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[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"
After about a three weeks of writing my low carb and keto posts, I think it’s time to share a Keto Diet Plan for those of you interested in learning more about this diet.I don’t just want to share diet basics; you need to leave here with a real understanding of how keto works. That’s my job, to make this so simple anyone can do it. AlthoughI don’t want you to just know how to make keto work, I want you to understand keto inside and out!
Although the exact role of the ketogenic diet in mental and brain disorders is unclear, there has been proof of its efficacy in patients with schizophrenia. And, to boot, the ketogenic diet works to reverse many conditions that develop as a side effect of conventional medications for brain disorders, like weight gain, type 2 diabetes and cardiovascular risks. More research is needed to understand the role of the ketogenic diet in treating or improving schizophrenia, as the current available studies are either animal studies or case studies, but the benefits of a high fat, low carbohydrate diet in neurology is promising.
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!

A lot of changes are happening in your body and you’re going to feel it! The first five to seven days can be pretty rough, but your body is getting over its dependency on sugar. During this time of transition it is essential that you supplement electrolytes. Your body is flushing out lots of water, and with that goes electrolytes. The Keto Flu can be greatly reduced if you add sodium, potassium and magnesium to your diet. Check out our supplements page for a list of electrolyte supplements we recommend. Stay on course and you’ll start feeling better in no time!
The biggest draw for me is how many of those who’ve tried it say they don’t get hungry. The possibility of that blows my mind, as someone who’s used to any sort of calorie restriction meaning hours of feeling hungry every day. It’s tantalizing enough that I at least want to try. And what have I got to lose, right? I’m already morbidly obese; it’s hard to imagine screwing this up so bad it makes that worse.

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!
I like it – and I’m surprised I like it. I’m only down 5 lbs. after a month but I’m down 3 inches on my waist and 2 inches on my hips. I do feel better physically and I love not being hungry! I used to be that person who could eat pasta like a lumberjack – now I often don’t even finish my food. I have had a hard time sticking to 20 net carbs, I usually end up in the high 20’s somewhere, but I’m in ketosis according to the testing strips. It’s much harder to stick to 20 net as a vegetarian. Everything you eat has some level of carbs and they do add up. But overall, this is the only thing I’ve lost any weight or inches on in about 7 or 8 years. Starvation used to work until I hit 45 and then, forget it, I could eat 700 calories a day and not lose a pound. I’m so excited *something* is actually working.
Because the main tenet of the keto diet is counting and cutting carbs — a commonly used way to control blood sugar — this eating approach has become increasingly popular among people with type 2 diabetes who are looking to lower their A1C, which is the two- to three-month average measurement of blood sugar levels. Indeed, research suggests this diet may lead to fast weight loss and potentially lower blood sugar for people with the disease. (13)
This is an adaptation period, where we’re essentially re-training our muscles and our brain to use fat as the primary fuel source instead of glucose. This adaptation can take a couple of weeks to a couple of months. As a hallmark of being keto-adapted and not just in ketosis, the skeletal muscles are able to burn fat directly for fuel, and the brain relies on the higher volume of ketones in the blood as its main source of energy.
The diet that worked for me was keto. Thanks for the recommendation for the keto strips- I ordered the exact ones and used my first test strip this morning- it worked great!! So I’ve got something else to keep me in check. Dropped 100 pounds after my first child (I really went overboard about eating for two- I thought I was doing something good) and then dropped 30 after my second child. Since then, it’s the same 10-15 pounds that I keep losing and gaining back. Love your mantras- I’ve written a few down in my journal and some just ring in my head like a music track- never two in a row!! Can’t outrun your fork!! With keto, it gets me fantastic and very quick results and I go with a recarb meal (not recarb day) once a week. Eat a little more carbs after workouts. Now with the strips, I can see if what I’m doing post-workout keeps me in keto. Thanks for all your resources- they are so eye-opening and so motivating (and funny)!! I did hours of research about keto- if your article had come out a couple of months earlier- it would havr saved me all that time!! Great knowing that if I feel like I need the boost with 1-1 coaching it is available. Keep up the outstanding work!
Beverages: It’s common to become dehydrated on the keto diet. Your insulin levels drop when you restrict carbs, and low insulin makes it harder for your body to retain sodium and water.[9] Drink plenty of plain water, and sip on bone broth to replenish electrolytes, especially during the first couple of weeks when your body is adjusting to the new diet.

Those issues can be part of what's known as the “keto flu,” Warren says. Other side effects of the keto diet, all of which are tied to carb withdrawal, can include lightheadedness, nausea, mental fog, cramps, and headaches, in addition to tiredness. Luckily, the keto flu doesn't usually last more than a week—which is coincidentally about when people start to see the number on the scale go down, says Warren.

Others consider the keto diet a short-term solution for weight loss. Tyler Drew, a 34-year-old real estate broker from Los Angeles, first read about the diet on Reddit and used it to lose 45 pounds in six months before returning to a traditional diet. While on the keto diet, Drew’s cholesterol levels improved, even though a typical day of eating involved bacon at both breakfast and dinner.


A: The amount of weight you lose is entirely dependent on you. Obviously adding exercise to your regimen will speed up your weight loss. Cutting out things that are common “stall” causes is also a good thing. Artificial sweeteners, dairy, wheat products and by-products (wheat gluten, wheat flours, and anything with an identifiable wheat product in it).
A: There's no specific answer for this question, as it is dependent on many factors. However, you may be able to spot improvements right away. In a study that tested the ketogenic diet on obese people, researchers noted that after 24 weeks, the test subjects lost around 14 kilograms (30.8 pounds) of excess weight, going from an average 101.03 kilograms to 86.67 kilograms (222.7 pounds to 191 pounds).67
The book contains a two week menu for beginners. (Face it, there's a 90% chance you won't follow it to the letter, but it does help set your thinking in the right direction.) For each individual week there's a shopping list which, by itself, will help you adjust your kitchen quite a bit. There are tips on the best sweeteners (Swerve over Splenda), the oils you'll need, produce, canned and bottled items, pantry items, and meats. Something to consider as you go along is that some items, like almond and coconut flour are expensive items to stock up on, but you'll use considerably less than non-keto recipes will use for regular flour. Do what you can afford. Just know that there are some must-have staples like coconut oil and olive oil.
• Constipation: No one likes to feel backed up, and sadly if you're not careful about your diet choices when going keto, it could become a regular concern. One 10-year (albeit small) study looking at the effects of a keto diet on young children found that 65 percent experienced digestive woes. Thankfully, going keto is not a life sentence for problem bowels. Since you're cutting out whole grains and fruit (two of the most common sources of fiber), aim to up your fiber-rich veggies, and consider a supplement.
• High-protein ketogenic diet — This method is a variant of the SKD. In a high-protein diet, you increase the ratio of protein consumption to 10 percent and reduce your healthy fat consumption by 10 percent. In a study involving obese men that tried this method, researchers noted that it helped reduce their hunger and lowered their food intake significantly, resulting in weight loss.11
Basically, the role of exogenous ketones is to boost the amount of ketones in your body. These products do work wonders if, after a long time on a keto diet, you don’t feel energized or generally don’t feel like you are at your best. Ultimately deciding to take exogenous ketones or not comes down to how you feel on your keto diet and trying to find a product with the highest possible quality.
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.
For athletes, research on the keto diet highlights potential improvements in athletic performance, especially when it comes to endurance activities. An article suggests ketogenic-type diets may allow endurance athletes to rely mostly on stored fat for energy during exercise rather than having to refuel with simple carbohydrates during endurance training and competition while additionally improving recovery times. (10)
I have been on keto for about 3 weeks now thanks for all the info what I have lost probably fluid but my main thing is my stomach going doen slowly..I have some medical pre diabetic. BP and 2 strokes.must lose at least 70 pounds but I sincerely fo not understand the macros how do you count them I am rating only 2 meals now though loving that staying full not hungry walk about 3 days a week..more during summer…the grocery list I have down but can’t quite undetstand the macros..very happy to have people to talk to thanks glad you are available
I like it – and I’m surprised I like it. I’m only down 5 lbs. after a month but I’m down 3 inches on my waist and 2 inches on my hips. I do feel better physically and I love not being hungry! I used to be that person who could eat pasta like a lumberjack – now I often don’t even finish my food. I have had a hard time sticking to 20 net carbs, I usually end up in the high 20’s somewhere, but I’m in ketosis according to the testing strips. It’s much harder to stick to 20 net as a vegetarian. Everything you eat has some level of carbs and they do add up. But overall, this is the only thing I’ve lost any weight or inches on in about 7 or 8 years. Starvation used to work until I hit 45 and then, forget it, I could eat 700 calories a day and not lose a pound. I’m so excited *something* is actually working.
A keto diet has shown to improve triglyceride levels and cholesterol levels most associated with arterial buildup. More specifically low-carb, high-fat diets show a dramatic increase in HDL and decrease in LDL particle concentration compared to low-fat diets.3A study in the long-term effects of a ketogenic diet shows a significant reduction in cholesterol levels, body weight, and blood glucose. Read more on keto and cholesterol >
Taking your first step into the ketogenic diet is an exciting phase for your health. But before coming up with an actual ketogenic diet food list, it's important to first take a look at what you're eating now and take out anything that's unhealthy. This means that you have to remove sugars, grains, starches and packaged and processed foods from your diet. Basically, anything that won't add to your new eating regimen has to go. This is what I call a "pantry sweep."

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.


Over the past century, ketogenic diets have also been used to treat and even help reverse neurological disorders and cognitive impairments, including epilepsy and Alzheimer’s symptoms. Research shows that cutting off glucose levels with a very low-carb diet makes your body produce ketones for fuel. This change can help to reverse neurological disorders and cognitive impairment, including inducing seizure control. The brain is able to use this alternative source of energy instead of the cellular energy pathways that aren’t functioning normally in patients with brain disorders.
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.
Each of the above methods is good for its own reason; however, we would suggest only one: the blood test.  The urine strips are cheap, yet not accurate.  The breath analyzer is expensive, difficult to find and has definite quirks.  The blood tests, while somewhat expensive, are fully reliable and testing your blood - the most accurate place to measure your ketones.

Another third tip is snacking. Really important if you’re a snacker and you are just starting your Ketogenic diet you’ll probably need some form of snacks. Some of the best snacks for beginners include celery, nuts and nut-based hummus, cucumber. If you have more of a sweet-tooth, dark unsweetened chocolate is a great option, as is coconut or almond butter or even peanut butter.
The keto diet (also known as ketogenic diet, low carb diet and LCHF diet) is a low carbohydrate, high fat diet. Maintaining this diet is a great tool for weight loss. More importantly though, according to an increasing number of studies, it helps reduce risk factors for diabetes, heart diseases, stroke, Alzheimer’s, epilepsy, and more1-6.On the keto diet, your body enters a metabolic state called ketosis. While in ketosis your body is using ketone bodies for energy instead of glucose. Ketone bodies are derived from fat and are a much more stable, steady source of energy than glucose, which is derived from carbohydrates.
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.
Some people like to start a ketogenic diet, or restart one, with a more restrictive plan. These aren’t for everyone, since most people adjust better to slow, gradual changes. If you’re the kind of person who likes to change everything all at once, you can try one of these short term hacks to get you kick-started in keto, and maybe even help you lose those first couple of pounds, or the last couple that just won’t seem to budge.
You are so welcome Christine! I really do believe that in order for a diet to become a lifestyle, it has to be simple otherwise people will lose interest or slip up easier. With weight loss, patience is key. Also, if you find that something is not working for you, don’t be afraid to switch it up! Every body is different so what works for one, might not work for all.
To prevent side effects such as the keto flu, begin transitioning your meal plan gradually. Start by understanding how many carbohydrates you take in most days. Then begin slowly reducing your carbohydrate intake over a period of a few weeks while gradually increasing your intake of dietary fat to keep your calories the same. You should also make sure to seek guidance from a professional to make sure this plan works best for you and your health goals. “See a dietitian and adapt the diet to fit your long-term needs,” Spano recommends.
Many books could be written on this very subject, and undoubtedly they have been. There are many answers, and they all depend on context. Lots of variables impact how well, and how consistently we lose weight. How much sleep do we get each night, and how restful is that sleep? What micronutrients are we not getting enough of? How much water are we drinking? How much are we exercising?
5) By now you should know both where you are and where you want to be. Those are the first steps. Now it’s time to start planning your meals. You can use these food lists to help you figure out what kinds of foods you should be eating. Remember this is not a diet plan that has an end date. This is a lifestyle change that you will pass on to your children.

The average person's diet contain about 55% carbohydrates, 30% fat, and 15% protein. On the keto diet, you eat a whole lot more fat, and a lot less carbs: 80% of the diet is comprised of fat, 15% is protein, and a mere 5% of calories come from carbohydrates. For someone on a 1,500-calorie diet, that translates to 19 grams of carbohydrates per day, which is less than what you find in one medium-sized apple.
Some people like to start a ketogenic diet, or restart one, with a more restrictive plan. These aren’t for everyone, since most people adjust better to slow, gradual changes. If you’re the kind of person who likes to change everything all at once, you can try one of these short term hacks to get you kick-started in keto, and maybe even help you lose those first couple of pounds, or the last couple that just won’t seem to budge.

If this diet is so tough, then why has it been around since the 1920s? For starters, there’s some evidence to suggest that ketogenic diets help regulate epilepsy, according to research in ISRN Pediatrics.Redox Biology reports the diet may benefit cancer patients. While it may be helpful for short-term weight loss, that wasn’t the diet’s original intention, and the jury’s still out on its long-term effects.

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