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.
There are so many tricks, shortcuts, and gimmicks out there on achieving optimal ketosis – I’d suggest you don’t bother with any of that. Optimal ketosis can be accomplished through dietary nutrition alone (aka just eating food). You shouldn’t need a magic pill to do it. Just stay strict, remain vigilant, and be focused on recording what you eat (to make sure your carb and protein intake are correct).
What is the keto diet? Rather than relying on counting calories, limiting portion sizes, resorting to extreme exercise or requiring lots of willpower (even in the face of drastically low energy levels), the ketogenic, low-carb diet takes an entirely different approach to weight loss and health improvements. It works because it changes the very “fuel source” that the body uses to stay energized: namely, from burning glucose (or sugar) to dietary fat, courtesy of keto recipes and the ketogenic diet food list items, including high-fat, low-carb diet foods.

After about two to seven days of following this eating routine, you go into something called ketosis, or the state your body enters when it doesn't have enough carbs for your cells to use for energy. Then it starts making ketones, or organic compounds that your bod then uses in place of those missing carbs—and oh, it also burns fat for more energy, says Beth Warren, R.D., founder of Beth Warren Nutrition and author of Living A Real Life With Real Food.
I have read your article and lots of other stuff on Keto, but I still don’t understand why it has to be so high in fat? I am on a calorie controlled diet which should also be pushing me into ketosis (Optifast + veges) nutritionist suggestion to go hard for a month. But after that was looking at moving to a Ketogenic diet. I am just having a hard time with understanding why it has to be high fat. Can you help me understand? Also love your writing style (particularly referencing Ace Ventura).
But generally speaking, if you plan to follow a ketogenic diet, you should aim to consume less than 10 percent of your total calories from carbohydrates per day. The remaining calories should come from 20 to 30 percent protein and 60 to 80 percent fat. That means if you follow a daily 2,000-calorie diet, no more than 200 of your calories (or 50 grams) should come from carbs, while 400 to 600 calories should come from protein and 1,200 to 1,600 should come from fat. (There’s a reason this plan is also called a high-fat, low-carb diet!)
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.
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] 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"
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.
This also enables you to see what you were eating prior to a woosh of weight loss, or a stall, or even a gain. You can see possible triggers for these events, like having extra vegetables, or having too many nuts and cheeses. It also lets you see if you may have sensitivities. If you try a week without dairy but keep your calories the same, for example, you may or may not notice a spontaneous drop in weight.
Thank you Lauren for your website! I have been in diet denial thinking that I am doing something wrong as my husband and I have been doing the Keto diet for 2 weeks now and he has lost almost 30 pounds and I have gained 2! I know that men always lost it faster and he has way more weight than me to lose but it is still frustrating nonetheless! I appreciate your words of encouragement throughout your blog and to your readers comments! “Keeping it simple” was like an Ah-Ha moment! Before Keto I cooked very simply…meat, starch, veggie…but once we started Keto I felt like I had to come up with fancy meals to supplement what I thought I would be missing! It’s exhausting and expensive like you mentioned! Another frustration is constantly counting everything. It really is almost a turn off for me not to mention constantly thinking about food which I NEVER DID BEFORE! So, in general, I guess what I wanted to say was thank you for keeping it real and really simple.
• Type 2 Diabetes: This population has been studied heavily with the keto diet since it's technically as low-carb as you can get. While the research to date has been conducted in very small sample sizes, evidence suggests that an ultra-low-carb diet (like the keto diet) may help reduce A1C and improve insulin sensitivity by as much as 75 percent. In fact, a 2017 review found that a keto diet was associated with better glucose control and a reduction in medication use. Having said that, the authors cautioned that it was unclear whether the results were due to weight loss in general, or higher ketone levels.

The removal of many grains and fruits with such a large emphasis on fats can bring about its own set of side effects. “If not done properly — with most of your carbohydrates coming from fiber-rich vegetables — you may not be getting enough fiber, which can lead to constipation,” says Chris Mohr, PhD, RD, a sports dietitian based in Louisville, Kentucky, and co-owner of MohrResults.com. (5)
Since last week, I no longer experience consistent headaches, fatigue, bloating, gas, headaches, fatigue, bloating, gas, headaches..yeah, you get it (repetition intentional). Oh, and chronic constipation? What just happened here? It’s going bye-bye. Not a Celiac; gluten-sensitive? I don’t know but right now, honestly, I don’t care. After the gone-with-the-sh*t last week, I’m staying away from those “carbs” and the wreck they havoc’d on my system for years (and made me paranoid I had a brain tumour which the doctor ruled out).
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.
Chapter 2 - Go Keto in 5 steps. 1-clean out your pantry. Egads! No dates or peas, 2 of my favorites! 2-Go shopping and stock up on the basics- water, coffee, tea, spices, herbs, non-sugar sweeteners, lemon & lime juice, mayo, mustard, pesto, sriracha, broths, pickled foods, nuts & seeds, meats, eggs, wild caught fish, nonstarchy veggies, berries, avocados, full fat dairy, avocado oil, olive oil, butter, lard, bacon fat. 3-set up your kitchen with a food scale, food processor, spiralizer, hand mixer, and cast iron pan. 4- plan your meals, and 5 -exercise!
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.

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.
In the first week, many people report headaches, mental fogginess, dizziness, and aggravation. Most of the time, this is the result of your electrolytes being flushed out, as ketosis has a diuretic effect. Make sure you drink plenty of water and keep your sodium intake up.6One of the fathers of keto, Dr. Phinney, shows that electrolyte levels (especially sodium) can become unbalanced with low carb intake.
It also interferes with some of the social aspects of food, considering how limiting it is. No cake on your birthday. No pie on Thanksgiving. No chocolate truffles on Valentine's Day. Boo to that! If you consider yourself someone who loves to eat and takes great joy in the social experience of a good meal, then the restriction of this diet may be emotionally unhealthy.
The biggest challenge with vegan and vegetarian diets is getting enough protein. These diets are traditionally lower in protein anyway, since they exclude the concentrated proteins in animal flesh. These individuals may want to include plant-based protein powders and shakes. Be wary of the ingredients, since these powders may contain various sugars that aren’t compatible with a ketogenic diet.
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.

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.


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.
Bonnie J. Brehm, Randy J. Seeley, Stephen R. Daniels, and David A. D’Alessio, “A Randomized Trial Comparing a Very Low Carbohydrate Diet and a Calorie-Restricted Low Fat Diet on Body Weight and Cardiovascular Risk Factors in Healthy Women,” The Journal of Clinical Endocrinology & Metabolism: Vol 88, No 4; January 14, 2009. http://press.endocrine.org/doi/full/10.1210/jc.2002-021480.
In my book "Fat for Fuel," I sought to educate readers about the benefits of using healthy fats as a catalyst to bring about improved mitochondrial function, thus allowing you to achieve better health. In essence, the book answers WHY it is important for you to consume healthy fats. However, you still need to know HOW to prepare the right ketogenic foods in an appetizing way.

In a state of ketosis, your body breaks fat down in the liver and converts it into ketones to be used for energy. Fat doesn't generate an insulin response, so insulin levels remain stable. This makes it much harder to store excess fat, and easier to tap into body fat stores for energy. Not only will this allow you to maintain your weight, but it will greatly encourage weight loss.


You’re absolutely gorgeous, and I am looking forward to losing more than 40 lbs. also. I’m on my third week and feel like I hit a wall. I was waking up in the morning feeling my tummy a little flatter, some clothing a bit looser, etc. and now don’t feel like that. So, I looked up foods again, and I don’t think I was eating enough fat. Thank you for a simple version and grocery list of keto foods. It helps a lot! I hope to visit again soon and report double digit weight loss! Blessings!
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).
Some people like to weigh their food when they first transition from a normal diet to a ketogenic diet, in order to have a fuller understanding of the amount of carbohydrates that they consume, although this can be used just in the beginning as a guide. But ultimately no, you do not have to weigh your food in order to be successful with a keto diet.

At 4 weeks you should be feeling pretty darn good.  If you are feeling better, but not awesome, give it a little more time.  If you have not felt better throughout this time and have stuck strictly to your low carbs and high fat, your body may not align with the keto diet.  If you only feel bad because you're craving bad food, this may be a mental "block" that you need to deal with.  Coaching can help.


“Eggs have a lot of vitamins like vitamin A, B complex, D, K, E, calcium, and zinc,” says Ryan Weaver, a personal trainer and keto enthusiast. “That’s why eggs are an excellent choice for breakfast when you follow the keto diet. To avoid getting bored, you can try different ways of preparing the eggs—boiled, fried, or baked. Also, you can combine the eggs with different foods like bacon, ham, cheddar cheese, butter, mayonnaise, so you get a different recipe each day although using the same main ingredient.”

“Eggs have a lot of vitamins like vitamin A, B complex, D, K, E, calcium, and zinc,” says Ryan Weaver, a personal trainer and keto enthusiast. “That’s why eggs are an excellent choice for breakfast when you follow the keto diet. To avoid getting bored, you can try different ways of preparing the eggs—boiled, fried, or baked. Also, you can combine the eggs with different foods like bacon, ham, cheddar cheese, butter, mayonnaise, so you get a different recipe each day although using the same main ingredient.”


I’m honestly a little skeptical about it the idea of keto permanently. My brief glance at the literature seems to imply that it can have side effects of kidney stones, skeletal fractures, and slow the growth rate of children, but that was a study on kids with epilepsy (which it treated very effectively), so who knows how that applies to adults. And the other studies I found dealt with overweight and obese subjects, so it may be hard to find something on the long term effects on otherwise healthy adults.

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