Some athletes swear by the ketogenic diet, not just for weight loss but for improved performance in their sport, as well. But Edward Weiss, PhD, associate professor of nutrition and dietetics at Saint Louis University, doesn’t buy it. “I hear cyclists say all the time that they’re faster and better now that they’re on keto, and my first question is, 'Well, how much weight did you lose?'” he says.
Weight loss is the primary reason my patients use the ketogenic diet. Previous research shows good evidence of a faster weight loss when patients go on a ketogenic or very low carbohydrate diet compared to participants on a more traditional low-fat diet, or even a Mediterranean diet. However, that difference in weight loss seems to disappear over time.
The American Heart Association’s recommendations for controlling cholesterol include getting more fiber and limiting your intake of saturated fat, both of which would be extremely difficult on a ketogenic diet. While it’s true that research around saturated fat is still evolving, making room for good sources of fiber and unsaturated fats, which reduce the risk of cardiovascular disease, and allowing for a more balanced intake of nutrients, is ideal. In any case, you should check with your doctor before you start a ketogenic (or any new) diet, especially if you have any health conditions like high blood pressure or high cholesterol.
Burgers. Everyone loves burgers, right? Even once I made the switch to Keto, I would still make an occasional allowance, as one bun wasn’t going to break the carb bank. But I came to learn that buns, much like other wheat based products, are in essence, just a delivery mechanism, they hold very little flavor, and in the quest for the best replacement, I made these delightful burger boats.

The first modern study of fasting as a treatment for epilepsy was in France in 1911.[12] Twenty epilepsy patients of all ages were "detoxified" by consuming a low-calorie vegetarian diet, combined with periods of fasting and purging. Two benefited enormously, but most failed to maintain compliance with the imposed restrictions. The diet improved the patients' mental capabilities, in contrast to their medication, potassium bromide, which dulled the mind.[13]
I actually went on a ketogenic diet last year to see if it would help my migraines. I have a history of chronic migraines which would usually last 3 days, sometimes longer. Triptans help a lot but I don’t like having to take them. I stayed in ketosis for about 8 months and experienced a significant reduction in migraines, from feeling some type of headache (mild o r severe) almost everyday to 1 or 2x per month while in ketosis. Although I’m very healthy otherwise, I do think my migraines may have something to do with blood sugar fluctuations (despite previously eating a whole foods diet and no refined carbs), and keto totally stabilized this. I eventually came off of Keto because I’m not really a meat lover. When I came off, but remained low carb, my migraines stayed under control for the most part. When I increase carbs, they do return.
The easiest macro to calculate in the ketogenic diet is fat. Once you've got your carbs and protein set, simply fill the rest of your daily calorie needs with fat sources. If you find yourself wanting to gain a bit of weight, add approximately 500 calories, or 55 grams. If you want to lose weight, cut down on your fat intake by 200-500 calories, or 22-55 grams.

First real post! Bear with me lol. I’m just hoping I did it right. I started keto in early September after losing about 50 pounds counting calories. I was happy with the loss but it took so long and I couldn’t stick with it. I felt yucky most days and I was always hungry. Then a girl I worked with told me about keto. I started researching it and found reddit and y’all. You guys are by far the most supportive, enthusiastic, and kindest group on reddit! I come here every morning and every evening to check out your pics, progress, and tips. Everyone is so inspiring. Your enthusiasm is contagious. I do lazy keto. Very. I don’t really count anything. I just eat keto foods and I’m full all day. I still have a long way to go. But I’m sure this time, it’s last time I’m losing weight. Rock on fellow keto peeps! I’m thankful for all of you😀
Just wanted to throw some little updates, but Keto Diet must be one of the diets that so far is working for my lifestyle. I rarely feel hungry, and I am slowly losing weight (started few days ago) and usually, when I start diets, I really suffer with the disgusting feeling when my body has no energy or any resource whatsoever, feeling really tired and stuff, and craving carbs and unhealthy food so much to feel full, both emotionally and physically, but with keto, I really don’t feel empty at all. I don’t even count until when can I eat, it’s that filling, and healthy too.
The Ketogenic Diet is unlike any other diet in the world in that it utilizes a high fat, minimal carbohydrate and moderate protein system in order to reset your body’s ability to burn unwanted, stored fat. By restricting  carbohydrates that are converted into glucose, you begin the journey to re-program your metabolism to start burning stored fats for fuel and energy instead of first burning beneficial glycogen that is stored in your muscles.

While guest starring on the Rachael Ray Show, the actress opened up about how she stays motivated through intense workouts: “No carbs. No dairy. No refined sugar. [It’s] eating real foods. It’s honestly high-fat, high-protein. I think that we’ve been brainwashed to think that fat is bad, but really, it’s what going to make you feel fuller longer. And your body can burn it and use it as fuel.”
If you think you may have a medical emergency, call your healthcare provider or 911 immediately. Any mention of products or services is not meant as a guarantee, endorsement, or recommendation of the products, services, or companies. Reliance on any information provided is solely at your own risk. Please discuss any options with your healthcare provider.

I have great respect for Harvard Medical School. I notice that they support their readers posting comments and I am most appreciative of the article and all the many thoughtful comments by the readers. The readers seem to have the most expertise here and I hope that the doctor who wrote the article will think long and hard about the comments by readers. After 35 years of clinical practice in mental health, I notice that all issues of emotion involve medical issues, nutrition, and the gut bacteria. I would say that these issues and all of the executive brain functions seem to improve with ketogenic principles. For those that apply it in a flexible and smart manner, it appears to improve every area of their lives. I strongly encourage the author of the article to take one class via The Institute for Functional Medicine. If he is open to more learning he can take more classes and get certified. I’m sure a fine doctor, he will be an even better doctor and personally healthier, if he gets more training. Are we all open to new learning(especially us healthcare providers)?
One thing many people love about keto diet meal plans is that tracking your food is optional. "One of the biggest benefits of the ketogenic diet is that there's no need to meticulously track your calories like you may in other diets," notes Dr. Josh Axe, D.N.M., C.N.S., D.C., founder of DrAxe.com, best-selling author of Eat Dirt, and cofounder of Ancient Nutrition. "Because you're filling up on fat and protein, you're more likely to feel satisfied and energized all day long, which causes you to naturally eat less." This isn't to say that food tracking on keto is discouraged. "Some people may find calorie counting a useful tool to be more mindful and aware of what they're eating, but it's not necessary on the ketogenic diet," says Dr. Axe, but there's no need to get too stressed about hitting a certain caloric goal, especially if you're not trying to lose weight. (Related: The #1 Reason to Stop Counting Calories)
Stats: female, 31, 5'5" 169 lbs. Down from 221 since March 2018. Would like to keep the weight loss going, but in a sustainable way. I just got hired on as a seasonal worker in a warehouse. I am spending 5 hrs a day moving boxes up to 70 lbs. I walk about 1500 steps in my shift according to my fitbit, and have 250-300 minutes of what it thinks of as "activity." The fitbit says I am burning 4000 kcal daily. Which i know can be overestimated. The last week i have logged 11+ miles per day between work and my usual life stuff. Prior to this, i was eating about 1300 kcal daily and averaging about 9k steps daily, with roughly 30-60 minutes of activity (fitbit recognizes activity as anything that elevates heart rate above 120 bpm--I was doing cardio and weight lifting 5 days a week for 60-90 mins. Cardio counts towards this, weight lifting does not) So clearly 1300 kcal in ratio of 90/90/20 is not enough food to sustain the kind of activity I am currently doing, but I have no idea how to recalculate my macros for this!
A lot of people take their macros as a “set in stone” type of thing. You shouldn’t worry about hitting the mark every single day to the dot. If you’re a few calories over some days, a few calories under on others – it’s fine. Everything will even itself out in the end. It’s all about a long term plan that can work for you, and not the other way around.
It’s easy to get caught up on the “low-carb” part of the diet and not give enough attention to the “high-fat” part. Fat is what makes you full, gives you energy (when in ketosis), and makes food taste delicious. For most people this figure should be north of 70 percent of daily calories. Keep carbs under 20g, hit your protein goal, and eat fat until you’re full.
Ready to head out the door and start buying groceries? Slow down there, chief. Go through the pantry, fridge, freezer, and secret stashes under the bed, and get rid of foods with any significant carb content. In the first few days, you could end up craving them—badly. This means fruit, too. Even carrots and onions are too high-glycemic to work with keto, Wittrock says.
The Ketogenic Diet is unlike any other diet in the world in that it utilizes a high fat, minimal carbohydrate and moderate protein system in order to reset your body’s ability to burn unwanted, stored fat. By restricting  carbohydrates that are converted into glucose, you begin the journey to re-program your metabolism to start burning stored fats for fuel and energy instead of first burning beneficial glycogen that is stored in your muscles.
“The cleaner, the better when it comes to the keto diet,” says Jadin. Focus on “whole” and “unprocessed.” Also, strive for a mix of saturated and unsaturated fats for balance. Note: Tipping the scale toward too much protein is a common pitfall many people make on the keto diet. Mind your protein intake, since too much can kick you out of ketosis, says Jadin.
Epilepsy is one of the most common neurological disorders after stroke,[7] and affects at least 50 million people worldwide.[8] It is diagnosed in a person having recurrent unprovoked seizures. These occur when cortical neurons fire excessively, hypersynchronously, or both, leading to temporary disruption of normal brain function. This might affect, for example, the muscles, the senses, consciousness, or a combination. A seizure can be focal (confined to one part of the brain) or generalised (spread widely throughout the brain and leading to a loss of consciousness). Epilepsy may occur for a variety of reasons; some forms have been classified into epileptic syndromes, most of which begin in childhood. Epilepsy is considered refractory (not yielding to treatment) when two or three anticonvulsant drugs have failed to control it. About 60% of patients will achieve control of their epilepsy with the first drug they use, whereas about 30% do not achieve control with drugs. When drugs fail, other options include epilepsy surgery, vagus nerve stimulation and the ketogenic diet.[7]
For breakfast, we are going to change it up a bit. Here’s where we introduce ketoproof coffee. Now, don’t get me wrong – I know some of you won’t like it. If you’re not a fan of coffee, then try it with tea. If you’re not a fan of the taste (which is very rare), then try making a mixture of the ingredients by themselves and eating it like that. So, why ketoproof coffee?
Those issues can be part of what's known as the “keto flu,” Warren says. Other side effects of the keto diet, all of which are tied to carb withdrawal, can include lightheadedness, nausea, mental fog, cramps, and headaches, in addition to tiredness. Luckily, the keto flu doesn't usually last more than a week—which is coincidentally about when people start to see the number on the scale go down, says Warren.
Because the ketogenic diet alters the body's metabolism, it is a first-line therapy in children with certain congenital metabolic diseases such as pyruvate dehydrogenase (E1) deficiency and glucose transporter 1 deficiency syndrome,[34] which prevent the body from using carbohydrates as fuel, leading to a dependency on ketone bodies. The ketogenic diet is beneficial in treating the seizures and some other symptoms in these diseases and is an absolute indication.[35] On the other hand, it is absolutely contraindicated in the treatment of other diseases such as pyruvate carboxylase deficiency, porphyria and other rare genetic disorders of fat metabolism.[9] A person with a disorder of fatty acid oxidation is unable to metabolise fatty acids, which replace carbohydrates as the major energy source on the diet. On the ketogenic diet, their body would consume its own protein stores for fuel, leading to ketoacidosis, and eventually coma and death.[36]

In 1921, Rollin Turner Woodyatt reviewed the research on diet and diabetes. He reported that three water-soluble compounds, β-hydroxybutyrate, acetoacetate and acetone (known collectively as ketone bodies), were produced by the liver in otherwise healthy people when they were starved or if they consumed a very low-carbohydrate, high-fat diet.[10] Dr. Russell Morse Wilder, at the Mayo Clinic, built on this research and coined the term ketogenic diet to describe a diet that produced a high level of ketone bodies in the blood (ketonemia) through an excess of fat and lack of carbohydrate. Wilder hoped to obtain the benefits of fasting in a dietary therapy that could be maintained indefinitely. His trial on a few epilepsy patients in 1921 was the first use of the ketogenic diet as a treatment for epilepsy.[10]


In a recent study in the Journal of Sports Medicine and Physical Fitness, Weiss and his colleagues found that participants performed worse on high-intensity cycling and running tasks after four days on a ketogenic diet, compared to those who’d spent four days on a high-carb diet. Weiss says that the body is in a more acidic state when it’s in ketosis, which may limit its ability to perform at peak levels.


A review of multiple studies in the journal Nutrients found that ketogenic diets are connected to significant reductions in total cholesterol, increases in “good” HDL cholesterol levels, dips in triglycerides levels and decreases in “bad” LDL cholesterol; there are questions as to whether diets high in saturated fat negate these benefits. The same paper reports that a ketogenic may slightly reduce blood pressure, but science is still very scant on this point.
I’m discouraged to see that nowhere in the article nor in the comments is there a mention of a diet’s best fit to genetics. Consider if someone is an APOE E2 carrier and/or has certain polymorphisms of the APO5 gene. These are quite rare in Okinawa but much more prevalent in the USA (12% of the population). According to a number of well-designed studies, these genetic characteristics point to a higher fat, lower carbohydrate diet as beneficial and even a “moderate” carb diet as problematic.
The ketogenic diet is usually initiated in combination with the patient's existing anticonvulsant regimen, though patients may be weaned off anticonvulsants if the diet is successful. There is some evidence of synergistic benefits when the diet is combined with the vagus nerve stimulator or with the drug zonisamide, and that the diet may be less successful in children receiving phenobarbital.[3]
Ketogenic diets are, however, a well-established way to help control Type 2 diabetes, and the plan has for nearly 100 years been used to reduce instances of childhood epileptic seizures. Some scientists also think the high-fat diet may hold promise for staving off Alzheimer's, and there are some early indications it might help improve certain cancer treatment outcomes when used in conjunction with drugs. (Harper is part of a research team investigating how the diet might help boost treatment among people with breast cancer.)
You may also be a great candidate for the Keto diet if you experience migraines, joint pain, muscle weakness or mental fatigue. In addition, "Keto diet can be beneficial for mental health conditions like depression, autism and Alzheimer's". Other than that, "you can also follow this diet plan if you're trying to get pregnant since it improves fertility", she notes.
Children who discontinue the diet after achieving seizure freedom have about a 20% risk of seizures returning. The length of time until recurrence is highly variable but averages two years. This risk of recurrence compares with 10% for resective surgery (where part of the brain is removed) and 30–50% for anticonvulsant therapy. Of those that have a recurrence, just over half can regain freedom from seizures either with anticonvulsants or by returning to the ketogenic diet. Recurrence is more likely if, despite seizure freedom, an electroencephalogram (EEG) shows epileptiform spikes, which indicate epileptic activity in the brain but are below the level that will cause a seizure. Recurrence is also likely if an MRI scan shows focal abnormalities (for example, as in children with tuberous sclerosis). Such children may remain on the diet longer than average, and it has been suggested that children with tuberous sclerosis who achieve seizure freedom could remain on the ketogenic diet indefinitely.[45]

If there's one thing that's for sure right now, it's that the ketogenic diet is insanely popular. People searching for how-to info, detailed meal plans, and high-fat recipes such as keto-friendly smoothie recipes, vegetarian keto recipes, even meals that'll work in the Instant Pot has been steadily increasing throughout 2018. (Related: Is the Keto Diet a Good Idea for Vegetarians?)


Some research suggests that ketogenic diets might help lower your risk of heart disease. Other studies show specific very-low-carb diets help people with metabolic syndrome, insulin resistance, and type 2 diabetes. Researchers are also studying the effects of these diets on acne, cancer, polycystic ovary syndrome (PCOS), and nervous system diseases like Alzheimer's, Parkinson's, and Lou Gehrig's disease.
"You can find a lot of "fat bomb" recipes on the Internet," Wittrock says. "These are very good at satisfying your sweet tooth, and are a great way to increase fat consumption without going over on protein. Also, I'm a huge fan of salted pumpkin seeds and salted sunflower seed kernels. Believe it or not, pork rinds are also a very good keto snack."
I was a Corpsman (not a corpse-man as some recent somewhat fanatical president would say), and I can tell you many stories of Marines and Sailors who maintained restrictive diets (aka picky eaters). Most obvious was lack of sustaining energy (hypoglycemia) at mile 15 (with 80lbs of gear including a 6.5lb rifle and 200 rnds of ammo, etc.) and depletion of essential vitamins, electrolyte imbalance. They were always the first to collapse and have to hear me scold “see I told you so.” An IV of D5W usually does the trick (D is for dextrose, OMG!)
H. Guldbrand, B. Dizdar, B. Bunjaku, T. Lindström, M. Bachrach-Lindström, M. Fredrikson, C. J. Östgren, F. H. Nystrom, “In Type 2 Diabetes, Randomisation to Advice to Follow a Low-carbohydrate Diet Transiently Improves Glycaemic Control Compared with Advice to Follow a Low-fat Diet Producing a Similar Weight Loss,” Diabetologia (2012) 55: 2118. http://link.springer.com/article/10.1007/s00125-012-2567-4.
While guest starring on the Rachael Ray Show, the actress opened up about how she stays motivated through intense workouts: “No carbs. No dairy. No refined sugar. [It’s] eating real foods. It’s honestly high-fat, high-protein. I think that we’ve been brainwashed to think that fat is bad, but really, it’s what going to make you feel fuller longer. And your body can burn it and use it as fuel.”
For breakfast, we are going to change it up a bit. Here’s where we introduce ketoproof coffee. Now, don’t get me wrong – I know some of you won’t like it. If you’re not a fan of coffee, then try it with tea. If you’re not a fan of the taste (which is very rare), then try making a mixture of the ingredients by themselves and eating it like that. So, why ketoproof coffee?

The keto diet is taking the fad diet arena by storm. Folks are turning to the diet as a means of weight loss, and some believe that it can also help with a slew of health conditions. But even though you may know someone who swears by it, as a dietitian focused on healthy, delicious food, I've never been able to condone such an extreme diet (whether used as a way of life or as a timebound diet to "reset"). (Related: Is the Keto Diet Bad for You?)
Sleep enough – for most people at least seven hours per night on average – and keep stress under control. Sleep deprivation and stress hormones raise blood sugar levels, slowing ketosis and weight loss a bit. Plus they make much it harder to stick to a keto diet, and resist temptations. So while handling sleep and stress will not get you into ketosis on it’s own, it’s still worth thinking about.
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