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It's advertised as a weight-loss wonder, but this eating plan is actually a medical diet that comes with serious risks. In the world of weight-loss diets, low-carbohydrate, high-protein eating plans often grab attention. The Paleo, South Beach, and Atkins diets all fit into that category. They are sometimes referred to as ketogenic or "keto" diets. But a true ketogenic diet is different. Unlike other low-carb diets, which focus on protein, a keto plan centers on fat, which supplies as much as 90% of daily calories. And it's not the type of diet to try as an experiment. Kathy McManus, director of the Department of Nutrition at Harvard-affiliated Brigham and Women's Hospital. How does the keto diet work? Here are the basics of keto: The diet aims to force your body into using a different type of fuel. Instead of relying on sugar (glucose) that comes from carbohydrates (such as grains, legumes, vegetables, and fruits), the keto diet relies on ketone bodies, a type of fuel that the liver produces from stored fat. Whether you prefer this veggie as a mashed potato stand-in or masquerading as rice, cauliflower is an ideal substitute for many starchy meals and snacks. With just two measly grams of sugar in an entire cup, it is safe to eat with abandon. Scrambled, boiled, poached, or fried, all varieties of eggs are welcome on the keto diet. With a healthy dose of both fat and protein, the ratio of macronutrients makes this protein one of our go-to keto diet foods. Mushrooms' meaty texture makes them one of the most satisfying vegetables around. They also happen to be particularly low in sugar and carbohydrates, a dream come true for people going keto. This tropical oil has faced some controversy in recent years, but its high fat content makes it a staple for keto dieters. Whether you use it in a salad dressing or to saute your favorite cut of steak, coconut oil is a ketogenic mainstay. When it comes to maximizing your fat intake, hard cheeses like cheddar have an edge over softer options like goat or feta. In fact, a recent study published in the British Journal of Nutrition concluded that an increase in lycopene consumption is associated with a lower risk of developing cardiovascular disease. Unfamiliar with this fatty food? Ghee is a form of clarified butter that regularly makes an appearance in Indian food as well as on our list of fat-burning keto diet foods. In addition to its abundance of fat, ghee is also high in fat-soluble vitamins such as vitamin A, vitamin E, and vitamin D. You can, of course, buy ghee at the grocery store or you can make your own: The Easiest Way to Make Ghee at Home. These mini cabbages are a winter and fall favorite that you can enjoy all year-round on the ketogenic diet. Brussels sprouts are chock-full of nutrients including vitamin C, vitamin K, folate, and phosphorus, so don't be afraid to dig in. Asparagus is a low-carbohydrate vegetable that you should make an effort to incorporate into your diet, whether you are going keto or not. The stalky green is rich in glutathione, a compound with major cancer-fighting benefits. A study published in the journal Cancers found that glutathione participates in cell protection and regulation. Caffeine-fiends are in luck: coffee is allowed on the ketogenic diet. The bad news? Sugar and milk are both off-limits. If you can't stomach the idea of drinking your coffee black, you can make bulletproof coffee, which is made by adding butter and coconut oil or concentrated MCT oil to your morning brew. Just make sure you're choosing the right keto add-in, because some keto creamers are on our list of 7 Things You Should Never Add to Your Coffee. Unfortunately, keto diets are probably more prone than many others to end with weight regain because they can be hard to stick to in the long run, Carson said. And being in ketosis for more than a few weeks might not be best for overall health, she said. Some of this is genetically determined: The extent to which dietary fats and cholesterol translate to increased levels of blood cholesterol (which are associated with heart disease) is partly individual, Carson said. Ketogenic diets also tend to cause more calcium to be lost in the urine, Carson said, which can lead to a decrease in bone density over time and increase the risk of osteoporosis. The AHA recommends eating a variety of fruits, vegetables, whole grains, low-fat dairy, skinless poultry and non-fried fish, nuts and legumes, and limiting red meat, saturated fat and sweets for a heart-healthy diet. Majumdar said. In the case of keto diets, putting the kibosh on fruits, many veggies and whole grains means that people don't end up consuming much fiber. The AHA also recommends at least 150 minutes of moderate exercise a week for heart health. Weight loss and maintenance might take a lot more exercise than that, Carson said, which could be a problem for those on ketogenic diets. 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. While following keto, you’re encouraged to eat as much fat as you want, no matter the source (e.g., butter, olive oil, meats, cheeses), until you feel full. Fat can have a strong satiety effect, but following this recommendation may not be comfortable for everyone. According to recent research, fatty foods may increase feelings of nausea and bloating for some people. Beyond potential physical discomfort, it also might not be emotionally comfortable for everyone-after all, keto is still a restrictive diet, which typically is not a good choice for anyone with a disordered relationship to food and eating. And as with any restrictive dietary plan, following a ketogenic diet can present challenges when it comes to social occasions, celebrations, office parties, meals out, etc. It also might be necessary to limit or avoid culturally relevant foods on the diet in order to stay in ketosis.|These symptoms have been dubbed “the keto flu.” Constipation is also common on the keto diet due to the lack of fiber. The high-fat nature of the diet could also have negative impacts on heart health. The American Heart Association recommends limiting saturated fat intake to 5 to 6 percent. “In practice, many people eat high amounts of saturated fats, which could increase cardiovascular disease risk,” says Dr. Maganti. “Patients with kidney disease have an increased risk of requiring dialysis on the keto diet due to the additional ketones that their renal system has to process,” says Dr. Maganti. Some people also experience dehydration on the keto diet because they’re eradicating glycogen, which holds water, from their bloodstream. “When you micromanage your food intake by tracking how much you eat, it disconnects you from what your body is asking for,” says Gomez. Monitoring food so closely can lead to psychological distress, such as shame, and binge eating. Restriction can lead to bingeing, which often leads to guilt, which then leads back to restriction in a continuous cycle. Both Dr. Ring and Dr. Maganti recommend balanced approaches, like the Mediterranean diet, for long-term weight loss. “You can still receive the benefits of ketosis while eating a varied and balanced diet through intermittent fasting,” says Dr. Ring. Gomez advocates making small changes based on your health goals. “All foods fit into a healthy diet,” she says.
“Yes, it could promote weight loss, but there are several other methods to losing weight successfully that don’t involve restricting entire food groups, counting every last carbohydrate, counting your percentage of fat and protein intake daily, and being limited to meat, dairy, eggs, avocado, coconut, and low-carb vegetables,” she says. 3. The side effects can be unpleasant. If the thought of missing out on your favorite carbs doesn’t bother you, the side effects of the keto diet may. Headaches, bad breath, and lack of energy (collectively referred to as keto flu) are common when people start the keto diet. Not to mention, you may experience constipation because your fiber intake plummets. The bottom line: The keto diet may help you lose weight at first, but it’s not sustainable for the average person. If losing weight is a major goal for you this year, consider exploring all of your options (preferably with your doctor and a registered dietitian nutritionist) before you commit to a diet. What is the keto diet? The keto diet can go by a few different names: low-carb diet, ketogenic diet, Atkins diet, and low-carb high-fat (LCHF) diet. The main takeaway is that it’s a dietary lifestyle that cuts down carbohydrate consumption. It’s a “way of eating” that tells the body to use fat (ketones) instead of sugar (glucose) for fuel. Don’t worry, we’ll teach you how to easily start the keto diet below! Make sure to sign up for our exclusive emails! You’ll get a free keto e-book, new delicious recipes every week, keto tips, the best keto deals - we promise to only drop in your inbox with stuff you really want to see! How Do I Know If I’m in Ketosis? So why cut carbs? Removing simple carbohydrates like sugar, bread, and pasta while subbing in meat, nuts, cheese, low-starch plants, and seeds, eliminates around 300g carbohydrates (what the average American eats daily) to as little as 20g total carbohydrates per day.|Wondering how many carb foods you can eat and still be “in ketosis”? The traditional ketogenic diet, created for those with epilepsy consisted of getting about 75 percent of calories from sources of fat (such as oils or fattier cuts of meat), 5 percent from carbohydrates and 20 percent from protein. For most people a less strict version (what I call a “modified keto diet”) can still help promote weight loss in a safe, and often very fast, way. In order to transition and remain in this state, aiming for about 30-50 net grams is typically the recommended amount of total carbs to start with. This is considered a more moderate or flexible approach but can be less overwhelming to begin with. Once you’re more accustomed to “eating keto,” you can choose to lower carbs even more if you’d like (perhaps only from time to time), down to about 20 grams of net carbs daily. This is considered the standard, “strict” amount that many keto dieters aim to adhere to for best results, but remember that everyone is a bit different. The ketogenic diet is increasingly used to treat metabolic disorder. Because maintaining a ketogenic diet reduces blood sugar levels, it’s a natural strategy for treating diabetes and even potentially reversing pre-diabetes. More research is underway to illuminate the effectiveness of keto for those with metabolic disorders. In cancer patients, a keto diet preserves lean mass and causes fat loss. Many researchers are exploring the use of ketogenic diets in preventing and treating cancer, although results are very preliminary. Being keto-adapted has several advantages for anyone interested in physical performance. It increases energy efficiency. It also spares glycogen. Glycogen is high-octane fuel for intense efforts. We store it in the muscles and liver, but only about 2400 calories-worth-enough for a couple hours of intense activity at most. Once it’s gone, we have to carb up to replenish it. Keto-adaptation allows us to do more work using fat and ketones for fuel, thereby saving glycogen for when we really need it. Since even the leanest among us carry tens of thousands of calories of body fat, our energy stores become virtually limitless on a ketogenic diet. There’s a question making the rounds on the internet that has a spectrum of answers: Is the keto diet healthy? The truth is, while the little-to-no carb, high-fat diet can dramatically help shed pounds, there haven’t been any long-term, randomized clinical studies to help determine the long-term effects on the body. Most studies to date are smaller scale, and they’re filled with both positives and negatives. Some suggest it improves blood sugar in diabetics and lessens cardiovascular risk factors, like obesity. Others report spikes in “bad” cholesterol, heart problems, and hypoglycemia. To add to the uncertainty, its effectiveness as a weight loss treatment hasn’t even been clinically proven, experts have said. What’s left is anecdotal evidence and people from all corners of the web - including physicians, nutritionists, and celebrities - raving or ranting about it. “I am open-minded when patients come to us with diets or nutritional trends, especially because I appreciate that they have taken an interest in their health,” said Neel Chokshi, MD, MBA, an associate professor of clinical medicine and medical director of the Sports Cardiology and Fitness Program at Penn Medicine.
The diet works in the following way. First Step - You will have to fill in a few pieces of data about yourself. These include your age, gender, food preferences, workout intensity, weight, height, and desired weight. This helps the website understand your present status to analyze required calories, activity level, BMI, nutrition intake. This is the initial step to help prepare your exclusive Custom Keto Diet plan. Second Step - After filling in the data and going through the analytics, you will be asked to enter your name and mail id after which you will be taken to the payment portal. Once you have purchased the plan, you will receive a mail with your custom keto diet plan. Third Step - The final step is to keep up consistency in following the plan. You mustn’t break in between. Be it the meal plans, or workout routines stick to the planner so that you can lose weight healthily. It is not really a sustainable diet in real life situations. More importantly, your goal is not just to lose weight-anyone can lose weight. The keto diet can be an effective way to reduce excess body fat but there are several cons that should be noted by anyone wanting to follow this eating plan, says Ms. Zarabi says. In fact, the keto diet has serious risks. For one thing, it’s high in saturated fat, which has been linked to heart disease. Additionally, a nutrient deficiency and constipation could occur since the keto diet is very low in fibrous foods such as fruits, vegetables, and whole grains. Liver problems for those with existing liver conditions could possibly worsen since the keto diet puts stress on the liver, and kidney problems could also occur. If you are considering going on the keto diet, work with a knowledgeable practitioner or seek out a registered dietitian with experience in prescribing it and following you to avoid any adverse effects, Dr. Goss says. The ketogenic diet is increasingly used to treat metabolic disorder. Because maintaining a ketogenic diet reduces blood sugar levels, it’s a natural strategy for treating diabetes and even potentially reversing pre-diabetes. More research is underway to illuminate the effectiveness of keto for those with metabolic disorders. In cancer patients, a keto diet preserves lean mass and causes fat loss. Many researchers are exploring the use of ketogenic diets in preventing and treating cancer, although results are very preliminary. Being keto-adapted has several advantages for anyone interested in physical performance. It increases energy efficiency. It also spares glycogen. Glycogen is high-octane fuel for intense efforts. We store it in the muscles and liver, but only about 2400 calories-worth-enough for a couple hours of intense activity at most. Once it’s gone, we have to carb up to replenish it. Keto-adaptation allows us to do more work using fat and ketones for fuel, thereby saving glycogen for when we really need it. Since even the leanest among us carry tens of thousands of calories of body fat, our energy stores become virtually limitless on a ketogenic diet. The plan provides a list of recipes, the grocery list, and the portion size of each meal. What does the Custom Keto Diet include? When you purchase the Custom Keto Diet, you will get an 8-week customized meal plan designed specially by experts. There is a panel of fitness trainers, chefs, and nutritionists making sure that the plan is designed only after taking into account your overall health, and your choice of foods. The plan includes foods you can eat and avoid. And no, it is not about eating less. It is about eating food properly, and avoiding carbs, and sticking to healthier alternatives in your diet. This makes your diet more enjoyable and you are likely to stick to it for longer. The meal plan is customizable as per your taste. It comes with instructions that help you keep your diet in order and make it free from any sort of confusion. There are several recipes in the Custom Keto Diet program, and each recipe that is designed comes with detailed instructions. This is a keto diet with a mostly plant-based or pescatarian twist. It’s a great fit for people who want to experience the benefits of keto but still want to eat a largely plant-based diet. “Eco-Keto” is a catchy way of describing an eco-friendly, ketogenic diet. Most people interpret eco-keto as being totally plant-based, aka a vegan keto diet. Find out how you can combine intermittent fasting and keto. How do you know you’re in ketosis? The best way is to test yourself either through urine tests, a breath test or a blood test, says Whitney Lauritsen, co-author of The Vegan Ketogenic Diet Cookbook. “In the book we talk about the different pros and cons. So the urine test can measure your level. You pee on it. It’s very affordable. It gives you quick results. You can buy them online, but it’s not the most reliable test,” she says. “A breath test you can buy a device online and that can measure the byproducts of ketones in your breath. They are precursors to ketones and help your body burn fat instead of burning carbs. Weight Loss: MCTs are easily digested and have a thermogenic (energy-creating) effect, also known as boosting your metabolism. Energy: MCTs are a fast-acting source of energy. They break down into ketones which can then be used as fuel for your body. Digestion: MCTs support your gut microbiome by combating harmful bacteria, fungi, and viruses. Overall Health: MCTs contain antioxidant properties which reduce internal inflammation and improve overall performance of your heart, brain, and nervous system. Learn more about MCTs and oil here or try the Perfect Keto MCT Oil Powder. While MCTs and MCT oil play a role in fat loss, this next supplement may improve the condition of your hair, skin, nails, joints, and more. Collagen is a type of protein - one of over 10,000 in your body. Collagen is the most abundant protein in your body, accounting for 25-35% of all protein.
Whether you prefer this veggie as a mashed potato stand-in or masquerading as rice, cauliflower is an ideal substitute for many starchy meals and snacks. With just two measly grams of sugar in an entire cup, it is safe to eat with abandon. Scrambled, boiled, poached, or fried, all varieties of eggs are welcome on the keto diet. With a healthy dose of both fat and protein, the ratio of macronutrients makes this protein one of our go-to keto diet foods. Mushrooms' meaty texture makes them one of the most satisfying vegetables around. They also happen to be particularly low in sugar and carbohydrates, a dream come true for people going keto. This tropical oil has faced some controversy in recent years, but its high fat content makes it a staple for keto dieters. Whether you use it in a salad dressing or to saute your favorite cut of steak, coconut oil is a ketogenic mainstay. When it comes to maximizing your fat intake, hard cheeses like cheddar have an edge over softer options like goat or feta. For everyday dieters, it might be for the more anecdotal side effects, such as a clearer head. But it can be risky for certain folks, like those with kidney issues, according to experts at the Keck School of Medicine of USC. Ninety percent of Americans have been on a diet and when you ask why they’re dieting - is it for health or to lose weight? “the predominant answer is to lose weight,” according to Dean Pinchas Cohen of the USC Leonard Davis School of Gerontology. So it’s no surprise keto - essentially a new take on the Atkins diet - is popular since it results in weight loss, he said. But long term, the keto diet could be detrimental, since cutting out carbs increases health risks and mortality over time, Cohen said. The ketogenic diet is usually something that’s prescribed by a registered dietitian. For example, Jessica Lowe, a Keck School of Medicine of USC ketogenic dietitian, said she might prescribe it to a patient who has epilepsy, since there’s research that shows it can help control seizures. Simply focus on hitting your protein goal when you do get hungry and eat, but otherwise let your body signal when to eat. 9. Avoid The Keto Flu. Maybe you’ve heard of the keto flu, or maybe you’ve just experienced side effects of starting keto. It’s one of the most common questions about the keto diet for beginners. As your body shifts its primary fuel source from glucose and carbohydrates to ketones and fat, it can take your body some time to adjust to this metabolic change. Ketosis also flushes out a lot of water stored in the body, which can cause your electrolyte levels to dip. How to avoid the keto flu? The good news is, the keto flu is temporary and avoidable. The short version is, make sure you get enough electrolytes (especially sodium, potassium and magnesium) to avoid the keto flu. Salting your food generously is one of the best things you can do here; some people even add sea salt to their water.
That said, long-term compliance with these diets can be challenging, and the long-term risks-and benefits-of low-carb diets, especially keto, are not yet fully understood, noted Kirkpatrick and Maki. Starting very low-carb diets like keto can also come with some serious side effects. People may experience symptoms known as the “keto flu,” which includes lightheadedness, dizziness, fatigue, difficulty exercising, poor sleep, and constipation, said Kirkpatrick and Maki. When it comes to cholesterol, the effect of very low-carb and ketogenic diets on LDL (“bad”) cholesterol is variable. Some individuals may see an increase in LDL levels with these diets, especially due to high intakes of saturated fatty acids and dietary cholesterol. Thus, baseline and follow-up lipid/lipoprotein assessments are recommended for individuals choosing to follow these diets, said Kirkpatrick and Maki. It’s also important to note that very low-carb or keto diets are not for everyone. People with type 2 diabetes may experience hypoglycemia (low blood sugar) if they don’t adjust their medication, and those who take vitamin K-dependent anticoagulants may need more frequent monitoring due to a potential change in vitamin K intake. In the world of nutrition, the ketogenic diet is enjoying its moment as diet du jour. Google trends show a sharp uptick in searches for the ketogenic diet since 2016. Almost 550,000 people subscribe to the r/keto subreddit. Twitter, I found an endless stream of modified keto recipes and stories claiming successful weight loss. Alicia Vikander, the new Lara Croft in Tomb Raider, and Silicon Valley bros have reportedly used the diet to change their bodies. You can even buy keto dog food. According to some advocates, keto diets are a one-size-fits-all solution for obesity and the hunger that comes from traditional weight loss diets. On the other hand, a panel of nutrition experts ranked the ketogenic last (along with the Dukan Diet) among 38 other diets in US News and World Report’s annual diet rankings. How wide is the divide between the hype and the research? Originally developed to treat severe epilepsy in infants and children under medical supervision, today the ketogenic diet is moving to the mainstream as a low-carbohydrate tool for weight loss and as a means to reduce cardiometabolic risk factors-but not without controversy. Today's Dietitian looks at what the ketogenic diet is, what's known about its risks and benefits, and whether patients who say they're "doing keto" are actually following a ketogenic diet. The ketogenic diet isn't just any low-carbohydrate diet, and it's not necessarily similar to the Atkins or Paleo diets. The Atkins diet restricts carbohydrates while emphasizing protein and limiting fat, and while the Paleo diet restricts some carbohydrate-rich foods-primarily grains and pulses-it isn't necessarily low carb. The ketogenic diet is very low in carbohydrates and very high in fat, putting the body into ketosis-the burning of fat instead of glucose for fuel.
It’s not a diet that you can do part time. As we talked about above, you spend the first week on keto losing your glycogen stores and water weight. Only after your glycogen is used up do you enter ketosis. So it’s something you need to commit to for at least a month to see results. Once you have been on keto for 5-6 weeks You may want to try ‘carb refeeds’ as we talk about in the Keto Family Class. This off-and-on will prevent you from really entering the incredibly beneficial phase of being fat adapted. What if I don’t feel good on the keto diet? If you’ve tried keto and felt brain foggy, low energy, and/or had headaches, there are three main reasons for this: First, your electrolytes are off. This is what we’ll discuss next. Second, you aren’t eating real food! With the popularity of the keto diet, comes tons of fake sweeteners, packaged keto shakes and bars, and treats.|The Atkins diet is one of the most famous low-carb, high-protein diets that’s often associated with the keto diet. However, the two diets have some major differences. Dr. Robert C. Atkins created the Atkins diet in the 1970s. It’s often promoted as a way to lose weight that also controls numerous health issues, including type 2 diabetes. While cutting excess carbs is a healthy step, it’s not clear if this diet alone can help diabetes. Weight loss of any kind is beneficial for diabetes and high blood sugar levels, whether it’s from the Atkins diet or another program. Unlike the keto diet, the Atkins diet doesn’t necessarily advocate increased fat consumption. Still, you might increase your fat intake by limiting carbohydrates and eating more animal protein. The potential drawbacks are similar. Aside from a high saturated fat intake, there’s the possibility of low blood sugar, or hypoglycemia, from restricting carbs too much. This is especially true if you take medications that increase insulin levels in the body and don’t change your dosage. Cutting carbs on the Atkins diet can potentially aid weight loss and help you control diabetes symptoms. However, there aren’t enough studies to suggest that Atkins and diabetes control go hand-in-hand. Though it may seem new to your newsfeed, the ketogenic diet has been around since the 1920s. The low-carbohydrate, high-fat diet gained a foothold when proven to reduce seizures in pediatric patients with epilepsy. While still prescribed for that purpose today, the diet is now touted as a weight loss tool. The keto diet is all about cutting carbs and eating more fat. 5 percent of calories from carbohydrates, including low-carb, non-starchy vegetables and small amounts of leafy greens. The keto diet excludes carb-rich foods like grains, beans, fruits and starchy vegetables. 20 percent of calories from protein, such as meat, eggs and cheese. 75 percent of calories from fat, such as oils, unprocessed nuts, butter and avocado. According to Dietitian Richelle Gomez, MS, RDN, LDN, Northwestern Medicine McHenry Hospital, the ketogenic diet is designed to burn fat by cutting carbs. “Your body turns carbohydrates into glucose for energy,” she explains. Breaking down fats for energy is called ketosis. 2g Creatine: Increases your body’s ability to produce energy fast through cellular hydration. 2g BCAA (2:1:1): Branched chain amino acids composed of leucine, isoleucine and valine. Together, they promote muscle protein synthesis and cellular glucose uptake for muscle growth and better endurance. 1.5g Beta-Alanine: Promotes muscle endurance and more power output during training. 500mg L-citrulline: Helps reduce muscle soreness and promotes better endurance for your workouts. 50mg Caffeine: Derived from green tea, it promotes alertness without the blood pressure and heart rate elevation caused by caffeine. Learn more about exercising on keto or try Keto Perform Pre-Workout. Many people question whether or not it’s possible to follow a ketogenic diet while being a vegan. Although difficult (and not recommended), it’s not impossible to become a keto vegan. 1. The biggest issue many face when trying this style of keto is unknowingly eating too many carbs from vegetables and not enough dietary fat. 2. Avoid pastas, breads, chips, tortillas, rice, starch, white and sweet potatoes, fruit juices, sodas, and cereal. 3. Stick with spinach, kale, collard greens, asparagus, cucumber, Brussels sprouts, broccoli, cauliflower, bell peppers, and the other vegetables mentioned earlier in this guide. 4. Enjoy berries as your primary fruits, occasionally. 5. Good sources of protein include eggs, dairy, tempeh, natto, miso, nuts, and seeds (which are also great fat sources too). 6. Whether you’re vegan or vegetarian, these fats are ideal: olive oil, avocado oil, coconut oil, MCTs, macadamia oil, olives, avocado, cocoa butter, and organic dairy options. 7. Avoid pre-packaged vegan options as many are filled with fillers and soy, which, just like tofu, may not be right for some. While tofu is an option, there are limitations to consider since it contains xenoestrogens and phytoestrogens which can actually trigger your body to stop making its own estrogen. For some, this means processed tofu is not something you want to consume a lot of. This process is known as ketosis: It’s like when a hybrid car runs out of gas and reverts to pure electricity. “Your liver produces ketones all the time, but the rate depends on carbohydrate and protein intake,” says Jeff Volek, Ph.D., R.D., a professor of human sciences at Ohio State University. When the majority of your diet is made up of of carbs and protein, ketogenesis slows. Replacing carbs and protein with fat will put your body into ketosis, thus ramping up ketone production. Essentially, you're burning fat instead of carbs for energy. This process takes about three days to induce. Can’t you take ketone supplements? No. While it is possible to elevate ketones by taking them, “without the low-carb stimulus, there is no net increase in ketone production, no decrease in insulin, and no net increase in fat oxidation,” says Volek. Don’t trust trainers or “body hackers” who say you can induce ketosis quickly without changing your diet. What can you eat on the keto diet?|Can it promote weight loss? There are several proposed weight loss mechanisms associated with the ketogenic diet, though long-term studies are lacking. Thus, the keto diet may be an effective strategy to regulate your hunger levels, though its long-term safety must be taken into consideration. Another potential weight loss mechanism of the keto diet is the loss of water weight that accompanies the significant reduction in carb intake. Thus, when you reduce your carb intake, such as during the initiation phase of the keto diet, stored carbs are released along with additional fluid, resulting in weight loss of varying amounts. To determine whether the keto diet can aid weight loss, it’s important to review how weight loss is traditionally achieved. To lose weight, you must eat fewer calories than you burn, which is also referred to as a calorie deficit. One study in 17 men with obesity or excess weight found that the keto diet was associated with a small increase in the number of calories burned. These results suggest that the ketogenic diet is not necessarily superior to a traditional diet for weight loss when calorie intake is matched. The keto diet’s weight loss effects are therefore much more likely to be a result of reduced calorie intake due to changes in satiety signals associated with high fat, very low carb diets. The keto diet has been associated with weight loss, though the exact mechanisms remain unclear. Studies suggest that weight loss related to the keto diet is likely due to a calorie deficit, reduction in hunger levels, and water weight loss. In addition, routine consumption of foods that are high in saturated fat (think bacon, butter, and cheese) can ultimately lead to high LDL (harmful) cholesterol levels-a known marker of increased heart event risk. 35% increase in their LDL levels on average. The Medifast diet has been around since the '80s, and while this carbohydrate-controlled, low-fat diet is known to help you drop weight fast, it may not be good for your heart. With more than 40 portion-controlled and fortified meals to choose from, this calorie-restrictive diet is marketed toward people who need to lose a lot of weight and don't have time to cook or prepare their own meals. While this may sound appealing to many, Klodas warns that a whole day's worth of meals and snacks could cause you to consume three times the recommended amount of protein. Not to mention, the meals are heavily processed. Referred to as "yo-yo dieting," significant fluctuations in weight can double your risk of heart disease, Klodas says.
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Who It's Best For This is for those who want a flexible approach to healthy eating that is sustainable long term, notes McDonough, and who want more emphasis on Mediterranean elements like nonprocessed food and high nutrient density. If you’re a huge fan of salmon and sardines, this may be your favorite keto choice. Risks to Note The standard Mediterranean diet - which is not keto, thanks to its amount of whole grains and fruits - has many elements that are worth shuttling into a keto plan, so the risks are minimal, says McDonough. If you want to get truly Mediterranean, incorporate social time into your meals, rest after eating, and get regular physical activity. How It Works The latest revamp of the keto diet is Keto 2.0, which is gaining traction for those who feel the standard keto diet is too restrictive and difficult to sustain in the long run, says Penny Scholl, RD, in Avon, Massachusetts, who covers keto approaches on her blog, Remake My Plate. Make sure the bulk of your diet still comprises nutrient-dense whole foods whether or not you choose to include sugar alcohols in your keto diet. Is coconut sugar keto? For all intents and purposes, coconut sugar is the same as regular white sugar in the context of a keto diet. They contain similar carbs and calories per serving. The glycemic index of coconut sugar is a bit lower but not enough to really matter. That said, a small amount of sugar, coconut or otherwise, won’t automatically kick you out of ketosis. One teaspoon of sugar has 4 grams of carbs. I add a teaspoon of sugar to my coffee each morning with no ill effects. Is it the best use of your carb allowance from a nutrition perspective? No, but if it’s the sensible indulgence that allows you to reap maximum enjoyment from your keto diet, don’t sweat it. Can you build muscle on keto? Absolutely. Plenty of folks successfully build and maintain muscle mass on a ketogenic diet. Risks to Note Despite the name, this isn’t really keto, Scholl says. With the higher carb intake, you’ll no longer be in ketosis, with your body using fat for energy instead of carbs. The macros with Keto 2.0 make it closer to a moderately low-carb diet, such as the maintenance phase of the Atkins diet, according to Scholl. So the risk is that you’re not actually doing keto and getting into ketosis, which may lead to weight gain, but that said, this might be a nice bridge from higher-carb eating toward more traditional keto approaches. How It Works Is this diet as fun as it sounds? Depends on whom you ask. The macronutrient distribution in the “dirty keto” approach is the same as in the standard keto plan, according to Melissa Nieves, RD, an advisor for HealthyMeals Supreme who is based in Puerto Rico. The big difference is that the source of these macros can come from any kind of food, including highly processed and prepackaged meals. From your brain to your blood cells, glucose is typically the most readily available source of energy. We get glucose from the foods that we eat - whether that’s breads and refined sugars or those found naturally in nature, like fructose from fruits. But to keep the body and brain functioning in times of starvation when carbohydrates weren’t available, the human body can adapt to using ketones, instead of carbs for fuel. While the shift from using glucose to ketones might seem unnatural, your brain actually processes ketones more efficiently than glucose. Your brain is like a luxury car - why put in economy fuel if you can afford premium? But don’t just take our word for it. The keto diet was originally created to treat epilepsy in children, and is still used today in treatment for children and adults with drug-resistant forms of epilepsy. Does the ketogenic diet work? According to the NIH, there is, “no doubt that there is strong supportive evidence that the use of ketogenic diets in weight loss therapy is effective.” In fact they agree that there are many other positive benefits too, like improved mood and protection from cognitive impairment caused by obesity. There are many different ways to follow a keto diet. Here are the four of the most common. This standard ketogenic diet is one of the most researched versions of the keto diet and is what we’re referring to throughout this article (although, the same principles we’ve discussed apply to most of the other forms). The SKD generally includes 5 percent carbs, 20 percent protein and 75 percent fat. The targeted ketogenic diet allows you to add extra carbs around workouts, surpassing the SKD 5 percent carb rule, and may be a better option for those who are extremely active and train more than twice per week. The easiest way to see if this is working for you is to keep testing your ketone levels when you add carbs after workouts and make sure that they don’t kick you out of ketosis. The high protein ketogenic diet is close to the standard ketogenic diet, but with a higher ratio of protein.
2g Creatine: Increases your body’s ability to produce energy fast through cellular hydration. 2g BCAA (2:1:1): Branched chain amino acids composed of leucine, isoleucine and valine. Together, they promote muscle protein synthesis and cellular glucose uptake for muscle growth and better endurance. 1.5g Beta-Alanine: Promotes muscle endurance and more power output during training. 500mg L-citrulline: Helps reduce muscle soreness and promotes better endurance for your workouts. 50mg Caffeine: Derived from green tea, it promotes alertness without the blood pressure and heart rate elevation caused by caffeine. Learn more about exercising on keto or try Keto Perform Pre-Workout. Many people question whether or not it’s possible to follow a ketogenic diet while being a vegan. Although difficult (and not recommended), it’s not impossible to become a keto vegan. 1. The biggest issue many face when trying this style of keto is unknowingly eating too many carbs from vegetables and not enough dietary fat. 2. Avoid pastas, breads, chips, tortillas, rice, starch, white and sweet potatoes, fruit juices, sodas, and cereal. 3. Stick with spinach, kale, collard greens, asparagus, cucumber, Brussels sprouts, broccoli, cauliflower, bell peppers, and the other vegetables mentioned earlier in this guide. 4. Enjoy berries as your primary fruits, occasionally. 5. Good sources of protein include eggs, dairy, tempeh, natto, miso, nuts, and seeds (which are also great fat sources too). 6. Whether you’re vegan or vegetarian, these fats are ideal: olive oil, avocado oil, coconut oil, MCTs, macadamia oil, olives, avocado, cocoa butter, and organic dairy options. 7. Avoid pre-packaged vegan options as many are filled with fillers and soy, which, just like tofu, may not be right for some. While tofu is an option, there are limitations to consider since it contains xenoestrogens and phytoestrogens which can actually trigger your body to stop making its own estrogen. For some, this means processed tofu is not something you want to consume a lot of. While fat reigns supreme on the diet, don’t just turn to bacon, cheese, and cream. When choosing your fats, aim to include more anti-inflammatory omega-3s, particularly EPA and DHA, the type that are found in salmon, sardines, oysters, herring, and mussels, says Clevenger. Other healthy fats are a good choice, too; if you haven’t stocked up on avocado, olive oil, and seeds such as chia seeds and flaxseed, definitely do. They’re not only keto friendly - they also offer healthy polyunsaturated and monounsaturated fat that your body needs to perform at its best. With people consuming more sodium than ever in a diet rich in processed food, you’re probably not used to hearing the call to eat more salt. But on keto, it’s necessary. Not only does the clearance of ketones cause the body to lose sodium, but you may be getting much less table salt (which is comprised of 40 percent sodium and 60 percent chloride) now that you’ve kicked out the top source of salt in the standard American diet: packaged, processed foods, including bread, chips, crackers, and cookies.
For instance, Weiss himself has been on a low-carb high-fat (though not strictly ketogenic) diet for more than six months, and claims he does feel much better. But he’s clear about what he knows and what he doesn’t. He’s lost weight and his borderline pre-diabetes is gone. “I think I feel great,” he said. But that might be because he’s eating less processed food, sleeping better, or enjoying compliments on his new physique. As to the most exotic claims from health and diet gurus - such as keto diets resulting in euphoria, cognitive boosts, and improvements in anything from kidney function to cancer treatment - “We just don’t have the data on that yet,” said Weiss. The researchers agree that the diet itself isn’t inherently dangerous. But, cautions Weiss, “If you have any medical condition, if you take any medicine at all - there are lots of things that change how medicines work in our bodies, and nutrition is definitely one of them.|A 2012 case study analyzed the anti-convulsant effects of the keto diet on a 26 year old patient experiencing epilepsy. The study showed that the diet improved her symptoms significantly within two weeks of starting the diet in addition to her anti-epileptic medications. When following the keto diet, weight loss can vary from person to person, says Jeff Volek, a registered dietitian and professor at Ohio State University. The initial weight loss is partly due to losing water weight because you tend to retain less water on a low-carb diet. And some studies suggest that you may not continue to lose weight on keto long-term. Some call this the "keto plateau" which is when you stop losing weight altogether. The ketogenic diet isn't necessarily for everyone. Take kids, for example. Nutritionists told Insider that putting children or teens on the keto diet - or any restrictive diet - can lead to nutritional deficiencies and eating disorders. Similar to the Medifast diet, the Nutrisystem diet largely consists of prepackaged, frozen meals, which can cost up to $400 a month (excluding the additional groceries you may need to prepare some of the food yourself). Klodas says the ingredient profiles of many of Nutrisystem's prepackaged meals should be subject to skepticism, since they're laden with additives, preservatives, and artificial flavors. Best diet for heart health. Klodas isn't the only health expert who thinks the Mediterranean diet is great for your heart. In fact, it was the top diet in U.S. News' ranking of the best diets for overall health this year, which is created by a panel of registered dietitians, physicians, and preventive medicine specialists (just to name a few). The Mediterranean diet emphasizes whole foods, primarily fresh fruits and vegetables, legumes, and lean protein selections like fish. And unlike these other diets, this way of eating is considered a lifestyle rather than a quick way to lose weight. These fats are solid at room temperature while monounsaturated and polyunsaturated fatty acids remain a liquid at room temperature. Just because you’re following a ketogenic diet doesn’t mean you should indulge in every fat you come across. All fats are not created equal. 1: Hydrogenated and partially hydrogenated oils. These fats are found in packaged foods. They increase inflammation and your risk of developing heart disease, cancer, and high cholesterol. If you’re relying on packaged foods to get you through keto, check the label and ditch any foods with these. 2: Highly processed vegetable oils. Corn oil, peanut oil, canola oil, soybean oil, sunflower, and grapeseed oil are all fats that sound healthier than they actually are. 1. Are usually made with genetically modified seeds that are potential allergens. 2. Are cooked well above their smoke point, which makes the oils go rancid. This puts you at risk of developing certain cancers, obesity, and depression. But whether runners, specifically, should put their bodies in a state of ketosis depends on your goals. One study of five endurance athletes, published in the Journal of the International Society of Sports Nutrition, showed that a 10-week keto diet improved the athletes’ body composition and well-being but not their performance. In fact, the athletes initially experienced reduced energy levels and an inability to undertake high-intensity bouts of exercise. Another recent study in the journal Medicine & Science in Sports & Exercise looked at the effects of the keto diet on exercise efficiency in eight trained athletes. After following the diet, the athletes saw a decline in running speed and power-running speed at VO2max declined by 5 percent. However, both studies were small, and experts acknowledge more research is needed to study keto’s full, long-term effects. “There isn’t really a lot of good research that shows those people can perform better, and that’s really what runners care about,” Kasparek says.
Ketosis is a natural metabolic state in which the body burns fat rather than carbs. ’s the primary reason why people start it,” says Los Angeles-based Franziska Spritzler, RD, founder of Low Carb Dietitian. There are some other researched benefits beyond weight loss, including possibly acting as a mood stabilizer in those with bipolar disorder (per a very small study in Neurocase) and, more rigorously studied, lessening epileptic seizures (according to a study published in May 2016 in Epilepsy & Behavior). But not everyone’s a fan. “For most people, going keto means jumping on the diet-of-the-moment bandwagon,” says Jackie Newgent, RDN, a culinary nutritionist in New York City and the author of The All-Natural Diabetes Cookbook. “For most, it’s a fad diet that will offer temporary results.” That runs counter to Newgent’s usual advice to find an eating plan you can follow for a lifetime. She also worries that reducing carbs as much as the original keto diet calls for will cut out nutrient-rich foods, like whole grains, certain veggies, and fruits.|Liver problems. With so much fat to metabolize, the diet could make any existing liver conditions worse. Kidney problems. The kidneys help metabolize protein, and McManus says the keto diet may overload them. Constipation. The keto diet is low in fibrous foods like grains and legumes. Fuzzy thinking and mood swings. Those risks add up - so make sure that you talk to a doctor and a registered dietitian before ever attempting a ketogenic diet. What about the other diets? The popular low-carb diets (such as Atkins or Paleo) modify a true keto diet. But they come with the same risks if you overdo it on fats and proteins and lay off the carbs. So why do people follow the diets? McManus says. Theories about short-term low-carb diet success include lower appetite because fat burns slower than carbs. As a service to our readers, Harvard Health Publishing provides access to our library of archived content. Please note the date of last review or update on all articles. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician. However, if you listen to your body, you’ll likely pick up on a few tell-tale signs of ketosis. Rest assured, these symptoms typically only occur during the first 1-2 weeks of beginning a ketogenic diet and go away once your body starts to adjust. Once you reach this sweet spot, you’ll understand why the keto diet can be so rewarding and life-changing! Head over here for more information on the signs of ketosis. What are some of the benefits of eating a high-fat diet? Want to start out on the right foot? My Hip2Keto team offers a FREE 30-Day Keto Challenge where we’ll help coach you to the best keto journey possible! The FREE 30-Day Keto Challenge was designed with YOU in mind to help you reach your wellness goals with a fun and engaging challenge. In this series, we share helpful keto tips and tricks, insightful reads from our Keto Nutritionist, weekly meal plan ideas, meal prep tips, and delicious dining out advice. If you are among the minority of people who have a healthy metabolism and good insulin response, then you don't have to worry about your carb intake. Good metabolic health means you don't struggle with some combination of issues with blood pressure, blood sugar, cholesterol, weight, or low energy. Low-carb diets can lead to weight loss, research suggests, since they can help to manage appetite and reduce sources of added calories such as sugar and refined grains. But the primary benefit of keto is restoring metabolic health, improving insulin response, and reducing inflammation, Cucuzzella said. And while weight-loss diets work by restricting calories, Cucuzzella said that could backfire if you're doing keto for the first time, making it tougher to transition to burning fat for fuel if you aren't eating enough overall. Finally, a significant amount of the quick weight loss that people can have on short-term keto diets is water, and those pounds can return when you reintroduce carbs into your diet. Low-carb diets can also be problematic if you have a difficult relationship with food, including current or previous disordered eating habits. These include feelings of anxiety about gaining weight and a compulsive need to monitor or limit food, as well as binge eating, emotional eating, or addictive eating behaviors. Any diet that restricts what you can eat can be extremely triggering for anyone with these or other forms of disordered eating, which experts say can be risky if left untreated. It's best to seek professional support when considering a new diet. It may be tempting to make a dramatic change during a tough time. But if you can't manage your stress, you're not getting enough sleep, or you recently had an upsetting life event, it's the worst time to change your diet, Cucuzzella said.
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Anxiety, depression, PTSD, and other mental health issues have been shown improvement with a very low carbohydrate diet. To reduce brain fog and improve cognition. In a study from 2014, improved memory, cognition, and other ‘thinking’ aspects are correlated with a ketogenic diet. Epilepsy and seizures - historically this has been the most medically-common use of the ketogenic diet (source) For children on keto - please see this article to discuss children and keto further. Cancer, especially alongside conventional cancer treatments. Numerous studies show anti-tumor properties associated with the ketogenic diet. To balance HDL and LDL. A study from 2004 showed improved cholesterol markers in obese patients after 24 weeks on the ketogenic diet. Athletic performance, especially for endurance athletes. A 2014 study on endurance cyclists showed increase athletic performance, especially when they had been on the ketogenic diet long term, when riding for 2-5 hours. The study also showed lower muscle damage following exercise compared to those following a carb-heavy diet. Risks to Note Despite the name, this isn’t really keto, Scholl says. With the higher carb intake, you’ll no longer be in ketosis, with your body using fat for energy instead of carbs. The macros with Keto 2.0 make it closer to a moderately low-carb diet, such as the maintenance phase of the Atkins diet, according to Scholl. So the risk is that you’re not actually doing keto and getting into ketosis, which may lead to weight gain, but that said, this might be a nice bridge from higher-carb eating toward more traditional keto approaches. How It Works Is this diet as fun as it sounds? Depends on whom you ask. The macronutrient distribution in the “dirty keto” approach is the same as in the standard keto plan, according to Melissa Nieves, RD, an advisor for HealthyMeals Supreme who is based in Puerto Rico. The big difference is that the source of these macros can come from any kind of food, including highly processed and prepackaged meals. What can I expect on the keto diet? You’ll likely experience a rocky start as the liver begins to turn fat into ketones to be used as energy. “At the beginning, it is very uncomfortable, since our body is not used to this form of fuel,” Sharp says. “You tend to experience brain fog, headaches, nausea, and fatigue, along with bad-smelling breath, sweat, and urine. As your body levels out over time, many of these symptoms will subside, and things get better. Some research even points to enhanced cognitive activity and focus as the brain gets used to running on ketones. In the first days of the diet, your regular workout might prove exhausting without carbs to keep you going. Should I try it? Let’s put it this way: as popular diets go, it doesn’t have a great track record. The Atkins diet, hugely popular in the early aughts, has since been proven more or less ineffective for significant weight loss.
However, a more “moderate” approach to the keto diet is also a good option for many people that can allow for an easier transition into very low-carb eating and more flexibility (more on these types of plans below). What can you eat on a keto diet? Something that makes the keto diet different from other low-carb diets is that it does not “protein-load.” Protein is not as big a part of the keto diet as fat is. Reason being: In small amounts, the body can change protein to glucose, which means if you eat too much of it, especially while in the beginning stages, it will slow down your body’s transition into ketosis. Protein intake should be between one and 1.5 grams per kilogram of your ideal body weight. To convert pounds to kilograms, divide your ideal weight by 2.2. For example, a woman who weighs 150 pounds (68 kilograms) should get about 68-102 grams of protein daily. Your “macros” are your grams of fat, protein and net carbs (not to be confused with calorie counting!). What is the ketogenic diet? The ketogenic diet is a diet that produces reactions in the body similar to those that occur during fasting. This is a type of extreme low-carb diet that was first developed in 1921 due to the ability of this type of diet to reduce or suppress seizures. As new medications to treat seizures were developed, the ketogenic diet became less popular as a way to manage seizure disorders. However, in 2008, a clinical trial showed that a ketogenic diet could help children with treatment-resistant epilepsy become seizure-free. A ketogenic diet is often prescribed for people who have failed two mainline antiseizure drugs, with studies showing seizure-reduction rates as high as 85% after this treatment. It can be effective for patients of any age or seizure type. The reasons why a ketogenic diet works to help reduce seizures are unclear, but it is believed to induce metabolic changes that lower the risk of seizures. The diet itself is a low-carb, high-fat diet that involves extreme reduction of carbohydrate consumption and replacing it with fat, up to a concentration of 70%-80% of calories from fat. If you can get a handful of cheese, handful of walnuts or pecans, or add 1-2 tbsp of olive oil, caesar, or ranch dressing to your salad, you’ll get the fat you need. If you can follow those four rules, you should get into ketosis and start losing fat. But to make sure that you’re doing it successfully, it helps to do some degree of tracking. The easiest way is to track your weight. If your weight is going down, you’re probably doing it right. The next easiest way is to get some ketone pee strips. These will change colors based on the level of ketosis you’re in. They’re not perfect, but they’ll give you a rough idea of whether or not you’re getting into keto. The third and best method is to get a blood ketone testing device like I use. This lets you see very clearly whether or not you’re in ketosis, so you know how well you’re sticking to the diet. And what if you use one of these tests and it seems like the diet isn’t working? You’re either not losing weight or not in keto? Make sure you’re really eating no carbs. No sweeteners, no carby dressings or spreads, no high-carb nuts. Reduce your meat intake. You might be having too much meat, so cut it back to one and a half fists. Reduce your total intake. You don’t want to reduce the ratio of fat, so the last thing to try (primarily if you’re not losing weight) is to simply eat less of everything. Follow these five rules, and you should have no problem getting into and staying into ketosis. The first week might be a little rough, but after that you’ll find it’s a surprisingly easy diet to live on.|Most animal products are very low in carbs and ideal for the ketogenic diet. All meat and fish apart from liver and some types of seafood are zero carb. Also, beware of processed meat such as sausages as these foods may contain hidden carbs from added starches and sugar. When it comes to leafy greens, the darker the leaves, the better. Dark leafy green contain very few carbs and are nutrient-dense. Include a variety of greens in your diet, such as spinach, arugula, watercress, Swiss chard, kale, collards, bok choy, lettuce, and beet greens. And keto eating is not all about greens! There are plenty of other low-carb vegetables such as cabbage, cauliflower, Brussels sprouts, zucchini, broccoli, tomatoes, peppers, radishes, daikon, okra, turnips, rutabaga, cucumber, celery, eggplant, asparagus, pumpkin, spaghetti squash, kohlrabi, sea vegetables, and mushrooms. Even fruits have a place in a healthy keto diet. Include low-carb fruits such as raspberries, blackberries, strawberries, blueberries, blackcurrants, lemon, lime, rhubarb, coconut, and avocado. Nuts and seeds are a fantastic source of healthy fats. Macadamia nuts, hazelnuts and pecans are very low in carbs and a great source of monounsaturated fats. Almonds are a good source of protein. Other keto friendly options are walnuts, pine nuts, Brazil nuts, flaxseed, pumpkin seeds, sesame seeds, sunflower seeds, and hemp seeds. Apart from whole nuts, you can use nut and seed butters, coconut, avocado, and cacao butter. Beware of cashew nuts and pistachios as they’re relatively high in carbs. For more about nuts and seeds, check out this Guide to Nuts & Seeds on a Keto Diet.
Targeted ketogenic diet (TKD): This eating plan simply tells you to follow the keto diet BUT allows you to add carbs around workouts. So on the days you exercise, you will be eating carbohydrates. Restricted ketogenic diet (RKD): Designed to treat cancer, this ketogenic meal plan restricts calories as well as carbohydrates. Some studies indicate that calorie restriction and ketosis may help treat cancer. High-protein ketogenic diet (HPKD): This version of the keto diet is often followed by folks who want to preserve their muscle mass like bodybuilders and older people. Rather than protein making up 20 percent of the diet, here it’s 30 percent. Meanwhile, fat goes down to 65 percent of the diet and carbs stay at 5 percent. Vegan ketogenic diet or vegetarian diet: Yes, both are possible. Instead of animal products, plenty of low-carb, nutrient-dense vegan and/or vegetarian foods are included. Nuts, seeds, low-carb fruits and veggies, leafy greens, healthy fats and fermented foods are all excellent choices on a plant-based keto diet. No. However, you will need to significantly cut back on your carb intake at first. After two to three months, you can have carbs on special occasions-as long as you return to the diet right after. Will I lose muscle mass? There is some risk of losing muscle mass in any diet. However, high protein intake and ketone levels can minimize muscle loss, particularly if you strength train. What if I am constantly fatigued? If you’re constantly feeling tired or fatigued, you may not be in full ketosis. Your body might not be using ketones and fats in the most effective way. You should try lowering your carb intake or adding supplements to your diet. MCT oil or exogenous ketones can help battle fatigue. I have digestion issues. What should I do? Digestive disturbances are a common side effect of switching to a ketogenic diet. Symptoms should pass in three to four weeks. In the meantime, try eating more high-fiber vegetables or supplementing with magnesium to relieve constipation. So if your goal is weight loss, eat enough fat to be satisfied, but there’s no need to “get your fats in” once you’re satisfied. 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. Keep up electrolytes. The major electrolytes in our bodies are sodium, potassium and magnesium. Because a low carb diet (especially a keto diet!) reduces the amount of water you store, this can flush out electrolytes and make you feel sick (called “keto flu”). This is temporary, but you can avoid or eliminate it by salting your food liberally, drinking broth (especially bone broth), and eating pickled vegetables.
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The plan provides a list of recipes, the grocery list, and the portion size of each meal. What does the Custom Keto Diet include? When you purchase the Custom Keto Diet, you will get an 8-week customized meal plan designed specially by experts. There is a panel of fitness trainers, chefs, and nutritionists making sure that the plan is designed only after taking into account your overall health, and your choice of foods. The plan includes foods you can eat and avoid. And no, it is not about eating less. It is about eating food properly, and avoiding carbs, and sticking to healthier alternatives in your diet. This makes your diet more enjoyable and you are likely to stick to it for longer. The meal plan is customizable as per your taste. It comes with instructions that help you keep your diet in order and make it free from any sort of confusion. There are several recipes in the Custom Keto Diet program, and each recipe that is designed comes with detailed instructions. The ketogenic diet - more commonly known as the keto diet, is one of the most popular current ways to lose weight. Keto is a high fat, medium protein, very low carbohydrate diet, like a sort of turbo-charged Atkins diet. It's not the easiest diet to follow, for reasons we'll come to shortly, but it can be a sure-fire way to lose belly fat and feel healthy. We asked the Product Director of Bulk Powders supplements if the keto diet is safe and how to get started with keto. Given that Bulk Powders makes keto-specific supplements, he was, not surprisingly, quite into it. But should YOU try the keto diet? Seeing all the jaw-dropping before and after pictures, we were interested and even intrigued to find out more about the keto diet. Many people claim they lost weight following this strict diet, seeing results sooner rather than later.|A traditional keto diet restricts protein to this level, but the lazy keto diet may not. If someone eating a lazy keto diet consumes more protein than this, ketosis may not happen. However, a low carbohydrate diet can be beneficial for weight loss, diabetes, and cardiovascular risk, even if a person does not enter ketosis. By requiring people to limit carbohydrates to 10% or less, the lazy keto diet may help them avoid heavily refined foods and added sugars. As a result, this approach could help a person manage their weight or improve their health, depending on their food choices. On the other hand, a low carbohydrate diet that is lacking in fruits, vegetables, whole grains, beans, lentils, and other sources of dietary fiber may not promote health. Also, some researchers have reported that low carbohydrate diets are not superior to other balanced diets. Someone eating a lazy keto diet should ensure that they eat enough fruits, vegetables, and dietary fiber, all of which experts list as being important for promoting health. A 2015 review suggests that this dietary approach is also associated with improved diversity in gut bacteria. According to the authors, eating a diet high in animal protein and low in plant-based foods may increase colonic disease risk. In response the criticism and misstatements in the article, some 300 health-care professionals-200 of them doctors- from around the world recently signed a response letter written by the Low-carb Action Network, which welcomes skepticism yet wonders why the U.S. News editorial team has been so excessively critical of a new, evidence-based approach that is strongly supported by rigorous, clinical trial evidence and, in the view of many doctors working on the front lines dealing with diet-related diseases, offers the first truly promising solution to a long-tragic epidemic. Unfortunately, it’s not just US News that appears to have bias against a low-carb or keto diet. In fact, CNN Health recently published an article questioning the sustainability of keto diets. “Absent ketosis, keto is just a false label for some kind of diet that presumably restricts added sugar and refined carbohydrate - which, frankly, any good diet does,” Katz said. That is incorrect. This way of eating is a means to reduce hyperinsulinemia which is driving the majority of modern chronic disease. The keto - or ketogenic - diet is popular but unsustainable for many people. It involves eating high fat and low-carb foods, with the aim of burning body fat for fuel instead of glucose. Common reasons for quitting the diet include getting "keto flu," lacking energy, and being too deprived. Visit Insider's homepage for more stories. The keto diet is one of the most popular weight-loss strategies of the moment, despite having been ranked among the worst by the US News & World Report, where it scored particularly low for heart health and sustainability. The keto - or ketogenic - diet requires eating high-fat and low-carb foods: about 20 to 50 grams of carbs a day. To stay under this threshold, followers of the keto diet don't eat traditional carbs like bread, pasta, rice, or potatoes, but also generally avoid fruit, beans, lentils, and starchy vegetables as they are all too high in carbohydrates. The idea is that by cutting out carbs, your body enters ketosis and burns fat for fuel, rather than glucose.
The main goal of this eating pattern is to minimize your carb intake to make the body use fat as a source of energy. When you drastically reduce your consumption of carbs and increase fat intake, your liver starts producing ketone bodies from fat. Ketone bodies are small molecules that serve as an alternative source of energy for the body and brain. Ketosis is a state when your body uses ketone bodies (fat) as a primary source of energy. This diet contains all essential nutrients, and minimizes feelings of hunger as you can eat high fat foods that lead to a feeling of satiety. Thus, elimination of carbohydrates forces the body to start the process of breaking down fats which leads to weight loss. Read More: 30 Day Keto Challenge: Will Upping Your Fat Intake Help You Lose Weight? Start a keto diet step by step, gradually reducing your carbohydrate intake by 10 grams per day. Increase your fat intake every day for satiety, while maintaining your protein the same. Every January, we’re told that detoxes, diets, and a new gym membership are the key to a successful new year. It seems as though everyone’s trying to shave off the pounds as quickly as possible, and whatever diet can promise fast weight loss is the one they’re willing to try. Enter: the ketogenic diet. The ketogenic (often abbreviated to just “keto”) diet promises health benefits from weight loss to increased mental focus. But is it backed by science? Should you jump on the bandwagon or steer clear? What is the ketogenic diet? The ketogenic diet consists of an eating pattern that’s high in fat, moderate in protein and low in carbohydrates. It’s typically rich in foods like eggs, meats, nuts, butters, cheeses, seeds, oils and few low-carb green vegetables. It does not allow fruits, most vegetables, grains, potatoes, sweets, or other carb-rich foods. One common distribution is eating 5% of total calories from carbs, 20% from protein, and 75% from fat. If you search online for the term “keto diet,” you'll see that the health claims associated with the ketogenic diet are numerous. But before you give this diet approach a try, it’s important to know what the science suggests about how it may affect your health. Namely, you'll want to be aware of potential keto diet dangers. One of the most common side effects of starting the ketogenic diet is the “keto flu.” This term describes the often unpleasant, fatigue-inducing symptoms that occur as the body adjusts from a high-carbohydrate to a low-carbohydrate diet. During the keto flu, the body’s stored glucose begins depleting, and the body starts adapting to producing and utilizing ketones as energy. 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. Here are a few things you should know before you start. Yes, you might lose pounds really quickly, but you should also watch out for the side effects or complications. Drastic changes in nutrition can cause headaches, dizziness, weakness and fatigue, aches throughout the body, nausea and other common symptoms of flu. Often, people who stick to a keto diet experience this kind of discomfort, however, the reason behind this is not a virus or infection. The keto flu is caused by the body’s reaction to carbohydrate restriction. Your body is used to using carbs as a source of energy, so drastically reducing them can make you feel lethargic and lifeless. Your body needs some time to adapt to a new eating plan, usually, it takes around 24-48 hours. As you see, keto-flu can feel similar to ordinary flu. You may or may not have all symptoms from the list. Some switch to keto diets so easily that they experience few or no unpleasant symptoms, others feel sick from the first days until the end of the diet but that is not common.|People who follow the targeted keto diet tend to experience the most success when they eat before and during exercise. First, they feel that the extra glucose helps to fuel glycolytic exercises. Second, when performing vigorous exercises, they burn glucose so quickly that they rapidly return to a ketogenic state. However, protein synthesis requires fat and protein, not carbs. 18. Why Should I Eat Fast-Absorbing Carbs? According to the standard keto diet, you should eat low-glycemic, high-fiber carbohydrate sources, like squash, carrots, and blackberries. However, on the targeted keto diet, your goal is to use the carbs immediately to fuel a high-intensity workout. Some people like dextrose, which is found in pre-workout drinks and snacks. A more natural option is potatoes or rice. 19. How Can I Keep Calories Constant? The beauty of a diet that counts macros is that maintaining consistent calories is easy. Simply subtract four grams of fat from your daily allowance for every nine grams of carbs you eat before your workout. Have any more questions about the targeted ketogenic diet? Contact us today at Naples Vitality in Naples, FL to learn more. We’re committed to helping our clients live their best possible lives. We are more than happy to answer any and all questions you have about this revolutionary diet. Similar to the Medifast diet, the Nutrisystem diet largely consists of prepackaged, frozen meals, which can cost up to $400 a month (excluding the additional groceries you may need to prepare some of the food yourself). Klodas says the ingredient profiles of many of Nutrisystem's prepackaged meals should be subject to skepticism, since they're laden with additives, preservatives, and artificial flavors. Best diet for heart health. Klodas isn't the only health expert who thinks the Mediterranean diet is great for your heart. In fact, it was the top diet in U.S. News' ranking of the best diets for overall health this year, which is created by a panel of registered dietitians, physicians, and preventive medicine specialists (just to name a few). The Mediterranean diet emphasizes whole foods, primarily fresh fruits and vegetables, legumes, and lean protein selections like fish. And unlike these other diets, this way of eating is considered a lifestyle rather than a quick way to lose weight.
It should be noted that the keto diet may not always trigger weight loss, especially if you already have a low body fat percentage. 4 Reasons Why You Should Follow a Keto Diet? Weight loss isn’t the only reason to follow a ketogenic diet. Let’s look at some of the other benefits. This is why, despite information that states a certain amount of glucose is needed per day for optimal brain function, a keto diet can actually support cognitive function. In fact, some people report improved focus, concentration and mental alertness when they enter ketosis. A high-carb diet (especially when it comes to dairy products and refined sugar) has been shown to trigger sebum (oil) production in the skin. Removing sugar from your diet may also support skin health. Since high fat foods are also richer and more satiating than carbs, you’ll also feel full with smaller portions. In order for the keto diet to work, you’ll need to know if you’re in ketosis or not. “Both alcoholic ketoacidosis and diabetic ketoacidosis create medical emergencies due to the rapid change in the body’s acid-base balance,” Dr. Gonzalez-Campoy says. Common complications of diabetic ketoacidosis include very low blood sugar, or hypoglycemia, and swelling of the brain (cerebral edema). As such, when a person is in ketoacidosis, there is such a high level of ketones produced that can push a person into cardiac arrest (heart attack) or kidney failure. Hence, the very important reason for taking occasional keto breaks go give your body a bit more nourishing carbs. The ketogenic diet was originally formulated by doctors to help treat people with epilepsy, and it was found especially effective in children who didn’t respond to medication.1,2 Indeed, the keto diet has been found to reduce the frequency and intensity of seizures, which are common complications of this condition. This high fat/low carb diet may also help improve certain other neurological disorders like Alzheimer’s disease and Parkinson’s disease,3 according to the Epilepsy Foundation. There is no one standard ketogenic diet, and different ratios of nutrients have been used in so-called keto diets. All have in common the reduction of carbohydrates and an increase in fat along with a moderate amount of protein. The reduction in carbohydrates deprives the body of glucose and causes a metabolic state known as ketosis, due to the accumulation of molecules known as ketones in the bloodstream. Ketones consist of acetoacetate, acetone, and beta-hydroxybutyrate and form in the liver from long- and medium-chain fatty acids when the body burns stored fat for energy after glucose is depleted or in situations in which there is inadequate insulin present for glucose to be used as energy. In addition to seizure disorders, ketogenic diets have been tested in the management of some people with other conditions including diabetes, cancer, polycystic ovary syndrome, and Alzheimer's disease. Further, the "keto diet" has gained attention as a potential weight loss tool. Its proponents argue that a carefully controlled ketogenic diet can avoid the dangers of ketoacidosis and be an effective way to lose weight. While it might seem tough to limit carbohydrate intake this strictly, there's one important loophole to keep in mind. Because some carbs come from dietary fiber, which the body doesn’t break down and absorb, keto dieters can subtract those from their daily count. The resulting number is called net carbs, and it's a better measure of how many carbohydrates you're ingesting. For example, while a carrot may have 6 grams of carbs, about 1.7 of them are dietary fiber, so the net carb intake from the carrot is just over 4 grams. Similarly, more than 75% of the carbs in spinach are fiber, making it a relatively safe choice for keto-ers. Kirkpatrick suggests dieters limit their net carb intake to 25 grams a day. Like any restrictive diet, it’s hard to get a balanced plate of all the vitamins and minerals your body needs to stay healthy on a keto plan. The diet is also not recommended for pregnant women, people with liver and kidney problems, or anyone prone to gout . There are three main reasons to stay away from the keto diet. If the keto diet may help you lose weight or improve certain health markers, why wouldn’t you do it? The answer is simple: It’s very restrictive, so it’s not ideal for long-term for weight loss. 1. It is not sustainable for most people. Asche agrees that the diet is sustainable for some people long-term, but unless you are content with never eating carbs again, it’s just not realistic. 2. It can hurt your relationship with food. The keto diet can also impact your enjoyment of food and how you experience food-centric events, like family dinners, brunch with friends, or happy hour with coworkers. Because keto requires strict adherence that doesn’t allow wiggle room for occasional splurges, it can get in the way of enjoying everyday life. This type of restriction might even make you a bit obsessive, “where you have to track every last gram, macro, never allowing yourself to ‘splurge’ on anything containing carbs or sugar in fear of knocking you out of ketosis,” Asche says.
Up to 80 percent of people with Parkinson’s may also go on to develop dementia. 15) The ketogenic diet may help preserve cognitive function and memory in people who are at a relatively higher risk for dementia. Alzheimer’s disease, I’m not shy about suggesting it as an intervention - and, typically, I do,” says Robert Krikorian, PhD, professor of clinical psychiatry and the director of the division of psychology at the University of Cincinnati College of Medicine. That said, the keto diet as a therapy “is not widely accepted, but in my mind, there’s enough data to recommend it,” he says. Krikorian will be publishing research on early Parkinson’s patients with mild cognitive impairment. And while he can’t yet share the results, he says ketosis appears to have multiple effects, including improved brain function and cognition, potentially by way of enhancing energy production and normalizing insulin levels in the brain. One reason reason that low-carb diets like keto may improve cognitive functioning is through reducing insulin secretion in the body. That’s important because research suggests that higher insulin in the circulation correlates with lower levels of insulin in the brain, says Dr. Krikorian. Insulin in the brain is necessary to support memory consolidation; it also correlates with an enzyme that helps clear beta amyloid out of the brain, proteins that form plaques that disrupt brain function as in Alzheimer’s disease, he explains. That said, while it’s a promising area of research, more long-term studies are still need to be done before the keto diet is widely recommended in this disease. “We often don’t have a lot of data to guide us on the positive or negative effects, so I am cautious to say this is the right thing to do and not the right thing to do. In its strictest form, the keto diet consists of 75 percent fats, 20 percent protein, and five percent carbohydrates. That means foods like healthy meats and cheese are fair game, but no more bread, rice, or soda. Under regular circumstances, cells in the body use carbohydrates as a source of energy, which is converted into glucose and sent into the bloodstream. But depriving the body of that source forces it to go after fats, which is known as “ketosis.” During ketosis, the body breaks down fat molecules into something called ketone bodies to generate energy. “It’s a catabolic process in some sense. It breaks down fat and muscle mass if you don’t take on calories,” Chokshi says. 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. While following keto, you’re encouraged to eat as much fat as you want, no matter the source (e.g., butter, olive oil, meats, cheeses), until you feel full. Fat can have a strong satiety effect, but following this recommendation may not be comfortable for everyone. According to recent research, fatty foods may increase feelings of nausea and bloating for some people. Beyond potential physical discomfort, it also might not be emotionally comfortable for everyone-after all, keto is still a restrictive diet, which typically is not a good choice for anyone with a disordered relationship to food and eating. And as with any restrictive dietary plan, following a ketogenic diet can present challenges when it comes to social occasions, celebrations, office parties, meals out, etc. It also might be necessary to limit or avoid culturally relevant foods on the diet in order to stay in ketosis.|These symptoms have been dubbed “the keto flu.” Constipation is also common on the keto diet due to the lack of fiber. The high-fat nature of the diet could also have negative impacts on heart health. The American Heart Association recommends limiting saturated fat intake to 5 to 6 percent. “In practice, many people eat high amounts of saturated fats, which could increase cardiovascular disease risk,” says Dr. Maganti. “Patients with kidney disease have an increased risk of requiring dialysis on the keto diet due to the additional ketones that their renal system has to process,” says Dr. Maganti. Some people also experience dehydration on the keto diet because they’re eradicating glycogen, which holds water, from their bloodstream. “When you micromanage your food intake by tracking how much you eat, it disconnects you from what your body is asking for,” says Gomez. Monitoring food so closely can lead to psychological distress, such as shame, and binge eating. Restriction can lead to bingeing, which often leads to guilt, which then leads back to restriction in a continuous cycle. Both Dr. Ring and Dr. Maganti recommend balanced approaches, like the Mediterranean diet, for long-term weight loss. “You can still receive the benefits of ketosis while eating a varied and balanced diet through intermittent fasting,” says Dr. Ring. Gomez advocates making small changes based on your health goals. “All foods fit into a healthy diet,” she says. The ketogenic diet requires eating your macronutrients at a ratio of 60 percent fat, 30-35 percent protein and 5-10 percent carbohydrates. For someone consuming 2,000 calories a day, they would only be allowed to consume 20-25 grams of carbohydrates. Eating carbs at such low levels requires staying away from foods such as rice, pasta, bread, fruit and potatoes. However, you can eat foods high in dietary fat such as meats, nuts, cheese, avocados and eggs. How does the keto diet work? Avoiding eating carbohydrates and increasing the amount of dietary fats you eat for a long period of time (1-2 weeks) causes your body to change its metabolism and enter a condition called ketosis. Ketosis mimics the effects of prolonged fasting and starvation. We use fuel (e.g., the calories we eat) in a way that can be compared to hybrid cars. If one fuel source is used up, the backup fuel source will kick in. Normally our brains rely heavily on a steady supply of glucose (carbs) for fuel.|The ketogenic diet is having a moment. And, its 15 minutes of fame don’t appear to be fading anytime soon. So, why is keto so popular right now? The ketogenic diet has actually been around for a long time and was originally created to help treat kids with epilepsy. One reason it may have gained attention (aside from celebs touting it on Instagram) is that it is similar - but even more extreme - to the wildly popular Atkins diet. And, we all remember the Atkins era. People lost weight fast. On a keto diet as well, people tend to see quick results. Another possibility for its popularity is that it’s an easy diet to understand due to some straightforward rules. What's the best diet for weight loss? What is a keto diet? In case you haven’t jumped on the keto train and are wondering what exactly all the hype is about, here you go: The diet is very high fat and (almost) no carb. And basically ketones can stand in as glucose for fuel when we’re not eating carbs. Just to break it down again: On the high-carb diet you eat carbs like pasta or bread, your glucose levels rise, the pancreas secretes insulin and then the insulin moves the glucose into our cells to power our body. On the keto diet, a person eats fats like steak and eggs. The glucose and insulin levels in the body fall. The liver converts the fat into ketones and then the ketones fuel the cells and tissues of the body. You’re making the body find a way to use fat as a source of fuel. Is there another way to get the body into ketosis? Starvation. When you fast - think about it again, our bodies don’t have glucose stored up anywhere. When you’re not eating, it has to turn to fat stores to start to get energy to keep going.
The main issue is that ketosis is arguably a backup mechanism for fuel and energy for the body, he says. There have been many positive effects reported, but researchers don’t understand the long-term effects of sustained keto-based nutrition. Even though he isn’t a fan of diets in general - “I prefer habits,” he says - Chokshi recognizes the benefits of keto for some patients looking to lose weight and make a healthy change in the short term. Many have had success with dropping pounds, he says, and reported feeling “healthier and more fit.” It’s even better if it kickstarts a more sustainable heathy lifestyle. He also suspects there are some benefits for the heart and reversing diabetes since it has been shown to improve insulin sensitivity. “I can see a potential benefit because diabetes is exacerbated by excessive carbohydrate intake,” he says. Higher HDL cholesterol levels and lowering blood sugar are also associated with lower risk of heart disease. Still, there are potential downsides that patients need to watch out for, Chokshi says.|During ketosis, chemical molecules called “ketones” are produced in the liver when fat is burned, and they are sent into your bloodstream to be used as fuel for the brain, muscles, and tissues. The keto diet deliberately reduces carbohydrate intake to encourage the body to burn fat instead. Meat, vegetables, cheese, nuts, and other dairy products are a great way to get started. Limit fruits to 2x day. Fruits are naturally high in sugars, so they should be eaten sparingly. Some fruits are lower in natural sugars and are easier to fit into your macros. Generally, berries such as strawberries, blueberries, blackberries, and raspberries are a good option when you're living a low carb lifestyle. The first week is mainly water loss. But the more you have to lose, the faster you will lose. If you only have a little to lose, it may take a few weeks to start seeing real weight loss. Keto weight loss will fluctuate from week to week and depending on how much they have to lose. Increases energy, allowing those who typically don’t like to exercise to be excited about it. An insulin response is associated with fatigue, and when we keep our carbohydrate load down below 30-40 g/day, we just don’t have that much of an insulin response. Gives you a quick-win with a 5-15 pound weight loss the first week. Yes, this is water weight, but seeing the number drop so drastically, with bloating go down, provides a boost of self confidence. Reduces anxiety, depression, and gives a general sense of well being within the first week (source), which can help those tremendously who typically stress eat. Tames hunger because the body’s process of running on fat, not carbs, acts as a natural appetite suppressant. Reduces insulin response and blood sugar crashes. It’s common for those who previously self-described themselves as the type of people who ‘never skipped a meal’ to now realize they completely forgot to eat lunch, or they can skip breakfast and still go work out - no problem. The keto diet - what is it? Little is known on whether or not long-term adherence is safe or if the diet is safe for everyone in the short term, especially those with pre-existing health conditions. Why was the keto diet developed? The ketogenic diet premiered in the medical setting in 1921 by Dr. Russel Wilder. The diet was originally intended to treat children diagnosed with epilepsy. The anti-seizure effects were first noticed in response to fasting. However, the ketogenic diet was crafted to support growth and development in children without long periods of not eating. What are macronutrients and why are they important? Recently the ketogenic diet (also known as the keto diet) has risen to fame as a fad diet that claims to treat obesity. Calories in food come from three different sources: fats, carbohydrates and proteins. These three sources are called macronutrients. According to the USDA, the standard American diet follows a macronutrient composition of 40 percent fat, 11 percent protein and 48 percent carbohydrate.|“Chances are if you’re following a ketogenic diet you will need to prepare most, if not all, of your own meals and snacks from scratch, so simply season with salt,” says Tucci. Many followers of the keto diet try it because they’re hoping to use it therapeutically for a medical condition. If that’s you, talk to your doctor first and make sure they’re on board with your plan - especially if you’re also taking medication, says Clevenger. “Some medications may need to be adjusted by your healthcare practitioner as your signs and symptoms improve,” she says. Just one example is insulin, as a lower dose may be needed now that you’re severely limiting carbohydrates. Vegetables have carbohydrates. And that means that you have to watch how much you eat - even lettuce. If you're not careful or are eating them as a free-for-all, you could overconsume carbs, and thus get kicked out of ketosis.
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