Sharon M. Nickols-Richardson, PhD, RD, , Mary Dean Coleman, PhD, RD, Joanne J. Volpe, Kathy W. Hosig, PhD, MPH, RD, “Perceived Hunger Is Lower and Weight Loss Is Greater in Overweight Premenopausal Women Consuming a Low-Carbohydrate/High-Protein vs High-Carbohydrate/Low-Fat Diet,” The Journal of Pediatrics: Vol 105, Issue 9: 1433–1437; September 2005. http://www.sciencedirect.com/science/article/pii/S000282230501151X.
One of the most common side effects of starting the ketogenic diet is the “keto flu.” This term describes the often unpleasant, fatigue-inducing symptoms that occur as the body adjusts from a high-carbohydrate to a low-carbohydrate diet. During the keto flu, the body’s stored glucose begins depleting, and the body starts adapting to producing and utilizing ketones as energy. (2)
The hallmark of a ketogenic diet is being in ketosis for extended periods of time, and is achieved by carbohydrate restriction. While there isn’t a strict prohibition of artificial sweeteners, grains, and manufactured foods, there is a strong preference in the community to lean towards natural, whole foods. Keto is for overall health, and weight loss is a welcome side effect for many people.
Now, there’s even evidence that a low-carb, high-fat diet helps you live longer, compared to a low-fat diet. In a study by the medical journal The Lancet that studied more than 135,000 adults from 18 countries, high carbohydrate intake was associated with higher risk of total mortality, whereas total fat and individual types of fat were related to lower total mortality. Total fat and types of fat were not associated with cardiovascular disease, myocardial infarction or cardiovascular disease mortality.
Okay, I’ll admit I bailed just after the sriracha covered chicken costume, so maybe I missed it, but I wanted to ask: is Keto intended to be a permanent diet change? It seems very challenging, and as I was reading, I kept asking myself “How is this consistent with the concept of small sustainable changes?” Is it? I think it’s a great topic to cover, but how would you describe the relationship between the keto diet and NF philosophy regarding sustainability? Thanks!
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!

Mistakes, refinements, pivots, corrections, whatever your want to call them… These changes are the vehicle that takes us from stage to stage of the Ketogenic Hierarchy of Needs. The good news is they are also the vehicle to break through plateaus and reach new performance levels. Changing habits is tough, no doubt about it, but have fun and go for it!


Before we go any further, please take a minute to subscribe to my blog. I will send out weekly emails so you can stay on top of all the things you need to know about your body, as well as recipes, and tips. Feel free to email me at any time with questions you may have. I am always happy to help, and who knows, maybe your question will inspire a blog post!

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.
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.

In some ways, it’s similar to the Atkins diet, which similarly boosts the body’s fat-burning abilities through eating only low-carb foods, along with getting rid of foods high in carbs and sugar. Removing glucose from carbohydrate foods will cause the body to burn fat for energy instead. The major differences between the classic keto diet and the Atkins diet is ketogenic emphasizes healthier fats, less overall protein and no processed meat (such as bacon) while having more research to back up its efficacy.
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.
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
You’re transitioning. Your body is equipped to process a high intake of carbs and a lower intake of fat. Your body needs to create enzymes to be able to do this. In the transitional period, the brain may run low on energy which can lead to grogginess, nausea, and headaches. If you’re having a large problem with this, you can choose to reduce carb intake gradually.
Fats are great if you want to add flavor and texture to your meals, and will help you feel full. Some people believe swear by coconut oil, and whether or not the claimed health benefits are actually present, it’s one of the fats that you might want to add to your diet. Butter is an excellent choice, as is ghee (Indian clarified butter). Duck fat is highly prized. Avocado oil is a great choice when making dressings or sauces, as it’s liquid at room temperature and has a mild flavor. The fats and oils listed here are primarily saturated, and they are the least likely to go rancid and produce free radicals and inflammation in the body (5, 6).
Okay, I’ll admit I bailed just after the sriracha covered chicken costume, so maybe I missed it, but I wanted to ask: is Keto intended to be a permanent diet change? It seems very challenging, and as I was reading, I kept asking myself “How is this consistent with the concept of small sustainable changes?” Is it? I think it’s a great topic to cover, but how would you describe the relationship between the keto diet and NF philosophy regarding sustainability? Thanks!

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