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)
And good news for coffee addicts: you can still have your morning cup of joe. You'll just need to adjust what you stir into it. Switch out flavored creamer for the real deal”full-fat heavy whipping cream, which has only 1 gram of carbs per tablespoon. If you want to give your java a jolt of sweet, stir in a low-carb sweetener that uses sugar alcohols. But if you can skip the sweet, even better. In time, you'll retrain your palate to not crave a sugary start to the day.
This is one reason why tracking your food intake should be a priority. There are apps like Cronometer, MyFitnessPal, and LoseIt! that allow you to record all your foods for the day, and each has a large database of fresh foods, packaged foods, and restaurant meals, plus you can enter in your own recipes. This way you can know exactly what macro- and micro-nutrients you're getting, with no guess work.
This means that if you have risk factors for heart disease ” such as elevated cholesterol levels, high blood pressure (hypertension), or a strong family history of the disease ” you should use caution when following this diet. The diet's heavy reliance on fat, especially saturated fat, can elevate cholesterol levels, further increasing your chances of developing heart disease in the future. (7)

Frederick F. Samaha, M.D., Nayyar Iqbal, M.D., Prakash Seshadri, M.D., Kathryn L. Chicano, C.R.N.P., Denise A. Daily, R.D., Joyce McGrory, C.R.N.P., Terrence Williams, B.S., Monica Williams, B.S., Edward J. Gracely, Ph.D., and Linda Stern, M.D., œA Low-Carbohydrate as Compared with a Low-Fat Diet in Severe Obesity, N Engl J Med 2003; 348:2074-2081. http://www.nejm.org/doi/full/10.1056/NEJMoa022637.


Ketosis is the result of following the standard ketogenic diet, which is why it's also sometimes called œthe ketosis diet. Ketosis takes place when glucose from carbohydrate foods (like grains, all sources of sugar or fruit, for example) is drastically reduced, which forces the body to find an alternative fuel source: fat. Ketosis can also be achieved by multiple days of total fasting, but that isn't sustainable beyond a few days. (It's why some keto diet plans combine intermittent fasting or IMF with the keto diet for greater weight loss effects.)
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.
Ideally, your keto carb limit should be kept to under 50 grams a day, or 4 to 10 percent of your daily calories. This will help you transition to burning fat for fuel. However, this number may change depending on various factors. For example, if you have Type 2 diabetes, you will have to restrict your carb intake to as little as 20 grams per day. All in all, you will have to rely on your body's feedback to help you identify the ceiling amount for your carb intake.
A related clinical diet for drug-resistant epilepsy is called the medium-chain triglyceride ketogenic diet, in which MCT oil is extensively used because it's more ketogenic than long-chain triglycerides. (13a) Another dietary therapy for epilepsy called Low Glycemic Index Treatment (LGIT) was developed in 2002 as an alternative to the ketogenic diet. LGIT monitors the total amount of carbohydrates consumed daily, and focuses on carbohydrates that have a low glycemic index.) (13b)

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.


A ketogenic diet helps control blood sugar levels. It is excellent for managing type 2 diabetes, sometimes even leading to complete reversal of the disease. This has been proven in studies. It makes perfect sense since keto lowers blood-sugar levels, reduces the need of medications and reduces the potentially negative impact of high insulin levels.
On the other hand, the types of foods you'll avoid eating on the keto, low-carb diet are likely the same ones you are, or previously were, accustomed to getting lots of your daily calories from before starting this way of eating. This includes items like fruit, processed foods or drinks high in sugar, those made with any grains or white/wheat flour, conventional dairy products, desserts, and many other high-carb foods (especially those that are sources of œempty calories).
Frederick F. Samaha, M.D., Nayyar Iqbal, M.D., Prakash Seshadri, M.D., Kathryn L. Chicano, C.R.N.P., Denise A. Daily, R.D., Joyce McGrory, C.R.N.P., Terrence Williams, B.S., Monica Williams, B.S., Edward J. Gracely, Ph.D., and Linda Stern, M.D., œA Low-Carbohydrate as Compared with a Low-Fat Diet in Severe Obesity, N Engl J Med 2003; 348:2074-2081. http://www.nejm.org/doi/full/10.1056/NEJMoa022637.
Before we discuss how to measure ketone levels, let's set some guidelines for optimal ketone levels. Nutritional ketosis is detected when levels begin to read at 0.5 mmol/L of ketones in the blood, but your optimal ketone level will depend on your personal goals. For instance, if your goal is to lose weight, your target ketone level will be lower than someone who wants to improve mental performance. The following table provides some general guidelines based on your goal.
Oh man, this is a great read. Entertaining and full or resources and digestible content even though it is a long article. But I appreciate the research you went through it. I remember 5 years ago researching about Keto diet took forever because of how spread out the sources were. This is great work as a guide. Thanks for the article. Before reading this article I thought the requirements were too strict, but now that I read it, I am already doing a third of that list. I am trying IF right now, but I think this will help me with my satiety problem with meals, plus help me with weight loss. Thanks for the motivation and information Steve. I am starting my plan of attack and try a Keto diet.

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