One downside to a ketogenic diet for weight loss is the difficulty maintaining it. “Studies show that weight loss results from being on a low-carb diet for more than 12 months tend to be the same as being on a normal, healthy diet,” says Mattinson. While you may be eating more satiating fats (like peanut butter, regular butter, or avocado), you’re also way more limited in what’s allowed on the diet, which can make everyday situations, like eating dinner with family or going out with friends, far more difficult. Because people often find it tough to sustain, it’s easy to rely on it as a short-term diet rather than a long-term lifestyle.

Yvette, Oh no, sorry to hear about the chicken not being cooked! Was the chicken frozen to start with? If so, be sure to add 5 minutes to your Instant Pot cooking time (on manual high pressure). When we tested this, we literally just put everything into the IP (nestled down into the liquid, of course), and let it do its thing. The cream cheese softened, and when it was done cooking we removed the chicken to shred it, and the sauce stirred together nicely.

Ketosis is really a shortening of the term lipolysis/ketosis. Lipolysis simply means that you're burning your fat stores and using them as the source of fuel they were meant to be. The by-products of burning fat are ketones, so ketosis is a secondary process of lipolysis. When your body releases ketones in your urine, it is chemical proof that you're consuming your own stored fat. And the more ketones you release, the more fat you have dissolved.
"Plenty of people jump right in, thinking all they have to do is cut carbs and increase fat. All of a sudden, they hit a wall and get 'keto flu.' They feel tired, lethargic, and experience headaches," Wittrock says. "The primary reason they get these symptoms is lack of the three primary electrolytes: sodium, potassium, and magnesium. If you're deficient in any of these, you'll suffer mentally and physically. This is the single biggest reason people fail on the keto diet."
Jump up ^ Yiu H. Hui (February 1985). Principles and issues in nutrition. Wadsworth Health Sciences Division. p. 91. Retrieved 2014-05-19. Eskimos actually consume more carbohydrates than most nutritionists have assumed. Because Eskimos frequently eat their meat raw and frozen, they take in more glycogen than a person purchasing meat with a lower glycogen content in a grocery store. The Eskimo practice of preserving a whole seal or bird carcass under an intact whole skin with a thick layer of blubber also permits some proteins to ferment into carbohydrates.
The concentration of ketone bodies may vary depending on diet, exercise, degree of metabolic adaptation and genetic factors. Ketosis can be induced when a ketogenic diet is followed for more than 3 days.[34] This induced ketosis is sometimes called nutritional ketosis.[35] This table shows the concentrations typically seen under different conditions[1]
This is an absolutely necessary function for basic survival. As the body can only store carbs for a day or two, the brain would quickly shut down after a couple of days without food. Alternatively it would quickly have to convert our muscle protein into glucose – a very inefficient process – just to keep the brain going. That would make us waste away quickly. It would also ensure that the human race could hardly have survived all those millennia before we had 24-7 food availability.
Yvette, Oh no, sorry to hear about the chicken not being cooked! Was the chicken frozen to start with? If so, be sure to add 5 minutes to your Instant Pot cooking time (on manual high pressure). When we tested this, we literally just put everything into the IP (nestled down into the liquid, of course), and let it do its thing. The cream cheese softened, and when it was done cooking we removed the chicken to shred it, and the sauce stirred together nicely.
Brain glucose and KB uptake was investigated in rats subjected to mild experimental ketonemia induced by 2 weeks on the KD or by 48 h fasting. To test this, researchers developed a carbon-11 labeled AcAc (11)C-AcAc for PET use. They found in rats that after 10 days of KD (11)C-AcAc brain uptake increased up to 8-fold, an increase comparable to those measured after 48 h of fasting (Pifferi et al., 2008).
This is where we have to depart! Sorry to say but you’re on your own. You should have plenty of leftovers that are frozen, ready, and waiting! I know a lot of you out there have trouble with timing and are busy people – so making sure that some nights you make extras to freeze is important. All those leftovers you have in the freezer? Use them up! Create your own meal plan, at first using this as a guide, and then completely doing it yourself. Once you get the hang of it, it’ll be a sinch – I promise you 🙂
Adipose tissue can be used to store fatty acids for regulating temperature and energy.[21] These fatty acids can be released by adipokine signaling of high glucagon and epinephrine levels, which inversely corresponds to low insulin levels. High glucagon and low insulin correspond to times of fasting or to times when blood glucose levels are low.[23] Fatty acids must be metabolized in mitochondria in order to produce energy, but free fatty acids cannot penetrate biological membranes due to their negative electrical charge. So coenzyme A is bound to the fatty acid to produce acyl-CoA, which is able to enter the mitochondria.
A state of ketoacidosis is dangerous for more reasons than having ketones present in your body. When a diabetic is in a state of ketoacidosis or DKA, they have high blood sugar (uncontrollable with exogenous insulin) AND ketones in the blood. Not only does this mean that their high blood glucose can affect nerves and organs, but it also causes an increase in the amount of acid in the blood- further complicating their body’s homeostasis (or natural state of being). Most healthy individuals who are in ketosis due to a LCHF diet do not have high blood sugar at the same time as they are consuming increased amounts of fat.
Note that urine measurements may not reflect blood concentrations. Urine concentrations are lower with greater hydration, and after adaptation to a ketogenic diet the amount lost in the urine may drop while the metabolism remains ketotic. Most urine strips only measure acetoacetate, while when ketosis is more severe the predominant ketone body is β-hydroxybutyrate.[36] Unlike glucose, ketones are excreted into urine at any blood level. Ketoacidosis is a metabolic derangement that cannot occur in a healthy individual who can produce insulin, and should not be confused with physiologic ketosis.

The BBB, largely formed by the brain capillary endothelial cells, provides a protective barrier between the systemic blood and the extracellular environment of the CNS. Passage of FAs from the blood to the brain may occur either by diffusion or by proteins that facilitate their transport. Studies indicate that FATP-1 and FATP-4 are the predominant FA transport proteins expressed in the BBB based on human and mouse expression studies (Mitchell et al., 2011).
You've likely heard horror stories of what competitors feel like when they cut carbs low, or when the average bro talks about going keto. However, the odds are that those people were not actually in nutritional ketosis, or more importantly, following a well-formulated ketogenic diet. Yes, you may experience some fogginess and discomfort, but it doesn't have to be intense if you handle it right.

Hi Tammy, I still have to try the muffin tin method to ive you a better response. Why don’t you make the recipe using exact ingredients for one bread multiplied x 9-10 and divide between 12 muffin tin slots? I think this will work better. This way we are not changing the amount of eggs. If you use less eggs, the bread will be more dry, since it is gluten-free.
The most science-backed performance-boosting supplements, such as creatine monohydrate, beta-alanine, and caffeine, are all A-OK on the ketogenic diet. So, if you take a pre-workout, you should be able to continue without issue. I would also recommend gulping down some bouillon before your session to ensure your sodium and magnesium levels are on point.
In sheep, ketosis, evidenced by hyperketonemia with beta-hydroxybutyrate in blood over 0.7 mmol/L, occurs in pregnancy toxemia.[78][79] This may develop in late pregnancy in ewes bearing multiple fetuses,[78][79] and is associated with the considerable glucose demands of the conceptuses.[80][81] In ruminants, because most glucose in the digestive tract is metabolized by rumen organisms, glucose must be supplied by gluconeogenesis,[82] for which propionate (produced by rumen bacteria and absorbed across the rumen wall) is normally the principal substrate in sheep, with other gluconeogenic substrates increasing in importance when glucose demand is high or propionate is limited.[83][84] Pregnancy toxemia is most likely to occur in late pregnancy because most fetal growth (and hence most glucose demand) occurs in the final weeks of gestation; it may be triggered by insufficient feed energy intake (anorexia due to weather conditions, stress or other causes),[79] necessitating reliance on hydrolysis of stored triglyceride, with the glycerol moiety being used in gluconeogenesis and the fatty acid moieties being subject to oxidation, producing ketone bodies.[78] Among ewes with pregnancy toxemia, beta-hydroxybutyrate in blood tends to be higher in those that die than in survivors.[85] Prompt recovery may occur with natural parturition, Caesarean section or induced abortion. Prevention (through appropriate feeding and other management) is more effective than treatment of advanced stages of ovine ketosis.[86]
Hi Maya. I LOVE your site!! Interesting, informative with fab recipes and ideas. Hubby and I have just started eating low carb and I have to say, we are not finding it too difficult and I already feel sooo much better!! I find the hardest part is choosing low carb veg, I feel as if we are not eating enough. Any suggestions on how to get more veggies into our diet?
What is the link between ketones and diabetes? Ketone is a chemical produced by the body when fats are broken down for energy. Ketone testing is important for people with diabetes, because high levels can lead to diabetic ketoacidosis (DKA), when acid levels become too high in the blood and the person loses consciousness. Find out when and why to do ketone testing. Read now
“Keto is not easy to maintain, it’s not a palatable diet,” says Andrea Giancoli, a dietician and nutrition consultant in California. Getting 80-90 percent of your calories from fat—which is what’s generally required for keto—is actually difficult. It involves eating a lot of rich, heavy foods with little variety—think fatty meats and gravy on cauliflower. You’re only allowed 10 to 15 grams of carbohydrates per day, and though many dieters stretch that to more like 20 or 30 grams that’s still only about one banana. A single apple could also get you past that limit depending on its size (though the fiber in an apple means that many dieters don't count those carbs towards their daily limit) and a couple slices of bread likely fulfill the requirement as well.

Dr. Perlmutter is the leading integrative medicine neurologist in North America today. His ability to fully integrate conventional medicine diagnosis and treatment with the latest innovations in nutritional and environmental medicine is phenomenal. As a teacher and clinician, he has fundamentally changed how physicians and patients think about neurological degeneration and, happily, regeneration.
In ketogenesis, two acetyl-CoA molecules instead condense to form acetoacetyl-CoA via thiolase. Acetoacetyl-CoA momentarily combines with another acetyl-CoA via HMG-CoA synthase to form hydroxy-β-methylglutaryl-CoA. Hydroxy-β-methylglutaryl-CoA form the ketone body acetoacetate via HMG-CoA lyase. Acetoacetate can then reversibly convert to another ketone body—D-β-hydroxybutyrate—via D-β-hydroxybutyrate dehydrogenase. Alternatively, acetoacetate can spontaneously degrade to a third ketone body (acetone) and carbon dioxide, although the process generates much greater concentrations of acetoacetate and D-β-hydroxybutyrate. When blood glucose levels are low, ketone bodies can be exported from the liver to supply crucial energy to the brain.[28]
First, decide if you need to check ketones.  Amy Berger of Tuit Nutrition has a great post here to help you decide.  If, after reading that, you still want to check your ketone levels, there are several ways to check them. You can buy Bayer ketone stix, and check the levels of ketones in your urine. Or you can use a blood ketone meter.  The Precision Xtra has been the one to use until just recently. The problem is that this meter is hard to find, as the manufacturer Abbott keeps changing the name. The strips are even harder to find and buy.

We can say that no species, including humans, could have survived for millions of years without the ability to withstand brief periods of hunger or starvation (Amen-Ra, 2006). These periods of fasting are themselves ketogenic (McCue, 2010) during which the concentrations of insulin and glucose decrease while that of glucagon increases in the attempt to maintain normal blood glucose levels. When the body passes from a condition of food abundance to one of deprivation (or else via VLCKD simulated deprivation), there is, with a slight delay, an increase in the concentration of free FAs as well as KB in the blood. Thus, from this point of view KD could be compared to caloric restriction for fasting. These manipulations of nutrients, both in quantity and quality, seem to not only act on blood glucose/KB level but also to promote changes in metabolic pathways and cellular signaling. How this kind of metabolic condition (ketosis) can affect satiety and hunger mechanisms is still a matter of debate.
^ Jump up to: a b c Clemente FJ, Cardona A, Inchley CE, Peter BM, Jacobs G, Pagani L, Lawson DJ, Antão T, Vicente M, Mitt M, DeGiorgio M, Faltyskova Z, Xue Y, Ayub Q, Szpak M, Mägi R, Eriksson A, Manica A, Raghavan M, Rasmussen M, Rasmussen S, Willerslev E, Vidal-Puig A, Tyler-Smith C, Villems R, Nielsen R, Metspalu M, Malyarchuk B, Derenko M, Kivisild T (October 2014). "A Selective Sweep on a Deleterious Mutation in CPT1A in Arctic Populations". American Journal of Human Genetics. 95 (5): 584–589. doi:10.1016/j.ajhg.2014.09.016. PMC 4225582. PMID 25449608.
The discovery of many appetite-related hormones provided molecular basis for appetite control, decreasing the relevance of the metabolites hypothesis (Karatsoreos et al., 2013). Recently, Sumithran et al. demonstrated that there is a long-term persistence of changes in some peripheral hormones involved in food control (Sumithran et al., 2011). In this study, they found a significant difference in mean levels of many food intake-related hormones 1 year after the cessation of weight loss via the hypocaloric diet. There was a long lasting decrease of anorexigenic compounds: leptin, PYY, cholecystokinin, insulin, and pancreatic peptide and an increase of the orexigenic molecule ghrelin. Moreover, they found that hunger remained elevated 1 year after diet cessation. In a successive study the same group investigated hunger-related hormones after 8 weeks of KD, demonstrating that during ketosis the increase of ghrelin (a strong stimulator of appetite) was suppressed (Sumithran et al., 2013). These results are consistent with those of Ratliff et al (Ratliff et al., 2009), who found no significant change in fasting plasma ghrelin after 12 weeks of VLCD.
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.
Initially you may be surprised that on keto diets you eat less frequently.  That’s because the fats are pretty satisfying. But as you normalize and adjust into a ketogenic state, that may change and your appetite may increase.  That’s fine and completely normal.  Use whatever diet you decide to follow as a starting point – it should be “written in pencil” so that you can make changes along the way.  Consider adding an extra meal, marginally increasing the size of the meals or just adding a shake between meals.  It’s up to you – just listen to your body.  For example for me, I added a low-carb “green powder” shake supplement to my regimen along with either flax seed oil or some nuts in order to satisfy my hunger.
If you give your body any more than the absolute minimum amount of protein that it needs, it will immediately break it down into carbs. This is why keto sites often give a guideline for not eating too much protein. The problem is that there’s no one guideline that works for everyone, and without specifically tailoring keto to your body it’d be easy to accidentally ingest too much protein.

Hunger and satiety are two important mechanisms involved in body weight regulation. Even though humans can regulate food intake by will, there are systems within the central nervous system (CNS) that regulate food intake and energy expenditure. This complex network, whose control center is spread over different brain areas, receives information from adipose tissue, the gastrointestinal tract (GIT), and from blood and peripheral sensory receptors. The actions of the brain's hunger/satiety centers are influenced by nutrients, hormones and other signaling molecules. Ketone bodies are the major source of energy in the periods of fasting and/or carbohydrate shortage and might play a role in food intake control.
High blood sugar levels coupled with high blood ketones, on the other hand, will mean that you have a pathologically low level of insulin – something non-diabetics do not suffer from. This can lead to ketoacidosis – a potentially life-threatening condition. If this happens, you’ll need to inject more insulin; if you’re at all unsure of what to do, contact a medical professional. Coveting really high blood ketones for weight control is not worth the risk for type 1 diabetics.
Are you ready to take the guesswork out of that stressful weeknight meal planning? Peace, Love and Low Carb - Low Carb and Gluten Free Weekly Meal Plans are low carb, gluten free, and keto friendly. All recipes include a color photo and complete nutritional analysis. Comes with a printable grocery list, snack list, tips for meal prepping and suggestions for substitutions.
The findings of a stable (Chearskul et al., 2008) or slightly increased response (Sumithran et al., 2013) of post-prandial FFA after KD can be viewed in the nutrient-static context. Elevated circulating FFA may actually reduce food intake and glucose production through actions on specific hypothalamic neurons (Obici et al., 2003). It has been suggested that this effect could be mediated by the increase of cellular concentration of long-chain FAs-CoA in the arcuate nuclei of the hypothalamus (Obici et al., 2003).
To encourage ketone production, the amount of insulin in your bloodstream must be low. The lower your insulin, the higher your ketone production. And when you have a well-controlled, sufficiently large amount of ketones in your blood, it’s basically proof that your insulin is very low – and therefore, that you’re enjoying the maximum effect of your low-carbohydrate diet. That’s what’s called optimal ketosis.

Another mechanism that could be involved in food-regulation during KD is the gamma aminobutyric acid (GABA) and glutamate regulation. Wu et al. demonstrated that GABAergic signaling from the NPY/AgRP neurons to the parabrachial nucleus (located in the dorsolateral part of the pons) is involved in many regulatory sensory stimuli including taste and gastric distension, regulate feeding behavior. GABA signaling seems to prevent animals from anorexia when AgRP neurons were destroyed (Wu et al., 2009). These findings are yet another contradictory aspect of KDs and food behavior; ketosis should increase the availability of glutamate (via diminution of transamination of glutamate to aspartate) and therefore increase GABA and glutamine levels; moreover, in ketosis, the brain imports a huge amount of acetate and converts it through glia into glutamine (an important precursor of GABA) (Yudkoff et al., 2008). The result of these mechanisms, together with the increased mitochondrial metabolism and flux through the TCA cycle, is an increased synthesis of glutamine and a “buffering” of glutamate. These results are not consistent with the well-documented anorexigenic effect of KDs, and therefore the GABA hypothesis cannot be taken into account despite the mild euphoria often reported during a KD that is probably due to the action of BHB (Brown, 2007) and can help to reduce appetite.
Lunch: pat dry chicken and cut into cubes. Lightly (!) salt and pepper. Heat a skillet over medium heat, once hot add coconut oil and fry chicken cubes until brown from all sides. Remove chicken, and add crushed garlic, curry paste and fish sauce to pan. Stir until fragrant and remaining oil in pan and curry paste are well combined. Then add coconut milk and whisk until well combined. Simmer and reduce sauce until desired consistency (1-3 minutes). Pour sauce over chicken and sprinkle with sesame seeds. Serve with baby spinach.
Following the ketogenic diet and achieving ketosis may be beneficial if you’re living with type 2 diabetes and need to manage your symptoms. Limiting carbohydrate intake is crucial with type 2 diabetes because too many carbs can increase blood glucose levels, which can damage blood vessels and lead to vision problems, kidney problems, and nerve problems.

In addition to the seaweed and glycogen carbohydrates mentioned above, the Inuit can access many plant sources. The stomach contents of caribou contain a large quantity of partially digested lichens and plants, which the Inuit once considered a delicacy. They also harvested reindeer moss and other lichens directly. The extended daylight of the arctic summer led to a profusion of plant life, and they harvested plant parts including berries, roots and stems, as well as mushrooms. They preserved some gathered plant life to eat during winter, often by dipping it in seal fat.[71]
Hi I’m new to Keto. I have been reading about it, and understanding what to eat and what not to eat. My problem is I’m not sure if I’m doing it correctly. I’m constantly hungry whereas information reads that I will never be hungry. I use fats as required along with topping up with vegetables in my meals yet this does not fill me up. I haven’t experienced the Keto flu and I’ve even put on weight! I have been doing this for about 3 weeks now. Any ideas where I am going wrong.

Hi there. Thanks for your feedback! I document on my disclaimer page ( that I use MyFitnessPal for calcs, and that these are my calcs. No one should EVER use my calculation as their own. You should always calculate your own macros in accordance to the brands that you use. If you send me an email at I would happy to send you a screenshot from MyFitnessPal, but again, this probably won’t be helpful because you should calculate your own. I post it on my recipes as a ballpark. You are citing a difference of 70 calories, which is completely reasonable and appears materially accurate.
Two comments: first of all, I’ve only discovered your site recently because (a) I. no longer eat refined sugar, and (b) after a year of no ice cream, I bought an ice cream maker and am making maple syrup sweetened ice cream, with varied success, which brings me to my comments/questions: first, this recipe calls for xylitol or erythritol, and as a person with three dogs, may I just mention that dogs can be killed by consuming xylitol. For this reason, I don’t use it, because they adore ice cream, and I can’t resist giving them a little occasionally…and I might forget. This is important!! Second: I keep reading coconut milk ice cream recipes (and others as well) that jump up and down and insist that these recipes makes this amazing, creamy ice cream, and….it doesn’t. I have made ice cream with coconut milk (full-fat) And coconut cream and it is usually icy, if delicious. Not creamy. Same for my one or two forays into making dairy ice cream to see how that would work. All of it is full of ice crystals and while it may be delicious, creamy it is not, although ice cream made with cashews and plant milk does pretty well. My theory is that commercial ice cream is filled with chemicals and stabilizers and the like, and is therefore what we call creamy. All the ice cream I have made with my Cuisinart ice cream maker freezes hard as a rock, and again–while it may be delicious, it is NOT creamy. Is it possible that I’m doing something wrong? I can’t see that I’m doing anything differently from the various vegan and/or dairy recipes I’ve seen. I’ve used both maple sugar and maple syrup for sweetening, as well as occasionally coconut sugar. My most successful ice cream has been made with plant milk and maple syrup. Getting everything as cold as possible before freezing helps, of course, but it is NEVER creamy. Thoughts?
Janie, We haven’t made this recipe in the oven, but yes, we think it would work well! Here’s how we would do it: 1) crisp the bacon on the stovetop; 2) for step 2 in the recipe above, add all ingredients to a 9 by 13-inch casserole dish, cover it with foil, and bake it at 350F until the chicken is fully cooked, about 30 to 45 minutes (the chicken should not be pink in the center, and it should shred easily with a fork); 3) remove and shred the chicken; 4) stir the shredded chicken into the creamy sauce along with the cheddar cheese; 5) top with bacon and scallion and serve. If you give it a try, please let us know how it goes!
Though the hunger-reduction phenomenon reported during ketogenic diets is well-known, the underlying molecular and cellular mechanisms remain uncertain. Ketosis has been demonstrated to exert an anorexigenic effect via cholecystokinin (CCK) release while reducing orexigenic signals e.g., via ghrelin. However, ketone bodies (KB) seem to be able to increase food intake through AMP-activated protein kinase (AMPK) phosphorylation, gamma-aminobutyric acid (GABA) and the release and production of adiponectin. The aim of this review is to provide a summary of our current knowledge of the effects of ketogenic diet (KD) on food control in an effort to unify the apparently contradictory data into a coherent picture.

Drink lots of water. This is especially crucial on a low carb or keto diet. Why? When you eat carbohydrates, your body stores the extra as glycogen in the liver, where they are bound to water molecules. Eating low carb depletes this glycogen, which allows you to burn fat – but it also means you are storing less water, making it easier to get dehydrated. Instead of the traditional recommendation of 8 cups of water per day, aim for 16 cups when following a low carb lifestyle.