According to the USDA, a 100-gram serving of red tomatoes has 3.89 grams of carbohydrates.43 You may add this fruit to your ketogenic diet safely and gain its beneficial nutrients, particularly lycopene. Researchers from Ohio State University suggest that this antioxidant may help protect your skin from sun damage, which may result in a lowered risk of skin cancer tumors.44

Aside from carb flu, be warned that staying in long-term, continuous ketosis may have drawbacks that may actually undermine your health and longevity. To stay on the safe side, I recommend undergoing a cyclic ketogenic diet. The "metabolic magic" that ketosis brings to the mitochondria actually occurs during the refeeding phase, not during the starvation phase.
• Cancer: Early experimental research suggests that the keto diet may have anti-tumor effects, likely because it reduces overall calorie intake (and circulating glucose) for tumor growth. In one 2014 review of animal research, a ketogenic diet was found to be successful at reducing tumor growth, colon cancer, gastric cancer and brain cancer. More research on humans with larger sample sizes is needed, but it's definitely food for thought.
Your glycogen stores can still be refilled while on a ketogenic diet. A keto diet is an excellent way to build muscle, but protein intake is crucial here. It’s suggested that if you are looking to gain mass, you should be taking in about 1.0 – 1.2g protein per lean pound of body mass. Putting muscle on may be slower on a ketogenic diet, but that’s because your total body fat is not increasing as much.5Note that in the beginning of a ketogenic diet, both endurance athletes and obese individuals see a physical performance for the first week of transition.
During week 1 (and sometimes week 2) your body is transitioning to this whole new metabolic state, and there may be some initial side effects.  These are collectively known as the "keto flu".  The good thing is that if you don't take them for granted and think you're "superman" and that your body will be different, you can easily prevent these symptoms.
• Increasing muscle mass — Jeff Volek, Ph.D., is a registered dietitian specializing in how a high-fat, low-carb diet can affect health and athletic performance. He's written many scientific articles on this topic, as well as two books, and he explains that ketones have a similar structure to branched-chain amino acids that can be useful for building muscle mass. Ketones spare these amino acids, leaving higher levels of them around, which can help promote muscle mass.
The classic ketogenic diet is a very low-carb diet plan that was originally designed in the 1920s for patients with epilepsy by researchers working at Johns Hopkins Medical Center. (1) Researchers found that fasting — avoiding consumption of all foods for a brief period of time (such as with intermittent fasting), including those that provide carbohydrates — helped reduce the amount of seizures patients suffered, in addition to having other positive effects on body fat, blood sugar, cholesterol and hunger levels. (2)
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.
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.

Many people also experience cramping, notably in the feet and legs. Because of this, you’ll want to consume extra electrolytes any time you are on a ketogenic plan. People who suffer with these symptoms refer to them as the Keto-Flu, and while it isn’t like the real flu, the symptoms can knock you down until you get your electrolytes back in balance.

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.


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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