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My point here is that the warnings about the ketogenic principles are well taken and well documented. My concern is implications that this is a fad. I don’t use the word diet with my patients and I’m concerned that the principles behind the label and the real results that these readers have commented on might get minimized. I have found it best to encourage patients to read authors like: Stephen Phinney, Jeff Volek, Patricia Daly, and Charles Gant and the be partners with their doctors and check blood work as they move along. I am not for or against the article. If ketogenic principles offer people enduring, satisfying, and cohesive change then why not read about its potential and flexilbity?

You want to keep your cheats to none. Be prepared, make sure you’re eating what you need to be satiated (“full”), and make sure you’re satisfied with what you’re eating. If you have to force yourself to eat something, it will never work out in the end. This is just a guideline on how you can eat on a ketogenic diet, so you’re very welcome to change up what kind of foods you eat!
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.

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.
The ketogenic diet is indicated as an adjunctive (additional) treatment in children and young people with drug-resistant epilepsy.[25][26] It is approved by national clinical guidelines in Scotland,[26] England and Wales[25] and reimbursed by nearly all US insurance companies.[27] Children with a focal lesion (a single point of brain abnormality causing the epilepsy) who would make suitable candidates for surgery are more likely to become seizure-free with surgery than with the ketogenic diet.[9][28] About a third of epilepsy centres that offer the ketogenic diet also offer a dietary therapy to adults. Some clinicians consider the two less restrictive dietary variants—the low glycaemic index treatment and the modified Atkins diet—to be more appropriate for adolescents and adults.[9] A liquid form of the ketogenic diet is particularly easy to prepare for, and well tolerated by, infants on formula and children who are tube-fed.[5][29]
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.
The ketogenic diet is not a benign, holistic or natural treatment for epilepsy; as with any serious medical therapy, there may be complications.[27] These are generally less severe and less frequent than with anticonvulsant medication or surgery.[27] Common but easily treatable short-term side effects include constipation, low-grade acidosis and hypoglycaemia if there is an initial fast. Raised levels of lipids in the blood affect up to 60% of children[37] and cholesterol levels may increase by around 30%.[27] This can be treated by changes to the fat content of the diet, such as from saturated fats towards polyunsaturated fats, and, if persistent, by lowering the ketogenic ratio.[37] Supplements are necessary to counter the dietary deficiency of many micronutrients.[3]

Case in point: When I didn't have time to whip up a homemade keto snack—or even when I needed a keto-friendly dessert for my book club—I turned to Nui cookies. Not only did it satisfy my craving for a freaking cookie (the snickerdoodle and double chocolate flavors were my favorites), but they also use monk fruit extract, a sweetener that's reportedly 150 to 200 times sweeter than sugar (less is more!), so I didn't have to worry about going into carb overload from one cookie. In fact, I could have two. (Related: The Best Healthy Keto Packaged Snacks You Can Buy)
Hello Myriam, I am a dual certified personal trainer and Sports Nutrition Specialist. I really love how concisely you have put this article together. I did notice that on your macro breakdown for a 1500 calorie diet you actually listed the protein intake at around 31% of the daily calories (117*4=468..468/1500=.31). I was wondering if you did this to bring the protein amount closer to 1 gram per pound of body-weight to preserve lean mass?

Thanks for this inputs. 20 years ago I gain 17 pounds a year for 5 years. I was healthy but my dr told me start diet, any diet just come back in a month I want to see you start loosing… I started Atkins and lost 7 pound in a month. She was checking my progress every six months and checking my condition. I lost 64 pounds in 3 years. Now I started eating out of control. I am eating healthy but too much… I gain 40 pound back after 20 years. Now I will start again my Atkins to take off 30 pounds…
Dr. Campos, it is so discouraging to see that you disparage the ketogenic diet based on your assumption that it is very heavy in poor quality processed meats. No diet that relies on processed foods can be viewed as “healthy”. Become better informed by getting up to speed with what Jeff Volek, RD, PhD, calls a “well-formulated ketogenic diet.” Also, learn more about the potential of the diet to slow cancer progression (my specialty). You owe it to your patients who are depending on you for advice. Present them with facts, not opinions.
According to Macri, “If somebody is looking for physical and psychological health, the best way to get there is to focus on health. That entails eating in balance, not restrictively; moving regularly; and looking at the role of stress in one’s life. Those three areas will get someone to health as well as happiness.” Check out the 13 things doctors want you to know about the keto diet.
The ketogenic diet is not a benign, holistic or natural treatment for epilepsy; as with any serious medical therapy, there may be complications.[27] These are generally less severe and less frequent than with anticonvulsant medication or surgery.[27] Common but easily treatable short-term side effects include constipation, low-grade acidosis and hypoglycaemia if there is an initial fast. Raised levels of lipids in the blood affect up to 60% of children[37] and cholesterol levels may increase by around 30%.[27] This can be treated by changes to the fat content of the diet, such as from saturated fats towards polyunsaturated fats, and, if persistent, by lowering the ketogenic ratio.[37] Supplements are necessary to counter the dietary deficiency of many micronutrients.[3]
Before we dive further into weight loss, a note: Weight loss isn't for everybody, and neither is following a specific, restrictive eating plan. If your goal is to lose weight, that's fine, but your health matters more than a number on a scale (and if you have a history of disordered eating, you should discuss any plans to change your diet with a doctor first). In addition, successful long-term weight loss is the product of many factors: Your physical activity, how much sleep you get, stress management, and other factors like medical issues and hormones all play an important role. What you eat is just one part of the weight loss puzzle.
Christopher D. Gardner, PhD; Alexandre Kiazand, MD; Sofiya Alhassan, PhD; Soowon Kim, PhD; Randall S. Stafford, MD, PhD; Raymond R. Balise, PhD; Helena C. Kraemer, PhD; Abby C. King, PhD, “Comparison of the Atkins, Zone, Ornish, and LEARN Diets for Change in Weight and Related Risk Factors Among Overweight Premenopausal Women,” JAMA. 2007;297(9):969-977. http://jama.jamanetwork.com/art icle.aspx?articleid=205916.
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.
Symptoms of the keto flu include headache, fatigue, dizziness, sleep problems, heart palpitations, cramps, and diarrhea. These side effects usually lessen and eventually resolve in about two weeks. (2) But to lessen the effects of any discomfort, simply consider slowly transitioning onto a ketogenic diet rather than rushing to change your eating habits. By slowly lowering your carbohydrate intake, while gradually increasing your intake of dietary fat over time, you can transition with less of a negative impact and potentially prevent the keto flu.

Back to this book, though! We pretty much figured out how to live a Keto lifestyle from the internet and Pinterest. Some good things happened and we knew we were on the right track, BUT THIS BOOK PUTS IT ALL TOGETHER! It also deals with the misguided information we had randomly collected and now we are on track with the science and recipes to support our efforts! Honestly, one of the things that drew me to Maria’s books and perspective was that she is so lean herself! Not “skinny” but very lean with no extra fat at all. I don’t need to lose a bunch of weight and my husband doesn’t either, but 20 pounds of fat would be great, and to be lean like that would be amazing. So she’s inspiring that way, too, and I can trust her recipes because they are how she and eats and lives (as well as her family). This book explains how it all works, scientifically and practically. (from the perspective of both Maria and her husband, Craig). I also appreciate the “realness” and vulnerability—she has many personal stories to let the reader know it hasn’t always been this way for her and how living a Keto-adapted life has changed her body and outlook. I’d recommend this book before any others for someone wanting to get started with the ketogenic diet. And then her recipe books...!!!


“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.
Cauliflower is a great base for low-carb meals and is popping up everywhere—especially on keto diet blogs. This cauliflower soup by All Day I Dream About Food is super simple to whip up in the Instant Pot and tastes decadent thanks to cheese, bacon, and sour cream. Plus, it only has 5.5 grams of net carbs and delivers nearly 3 grams of fiber thanks to the cauliflower.

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 essence, it is a diet that causes the body to release ketones into the bloodstream. Most cells prefer to use blood sugar, which comes from carbohydrates, as the body’s main source of energy. In the absence of circulating blood sugar from food, we start breaking down stored fat into molecules called ketone bodies (the process is called ketosis). Once you reach ketosis, most cells will use ketone bodies to generate energy until we start eating carbohydrates again. The shift, from using circulating glucose to breaking down stored fat as a source of energy, usually happens over two to four days of eating fewer than 20 to 50 grams of carbohydrates per day. Keep in mind that this is a highly individualized process, and some people need a more restricted diet to start producing enough ketones.


We have solid evidence showing that a ketogenic diet reduces seizures in children, sometimes as effectively as medication. Because of these neuroprotective effects, questions have been raised about the possible benefits for other brain disorders such as Parkinson’s, Alzheimer’s, multiple sclerosis, sleep disorders, autism, and even brain cancer. However, there are no human studies to support recommending ketosis to treat these conditions.

I know you’ve been hearing and seeing the keto diet advertised everywhere. Maybe you’re already on the keto diet, but maybe you’re not and have no idea what all the buzz is about. Maybe you’re just doing a low carb diet and that’s working for you. Wherever you are in your health and journey, the keto diet is hot right now and getting a lot of attention and for good reason.
The original therapeutic diet for paediatric epilepsy provides just enough protein for body growth and repair, and sufficient calories[Note 1] to maintain the correct weight for age and height. The classic therapeutic ketogenic diet was developed for treatment of paediatric epilepsy in the 1920s and was widely used into the next decade, but its popularity waned with the introduction of effective anticonvulsant medications. This classic ketogenic diet contains a 4:1 ratio by weight of fat to combined protein and carbohydrate. This is achieved by excluding high-carbohydrate foods such as starchy fruits and vegetables, bread, pasta, grains and sugar, while increasing the consumption of foods high in fat such as nuts, cream, and butter.[1] Most dietary fat is made of molecules called long-chain triglycerides (LCTs). However, medium-chain triglycerides (MCTs)—made from fatty acids with shorter carbon chains than LCTs—are more ketogenic. A variant of the classic diet known as the MCT ketogenic diet uses a form of coconut oil, which is rich in MCTs, to provide around half the calories. As less overall fat is needed in this variant of the diet, a greater proportion of carbohydrate and protein can be consumed, allowing a greater variety of food choices.[4][5]
Because the main tenet of the keto diet is counting and cutting carbs — a commonly used way to control blood sugar — this eating approach has become increasingly popular among people with type 2 diabetes who are looking to lower their A1C, which is the two- to three-month average measurement of blood sugar levels. Indeed, research suggests this diet may lead to fast weight loss and potentially lower blood sugar for people with the disease. (13)
But to summarize, I started keto as a pretty vocal anti-keto'er. After a bunch of research on infertility and how the keto diet may help with it, I just had to give it a try. No baby yet, but wow, the changes are remarkable. Currently I'm doing about 1/2 lazy keto and 1/2 strict keto, due to how much I travel for work. 1-2 days/week I walk an hour. That's it.

Ketones—the molecules produced during fat metabolism on the keto diet and other very low-carb diets—are acidic. “When they start to build up in our blood, the blood becomes more acidic,” Notte says. One of the ways the body balances high acid levels is by using a base like calcium, she explains. “The body pulls this alkaline mineral from our bones.” In the long term, chronic calcium loss can lead to low bone density, osteoporosis, and fractures. Try these 15 ways to boost bone health.
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Following a ketogenic diet, your food intake would be roughly 5 to 10 percent carbohydrates, 15 percent protein, and 75 to 80 percent fat. This would be a pretty seismic shift for most people who follow a standard American diet; according to a 2016 report by the CDC, the average American adult’s diet is 50 percent carbohydrates, 16 percent protein, and 34 percent fat. Your average day on a ketogenic diet might include eggs, cheese, assorted meats and small amounts of nuts and avocados, and modest amounts of vegetables that are low in carbs, like spinach and lettuce.
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]
In its 2016 report “Healthy Eating Guidelines & Weight Loss Advice,” the Public Health Collaboration, a U.K. nonprofit, evaluated evidence on low-carbohydrate, high-fat diets. (The Keto diet falls under the LCHF umbrella.) Among 53 randomized clinical trials comparing LCHF diets to calorie-counting, low-fat diets, a majority of studies showed greater weight loss for the Keto-type diets, along with more beneficial health outcomes. The collaboration recommends weight-loss guidelines that include a low-carbohydrate, high-fat diet of real (rather than processed) foods as an acceptable, effective and safe approach.
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