Unfortunately, there’s no long-term data on ketogenic diets versus other diets. In a 2015 Italian study, those on a ketosis diet lost 26 pounds in three months. About half of the participants stayed on the diet for a year but lost little additional weight in the next nine months. People in a 2014 Spanish study who followed a very-low-calorie ketogenic diet lost an average of 44 pounds in a year—but a third of them dropped out, possibly because it was too hard to maintain.

Your glycogen stores can still be refilled while on a ketogenic diet. A keto diet is an excellent way to build muscle, but protein intake is crucial here. It’s suggested that if you are looking to gain mass, you should be taking in about 1.0 – 1.2g protein per lean pound of body mass. Putting muscle on may be slower on a ketogenic diet, but that’s because your total body fat is not increasing as much.5Note that in the beginning of a ketogenic diet, both endurance athletes and obese individuals see a physical performance for the first week of transition.
Y. Wady Aude, MD; Arthur S. Agatston, MD; Francisco Lopez-Jimenez, MD, MSc; Eric H. Lieberman, MD; Marie Almon, MS, RD; Melinda Hansen, ARNP; Gerardo Rojas, MD; Gervasio A. Lamas, MD; Charles H. Hennekens, MD, DrPH, “The National Cholesterol Education Program Diet vs a Diet Lower in Carbohydrates and Higher in Protein and Monounsaturated Fat,” Arch Intern Med. 2004;164(19):2141-2146. http://archinte.jamanetwork.com/article.aspx?articleid=217514.
Exogenous ketones, or ketones that are produced in a lab and then consumed, have been compared to jet fuel, both as a fuel for the brain and body, and as a flavor comparison. It’s like kick-starting ketosis, or enhancing it, since you wind up with vastly more ketone bodies in circulation with a concurrent drop in blood glucose. The best, most effective, and safest version of exogenous ketones currently available are ketone salts. They can potentially get you into ketosis faster, and help you reap the benefits of a low carb diet, but they’re still relatively new to the market (12).
Bulk buy and cook. If you’re someone who doesn’t like to spend a lot of time in the kitchen, this is the best of both worlds. Buying your food at bulk (specifically from wholesalers) can reduce the cost per pound tremendously. Plus, you can make ahead food (bulk cook chicken thighs for pre-made meat, or cook entire meals) that are used as leftovers, so you spend less time cooking.
Although fat is the centerpiece of any keto diet, that doesn't mean you should be subsisting on butter-topped steaks, says Kristen Mancinelli, RD, author of The Ketogenic Diet. “A big misconception is that you should just put meat at the center of your plate and add more fat on top,” she says. You also shouldn't be relying on fatty meats to hit your fat quota, she adds.
Before we discuss how to measure ketone levels, let’s set some guidelines for optimal ketone levels. Nutritional ketosis is detected when levels begin to read at 0.5 mmol/L of ketones in the blood, but your optimal ketone level will depend on your personal goals. For instance, if your goal is to lose weight, your target ketone level will be lower than someone who wants to improve mental performance.  The following table provides some general guidelines based on your goal.

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.
[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"
• Standard ketogenic diet (SKD) — SKD is the type I typically recommend for most people, because it is very effective. It focuses on high consumption of healthy fats: As I explain in my book, "Fat for Fuel," you should aim for having 70 to 85 percent of your total daily calories to come from healthy fats. For your protein intake, the general rule of thumb is to follow the formula of 1 gram of protein for every kilogram of your lean body mass.
Many people also experience cramping, notably in the feet and legs. Because of this, you’ll want to consume extra electrolytes any time you are on a ketogenic plan. People who suffer with these symptoms refer to them as the Keto-Flu, and while it isn’t like the real flu, the symptoms can knock you down until you get your electrolytes back in balance.
Other forms of ketogenic diets include cyclic ketogenic diets, also known as carb cycling, and targeted ketogenic diets, which allow for adjustments to carbohydrate intake around exercise. These modifications are typically implemented by athletes looking to use the ketogenic diet to enhance performance and endurance and not by individuals specifically focused on weight loss.

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.
Unfortunately, long-term fasting is not a feasible option for more than a few days, therefore the ketogenic diet was developed to mimic the same beneficial effects of fasting. Essentially the keto diet works by “tricking” the body into thinking it is fasting, through a strict elimination of glucose that is found in carbohydrate foods. Today the standard ketogenic diet goes by several different names, including the “no-carb diet” or “very low carbohydrate ketogenic diet”(LCKD or VLCKD for short).
• Cardiovascular Disease: This is definitely a point of confusion and controversy since a diet that relies so heavily on meat and fat is naturally thought to raise blood cholesterol and cause heart issues. However, some evidence suggests that this may not be the case. In fact, the keto diet may help improve triglyceride, HDL and LDL levels. A 2017 review looked at all of the available evidence around the ketogenic diet and cardiovascular health and found that the diet may be associated with some improvements in cardiovascular risk factors. Mind you, the authors also expressed their concerns with maintaining the diet in the long term, and they proposed that these benefits may not be long-lasting. It's clear that we need long-term studies to fill that gap.

The ketogenic diet may seem like the Jekyll to the Hyde-like low-fat craze of the 1990s. The bulk of current research finds that the middle ground between the two extremes is more beneficial for overall health. Make it easy for yourself: Eat at least two servings a week of fatty fish (salmon, sardines, mackerel) and cook with a variety of quality fats (olive oil, canola oil, avocado oil) throughout the week.


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 >

Short for “ketogenic diet,” this eating plan is all about minimizing your carbs and upping your fats to get your body to use fat as a form of energy, says Scott Keatley, R.D., of Keatley Medical Nutrition Therapy. While everyone's body and needs are slightly different, that typically translates to: 60 to 75 percent of your calories from fat, 15 to 30 percent of your calories from protein, and 5 to 10 percent of your calories from carbs.
“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.

This was a great read , Steve, thanks! I’m 19 days in but forever educating myself. Wish I’d been more prepared for the keto flu cos’ that hit me HARD! Out the other side now though and hoping to see some improvements in my cycling endurance and less reliance on the gels and goos! I’ll also be doing lots of HIIT for some racing that I’ll be doing this winter (in the UK) so looking forward to experimenting with that! As a former (and maybe still current) sugar lover, the dessert tips were especially useful. Thanks again!

Keep eating low carb to continue losing weight, feeling good and becoming healthier!Try making any of our hundreds of recipes available on the site. We make sure each and every recipe is delicious, nutritious and will keep you under your daily carb limit, even if you go for seconds. In addition, we provide step-by-step instructions to make the process as easy as possible. If you ever run into any issues or have any questions, be sure to leave a comment or contact us directly! We’re always happy to help.


• Athletic Performance Impediments: For those people who train heavy and hard, going keto might cramp your style. As important as protein is for muscle growth, carbs also play an equally critical role by releasing insulin to drive that protein into muscles faster. It also helps us build up glycogen stores for longer training sessions, runs or hikes. One comprehensive review of the literature in sports nutrition found that while research is lacking on the long-term impacts of the keto diet, in the short term, the keto diet is inferior to other diet protocols on anaerobic, aerobic and in some cases even strength performance measures.
Nursing Moms should lower carb intake slowly. Try 50 carbs a day and see if he/she still seems satisfied at nap/night time.. After a week of this, and if you’re not in ketosis, then go to 45, then if you’re not in ketosis and milk supply isn’t affected go down again. We shouldn’t go below 30 carbs a day though. However, the milk fat in our milk will increase and that should help little one! My son has done fine with me at 30 carbs a day, but I’ve always had an oversupply of milk, so it never bother my supply. Don’t try and pump to see if your supply changes because that’s inaccurate. Trust me your little one will let you know.
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.
• Fighting inflammation — The human body can use both sugar and fat as fuel sources. However, the latter is preferred because it is a cleaner, healthier fuel that releases far fewer reactive oxygen species (ROS) and secondary free radicals. By eliminating sugar from your daily food consumption, you're decreasing your risk of developing chronic inflammation throughout your body.
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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.
For a period of 3-4 days up to 2 weeks, you will be eating the minimal amount of carbohydrates and sugar (20 grams net carbs maximum per day). After this you may be able to add in small amounts of net carbs if your body can handle it, but probably not more than 50 net carbs total per day.  This is tricky, because some people can't handle more than the 20 net carbs even after they have adjusted to ketosis.  Others can handle 50 net carbs and easily stay in ketosis.  If you feel fine at 20 net carbs and it doesn't bother you, than there's no reason to make any changes.  You can test your ketosis by how you feel, or by actually testing - which is discussed in section 3.
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.
Instead of thinking about the total carbs you’re eating, assess what those carbs provide to you. Do the majority of your carbs come from fruit and vegetables, with a payload of fiber and disease-fighting antioxidants? Fantastic. Or are you consuming them in the form of added sugars (cookies, candy, soda) or refined flour? If you are, you know what to do.
Another great keto flu cure is bone broth! This is also a great healer when you are actually sick with a cold or flu or just want something comforting. Instead of its high carb alternative chicken noodle soup or even worse, store bought chicken broth (which is typically loaded with MSG and other preservative junk), bone broth is a delicious way to alleviate your flu symptoms. Bone broth is a great way to hydrate & it is also packed with electrolytes, good for you sodium and potassium.
Unfortunately, there’s no long-term data on ketogenic diets versus other diets. In a 2015 Italian study, those on a ketosis diet lost 26 pounds in three months. About half of the participants stayed on the diet for a year but lost little additional weight in the next nine months. People in a 2014 Spanish study who followed a very-low-calorie ketogenic diet lost an average of 44 pounds in a year—but a third of them dropped out, possibly because it was too hard to maintain.
• 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
Although studies have shown that the keto diet can reduce seizures for children with epilepsy, there is no evidence indicating that keto helps with other brain disorders or improves mental cognition, according to Harvard Health Publishing. Some studies show that keto may lower blood sugar for people with type 2 diabetes, but there is not enough long-term research to determine whether it’s safe and effective for diabetics.
Quick update – been doing a keto-type diet for a couple of months now. My BP is down to the lowest it’s been in something like 10 years, though still on 1/2 dose for my meds. I’ve lost about 30 pounds in the last 4 months (give or take a bit as I’m not sure exactly where I started). I’ll admit I still use Truvia and will have a Coke Zero every now and then, but eliminating the wheat and corn breads and sugars to reduce my carb intake to < 50g/day on average has made a huge difference. (I'm sure some still sneaks in with some of the food I eat out, but for the most part it's pretty good.)

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