Achieving ketosis is a pretty straightforward, but it can seem complicated and confusing with all of the information out there.4If you want to learn more about ketosis and the scientific process around it, you can visit a very in-depth discussion about on Dr. Peter Attia’s website. Here’s the bottom line on what you need to do, ordered in levels of importance:
Here are a few of the most common side effects that I come across when people first start keto. Frequently the issues relate to dehydration or lack of micronutrients (vitamins) in the body. Make sure that you’re drinking enough water (close to a gallon a day) and eating foods with good sources of micronutrients. To read more on micronutrients, click here >
The good news is that snacks are totally allowed (and I're not just talking about carrot sticks.) There are plenty of packaged options out there designed for keto fans. FATBAR is one of them. These snack bars have 200 calories, 16 grams of fat, and four grams of net carbs. They're also plant-based and are made with almond or cashew butter, cocoa butter, coconut, pea protein, sunflower seeds, and chia seeds.
Once ketone levels in the blood rise to a certain point, you officially enter into a state of ketosis. This state results in fairly rapid and consistent weight loss until you reach a healthier (and stable) body weight. Overall, people enter into ketosis at different rates, usually after 3–4 days of fasting or following a very low-carbohydrate diet (20 grams of net carbs or less) that forces the need for an alternative energy source. (3)
You’re transitioning. Your body is equipped to process a high intake of carbs and a lower intake of fat. Your body needs to create enzymes to be able to do this. In the transitional period, the brain may run low on energy which can lead to grogginess, nausea, and headaches. If you’re having a large problem with this, you can choose to reduce carb intake gradually.
Aside from carb flu, be warned that staying in long-term, continuous ketosis may have drawbacks that may actually undermine your health and longevity. To stay on the safe side, I recommend undergoing a cyclic ketogenic diet. The "metabolic magic" that ketosis brings to the mitochondria actually occurs during the refeeding phase, not during the starvation phase.
For any individual with diabetes, discussing dietary changes — especially those as dramatic as the ones the ketogenic diet requires — with your healthcare team is essential. Because carbohydrates are broken down into glucose in the blood, cutting carbohydrates from your diet could cause levels to crash rapidly depending on your current medication regimen. Such a change may require significant adjustments to medication and insulin to prevent dangerous side effects such as low blood sugar, called hypoglycemia. (8)
I’m honestly a little skeptical about it the idea of keto permanently. My brief glance at the literature seems to imply that it can have side effects of kidney stones, skeletal fractures, and slow the growth rate of children, but that was a study on kids with epilepsy (which it treated very effectively), so who knows how that applies to adults. And the other studies I found dealt with overweight and obese subjects, so it may be hard to find something on the long term effects on otherwise healthy adults.
Okay, I’ll admit I bailed just after the sriracha covered chicken costume, so maybe I missed it, but I wanted to ask: is Keto intended to be a permanent diet change? It seems very challenging, and as I was reading, I kept asking myself “How is this consistent with the concept of small sustainable changes?” Is it? I think it’s a great topic to cover, but how would you describe the relationship between the keto diet and NF philosophy regarding sustainability? Thanks!

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