Y. Wady Aude, MD; Arthur S. Agatston, MD; Francisco Lopez-Jimenez, MD, MSc; Eric H. Lieberman, MD; Marie Almon, MS, RD; Melinda Hansen, ARNP; Gerardo Rojas, MD; Gervasio A. Lamas, MD; Charles H. Hennekens, MD, DrPH, “The National Cholesterol Education Program Diet vs a Diet Lower in Carbohydrates and Higher in Protein and Monounsaturated Fat,” Arch Intern Med. 2004;164(19):2141-2146. http://archinte.jamanetwork.com/article.aspx?articleid=217514.

I have read your article and lots of other stuff on Keto, but I still don’t understand why it has to be so high in fat? I am on a calorie controlled diet which should also be pushing me into ketosis (Optifast + veges) nutritionist suggestion to go hard for a month. But after that was looking at moving to a Ketogenic diet. I am just having a hard time with understanding why it has to be high fat. Can you help me understand? Also love your writing style (particularly referencing Ace Ventura).


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.
“One of the best meal planning tips I’ve ever received is to structure breakfast and lunch so that you don’t have to think too much about it,” says Emily Bartlett, co-founder of Real Plans. “If you’re okay with repetition, it’s ideal to have a simple selection of recipes for breakfast—including some that can be taken on the go. For lunch, go ahead and use your leftovers with a fresh green salad, and be sure to include a dressing that you really love.”
I’m really interested in that article also. We had a baby almost a year ago. We decided to give the plant-based diet a go, and has been successful. But, I’m stuck now. Haven’t lost any more weight. And recently just learned of the keto diet! I started last week, but I’m a mess with what to eat, being plant-based and all. Can’t wait for that post! I’ve bookmarked this for future reference.

“Eggs have a lot of vitamins like vitamin A, B complex, D, K, E, calcium, and zinc,” says Ryan Weaver, a personal trainer and keto enthusiast. “That’s why eggs are an excellent choice for breakfast when you follow the keto diet. To avoid getting bored, you can try different ways of preparing the eggs—boiled, fried, or baked. Also, you can combine the eggs with different foods like bacon, ham, cheddar cheese, butter, mayonnaise, so you get a different recipe each day although using the same main ingredient.”


The current hypothesis is that the brain functions differently on ketones than on glucose, and this is what causes certain brains to reduce epileptic seizures. I would then also hypothesize that certain people who feel that “brain fog” lifted on ketosis is due to either placebo effect OR their brain actually functioning differently on ketones vs glucose.

“These past 60 days have changed my life. I found out about it from a friend on Facebook and never looked back…. It has quickly become my lifestyle and it’s definitely one of those fad diets you find everywhere. Aside from weight loss, I’ve gained a confidence that I never knew I had inside. My relationship with my husband and family has improved exponentially. When my body reached ketosis, my life changed along with my pant size!!! Keto Fit Diet for the win!”

For a period of 3-4 days up to 2 weeks, you will be eating the minimal amount of carbohydrates and sugar (20 grams net carbs maximum per day). After this you may be able to add in small amounts of net carbs if your body can handle it, but probably not more than 50 net carbs total per day.  This is tricky, because some people can't handle more than the 20 net carbs even after they have adjusted to ketosis.  Others can handle 50 net carbs and easily stay in ketosis.  If you feel fine at 20 net carbs and it doesn't bother you, than there's no reason to make any changes.  You can test your ketosis by how you feel, or by actually testing - which is discussed in section 3.

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.

The second way is called autophagy, and it goes hand in hand with letting your body rest from digestion. Autophagy is the process that cells use to remove waste, including malfunctioning parts of cells, or even whole cells that are not functioning correctly and can’t be healed. If you have read much about cancer, this may sound like it’s connected, and it is. Regularly allowing cells to be in a state of autophagy makes them more efficient and keeps them from growing into a malignant state. It also helps them to live longer, which translates to a longer, healthier life for you.


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.
It feels like everyone is talking about the keto diet — the high-fat, low-carb eating plan that promises to turn your body into a fat-burning machine. For that reason, keto has surged in popularity over the past year as a lose-weight-fast strategy. Thank Hollywood A-listers and professional athletes like Halle Berry, Adriana Lima, and Tim Tebow who’ve publicly touted the diet’s benefits, from shedding weight to slowing down aging. Here’s everything you need to know about going keto — and how to do it the Bulletproof way.
Although fat is the centerpiece of any keto diet, that doesn't mean you should be subsisting on butter-topped steaks, says Kristen Mancinelli, RD, author of The Ketogenic Diet. “A big misconception is that you should just put meat at the center of your plate and add more fat on top,” she says. You also shouldn't be relying on fatty meats to hit your fat quota, she adds.
• Athletic Performance Impediments: For those people who train heavy and hard, going keto might cramp your style. As important as protein is for muscle growth, carbs also play an equally critical role by releasing insulin to drive that protein into muscles faster. It also helps us build up glycogen stores for longer training sessions, runs or hikes. One comprehensive review of the literature in sports nutrition found that while research is lacking on the long-term impacts of the keto diet, in the short term, the keto diet is inferior to other diet protocols on anaerobic, aerobic and in some cases even strength performance measures.
• Weight loss — If you're trying to lose weight, then a ketogenic diet is one of the best ways to do it, because it helps access your body fat so that it can be shed. Obese people in particular can benefit from this method. In one study, obese test subjects were given a low-carb ketogenic diet and a low-fat diet. After 24 weeks, researchers noted that the low-carb group lost more weight (9.4 kilograms or 20.7 pounds) compared to the low-fat group (4.8 kilograms or 10.5 pounds).1
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.
Check the nutrition labels on all your products to see if they’re high in carbs. There are hidden carbs in the unlikeliest of places (like ketchup and canned soups). Try to avoid buying products with dozens of incomprehensible ingredients. Less is usually healthier.Always check the serving sizes against the carb counts. Manufacturers can sometimes recommend inconceivably small serving sizes to seemingly reduce calorie and carb numbers.
Before we go any further, please take a minute to subscribe to my blog. I will send out weekly emails so you can stay on top of all the things you need to know about your body, as well as recipes, and tips. Feel free to email me at any time with questions you may have. I am always happy to help, and who knows, maybe your question will inspire a blog post!
[i] 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"
The ketogenic diet is super high in fat (about 80 percent of your daily calories), super low in carbohydrates (less than 5 percent of your calories), and moderate in protein (typically 15 to 20 percent of your calories). This is a pretty drastic departure from the generally recommended macronutrient distribution of 20 to 35 percent protein, 45 to 65 percent carbohydrates, and 10 to 35 percent fat.
Aude, Y., A. S, Agatston, F. Lopez-Jimenez, et al. “The National Cholesterol Education Program Diet vs a Diet Lower in Carbohydrates and Higher in Protein and Monounsaturated Fat: A Randomized Trial.” JAMA Internal Medicine 164, no. 19 (2004): 2141–46. doi: 10.1001/archinte.164.19.2141. jamanetwork.com/journals/jamainternalmedicine/article-abstract/217514.
There are so many vegetables that you can use, and so many ways to prepare them, that an entire book could be written on the topic. Most vegetables that grow above the ground are high in fiber, vitamins, minerals, and antioxidants. They can be added to meat dishes, cooked on their own, or eaten as a salad. Vegetables are inexpensive, easy to prepare, and can be part of every meal. Most of them are quite low in carbohydrates, so it’s hard to overindulge in this food group.

Another third tip is snacking. Really important if you’re a snacker and you are just starting your Ketogenic diet you’ll probably need some form of snacks. Some of the best snacks for beginners include celery, nuts and nut-based hummus, cucumber. If you have more of a sweet-tooth, dark unsweetened chocolate is a great option, as is coconut or almond butter or even peanut butter.
• Type 2 Diabetes: This population has been studied heavily with the keto diet since it's technically as low-carb as you can get. While the research to date has been conducted in very small sample sizes, evidence suggests that an ultra-low-carb diet (like the keto diet) may help reduce A1C and improve insulin sensitivity by as much as 75 percent. In fact, a 2017 review found that a keto diet was associated with better glucose control and a reduction in medication use. Having said that, the authors cautioned that it was unclear whether the results were due to weight loss in general, or higher ketone levels.

A “moderate keto diet” is an option that can still encourage substantial weight loss and other improvements in symptoms. A moderate keto diet includes more foods with carbs and, therefore, more fiber too. Carbs are usually increased to about  30–50 net grams per day, which means foods like more high-fiber veggies, some fruit or some starchy veggies can also be included.
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.
Wrong! Dietary cholesterol has been shown to not increase blood cholesterol – check this article here. And fat is healthy when consumed as part of a nutritious meal. As pointed out in this study, a Low Carbohydrate Diet resulted in decreased bodyweight, abdominal circumference, diastolic blood pressure, triglycerides, insulin, and an increase in high-density lipoprotein cholesterol (the good stuff).

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Medical Disclaimer: The material on this site is provided for informational purposes only and is not medical advice. Always consult your physician before beginning any diet or exercise program.

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