If you do try the diet outside of medical supervision, Kizer says it’s important to test your urine with urinalysis ketone test strips to ensure your ketone levels don’t become dangerously high. Ketone urine test strips are also used by people with diabetes to determine if they’re at risk for ketoacidosis (DKA), a life-threatening complication that occurs when an individual doesn’t have enough insulin in their body. (Healthy ketosis is considered 0.5 to 3.0 mM blood ketones.)
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 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.
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.
There are several types of the keto diet, but essentially, to achieve a state of ketosis, you have to severely reduce the amount of carbs you eat. (You can use this ketogenic calculator to create a custom food plan.) Data suggest the average American man over age 20 consumes 47.4 percent of his daily calories from carbs, and the average American woman over age 20 consumes 49.6 percent of her daily calories from carbs. (3) But in the classic ketogenic diet, which was originally used for the management of seizure disorders, 80 to 90 percent of calories come from fat, 5 to 15 percent come from protein, and 5 to 10 percent come from carbohydrates.
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.
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.
Christopher D. Gardner, PhD; Alexandre Kiazand, MD; Sofiya Alhassan, PhD; Soowon Kim, PhD; Randall S. Stafford, MD, PhD; Raymond R. Balise, PhD; Helena C. Kraemer, PhD; Abby C. King, PhD, “Comparison of the Atkins, Zone, Ornish, and LEARN Diets for Change in Weight and Related Risk Factors Among Overweight Premenopausal Women,” JAMA. 2007;297(9):969-977. http://jama.jamanetwork.com/art icle.aspx?articleid=205916.
Short for “ketogenic diet,” this eating plan is all about minimizing your carbs and upping your fats to get your body to use fat as a form of energy, says Scott Keatley, R.D., of Keatley Medical Nutrition Therapy. While everyone's body and needs are slightly different, that typically translates to: 60 to 75 percent of your calories from fat, 15 to 30 percent of your calories from protein, and 5 to 10 percent of your calories from carbs.
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).
Over 8–10 mmol/l: It’s normally impossible to get to this level just by eating a keto diet. It means that something is wrong. The most common cause by far is type 1 diabetes, with severe lack of insulin. Symptoms include feeling very sick with nausea, vomiting, abdominal pain and confusion. The possible end result, ketoacidosis, may be fatal and requires immediate medical care. Learn more
Net carbs are what we track when following a ketogenic diet. This calculation is pretty straightforward. Net Carbs = Total Carbs – Fiber. For example, one cup of broccoli has 6g of total carbs and 2.4g of fiber. That would mean one cup of broccoli has 3.6g of net carbs. We count Net Carbs  because dietary fiber does not have a significant metabolic effect. 
The ketogenic diet — a high-fat and very low-carb eating plan — can be tough to start. After all, it’s likely a radical departure from the way you’re eating now (a typical standard American diet is high in carbohydrates and processed foods). But many people are trying the keto diet, which puts your body in a state of ketosis. That's what happens when your body’s carb-burning switch flips to a fat-burning one, a change that can cause weight loss and has even been credited with controlling diabetes. (1)

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