Carol- so sorry to hear about your stroke. I am not sure most doctors would approve of this diet due to most not being taught much on nutrition in med school, and most still believe in the old school high carb low fat way of eating. My experience has been a dramatic drop in my blood pressure in only a few weeks after starting this diet (172/105 down to 144/95!). I suggest giving it a trial of a few months to see how it may work for you.
Like most diets, the ketogenic diet is not a one-size-fits-all answer to all of our health and weight hopes and dreams. It might be enjoyable for some people, especially in the short term, but that doesn't mean it will be a fit for everyone. The experts we talked to for this post agreed that although it may lead to short term (water) weight loss, it might not be optimal as a sustainable weight loss solution. St. Pierre explains the way he sums it up for his clients: “I let them know that there isn't a universal approach that works for everyone, and that restrictive diets like keto can be hard for folks to stick to long-term.”

Everyone has to find their nutritional sweet spot for producing enough ketones and staying in ketosis, but “the core principle of the diet is to keep carbohydrate intake low enough, so your body continues producing ketones at elevated levels,” says Volek. “Your body adapts to this alternative fuel and becomes very efficient at breaking down and burning fat.”
In a state of ketosis, your body breaks fat down in the liver and converts it into ketones to be used for energy. Fat doesn't generate an insulin response, so insulin levels remain stable. This makes it much harder to store excess fat, and easier to tap into body fat stores for energy. Not only will this allow you to maintain your weight, but it will greatly encourage weight loss.
A study with an intent-to-treat prospective design was published in 1998 by a team from the Johns Hopkins Hospital[19] and followed-up by a report published in 2001.[20] As with most studies of the ketogenic diet, there was no control group (patients who did not receive the treatment). The study enrolled 150 children. After three months, 83% of them were still on the diet, 26% had experienced a good reduction in seizures, 31% had had an excellent reduction and 3% were seizure-free.[Note 7] At twelve months, 55% were still on the diet, 23% had a good response, 20% had an excellent response and 7% were seizure-free. Those who had discontinued the diet by this stage did so because it was ineffective, too restrictive or due to illness, and most of those who remained were benefiting from it. The percentage of those still on the diet at two, three and four years was 39%, 20% and 12% respectively. During this period the most common reason for discontinuing the diet was because the children had become seizure-free or significantly better. At four years, 16% of the original 150 children had a good reduction in seizure frequency, 14% had an excellent reduction and 13% were seizure-free, though these figures include many who were no longer on the diet. Those remaining on the diet after this duration were typically not seizure-free but had had an excellent response.[20][21]

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)
Leftovers will be another thing we will take into consideration. Not only is it easier on you, but why put yourself through the hassle to cook the same food more than once? Breakfast is something I normally do leftover style, where I don’t have to worry about it in the morning and I certainly don’t have to stress about it. Grab some food out the fridge, pre-made for me, and head out the door. It doesn’t get much easier than that, does it?
The Johns Hopkins Hospital protocol for initiating the ketogenic diet has been widely adopted.[42] It involves a consultation with the patient and their caregivers and, later, a short hospital admission.[18] Because of the risk of complications during ketogenic diet initiation, most centres begin the diet under close medical supervision in the hospital.[9]
Just this week, a 25,000-person study presented at the European Society of Cardiology Congress in Munich suggested that people on the lowest-carb diets had the highest risk of dying from cancer, cardiovascular conditions, and all other causes. Another study, published this month in the Lancet, also found that people who followed diets that were low in carbs and high in animal proteins had a higher risk of early death compared to those who consumed carbs in moderation. (The opposite was true, however, for low-carb dieters who opted for plant-based proteins over meat and dairy.)
With grains, most fruits, and many vegetables off the menu, your digestive tract will bog down. “It’s really hard to get adequate fiber eating that way,” says Notte. “A common side effect is significant constipation.” Not only is constipation unpleasant, but it’s also a sign that your gut isn’t happy. “Everything in the keto diet is low in fiber—and that does not support gut health.”
Physicians of ancient Greece treated diseases, including epilepsy, by altering their patients' diet. An early treatise in the Hippocratic Corpus, On the Sacred Disease, covers the disease; it dates from c. 400 BC. Its author argued against the prevailing view that epilepsy was supernatural in origin and cure, and proposed that dietary therapy had a rational and physical basis.[Note 3] In the same collection, the author of Epidemics describes the case of a man whose epilepsy is cured as quickly as it had appeared, through complete abstinence of food and drink.[Note 4] The royal physician Erasistratus declared, "One inclining to epilepsy should be made to fast without mercy and be put on short rations."[Note 5] Galen believed an "attenuating diet"[Note 6] might afford a cure in mild cases and be helpful in others.[11]
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?

While there have not been large studies that show the relationship between the ketogenic diet and cancer, we will be publishing a case study about that topic. The author failed to comment that pediatric patients with epilepsy are on the diet for usually about 2 years with no harmful effects. Before the false studies about heart disease and fat, the low carb diet was a respected way to lose weight. Studies into our metabolism show we can use both fat and carbohydrate as fuel. So stepping away from our high carb diet- I am sorry to say that we eat more carbs since the 70s with most of it processed and we now use high fructose corn syrup to sweeten products and we have a wide spread childhood obesity problem. If cholesterol is a concern try plant sterols and stenals to block cholesterol from the receptors in the body. So much more can be said about a keto diet than this article states
“These past 60 days have changed my life. I found out about it from a friend on Facebook and never looked back…. It has quickly become my lifestyle and it’s definitely one of those fad diets you find everywhere. Aside from weight loss, I’ve gained a confidence that I never knew I had inside. My relationship with my husband and family has improved exponentially. When my body reached ketosis, my life changed along with my pant size!!! Keto Fit Diet for the win!”

Protein will induce an insulin response in the body, if consumed in high amounts. The most intuitive way to start a keto diet for most people is by removing all of the carbs they have been eating. Typically people will replace those calories by increasing their lean meat consumption. That's a recipe for disaster! Keeping protein moderate is an often overlooked, but very important part of a keto diet. Most people need around 0.6g to 1.0g of protein per pound of lean body mass.
This was a great read. I aim to restrict carbs always because I believe most are why the American population is obese. I would very much like to hear more about carb restriction excluding the discussion on processed meats and processed high salt content foods because I consume neither. I also don’t consume dairy or eggs. So can you provide some substance.
This can be tough for folks who need a "cheat" day, but it can also take a mental toll on the dieter. In a usual diet plan when you go off of it for a day or two, you just get right back in the saddle and start again. With keto it's more than that: You need to start from scratch to get yourself back into ketosis, which can take a few days or weeks. This can really make you feel bad about yourself and take a psychological toll on your well-being and self-worth. (Related: Why You Should Give Up Restrictive Dieting Once and for All)

This is a well-known phenomenon with nearly every type of diet: If you relax the rules even a little bit, you suddenly find yourself overeating. Making entire food groups—such as grains, sugar, and other carbohydrates—off-limits helps make them even more attractive, Macri says. This type of reaction goes beyond a psychological reaction—it can also be physical, she says. “Serotonin is one of the feel-good brain chemicals, and when serotonin decreases, such as it does when you’re on a strict low-carb diet, the brain is on high alert for any kind of reward,” she explains. Let some sugar or bread into your diet, and you could be overcome with a desire for more, Macri warns. “This makes it much more likely that you’ll overeat or even binge on those foods.” 
For athletes, research on the keto diet highlights potential improvements in athletic performance, especially when it comes to endurance activities. An article suggests ketogenic-type diets may allow endurance athletes to rely mostly on stored fat for energy during exercise rather than having to refuel with simple carbohydrates during endurance training and competition while additionally improving recovery times. (10)
This week we’re introducing a slight fast. We’re going to get full on fats in the morning and fast all the way until dinner time. Not only are there a myriad of health benefits to this, it’s also easier on our eating schedule (and cooking schedule). I suggest eating (rather, drinking) your breakfast at 7am and then eating dinner at 7pm. Keeping 12 hours between your 2 meals. This will help put your body into a fasted state.
Many ketogenic dieters also swear by MCT oil. (MCT simply stands for medium chain triglycerides.) MCT's energy-sustaining powers can be explained as follows: When MCT oil is metabolized in the body, it behaves more like a carbohydrate than a fat. Unlike other fats, MCT oil does not go through the lymphatic system. Instead, it is transported directly to the liver where it is metabolized so it releases energy like a carbohydrate and creates lots of ketones (which can be used for fuel) in the process.
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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