One of the most common side effects of starting the ketogenic diet is the “keto flu.” This term describes the often unpleasant, fatigue-inducing symptoms that occur as the body adjusts from a high-carbohydrate to a low-carbohydrate diet. During the keto flu, the body’s stored glucose begins depleting, and the body starts adapting to producing and utilizing ketones as energy. (2)
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.
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).
The keto diet is known for helping people lose a few pounds very quickly, says Becky Kerkenbush, RD, a clinical dietitian at Watertown Regional Medical Center. Carbs hold on to more water than protein or fat, so when you stop eating them, your body releases all that extra H2O by making you pee more. As a result, the scale might read a few pounds lower, and you may look a bit leaner.
In another study that involved mice with brain tumors, administration of 65 to 75 percent of the recommended daily calories helped reduce tumor growth by 35 and 65 percent among two different test groups. Total carb consumption was restricted to 30 grams only.14 A different mice study strictly limited carb consumption to 0.2 percent only, which helped reduce the growth of glucose-fermenting tumors.15
Thanks for the very informative article. This was the push I needed to at least try it. Starting next weekend, my partner and I will be trying keto for 30 days. I’m all for small changes, in theory, but what I sometimes discover is that sweeping changes can have their place, too, if they produce positive results. Often, what will work for me is trying a big change, and even if I then throw out 80% of it, at least the remaining 20% sticks. By contrast, any backsliding from a small change can often mean just throwing it out entirely.
• Cancer: Early experimental research suggests that the keto diet may have anti-tumor effects, likely because it reduces overall calorie intake (and circulating glucose) for tumor growth. In one 2014 review of animal research, a ketogenic diet was found to be successful at reducing tumor growth, colon cancer, gastric cancer and brain cancer. More research on humans with larger sample sizes is needed, but it's definitely food for thought.
Instead of thinking about the total carbs you’re eating, assess what those carbs provide to you. Do the majority of your carbs come from fruit and vegetables, with a payload of fiber and disease-fighting antioxidants? Fantastic. Or are you consuming them in the form of added sugars (cookies, candy, soda) or refined flour? If you are, you know what to do.
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.
A keto diet has shown to improve triglyceride levels and cholesterol levels most associated with arterial buildup. More specifically low-carb, high-fat diets show a dramatic increase in HDL and decrease in LDL particle concentration compared to low-fat diets.3A study in the long-term effects of a ketogenic diet shows a significant reduction in cholesterol levels, body weight, and blood glucose. Read more on keto and cholesterol >
Although studies have shown that the keto diet can reduce seizures for children with epilepsy, there is no evidence indicating that keto helps with other brain disorders or improves mental cognition, according to Harvard Health Publishing. Some studies show that keto may lower blood sugar for people with type 2 diabetes, but there is not enough long-term research to determine whether it’s safe and effective for diabetics.
• 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.
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.
[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"
Lots of apps and website offer keto diet challenges—basically, a blueprint for the keto diet with a fixed starting and ending point (they typically last for a week to a month, though some may be longer). Speaking of apps, plenty of keto-centric ones are right at your fingertips (a.k.a., your smartphone), like the KetoDiet app, which can help you calculate your macros and track your keto diet effectively.
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.
5) By now you should know both where you are and where you want to be. Those are the first steps. Now it’s time to start planning your meals. You can use these food lists to help you figure out what kinds of foods you should be eating. Remember this is not a diet plan that has an end date. This is a lifestyle change that you will pass on to your children.
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.
Bulk buy and cook. If you’re someone who doesn’t like to spend a lot of time in the kitchen, this is the best of both worlds. Buying your food at bulk (specifically from wholesalers) can reduce the cost per pound tremendously. Plus, you can make ahead food (bulk cook chicken thighs for pre-made meat, or cook entire meals) that are used as leftovers, so you spend less time cooking.
Fats are great if you want to add flavor and texture to your meals, and will help you feel full. Some people believe swear by coconut oil, and whether or not the claimed health benefits are actually present, it’s one of the fats that you might want to add to your diet. Butter is an excellent choice, as is ghee (Indian clarified butter). Duck fat is highly prized. Avocado oil is a great choice when making dressings or sauces, as it’s liquid at room temperature and has a mild flavor. The fats and oils listed here are primarily saturated, and they are the least likely to go rancid and produce free radicals and inflammation in the body (5, 6).
The keto diet is currently being used as a safe and effective addition to the treatment of several types of cancer and can help slow tumor growth. As an example, we’d like to point to a promising study showed the intracerebral growth of the CT-2A & U87-MG tumors (related to malignant brain cancer) is significantly decreased by about 65% and 35% (27).
Unfortunately, long-term fasting is not a feasible option for more than a few days, therefore the ketogenic diet was developed to mimic the same beneficial effects of fasting. Essentially the keto diet works by “tricking” the body into thinking it is fasting, through a strict elimination of glucose that is found in carbohydrate foods. Today the standard ketogenic diet goes by several different names, including the “no-carb diet” or “very low carbohydrate ketogenic diet”(LCKD or VLCKD for short).
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 “empty calories”).

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.


At the core of the classic ketogenic diet is severely restricting intake of all or most foods with sugar and starch (carbohydrates). These foods are broken down into sugar (insulin and glucose) in our blood once we eat them, and if these levels become too high, extra calories are much more easily stored as body fat and results in unwanted weight gain. However, when glucose levels are cut off due to low-carb dieting, the body starts to burn fat instead and produces ketones that can be measured in the blood (using urine strips, for example).
Net carbs are used because fiber is not fully digested as energy, and does not impact your blood sugar the same as a regular carb.  This is why you should still eat plenty of high fiber, low net carb vegetables…your body needs that fiber, and it won’t hurt your ketosis.  Still confused on what a net carb is? Check out how to read a nutrition label on the keto diet.
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.
Having tempting, unhealthy foods in your home is one of the biggest reasons for failure when starting any diet. To maximize your chances of success with the keto diet, you need to remove as many triggers as you can. This crucial step will help prevent moments of weakness from ruining all your hard work.If you aren’t living alone, make sure to discuss with your family or housemates before throwing anything out. If some items are simply not yours to throw out, try to compromise and agree on a special location so you can keep them out of sight.
Cyclical ketogenic diet: The Bulletproof Diet falls into this category. You eat high fat, low carb (less than 50 grams of net carbs a day) five to six days of the week. On day seven, you up your carb intake to roughly 150 grams, during what’s called a carb refeed day. Carb cycling this way helps you avoid the negative effects some people experience when they restrict carbs long term, like thyroid issues, fatigue and dry eyes.[10] [11] Full ketosis isn’t for everyone, and adding carbs such as sweet potatoes, squash, and white rice one day a week keeps your body systems that need some amount of carbs functioning properly.
It comes down to simple mathematics. In order to stay in ketosis, you need to eat a very very low number of carbs. And if you eat too much protein, this can actually knock you out of ketosis as well. Therefore, if you’re eating almost no carbs, and you are eating moderate amounts of protein, the ONLY remaining macronutrient you can consume to fill you up each day would be fat. Add in that consuming fat allows you to stay in ketosis, and you are consuming a high fat, medium protein, low carb diet.

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