• High-protein ketogenic diet — This method is a variant of the SKD. In a high-protein diet, you increase the ratio of protein consumption to 10 percent and reduce your healthy fat consumption by 10 percent. In a study involving obese men that tried this method, researchers noted that it helped reduce their hunger and lowered their food intake significantly, resulting in weight loss.11
I came across your site yesterday, signed-up, and am a fan; thank you for all your exhaustive efforts which I have yet to explore. I have no issues re-welcoming more fatty, whole, and nutritious items into my daily regimen and am a healthy-eater to begin with; that is, I choose quality any day. Recently, I decided to give Keto a go. I don’t like “diet” nor am I a die-ter. I have to lose about 50lbs and began the transition (to Keto) a week ago. How? I removed all bread-related carbs, pasta, and the treats I’d been indulging in for a few years now.
•Sodium: Believe it or not, depending on your diet, you may be low on salt. When carb intake is low and insulin isn't being excreted, the kidneys absorb less sodium and potassium and excrete more as waste, leaving you feeling dizzy, fatigued and grumpy. Rather than reaching for more processed food, try seasoning your food a little more liberally with sea salt.
• 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.
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.

Because the main tenet of the keto diet is counting and cutting carbs — a commonly used way to control blood sugar — this eating approach has become increasingly popular among people with type 2 diabetes who are looking to lower their A1C, which is the two- to three-month average measurement of blood sugar levels. Indeed, research suggests this diet may lead to fast weight loss and potentially lower blood sugar for people with the disease. (13)


The book contains a two week menu for beginners. (Face it, there's a 90% chance you won't follow it to the letter, but it does help set your thinking in the right direction.) For each individual week there's a shopping list which, by itself, will help you adjust your kitchen quite a bit. There are tips on the best sweeteners (Swerve over Splenda), the oils you'll need, produce, canned and bottled items, pantry items, and meats. Something to consider as you go along is that some items, like almond and coconut flour are expensive items to stock up on, but you'll use considerably less than non-keto recipes will use for regular flour. Do what you can afford. Just know that there are some must-have staples like coconut oil and olive oil.
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.
On a keto diet, weight loss can often be substantial and happen quickly (especially for those who start the diet very overweight or obese). The 2013 study published in the British Journal of Nutrition found that those following a keto diet “achieved better long-term body weight and cardiovascular risk factor management when compared with individuals assigned to a conventional low-fat diet (i.e. a restricted-energy diet with less than 30 percent of energy from fat).” (4)
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)

Steve, thank you for the amazing article! Your style of writing was so funny and easy to follow, and had me actually laughing out loud so many times! Low carb is the only diet that has ever worked for me. I freaking love it. I got away from it, though, and started eating too much sugar again. My daughter is getting married next year, and I have to squeeze this badonkadonk into a cute dress next year, hopefully without looking like a mama hippo, so low carb it is. I see the basic program is the same, but there have been some advancements with the science of the diet which is great. I’m excited to get at it! Today is day 1 for me. Wish me luck; I’m going in…..
• Multiple Sclerosis: In a small 2016 study, patients with multiple sclerosis (MS) were put on a ketogenic diet. After six months, they reported improved quality of life, as well as physical and mental health improvements. Before doctors or researchers can make a connection between keto and MS, they need bigger sample sizes and more thorough research. Still, the preliminary findings are exciting.
• Cyclic ketogenic diet (CKD) — Whereas TKD is focused on fitness enthusiasts, CKD is focused more on athletes and bodybuilders. In CKD, you cycle between a normal ketogenic diet, and a short period of high carb consumption or "re-feeds."8 The idea here is to take advantage of the carbohydrates to replenish the glycogen lost from your muscles during athletic activity or working out.9
As far as fruits are concerned, most berries are low in carbs and can be consumed from time to time, and in limited amounts. These include raspberries, strawberries, and blackberries. Blueberries are a bit higher in carbs and should be eaten sparingly. Most other fruits, however, have too many carbs in just one serving, so it is best to avoid them.
Although a standard ketogenic diet is even more restrictive in terms of carb intake, a “moderate keto diet” (just as some folks have followed a modified Atkins diet) is another option that will very likely still be able to provide substantial weight loss results and other improvements in symptoms. Including slightly more carbs can be very useful for maintenance, allow for more flexibility, provide a higher fiber intake, and overall may feel more sustainable long term socially and psychologically.

Our bodies are incredibly adaptive to what you put into it – when you overload it with fats and take away carbohydrates, it will begin to burn ketones as the primary energy source. Optimal ketone levels offer many health, weight loss, physical and mental performance benefits.1There are scientifically-backed studies that show the advantage of a low-carb, ketogenic diet over a low-fat diet. One meta-analysis of low-carbohydrate diets showed a large advantage in weight loss. The New England Journal of Medicine study resulted in almost double the weight loss in a long-term study on ketone inducing diets.
It’s important to remember that the goal of any dietary change is to promote a healthy lifestyle, so make sure to select a meal plan you can envision yourself following long term. If you know you will not be able to comply with such stringent carbohydrate restrictions for years to come, the ketogenic diet is most likely not the right choice for you.

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., “A 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.

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!)
Gary D. Foster, Ph.D., Holly R. Wyatt, M.D., James O. Hill, Ph.D., Brian G. McGuckin, Ed.M., Carrie Brill, B.S., B. Selma Mohammed, M.D., Ph.D., Philippe O. Szapary, M.D., Daniel J. Rader, M.D., Joel S. Edman, D.Sc., and Samuel Klein, M.D., “A Randomized Trial of a Low-Carbohydrate Diet for Obesity — NEJM,” N Engl J Med 2003; 348:2082- 2090. http://www.nejm.org/doi/full/10.1056/NEJMoa022207.

The end result is staying fueled off of circulating high ketones (which are also sometimes called ketone bodies) — which is what’s responsible for altering your metabolism in a way that some people like to say turns you into a “fat-burning machine.” Both in terms of how it feels physically and mentally, along with the impact it has on the body, being in ketosis is a very different than a “glycolytic state,” where blood glucose (sugar) serves as the body’s energy source.
Quick update – been doing a keto-type diet for a couple of months now. My BP is down to the lowest it’s been in something like 10 years, though still on 1/2 dose for my meds. I’ve lost about 30 pounds in the last 4 months (give or take a bit as I’m not sure exactly where I started). I’ll admit I still use Truvia and will have a Coke Zero every now and then, but eliminating the wheat and corn breads and sugars to reduce my carb intake to < 50g/day on average has made a huge difference. (I'm sure some still sneaks in with some of the food I eat out, but for the most part it's pretty good.)

If you need to eat more or fewer calories per day, you can adjust accordingly by simply taking out or adding a bit more of the ingredients already included in a recipe. For example, adding/removing a tablespoon of olive oil or butter will add/remove about 100 calories. If you like or dislike certain recipes, feel free to shift things around. Make sure to keep an eye on the calories so you’re still falling within an acceptable range of your daily goal.


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.


It can be very difficult to obtain some of the very high levels of blood ketones on this table - especially as you become "fat adapted" or "keto adapted" or whatever you want to call it.  Once your body is efficient at using ketones, it makes only what it needs.  Beginners may see very high levels of ketones, and then they see them drop off.  This isn't because you are making a mistake and are out of ketosis - your body is no longer overproducing them.

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.


Many books could be written on this very subject, and undoubtedly they have been. There are many answers, and they all depend on context. Lots of variables impact how well, and how consistently we lose weight. How much sleep do we get each night, and how restful is that sleep? What micronutrients are we not getting enough of? How much water are we drinking? How much are we exercising?
You should know that the side effects of a ketogenic diet are still being studied. In addition, there have not been significant studies for long term dieters.  There are plenty of people that have used the diet long term (10+ years) and very happy with it.  It is up to the unique individual, so regular checkups with your doctor are recommended to check that "everything looks good".
I came across your site yesterday, signed-up, and am a fan; thank you for all your exhaustive efforts which I have yet to explore. I have no issues re-welcoming more fatty, whole, and nutritious items into my daily regimen and am a healthy-eater to begin with; that is, I choose quality any day. Recently, I decided to give Keto a go. I don’t like “diet” nor am I a die-ter. I have to lose about 50lbs and began the transition (to Keto) a week ago. How? I removed all bread-related carbs, pasta, and the treats I’d been indulging in for a few years now.

To see whether I was a good fit for the keto diet, Wali requested I have some lab work done, including a cholesterol panel and a fasting-insulin-level test. My results came back normal, meaning there was no medical necessity for me to go on the diet. If I were pre-diabetic or insulin-resistant, Wali would likely have made the keto diet part of my treatment.
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.

After increasing water intake and replacing electrolytes, it should relieve most all symptoms of Keto Flu. For an average person that is starting a ketogenic diet, eating 20-30g of net carbs a day, the entire adaptation process will take about 4-5 days. My advice is to cut your carbs to fewer than 15g to ensure that you are well on your way into ketosis within one week. If you are experiencing any more keto flu symptoms, double check your electrolyte intake and adjust.


The Atkins diet, on the other hand, is solely focused on weight loss. There is no restriction on artificial sweeteners or manufactured foods, as long as the foods consumed fit the Atkins prescribed ratios. There are four phases to the Atkins diet. The first phase is the most strict, designed to get you into ketosis. The second phase is a tolerance testing phase, where you add more foods to see how many grams of carbohydrate you can still eat and lose weight. The third phase is more generous with carbs, and the fourth phase is the most generous, and it’s in either the third or fourth phase that most people find a good maintenance level.
Also make sure that you know what foods have mostly carbs, fat, and protein, so you can make the right choices. For instance, it’s not just bread, pasta, chips, cookies, candy, and ice cream that contain carbs. Beans may contain protein, but they’re also very high in carbohydrates. Fruit and veggies also mostly contain carbs. The only foods that don’t contain carbs are meat (protein) and pure fats, like butter and oils (including olive oil and coconut oil).

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