward their daily carb allotment. In other words, total carbs – grams of fiber = net carbs. That’s the carb counts that matter most.

After about two to seven days of following this eating routine, you go into something called ketosis, or the state your body enters when it doesn't have enough carbs for your cells to use for energy. Then it starts making ketones, or organic compounds that your bod then uses in place of those missing carbs—and oh, it also burns fat for more energy, says Beth Warren, R.D., founder of Beth Warren Nutrition and author of Living A Real Life With Real Food.
Aude, Y., A. S, Agatston, F. Lopez-Jimenez, et al. “The National Cholesterol Education Program Diet vs a Diet Lower in Carbohydrates and Higher in Protein and Monounsaturated Fat: A Randomized Trial.” JAMA Internal Medicine 164, no. 19 (2004): 2141–46. doi: 10.1001/archinte.164.19.2141. jamanetwork.com/journals/jamainternalmedicine/article-abstract/217514.
Once ketone levels in the blood rise to a certain point, you officially enter into a state of ketosis. This state results in fairly rapid and consistent weight loss until you reach a healthier (and stable) body weight. Overall, people enter into ketosis at different rates, usually after 3–4 days of fasting or following a very low-carbohydrate diet (20 grams of net carbs or less) that forces the need for an alternative energy source. (3)
If you talk to keto aficionados, you’ll find many save leftovers from dinner for the next day’s lunch. Cook once, eat twice—your keto diet menu for lunch is solved. If you don’t like leftovers or if you’re craving something different for lunch, the mid-day meal can be as simple as a scoop of chicken salad. Or, hit the salad bar at a local grocery store and top a bowl of greens with some good-fat goodies. You can also try one of these simple keto lunches:
Disclaimer: The entire contents of this website are based upon the opinions of Dr. Mercola, unless otherwise noted. Individual articles are based upon the opinions of the respective author, who retains copyright as marked. The information on this website is not intended to replace a one-on-one relationship with a qualified health care professional and is not intended as medical advice. It is intended as a sharing of knowledge and information from the research and experience of Dr. Mercola and his community. Dr. Mercola encourages you to make your own health care decisions based upon your research and in partnership with a qualified health care professional. If you are pregnant, nursing, taking medication, or have a medical condition, consult your health care professional before using products based on this content.
Although a standard ketogenic diet is even more restrictive in terms of carb intake, a “moderate keto diet” (just as some folks have followed a modified Atkins diet) is another option that will very likely still be able to provide substantial weight loss results and other improvements in symptoms. Including slightly more carbs can be very useful for maintenance, allow for more flexibility, provide a higher fiber intake, and overall may feel more sustainable long term socially and psychologically.
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.
After increasing water intake and replacing electrolytes, it should relieve most all symptoms of Keto Flu. For an average person that is starting a ketogenic diet, eating 20-30g of net carbs a day, the entire adaptation process will take about 4-5 days. My advice is to cut your carbs to fewer than 15g to ensure that you are well on your way into ketosis within one week. If you are experiencing any more keto flu symptoms, double check your electrolyte intake and adjust.

Here’s the Knowledge Stage analogy: Say we are hungry and want to go out to eat. It wouldn’t make much sense to sprint to the nearest restaurant, right? Wouldn’t we be better served to take the few minutes to learn about what’s available, and then make a plan? Yes, we would take the time to Yelp or ask a friend for some knowledge and use that information to decide where we want to go.


The biggest shifts in your daily habits will be how you food shop and how you cook, and recipes that are ketogenic need to be followed rather than just low-carb. You will require the healthy fats in order to get into ketosis and have enough energy without the carbs. And you will be considerably more energetic and healthier when cooking your own keto-friendly food rather than buying supposedly keto foods off the shelf. So visit my page on keto recipes as well as keto snacks (including fat bombs!), and get started on a ketogenic meal plan!
Ketosis is the result of following the standard ketogenic diet, which is why it’s also sometimes called “the ketosis diet.” Ketosis takes place when glucose from carbohydrate foods (like grains, all sources of sugar or fruit, for example) is drastically reduced, which forces the body to find an alternative fuel source: fat. Ketosis can also be achieved by multiple days of total fasting, but that isn’t sustainable beyond a few days. (It’s why some keto diet plans combine intermittent fasting or IMF with the keto diet for greater weight loss effects.)
Alcohol also tends to interrupt ketosis, since your liver will burn it preferentially before anything else. Your body treats alcohol like a toxin and like a fuel source, so your body will use it before it uses foods or the calories stored in your fat cells. While it won’t necessarily “knock you out” of ketosis, it does pause it until the alcohol is cleared from your system.
Chickpeas are naturally high in carbs — a single cup contains 45 grams of carbohydrates.31 However, you can modify the recipe to make it more nutritious. Try this recipe from Pete Evans, which replaces the chickpeas with beetroot.32 Beware, though, that beets have the highest sugar content of all vegetables, so consume them in very controlled amounts.
Hi Sia, welcome to the wonderful world of keto! I would start simple – eat whole foods like avocado, protein, and dark veggies. Download MyFitnessPal or CarbCounter apps to track your macros for you. What works best for me is planning out my meals ahead of time. Ill meal prep my food then log it into MyFitnessPal app so I know I am on target then the next day, eat only what I’ve logged. Its the perfect way to make sure you have enough food that already prepared and the best way to stick to macros. Hope that helps!
4) So, how are you feeling? Are you excited to see the numbers behind what you will be eating? You should be, because you are about to discover how you can lose weight, and still enjoy foods that taste amazing! This is going to be the last big project you complete before we get to the actual food, so head over to this post to set up My Fitness Pal Keto Diet Settings.
It’s important to remember that the goal of any dietary change is to promote a healthy lifestyle, so make sure to select a meal plan you can envision yourself following long term. If you know you will not be able to comply with such stringent carbohydrate restrictions for years to come, the ketogenic diet is most likely not the right choice for you.
In the first week, many people report headaches, mental fogginess, dizziness, and aggravation. Most of the time, this is the result of your electrolytes being flushed out, as ketosis has a diuretic effect. Make sure you drink plenty of water and keep your sodium intake up.6One of the fathers of keto, Dr. Phinney, shows that electrolyte levels (especially sodium) can become unbalanced with low carb intake.
• Reducing appetite — Constant hunger can cause you to consume more calories than you can burn, which can eventually lead to weight gain. A ketogenic diet can help you avoid this problem because reducing carbohydrate consumption can reduce hunger symptoms. In one study, participants who were given a low-carbohydrate diet had reduced appetites, helping them lose weight easier.2

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.

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