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.

To be confident about being in ketosis, especially at the beginning when you're not quite sure how you should feel, it’s best to measure your ketone levels.  By monitoring your ketone levels, you can assure that you’re doing the diet correctly and make dietary adjustments based on what you measure. People also respond to diet and exercise differently, so the best way to cater the keto diet to your own biology is to measure.

It’s easy to get caught up on the “low-carb” part of the diet and not give enough attention to the “high-fat” part. Fat is what makes you full, gives you energy (when in ketosis), and makes food taste delicious. For most people this figure should be north of 70 percent of daily calories. Keep carbs under 20g, hit your protein goal, and eat fat until you’re full.
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.
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".
If you’d like to try intermittent fasting, it’s best to start by gradually decreasing your feeding window. Start with not eating for a 12 hour stretch, including the time that you’re sleeping. For example, you could stop eating at 8 in the evening, then have breakfast at 8 in the morning. Ultimately, you’ll want to be mostly done with digestion by the time you go to bed, and not be hungry until late morning, so for most people a feeding window of 10am to 6pm would be a good goal.
Note: Are you a vegetarian or vegan and want to go on a ketogenic diet? It’s still possible! Just keep in mind that the dietary restrictions can sometimes be a little bit intense. Make sure to plan ahead and prepare to aid your success. To help out, we’ve published articles (with 7 day meal plans included) for both the vegetarian ketogenic diet and the vegan ketogenic diet.
Hi Jordan – thank you for reaching out. We have a ton of articles on here (https://theketoqueens.com/category/blog/) that you may find helpful. We also wrote a post about starting a keto diet (https://theketoqueens.com/keto-diet/), then we have a keto course that walks you step by step to starting a keto diet (under shop), and if you need individual keto coaching I do that on my other website LaraClevenger.com. Please let us know if you can help in any way.
There are two major ways fasting is beneficial for overall health. First, it gives the body a break from digestion. Digestion is a surprisingly stressful activity, and if there is a longer period of time where your body can focus on simply using the nutrients it’s been given already without having to handle more, digestion tends to improve, as well as energy levels.
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?

Most alcoholic beverages don’t list the ingredients or nutritional information on the label, so be prepared and check your favorite drinks online so you know your limits beforehand. Most apps and trackers list many types of alcohol in their database, and this is the easiest way to be sure of what you’re drinking. Be warned, when you’re in ketosis your alcohol tolerance will go down, so you might not want to drink as much as you might be used to.
There are so many vegetables that you can use, and so many ways to prepare them, that an entire book could be written on the topic. Most vegetables that grow above the ground are high in fiber, vitamins, minerals, and antioxidants. They can be added to meat dishes, cooked on their own, or eaten as a salad. Vegetables are inexpensive, easy to prepare, and can be part of every meal. Most of them are quite low in carbohydrates, so it’s hard to overindulge in this food group.
It can be very difficult to obtain some of the very high levels of blood ketones on this table - especially as you become "fat adapted" or "keto adapted" or whatever you want to call it.  Once your body is efficient at using ketones, it makes only what it needs.  Beginners may see very high levels of ketones, and then they see them drop off.  This isn't because you are making a mistake and are out of ketosis - your body is no longer overproducing them.

The keto diet works for such a high percentage of people because it targets several key, underlying causes of weight gain — including hormonal imbalances, especially insulin resistance coupled with high blood sugar levels, and the cycle of restricting and “binging” on empty calories due to hunger that so many dieters struggle with. Yet that’s not a problem with what’s on the keto diet food list.
• 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

That said, I think the biggest changes are the result of me dropping the sugars and breads. Tracking my eating and being more conscious about my foods has made a difference. I definitely plan to keep on this track for a while and slowly work towards a fuller keto-adapted diet/body. I’m not going with the “all-in” that some recommend, cutting out all artificial sweeteners and such, though I have limited them. I’m not really tempted to indulge in the sweets that have been tempting in the past.


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!


After the initial transition period (often referred to as the fat-adaptation or keto-adaptation period), most people find they gain a ton of mental and physical energy.  They don’t have energy crashes in the afternoons and they often sleep a bit less but wake up feeling refreshed.  They also tend to eat less because they don’t feel hungry or have cravings.

[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"

Also make sure that you know what foods have mostly carbs, fat, and protein, so you can make the right choices. For instance, it’s not just bread, pasta, chips, cookies, candy, and ice cream that contain carbs. Beans may contain protein, but they’re also very high in carbohydrates. Fruit and veggies also mostly contain carbs. The only foods that don’t contain carbs are meat (protein) and pure fats, like butter and oils (including olive oil and coconut oil).

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Medical Disclaimer: The material on this site is provided for informational purposes only and is not medical advice. Always consult your physician before beginning any diet or exercise program.

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