[iv] 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"
Hi I having problems figuring out how to eat Keyto n lose weight. I've actually gained 7lbs in 2 months :( Wondering how u eat veggies without going over your carbs n how do you get all the fats in. I've put the requirements into my fitness pal(macros) but I'm still not losing. Mine are set at 5% carbs 25% protein n 70% fats. Don't know what I'm doing wrong. I'm allergic to gluten some dairy n eggs. Any help would be great so I can start losing instead of gaining Thank you Donna

Make things yourself. While it’s extremely convenient to buy most things pre-made or pre-cooked, it always adds to the price per pound on items. Try prepping veggies ahead of time instead of buying pre-cut ones. Try making your stew meat from a chuck roast. Or, simply try to make your mayo and salad dressings at home. The simplest of things can work to cut down on your overall grocery shopping.


Certain studies suggest that ketogenic diets may “starve” cancer cells. A highly processed, pro-inflammatory, low-nutrient diet can feed cancer cells causing them to proliferate. What’s the connection between a high-sugar diet and cancer? The regular cells found in our bodies are able to use fat for energy, but it’s believed that cancer cells cannot metabolically shift to use fat rather than glucose. (11)

The ketogenic diet is based on the principle that by depleting the body of carbohydrates, which are its primary source of energy, you can force the body to burn fat for fuel, thereby maximizing weight loss. When you consume foods that contain carbohydrates, the body converts those carbohydrates into glucose, or blood sugar, which it then uses for energy. (1)

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.
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.
Hello can you help me please. ive been on a keto diet plan now for 4 weeks (including diary) not sure if this is considered more clean eating?? anyway i have worked out that my personal macro's are: 1169 calorie intake 25g carbs 80g protein 83g fat The thing is even though ive been eating thing on the keto food list including one fat bomb a day and coffee using cream. i have no idea how to measure my fats or carbs. I would like to loose about 8 lbs but overall it is more about health as i am postmenopausal and I want to stick to something that will level out my hormones as well as provide me with energy. (which i have very little of now and my hormones are bothe wall!!) So how do i measure what ive eaten. Sorry i don't get it?
Basically, fat within your blood travels as lipoproteins, along with cholesterol, proteins, and phospholipids. In order for an artery to be “clogged”, there needs to be a small tear in its inner wall first. These tears can be due to stress, smoking, a highly-processed diet, etc. In order for the walls to be repaired and thus prevent “clogging”, Vitamin E must be used. Vitamin E, being a fat-soluble vitamin, requires fat in order to be available for your body to use. Therefore, the consumption of fat can help your arteries self-heal and thus prevent “clogging”.
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.

Each of the above methods is good for its own reason; however, we would suggest only one: the blood test.  The urine strips are cheap, yet not accurate.  The breath analyzer is expensive, difficult to find and has definite quirks.  The blood tests, while somewhat expensive, are fully reliable and testing your blood - the most accurate place to measure your ketones.


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.
High-fat, low-carb diets can help diminish hunger and also boost weight loss through their hormonal effects. As described above, when we eat very little foods that supply us with carbohydrates, we release less insulin. With lower insulin levels, the body doesn’t store extra energy in the form of fat for later use, and instead is able to reach into existing fat stores for energy.

The ketogenic, or "keto," diet — which first became popular in the 1920s as a treatment for epilepsy and diabetes— limits carbohydrates to no more than 50 grams a day, which is the rough equivalent of a plain bagel or a cup of white rice. By comparison, dietary guidelines from the US Department of Agriculture recommend from 225 to 325 grams of carbs a day.


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.
Beverages: It’s common to become dehydrated on the keto diet. Your insulin levels drop when you restrict carbs, and low insulin makes it harder for your body to retain sodium and water.[9] Drink plenty of plain water, and sip on bone broth to replenish electrolytes, especially during the first couple of weeks when your body is adjusting to the new diet.
Most alcoholic beverages don’t list the ingredients or nutritional information on the label, so be prepared and check your favorite drinks online so you know your limits beforehand. Most apps and trackers list many types of alcohol in their database, and this is the easiest way to be sure of what you’re drinking. Be warned, when you’re in ketosis your alcohol tolerance will go down, so you might not want to drink as much as you might be used to.
Hi Kristin, My meals and times vary! I usually skip breakfast because Im not hungry in the mornings anymore. Ill have a protein shake before lunch then my meals consist of proteins, fats like avocado and some veggies cooked in ghee. I still do indulge in diet soda but definitely pay attention to see how your body reacts to it! Everyone is different and reacts differently to some ingredients. Definitely figure out your macros and go from there 🙂
Mistakes, refinements, pivots, corrections, whatever your want to call them… These changes are the vehicle that takes us from stage to stage of the Ketogenic Hierarchy of Needs. The good news is they are also the vehicle to break through plateaus and reach new performance levels. Changing habits is tough, no doubt about it, but have fun and go for it!

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.
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.
Protein: Keep in mind that keto is high-fat, and not high-protein, so you don’t need to eat very much meat. Too much protein turns into glucose in the body, making it harder to stay in ketosis. Stick to fatty cuts of grass-fed, pasture-raised, or wild meat, and wild-caught fish. Red meats, offal/organ meats, pork, eggs (preferably pastured), fish, shellfish, and whey protein concentrate.
Aside from the various keto-friendly foods mentioned in this article, you may be wondering if there are other options that may help support your ketogenic diet. If you find that the ketogenic diet is limiting when you start out, don't worry. There's actually a lot you can add to your diet that's "keto" as long as consumption is controlled. Here are some commonly asked questions:
There are several medical studies — such as two conducted by the Department of Radiation Oncology at the Holden Comprehensive Cancer Center for the University of Iowa, and the National Institutes of Health’s National Institute of Neurological Disorders and Stroke, for example — that show the ketogenic diet is an effective treatment for cancer and other serious health problems. (12)
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.

Hi Jordan – thank you for reaching out. We have a ton of articles on here (https://theketoqueens.com/category/blog/) that you may find helpful. We also wrote a post about starting a keto diet (https://theketoqueens.com/keto-diet/), then we have a keto course that walks you step by step to starting a keto diet (under shop), and if you need individual keto coaching I do that on my other website LaraClevenger.com. Please let us know if you can help in any way.
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.
All of us are looking for the fastest and easiest way to achieve the body of our dreams. It can be difficult juggling a career, family, personal life and a busy schedule all while trying to achieve the body of our dreams and still maintain our sanity. Well with years of research, we have discovered that the Keto Fit Diet is the answer to our problems and allows us to maintain a healthy balance easily. You may have heard of the Keto Diet before and are probably well aware of the incredible results. We have implemented a team of healthcare professionals to create the most beneficial weight loss and nutrition methods to stop wasting time with things that simply dont work. We’ve eliminated the unnecessary hurdles of dieting and created a bare bones program that will guarantee results with the most enjoyable diet you can find. Those words usually don’t belong in the same sentence, but when youre done, you’ll agree. This is a lifestyle change that we can all enjoy. Years of research and trial and error have allowed us to come up with the most successful Keto Diet on the market with thousands of happy customers to back up these claims.
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.
But what does the science say? Results are mixed. In one Spanish study of 20 obese adults, participants were put on a low-calorie keto diet and lost an average of 40 pounds over four months. Another small experiment had a similar outcome. In a six-month Experimental & Clinical Cardiology study of 83 obese adults, those on the keto diet lost an average of 33 pounds, while lowering their bad (LDL) cholesterol levels and increasing their good (HDL) cholesterol.
There are variations of the ketogenic diet that are implemented for a variety of reasons.  One of the top reasons these variations are used are for athletes who are not getting the necessary energy required for their intense workouts.  There are also those who enjoy the benefits of ketosis, but they just do not feel the same without a carb refeed day every now and then.
Yancy WS Jr, Westman EC, McDuffie JR, Grambow SC, Jeffreys AS, Bolton J, Chalecki A, Oddone EZ, “A randomized trial of a low-carbohydrate diet vs orlistat plus a lowfat diet for weight loss,” Arch Intern Med. 2010 Jan 25;170(2):136-45. http://www.ncbi.nlm.nih.gov/pubmed/20101008?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum&ordinalpos=2.
Unfortunately, there’s no long-term data on ketogenic diets versus other diets. In a 2015 Italian study, those on a ketosis diet lost 26 pounds in three months. About half of the participants stayed on the diet for a year but lost little additional weight in the next nine months. People in a 2014 Spanish study who followed a very-low-calorie ketogenic diet lost an average of 44 pounds in a year—but a third of them dropped out, possibly because it was too hard to maintain.

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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