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.
Con: Results can vary depending on how much fluid you drink. By drinking more water, you dilute the concentration of ketones in the urine and thus a lower level of ketones will be detected on the strips. The strips don’t show a precise ketone level. Finally, and most importantly, as you become increasingly keto-adapted and your body reabsorbs ketones from the urine, urine strips may become unreliable, even if you’re in ketosis.
I’m really interested in that article also. We had a baby almost a year ago. We decided to give the plant-based diet a go, and has been successful. But, I’m stuck now. Haven’t lost any more weight. And recently just learned of the keto diet! I started last week, but I’m a mess with what to eat, being plant-based and all. Can’t wait for that post! I’ve bookmarked this for future reference.

The ketogenic diet works by eliminating carbohydrates from the diet and keeping the body’s carbohydrate stores almost empty, therefore preventing too much insulin from being released following food consumption and creating normal blood sugar levels. This can help reverse “insulin resistance,” which is the underlying problem contributing to diabetes symptoms. In studies, low-carb diets have shown benefits for improving blood pressure, postprandial glycemia and insulin secretion. (7) Therefore, diabetics on insulin should contact their medical provider prior to starting a ketogenic diet, however, as insulin dosages may need to be adjusted.


When you’re first getting started, it can be helpful to use a blood or breath ketone meter.  What these meters do is measure the amount of ketones (the energy source your body is switching to) in your blood or your breath.  Knowing those amounts and seeing how they increase or decrease depending on what you’re eating daily can often be a motivating and helpful indicator of the transition occurring in your body.
The end result is staying fueled off of circulating high ketones (which are also sometimes called ketone bodies) — which is what’s responsible for altering your metabolism in a way that some people like to say turns you into a “fat-burning machine.” Both in terms of how it feels physically and mentally, along with the impact it has on the body, being in ketosis is a very different than a “glycolytic state,” where blood glucose (sugar) serves as the body’s energy source.
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.
A modified version of the ketogenic diet, which allows you to eat protein more liberally — at 20 to 30 percent of your total calories — with the same carbohydrate restriction, is the more commonly used version of the diet today. Some of the aims of the latest version of the ketogenic diet are weight loss, weight management, and improved athletic performance.
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).
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.
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)
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.
Totally agree that it’s not something for everyone, though. Even one of the authors I read said he sometimes sneaks a french fry or a bite of cheesecake/ice cream, though he’s able to stop after just a little bit and it doesn’t throw him off horribly. Of course, that’s not license to eat junk all the time, but it does mean that once you’re well-adapted, you can sometimes indulge.
Achieving ketosis is a pretty straightforward, but it can seem complicated and confusing with all of the information out there.4If you want to learn more about ketosis and the scientific process around it, you can visit a very in-depth discussion about on Dr. Peter Attia’s website. Here’s the bottom line on what you need to do, ordered in levels of importance:

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.
The best place to get started if you’re interested in the ketogenic diet is to first take a look at the fats you can incorporate, such as avocado, olive oil, or cacao butter. You could also take a look at more of an animal-based fat like grass-fed tallow or pasteurized lard or, if you are not too sensitive to butter, grass-fed butter is a really good option.
• 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.
A “moderate keto diet” is an option that can still encourage substantial weight loss and other improvements in symptoms. A moderate keto diet includes more foods with carbs and, therefore, more fiber too. Carbs are usually increased to about  30–50 net grams per day, which means foods like more high-fiber veggies, some fruit or some starchy veggies can also be included.
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!

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