Another difference between older and newer studies is that the type of patients treated with the ketogenic diet has changed over time. When first developed and used, the ketogenic diet was not a treatment of last resort; in contrast, the children in modern studies have already tried and failed a number of anticonvulsant drugs, so may be assumed to have more difficult-to-treat epilepsy. Early and modern studies also differ because the treatment protocol has changed. In older protocols, the diet was initiated with a prolonged fast, designed to lose 5–10% body weight, and heavily restricted the calorie intake. Concerns over child health and growth led to a relaxation of the diet's restrictions.[18] Fluid restriction was once a feature of the diet, but this led to increased risk of constipation and kidney stones, and is no longer considered beneficial.[3]
A keto diet is very restrictive—more so, even, than plans such as paleo and Atkins. One piece of fruit or a serving of steamed beets can put someone over his or her entire daily carbohydrate limit. “Restrictive dieting is a psychological stressor,” says psychotherapist Shiri Macri, MA, LCMHC, clinical director at Green Mountain at Fox Run, who specializes in working with people who emotionally overeat or binge-eat. “When people deprive their bodies of the amount of nutrition and the nutrients that it needs, the body responds in a state of emergency. Levels of cortisol, a stress hormone, go up, and we also have a decrease in mood-boosting serotonin.” Check out the 11 hidden dangers of the keto diet.
To prevent side effects such as the keto flu, begin transitioning your meal plan gradually. Start by understanding how many carbohydrates you take in most days. Then begin slowly reducing your carbohydrate intake over a period of a few weeks while gradually increasing your intake of dietary fat to keep your calories the same. You should also make sure to seek guidance from a professional to make sure this plan works best for you and your health goals. “See a dietitian and adapt the diet to fit your long-term needs,” Spano recommends.

So people saying that – despite the lack of scientific support – likely have a financial reason to say it. Some of these products are sold under something like a multi-level marketing arrangement, so sales people are entirely paid based on commission. For example, the company Prüvit sells drinkable ketones, called KETO//OS with a multi-level marketing structure.

Net carbs are what we track when following a ketogenic diet. This calculation is pretty straightforward. Net Carbs = Total Carbs – Fiber. For example, one cup of broccoli has 6g of total carbs and 2.4g of fiber. That would mean one cup of broccoli has 3.6g of net carbs. We count Net Carbs  because dietary fiber does not have a significant metabolic effect. 
If you’re looking to get a jump start on your health and fitness goals this year, you may be thinking about trying the ketogenic diet. Maybe you’ve heard the phrase before — it’s a huge diet buzzword — but aren’t sure what it means. Here’s a primer: The ketogenic diet is an eating plan that drives your body into ketosis, a state where the body uses fat as a primary fuel source (instead of carbohydrates), says Stacey Mattinson, RDN, who is based in Austin, Texas.
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