Because people with type 2 diabetes are at an increased risk for cardiovascular disease, there’s a specific concern that the saturated fat in the diet may drive up LDL, or “bad,” cholesterol levels, and further increase the odds of heart problems. If you have type 2 diabetes, talk to your doctor before attempting a ketogenic diet. They may recommend a different weight-loss diet for you, like a reduced-calorie diet. Those with epilepsy should also consult their doctor before using this as part of their treatment plan.
The day before admission to hospital, the proportion of carbohydrate in the diet may be decreased and the patient begins fasting after his or her evening meal.[18] On admission, only calorie- and caffeine-free fluids[36] are allowed until dinner, which consists of "eggnog"[Note 8] restricted to one-third of the typical calories for a meal. The following breakfast and lunch are similar, and on the second day, the "eggnog" dinner is increased to two-thirds of a typical meal's caloric content. By the third day, dinner contains the full calorie quota and is a standard ketogenic meal (not "eggnog"). After a ketogenic breakfast on the fourth day, the patient is discharged. Where possible, the patient's current medicines are changed to carbohydrate-free formulations.[18]
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 have been looking for a weight loss plan, however, you've probably heard of one of the ketogenic diet’s biggest claims to fame: the quick results it supposedly produces. Some people report losing as much as 10 pounds in the first two weeks. But this weight loss is likely to be mostly water weight, not fat melting away, meaning you stand to gain it back once you replenish fluids. The ketogenic diet can act as a diuretic, causing water loss from glycogen storage in the liver, muscles, and fat cells. Keep in mind that for most people, about ½ pound to 2 pounds per week is considered safe.

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.
The ketone bodies are possibly anticonvulsant; in animal models, acetoacetate and acetone protect against seizures. The ketogenic diet results in adaptive changes to brain energy metabolism that increase the energy reserves; ketone bodies are a more efficient fuel than glucose, and the number of mitochondria is increased. This may help the neurons to remain stable in the face of increased energy demand during a seizure, and may confer a neuroprotective effect.[55]
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?

Contrary to what most people think, the keto diet isn’t a high-protein plan; it’s really about cutting carbohydrates and protein. And that protein deficit can be hard on your muscles, research suggests. When you limit carbs from things like fruits, vegetables, and grains, your body starts to steal protein from your muscles and other tissues to transform it into carbohydrate, Notte says. “Protein makes up our organs, our heart, our muscles as well as some hormones, antibodies, and neurotransmitters.”

No matter what your diet has been before now, keto will be a big change. If you're coming from a standard American diet (SAD), your carbs will go way down, your protein may either go up or down, and your fat will go way up. If you're coming from a bodybuilding-style diet, your fat intake will jump to alarming levels, and your protein will likely drop significantly.
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)
Achieving optimal ketosis hinges on finding the right balance of macronutrients (or “macros” in keto-speak); these are the elements in your diet that account for the majority of your calories, a.k.a. energy—namely, fat, protein, and carbohydrates. By the way, it’s often “net grams” of carbohydrates that are counted toward your daily intake; “net” deducts the amount of fiber in a food from its carbohydrate total.
And although in the short term, ketogenic diets seem safe for healthy people, we also lack long-term data on the diet, so it’s hard to confirm long-term safety with certainty. Complications seen with kids maintaining a ketogenic diet for epilepsy, for example, included kidney stones, constipation, gastrointestinal issues, pancreatitis, and vitamin D and calcium deficiencies.

The nerve impulse is characterised by a great influx of sodium ions through channels in the neuron's cell membrane followed by an efflux of potassium ions through other channels. The neuron is unable to fire again for a short time (known as the refractory period), which is mediated by another potassium channel. The flow through these ion channels is governed by a "gate" which is opened by either a voltage change or a chemical messenger known as a ligand (such as a neurotransmitter). These channels are another target for anticonvulsant drugs.[7]
“One of the best meal planning tips I’ve ever received is to structure breakfast and lunch so that you don’t have to think too much about it,” says Emily Bartlett, co-founder of Real Plans. “If you’re okay with repetition, it’s ideal to have a simple selection of recipes for breakfast—including some that can be taken on the go. For lunch, go ahead and use your leftovers with a fresh green salad, and be sure to include a dressing that you really love.”
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.
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