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Calcium is also lacking. Most Ketogenic diet enthusiasts remain unaware that complex carbohydrates contain hundreds of beneficial substances called phytochemicals; which are naturally occurring non-nutrients that help to prevent disease. Not a long-term solution. The weight loss from the Ketogenic approach is typically temporary, not permanent. When you change your eating habits short-term, your weight will also change short-term. The goal should not be short-term weight loss, but rather, long-term weight control. Fatigue and irritability. A Ketogenic diet increases the likelihood of hypoglycemia (low blood glucose levels) and can trigger what is known as the keto-flu. Symptoms may include headaches, fatigue, irritability and more unpleasant symptoms. Inability to perform regular sustained exercise. Carbohydrate is a major fuel source for muscles during exercise. When carbohydrate stores are low and/or hypoglycemia is present, it’s very difficult to exercise. Diet plus regular exercise is far more effective for long-term weight control than either one by itself. We gladly acknowledge that ketogenic diets have been shown to be helpful in treating severe epilepsy, and that a few people will be able to sustain their weight loss using this approach. Even for those dedicated few, long-term weight control will mean cycling in and out of ketosis. Unfortunately, more and more studies suggest that low-carb diets may actually increase your risk for all-cause mortality, as well as cardiovascular disease and cancer mortality. For the majority of the population though, the strict macro tracking, dietary limitations, and unpleasant side effects are enough reason to drop this fad and aim for making healthier lifestyle changes. She also says that the body flushes out the buildup of ketones in urine, which also depletes water and sodium from the body. All that to say: Drink up. Tucci recommends waking up to a large glass of water and sipping regularly throughout the day to reach a goal of consuming half of your body weight in ounces of water daily. As your body transitions from a carbohydrate burner to a fat burner, you may experience what’s known as the “keto flu,” or flu-like symptoms (including muscle cramps, nausea, aches, and fatigue) during the first two weeks of the keto diet. If you’re not prepared for this feeling, you may think something is drastically wrong and give up the diet completely. More than that, you can help yourself through the transition period of low energy by planning out your meals or meal prepping, says Clevenger. She also recommends eating foods rich in potassium, magnesium, and sodium, as well as hydrating to help ease keto flu symptoms. Because most folks live on a high carb diet, our bodies normally run on glucose (or sugar) for energy. We cannot make glucose and only have about 24 hours’ worth stored in our muscle tissue and liver. Once glucose is no longer available from food sources, we begin to burn stored fat instead, or fat from our food. Therefore, when you’re following a ketogenic diet plan for beginners, your body is burning fat for energy rather than carbohydrates, so in the process most people lose weight and excess body fat rapidly, even when consuming lots of fat and adequate calories through their daily food intake. Another major benefit of the keto diet is that there’s no need to count calories, feel hungry or attempt to burn loads of calories through hours of intense exercise. In some ways, it’s similar to the Atkins diet, which similarly boosts the body’s fat-burning abilities through eating only low-carb foods, along with getting rid of foods high in carbs and sugar.|When we eat more carbohydrates than we need, our body stores them for later use. Stored glucose is packed tightly into molecules called glycogen which can be used to maintain our body in case we go too long without eating a meal. These reserves can only last about one day; and once depleted, the body must switch to a different fuel source called ketones. Ketones are produced in the liver. In response to low levels of glucose, the body begins breaking down fat tissue for fuel in the form of free fatty acids. Free fatty acids can be used as a fuel source throughout the body except for in the brain. The chart above indicates that the keto diet requires eating macronutrients at a ratio of 60% fat, 30-35% protein and 5-10% carbs. This causes the brain to hit the metabolic panic button in demand for a source of fuel. In response, the liver begins to repackage fatty acids into ketones, which are allowed access into the brain for fuel. Dry wine, champagne, and hard liquor should be enjoyed sparingly. All spices and some sweeteners: Enjoy stevia and sucralose every once in a while. It's a pretty exhaustive list, and probably includes some of your favorites: Bread, rice, pasta, fruit, corn, potatoes, beans, baked goods, sweets, juice, and beer all get the axe. Basically, you have to avoid most sugars and starches. Whole grains like oatmeal don't even make the cut! Almost all fruits: Apples, bananas, oranges, grapes, watermelon, peaches, melon, pineapple, cherries, pears, lemons, limes, grapefruits, plums, mango, and more. Most grains: Wheat, rice, rye, oats, corn, quinoa, barley, millet, bulgur, amaranth, buckwheat, and sprouted grains. Starches: Bread (all of it!), bagels, cereal, pasta, rice, corn, oatmeal, crackers, pizza, popcorn, granola, muesli, flour. There are some work arounds that dieters can still enjoy, like faux tortilla wraps that are made from cheese. Legumes: Black beans, kidney beans, pinto beans, navy beans, soybeans, peas, chickpeas, lentils.|Just avoid pairing this fatty fruit with chips or toast in order to adhere to ketogenic principles-instead, enjoy it as a topping to your salad, baked with an egg inside, or as a side to your morning bacon and eggs. STAY INFORMED: Sign up for our newsletter to get the latest food news delivered straight to your inbox. Walnuts are an excellent source of fat and protein, which makes them a healthy choice for most kinds of meal plans. Their high fat content and zero sugar status make them a must for keto devotees. Another protein-packed pick, almonds are a great choice for keto dieters. The combination of fat, protein, and fiber is an ideal trio when it comes to annihilating hunger and stopping cravings in their tracks. If you're looking for more healthy foods to snack on during the keto diet, don't miss these 22 Best Keto Snacks to Buy For Fat Loss. It takes a degree of total carbohydrate reduction including natural carbohydrates like fruits to achieve this and stabilize blood sugar in both type 1 and type 2 diabetes patients. The popular keto diet flunked, coming in next to last - which it has done for several years now. Only the highly restrictive protein-only Dukan Diet ranks lower. “Most health professionals are concerned that the degree of carb restriction requires someone to cut out many of the foods that have been consistently recommended as being healthy: fruits, beans/legumes and whole intact grains,” said Stanford professor Christopher Gardner, who conducts research on low-carb diets at Stanford Prevention Research Center. Respectfully to Dr. Gardner, this is not a recommendation for the entire country but for those who have difficulty with blood glucose and hyperinsulinemia reducing the carbohydrates is the most effective means of correcting this condition. We suggest people eat to their glucometers. As a physician I am concerned about high blood sugar and unstable blood sugar not about some theoretically grain deficiency in the human being. The ADA 2020 standard of care document acknowledges this too. With such negative reviews, just how did keto capture such a faithful following? Experts say it’s because its legions of fans are focusing on the short-term benefits of fast weight loss, without factoring in possible long-term risks. Well-controlled diabetes is the leading cause of absolutely nothing. Poorly controlled diabetes drives about every chronic disease, organ system failure, as well as many forms of cancer. So, I am not sure what the risks are of reversing metabolic disease with a safe and well formulated low carbohydrate dietary pattern. Just because the ketogenic diet is trendy doesn't mean everyone needs to-or should-hop on the bandwagon. There are other dietary patterns that are shown to promote health and a healthy weight, including Mediterranean and vegetarian dietary patterns. So, if someone chooses the ketogenic diet, should they approach it with the intention of following it long term? The reality is that many people who attempt the ketogenic diet cycle in and out of it-it ranked second-to-last on U.S. Because the diet can have health benefits for some individuals, Ayesta thinks training and certification should be options for dietitians. Carrie Dennett, MPH, RDN, CD, is the nutrition columnist for The Seattle Times, owner of Nutrition By Carrie, and author of Healthy For Your Life: A Holistic Guide to Optimal Wellness. 1. Abbasi J. Interest in the ketogenic diet grows for weight loss and type 2 diabetes. 2. Brouns F. Overweight and diabetes prevention: is a low-carbohydrate - high-fat diet recommendable? Eur J Nutr.

Thousands of people every week are jumping on the keto diet bandwagon, but the basics of how to start the keto diet can be both overwhelming and simple at the same time. Simple to think of what we don’t eat on keto: bread, cereal, sugar, or even fruit. Overwhelming to figure out what we will eat in their place! Plus, what is this about electrolytes, net carbs, and what’s up with the sweeteners? Can I really eat all the low carb cake I want and be healthy? Here we are discussing the ins and outs of the ketogenic diet. Once you try it, you will see that keto is like dieting… … on easy mode! ’t been working for you, I encourage you to give it a try and see if you see the rapid results that hundreds of thousands of people also see. So it’s important to seek the guidance of a dietician if you’re unsure. What are the different types of ketogenic diets? Admittedly, the keto diet can be a bit difficult to follow in the long run. That’s mostly thanks to how different it is than the diet that most Americans are used to. As a result, there are several different types of ketogenic diets you can choose from, ranging from super restrictive to somewhat forgiving. Focuses on minimally-processed whole-foods, including plenty of healthy fats/oils, quality meats/protein in moderation, and lots of non-starchy vegetables, herbs, spices bone broth and probiotic foods. Involves eating very low-carb most days of the week, but intentionally increasing carb intake 1-2 days per week in order to replenish glycogen stores and prevent side effects like fatigue. Includes a bit more protein and carbs than a traditional keto diet, allowing for more flexibility and food variety. One drawback is that it may not be easy to stay in ketosis while following a modified plan, however some feel it’s a healthy and sustainable way to eat long-term. More than half the children with epilepsy who were put on the diet experienced half as many seizures, while 10 to 15 percent of the patients who followed this diet became seizure-free. The keto diet has also been studied as a possible cancer therapy. In a study focusing on people with cancer who followed the ketogenic diet as a medical therapy,4 the authors reported: “There is a great need for complementary approaches that have limited patient toxicity while selectively enhancing therapy responses in cancer versus normal tissues. In another study looking at ketogenic diets as a treatment for cancer,5 this research team concluded, “based on the results of rigorous preclinical and clinical studies performed thus far, the KD would appear to be a promising and powerful option for adjuvant therapy for a range of cancers. Proponents of the keto diet say that when and followed precisely, it does not “starve” the body.

The idea behind this is carbohydrates allow for more intense workouts and more efficient post-workout recovery. Immediately before and after your workouts, you can eat 20 to 30 grams of carbs. Your RDA of carbs is 70 to 80 grams. 2. What Should I Eat on the Targeted Ketogenic Diet? The healthiest way to get your carbs on the targeted keto diet is to consume fruit, dairy, and whole-grain foods. Fruits contain fructose. Dairy contains lactose. Whole grains contain glucose. To get your recommended daily allowance of fat calories, cook your food in vegetable oils that are high in omega-6 linoleic acid. Monounsaturated fats come from nuts, palm oil, olive oil, and avocados. Polyunsaturated fats come from nuts and fish. You can also get protein from nuts and fish as well as red meat and poultry. 3. Will the Targeted Keto Diet Kick Me Out of Ketosis? When you eat any amount of carbs, your blood glucose levels elevate and your body’s ketone production drops. Instead, listen to your body for cues. If you are feeling hungry right after a meal, you probably didn’t have enough protein or fat. When followed correctly, a keto-based meal will leave you feeling full and satiated for hours. Seek Nutritional Ketosis, Not Higher Ketone Levels. To gain the most benefit from this diet, you’ll want to aim for a level of ketosis between 1.5-3.0 mol/L on a blood ketone meter. You’ll be there when you are eating well-designed meals that carry you through to the next meal without hunger or other adverse symptoms (ie, nausea, insomnia, crankiness, inability to exercise). Higher ketone levels suggest you have more circulating ketones in your blood but don’t confuse this with efficient fat burning, which is the goal of this diet. Ketosis Isn’t Forever. It’s recommended that you follow this diet to arrive at a state in which your body adapts to burning fat and glucose stores for fuel.

The end result of the “ketone diet” is staying fueled off of circulating high ketones (which are also sometimes called ketone bodies) - which is what’s responsible for altering your metabolism in a way that some people like to say turns you into a “fat-burning machine.” Both in terms of how it feels physically and mentally, along with the impact it has on the body, being in ketosis is very different than a “glycolytic state,” where blood glucose (sugar) serves as the body’s energy source. So, is ketosis bad for you? Absolutely not. If anything, it’s the reverse. Many consider burning ketones to be a much “cleaner” way to stay energized compared to running on carbs and sugar day in and day out. And remember, this state is not to be confused with ketoacidosis, which is a serious diabetes complication when the body produces excess ketones (or blood acids). The goal is to keep you in this fat-burning metabolic state, in which you will lose weight until you reach your ideal set point. About half said that they were and subsequently began a strict low-carbohydrate, high-fat routine. The other men and women continued with a high-carbohydrate diet. Everyone’s meals were matched in terms of how many calories, relative to body weight, they ate. Before the diets kicked off, though, the researchers drew blood from the athletes before and after a workout, to establish their baseline bone health and other markers of their health and fitness. Bone is an active tissue, constantly breaking down slightly and remodeling itself in response to the demands we place on it. Knowing this, the researchers checked for the levels of specific substances in the athletes’ blood known to be associated with bone breakdown, rebuilding and overall metabolism. Then the athletes embarked on three and a half weeks of intense training, while eating mostly fat or mostly carbs. Afterward, the researchers again drew their blood and rechecked the markers of bone health. They found differences. The markers of bone breakdown were higher now among the athletes on the keto diet than at the start of the study, while those indicating bone formation and overall metabolism were lower. These same markers were generally unchanged in the high-carb athletes. The athletes on the ketogenic diet, in other words, showed signs of impaired bone health. How their bones might have been affected by their eating is still unclear, says Louise Burke, the head of sports nutrition at the Australian Institute of Sport in Canberra and one of the lead authors of the new study. “We believe that the keto diet may affect bone metabolism due to the downstream effects of low-carbohydrate availability on certain hormones, along with other factors,” she says. But more study, of course, is needed. By day seven, the strips informed me that I had reached a deep level of ketosis-aka, my self-inflicted carb deprivation was definitely paying off. If you're planning to try this diet, I highly recommend purchasing test strips to determine your individualized upper carb limit and get an idea of how certain foods affect your ketosis levels. Day nine was my downfall. I regretfully binged on chocolate frozen yogurt and microwaved stroopwafels. Cutting my net carbs to 10 grams the next day had me feeling extra moody and groggy, and by the end of day 10, I completely succumbed to all of my favorite carb-laden vices. My first week on the keto diet went remarkably well-as in, I wasn't swearing like a sailor or drooling over every whole-wheat roll my friends popped into the toaster. However, the influx of cravings and insatiable hunger I experienced toward the end of my experiment made me realize that this diet isn't very sustainable. Moving forward, I definitely plan to adopt a low-carb diet. Personally, cutting carbs-especially processed, refined carbs-completely alleviated the occasional bloating and abdominal pain I suffered from and endowed me with long-lasting energy. And by the end of the ten days, I had lost about a pound and a half and few centimeters off my waist-not enough to fit into my enshrouded pair of AG jeans, but a sufficient amount to feel some sense of pride. Convinced to embark on your own ketogenic journey? Before you start, stock up on these 20 Best Foods for the Keto Diet.|Targeted keto diet: this approach involves eating carbs up to one hour before exercise with the theory the carbs get used up through your workout. For the purpose of this guide, I’m going to concentrate on the standard keto diet as this is the most straightforward to start out on. This percent split is a general guide just to give you an idea of what you should be aiming for. It’s worth noting the numbers can vary slightly depending on your weight, activity levels, and your targets. The keto diet is a little different to other conventional diets where the focus is not so much on counting calories, instead you count net carbs. “What are net carbs? On the keto diet, your goal is to limit net carbs to 50 grams, or preferably lower, per day to reach ketosis. Don’t worry if this all sounds overwhelming and complicated. You can find some great apps or nutrition calculators around to help you work out your totals.

“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. Think of keto as a tool to make it much easier to maintain a calorie deficit. Even keto, as awesome as it is, isn’t a ‘eat as much as you want and still lose weight’ magic bullet. 1. When not in ketosis, your liver and muscles are full of glycogen, about 1-2 pounds worth depending on your body size. For every 1 part of glycogen, your body holds on to 3 parts of water (source). When we enter ketosis, our body will use up that glycogen and shed the associated 3 parts of water. 2. When you cut out major food groups, primarily sugar, grains, and gluten, your inflammation (mild swelling throughout the body) will go down. Most people are sensitive to these foods, and when we eliminate them we stop chronic inflammation. You can read more about inflammation and the body here. 3. When you eat a carbohydrate-rich diet, lots of water is required in your digestive tract to break down the carbohydrates. Real sweeteners and sugar: Cane sugar, honey, maple syrup, agave nectar, Splenda, aspartame, saccharin, and corn syrup. You'll have to settle for sugar alternatives, including natural substitutes like this monkfruit sugar replacement. Sweet treats: Candy, chocolate, cakes, buns, pastries, tarts, pies, ice cream, cookies, pudding, and custard. Dieters can shop for dessert alternatives like this keto-friendly ice cream that won't impact your blood sugar levels in a single serving. A selection of cooking oils: Canola oil, soybean oil, grapeseed oil, peanut oil, sesame oil, and sunflower oil. Alcohol: Beer, cider, sweet wines, and sweetened alcoholic drinks. If you're going to spring for wine, keep it as dry as possible - the bottle should have less than 10g of sugar in its entirety. Bottled condiments: Ketchup, BBQ sauce, tomato sauce, some salad dressings and hot sauces that contain added sugar. Low-fat dairy: Things like skim milk, skim mozzarella, fat-free yogurt, low-fat cheese and cream cheese should be swapped for higher-fat counterparts. If you're tempted to go keto, consult with your doctor before embarking on any extreme weight loss plan. While the ketogenic diet can include some healthful foods (we're all about broccoli), many others get nixed (bye, bananas and sweet potatoes).|One aspect of losing weight that many people don’t talk about is that your existing health conditions may be making it really tough to lose weight. That may well be why your friend or spouse can do a diet for a month and drop 20 pounds while you gain 5 pounds following the same plan. It’s not that you’re doing anything wrong with, and there may not even be anything wrong with that way of eating (for weight-loss purposes), but there may be some underlying health conditions that are making your body cling onto that extra weight. A keto diet plan may help certain health conditions (like type 2 diabetes, gut dysbiosis, sleep disorders, fatigue, etc.) and may make it easier for you to lose weight. There’s also research into using a keto diet to cure/prevent cancer (see Dr Seyfried’s research for more) and brain disorders like Alzheimer’s (see Dr. D’Agostino’s research for more).

Also, it takes more energy for your body to convert fat to ketones for fuel rather than using readily available glucose from carbohydrates. But the carbohydrate restrictions mean that most people have trouble sticking to the diet long term and end up regaining any lost weight when they revert to a “normal” eating plan. Q: Does a ketogenic diet help you build muscle? A: No. In fact, a ketogenic diet actually causes your body to lose muscle mass. Research suggests that even if your diet is high in protein, or your protein intake is constant, a carb-restricted diet may promote muscle loss. When we eat carbohydrates with lean protein, our bodies produce insulin. This acts as a sort of key, unlocking our muscles to let the protein in so that it can build muscle tissue. Skipping carbohydrates depletes our energy stores and reduces muscle-building potential. Q: What are the drawbacks? A: In addition to being tough to follow, the ketogenic diet coaxes your body to release more of the stress hormone cortisol. 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 . Too much omega-6 fatty acids can be inflammatory, so avoid sources of high omega-6s, such as grains and vegetable oils like corn oil or sunflower oil. Focus mostly on omega-3s from fish like trout, salmon, and sardines or take a high-quality fish oil supplement like krill oil. Also, be mindful of nuts and seeds because they do contain some carbs, especially pistachios and almonds. The quality of your dietary fat on keto makes a huge difference in the results you’ll see. It’s essential to learn which sources of fat are really considered healthy and safe to eat on keto. We covered this in great detail in this guide. Saturated fat has been shown to improve HDL and LDL cholesterol levels - both the good and bad cholesterol markers - and it can also fortify bone density and support your immune system and hormones. When you whip up a few keto recipes, you’ll probably be cooking with one of the items listed above.|To that end, most keto dieters try to keep daily carb intake between 20 to 50 grams. Considering there are roughly 6 grams of carbohydrates in one medium-sized carrot or a serving of plain Greek yogurt, keto meal planning requires forethought. It’s not as simple as swapping morning toast for a few strips of bacon. Since going keto can get complicated, one Redditor even created a keto food pyramid that he encourages people on the diet to print out and put on their fridge. Eggs, including the yolks. Oils, especially those containing healthy mono and polyunsaturated fats (like olive oil). This is critical because relying too much on more saturated fats from dairy and meat can cause digestion issues and hurt your heart. Avocados, another great source of monounsaturated fats. Cauliflower: Theveggie is low in carbs and high in dietary fiber, so many keto dieters use it as a substitute for bread, pasta, and crusts. Berries, especially blackberries and raspberries. And bacon and sausages have a lot of calories, protein, and saturated fat. If you go off keto and continue eating these while adding carbs back in, it’s likely that you’ll regain the weight. What’s more, consuming a lot of saturated fat, something that’s easy to do when choosing these types of foods, increases your levels of blood cholesterol, boosting the risk of heart disease and stroke, according to the American Heart Association. Also know that while pure sources of fat, such as olive oil or coconut oil, contain 0 carbs, other sources, like nut butter or avocado, may be primarily fat but have carbohydrates that need to be counted in your total, too. Still, with new research studies, like one published in January 2020 in the journal Circulation, showing that coconut oil consumption leads to an increase in LDL (“bad”) cholesterol levels (which raise your risk for heart disease and should be limited), it’s more important than ever to choose the right types of fat - even on a fat-friendly diet. A final guideline: Even if you’re on keto, portions of fat still matter, says Jill Keene, RDN, of White Plains, New York. “How much you specifically eat depends on your calorie needs and goals, but overconsuming fat can cause weight gain,” she says. Also, considering that fat is your body’s main fuel source on a keto diet, she advises spreading out your fats evenly throughout the day. Many people on a keto diet count net carbs, which are total carbs minus fiber and sugar alcohols (since fiber goes through your system undigested). We take both into account here. The main difference between the five types of Ketogenic Diets is this macronutrient ratio. All Ketogenic Diets are high in fat, adequate in protein and low in carbohydrates. This combination changes the way energy is used in the body, converting fat into fatty acids and ketones in the liver. When there is an elevated level of ketones in the blood, one is in a state of ketosis, which has a variety of therapeutic benefits for the sick and healthy alike. In addition to the macronutrient ratio, the frequency of eating can influence ketosis. More specifically, a practice called intermittent fasting, which reduces the window of time a person eats throughout the day, can help in obtaining and sustaining ketosis. When the eating window is shortened, the body is forced to access energy from its own fat stores rather than calories directly from the diet. An individualized and structured diet that provides specific meal plans. Foods are weighed and meals should be consumed in their entirety for best results. The ketogenic diet makes your body think it is in a state of ketosis, making you burn fat for fuel instead of carbohydrates or protein. What does the research say? The short-term weight loss effects of the ketogenic diet seem promising, but very little information is known on whether or not these effects continue during long-term compliance. In fact, one of the major concerns regarding the diet is its long-term feasibility. Strict dieting regimens that lead to short-term weight loss can eventually lead to increased weight gain once dieters stop following the diet. How safe is the keto diet? As mentioned earlier, the majority of calories in a ketogenic diet originate from fat. This causes many to fear the risks of developing heart complications due to increased consumption of saturated fats and cholesterol. Nevertheless a recent analysis reviewing more than 20 published trials reported there is no significant evidence that consumption of saturated fat increases the risk of heart complications. American Heart Association recommends limiting saturated fat intake to six percent of total caloric intake. This would be about 13 grams of saturated fat for someone consuming 2,000 calories. Strict avoidance of dietary carbohydrates can limit the diversity of an individual’s diet, which may increase the risk of nutrient deficiency. Dietary analysis shows that those consuming a ketogenic diet lack sufficient intake of calcium, vitamin D, phosphorus and magnesium. These nutrients are vital for bone health, and intake below the recommended amount can lead to osteoporosis.

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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. Well, while they have roughly the same nutritional value as any other type of beans, green beans and black soybeans are particularly low in carbs: “A 1/2 cup of black soybeans provides only eight grams of carbs, 11 grams of protein, seven grams of fiber, and six grams total of fat,” Gans notes. If you’re looking for a little bit more info on bean types and their various carb counts according to the USDA database, see below. Each of these nutritional values are determined based on half cup measurements. What are some good bean substitutes? Now that you have all the information you need on beans and their relationship to the keto diet, you might be wondering how you can work other low-carb, similarly-textured foods into your everyday eats and meal prep. (Or, if you just don’t like beans in general, you might be looking for some substitutes.) Here are some great go-to options, according to Sheth. Mushrooms. Because of their textured and earth-y taste, chopped mushrooms are a great substitute for any bean-centered meals if you’re looking for a swappable option. Eggplant. “Consider other low-carb vegetables as a swap for beans,” says Sheth. She recommends changing out carb-heavy options like hummus for eggplant-based dips like babaganoush. Peanuts. Yep, boiled peanuts are legumes, and they can totally be a go-to if you’re looking for a bean substitute. Why? “They are low in carbs and can provide a similar texture to dishes,” says Sheth. Avocado. Looking for a high-fat, low-carb substitute for your favorite beans? Avocados or dips like guacamole are a flavorful and easy-to-incorporate option, Sheth says. Ground meat. High-protein, lean ground meats are also a flavorful and filling substitute for beans, if you’re not on a vegetarian or vegan diet.|The ketogenic diet (also referred to as the keto diet) has been around for decades, but recently it’s grabbing headlines for its ability to enhance performance and melt pounds. But are these claims legit? And, more important, is it safe? “I get asked all of the time ‘What is the keto diet” followed by ‘Do you think I should do it,’” says Kelly Nohl, a registered dietitian with Henry Ford Health System. Here, Nohl answers those questions - and many more - so there’s no need to wonder about this popular diet plan anymore. Q: What is the ketogenic diet? A: The ketogenic diet (also called keto) dates back to the 1920s, when doctors began using it to control seizures among patients with epilepsy. The diet’s composition of carbohydrates, fat and protein force the body to use fat instead of carbohydrates for energy. Dubbed ketosis, this process creates acids in the blood called ketones that our bodies and brains use for fuel. This is the most important! For a low carb diet, aim for under 50g net carbs per day, though some variations limit to somewhere between 50-100g per day (mostly if you are more active). Get the carb limit down and you’re most of the way there! Limit protein intake. A keto diet or low carb diet is not a high protein diet! Low carb is generally higher in protein than keto, but be careful with both. High protein diets can stress the kidneys, and besides, excess protein converts to glucose. Make your protein intake a goal to meet each day, but more than that is not better. Use fat as a lever. We’ve been taught to fear fat, but don’t! Both keto and low carb are high fat diets. Fat is our source of energy as well as satiety. The key to understand, though, is that fat is a lever on a low carb or keto diet. Carbs and protein stay constant, and fat is the one you increase or decrease (push the lever up or down) to gain or lose weight, respectively.

On a personal note, I myself have adopted a low-carbohydrate diet with sufficient protein and liberal fat. People are shocked when they see me pour olive oil over my fish or salad. Although I don’t attempt to achieve the extremely high fat content of ketogenic diets, fat is the main source of calories in my diet. Eating this way I’ve experienced many benefits including clearer thinking and a greater energy level. No longer do I have the afternoon “slump.” My complexion is clearer and the post-meal bloating I experienced before is gone. When I’m asked about my diet, my simplest explanation is that I’m on ancestral diet with generous fats-this means natural and unprocessed foods including meat, fish, poultry, vegetables, berries and fats from nut and olive oil. This is what our early ancestors ate. I feel full for long periods and typically eat only two meals a day (not advised for children). Although it can be difficult to maintain this kind of diet in our carb-loaded society, eating at home is my best option. This lifestyle has also forced me to be a better advisor to my patients and students. Think the ketogenic diet is right for you? Talk to your doctor before adopting a ketogenic diet, or connect with one of our qualified diet professionals to determine a course of action that is right for you. The below links provide access to diet professionals and hospitals with expertise in ketogenic therapies.} Unlike with calorie restriction, keto helps you lose weight by putting your body into ketosis. When you eat minimal carbohydrates, your body produces ketones for energy. Ketones are made in your liver from fatty acids found in food or your own body fat. Therefore, your liver actually burns fat to make ketones. Ketones are used for energy in lieu of carbs. As your body steadily burns fat as a fuel source, you will start to lose weight. You may be wondering if keto can target specific problem areas, such as belly fat. Burning belly fat is high on the priority list for many people. The fat in your belly is visceral fat, which is a dangerous type of fat that lives deep inside the abdomen, encasing your internal organs. Visceral fat is linked to heart disease and type 2 diabetes. Technically, you can’t spot-target fat areas for reduction. Your body decides where weight loss will occur. However, keto may be useful for eliminating stubborn belly fat.

More than half the children with epilepsy who were put on the diet experienced half as many seizures, while 10 to 15 percent of the patients who followed this diet became seizure-free. The keto diet has also been studied as a possible cancer therapy. In a study focusing on people with cancer who followed the ketogenic diet as a medical therapy,4 the authors reported: “There is a great need for complementary approaches that have limited patient toxicity while selectively enhancing therapy responses in cancer versus normal tissues. In another study looking at ketogenic diets as a treatment for cancer,5 this research team concluded, “based on the results of rigorous preclinical and clinical studies performed thus far, the KD would appear to be a promising and powerful option for adjuvant therapy for a range of cancers. Proponents of the keto diet say that when and followed precisely, it does not “starve” the body. He says that when someone says they're doing the ketogenic diet, and they're doing it on their own or maybe seeing a coach once a month, they're probably not doing it correctly. One frequent side effect when someone starts a ketogenic diet is the "keto flu," which can include lightheadedness, fatigue, headaches, nausea, and constipation. This is the result of the body's rapid excretion of sodium and fluids as carbohydrates are restricted. Increasing sodium by 1 g to 2 g per day may restore the body's levels to normal. Volek agrees that many people who attempt to do a ketogenic diet on their own are missing the mark. With clients, Ayesta often uses 70% calories from fat and about 20% from protein sources. He has his patients use ketone monitors and modifies macronutrients as needed. Reid says that the average person doesn't fully understand what ketosis really means, or that it's necessary to measure blood levels of ketones.|A lot of people have found the keto diet helps them stay healthy and in shape. Advocates include top athletes like Ben Greenfield, as well as people who have struggled with weight issues for a long time like Jimmy Moore. Sounds like a great plan right? However, when you mention the keto diet to medical professionals, there might be some confusion and misinformation. The main confusion has arisen due to 2 very similar sounding words: ketosis and ketoacidosis. They sound similar but are actually very different. What is the Difference Between Ketosis and Ketoacidosis? When you’re on the keto diet plan, your body will go into a state of ketosis, which is the metabolic state that occurs when your body uses ketones as its primary energy source instead of glucose. During ketosis, your body breaks down fat to use as energy instead of using carbohydrates for energy (as normally happens when you eat food containing carbohydrates). If you’re looking to burn fat, then ketosis can be a very good thing. Just opt for the full-fat version and organic and raw, if possible. But for some people, dairy causes stomach bloating and abdominal pain, a condition referred to as lactose intolerance. Lactose intolerance comes from the sugar found in milk. A few dairy products should be avoided due to their high sugar and carb content. For example, a glass of whole milk (which doesn’t have any fat removed) contains 12.8g of carbs per glass. Protein is a vital component of any diet. Protein fuels your body with essential amino acids, helps regulate organs, and builds muscle and connective tissue. Ideally, you should consume 0.8 grams of protein per pound of lean body mass (at least). This will prevent muscle loss and help you build essential neurotransmitters and hormones. Some people consume up to 20% of total calories from protein and stay in ketosis. To learn more about the benefits of eating grass-fed meat, check out this guide. To really excel at keto, it’s not just about adding more fat to your diet; it’s also about removing the junk.

This only allows about 20 to 50 grams of carbs per day! The overall premise of the ketogenic diet is to produce ketone bodies, which are metabolites of fatty acids, and use them instead of glucose to fuel your cells. The ketogenic diet was first adopted as a treatment for people with epilepsy in the 1920s, since it was shown to reduce seizure activity in some patients. Today, most people opt for anti-seizure medication (because the diet is challenging to adhere to), but some still use this diet to help manage their condition. How is it supposed to work? Let’s zoom into the GI tract for a minute. When you eat a carbohydrate, which are found in anything from oatmeal to soda to tomatoes, it is broken down into glucose. The main role of glucose is to supply energy for all of our bodily processes. Our bodies are actually a lot less discriminatory toward the source of glucose than we might think - it uses the carbs from a tomato, a cracker, or a jellybean the same way: to make energy! After 20 years of January diets, my own experience suggested that nothing made any difference: you only lost weight if you took in less calories than you used, and if you took in less calories than you used then you were hungry. Simple as that. Could it be that a ketogenic diet really was different? Well, the principle makes sense. Bizarrely named “ketone bodies” are actually molecules that act as the body’s natural back-up fuel supply when glucose is scarce. Normally, we only enter ketosis (where ketone bodies accumulate in the blood) when we starve ourselves - not just overnight or by missing a meal, but for several days at time. Our metabolism then switches to fat-burning, and converts stored fat molecules into ketone bodies that can power our muscles and brain because the glucose has run out. Being in ketosis, then, does sound like a great way to burn off the fat. 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. The macro count for the HPK diet is roughly 5 percent carbs, 35 percent protein and 60 percent fat. This form rotates ketogenic days with high carb days, usually five ketogenic days followed by two high carb days. Sometimes referred to as ketogenic carb cycling, this version of the keto diet can help promote fat loss and muscle-building. Ketogenic carb cycling is also said to be less of a lifestyle stressor for some people, as the two high carb days make the CKD feel less restrictive and easier to follow. Since each person has a different body fat percentage and nutrient requirements, there is no one-size-fits-all caloric or macronutrient rule for getting into ketosis. For example, athletes who train four to five times per week will still be able to enter a state of ketosis by eating a higher percentage of carbs, compared to someone who’s mostly sedentary. If you’re not already a keto pro, you can calculate your personal optimal macronutrient ratios by using this ketogenic calculator. To set up the body for the benefits of keto-adaptation, we consume a healthy, rather than restrictive, amount of calories within the following macronutrient profile that includes ample vegetable intake, moderate protein amount and quality fats with a focus on carb content at around 50 grams for most people. The carb-heavy Standard American Diet is an evolutionary aberration. The constant drip of glucose into our blood is a modern luxury (or, more to the point physiologically-speaking, a modern burden). For most of human history, if we wanted carbs, we had to climb a tree and extricate a bee’s nest, spend hours digging tubers, or wait around for the wild fruit to ripen. We are designed for periods of low food availability, and, especially, low glucose availability. In short, we’re wired to favor fat and ketone burning. Plus, humans are remarkably good at slipping into ketosis. Whereas for most other animals ketosis is difficult to achieve, a human will be mildly ketotic just waking up from a full night’s sleep.

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Aside from being an energy source, ketones are also important neural signaling molecules and gene transcription facilitators. Ketones also seem to modulate the stress response in neurons and make them more resilient to excitatory nerve transmissions-the kind that can cause seizures. D’Agostino also found that ketones can elevate levels of the calming neurotransmitter GABA. Theories aside, when he treated SEALs with a keto diet, their seizures stopped. But brain diseases aren’t the only illnesses doctors are beginning to think are metabolic rather than purely genetic in origin. Many common types of cancer- esophageal, pancreatic, colon, kidney, thyroid-are associated with obesity and diabetes, and D’Agostino believes he’s on the path to understanding why. Cancer cells thrive in high-sugar environments because they rely on glycogen (sugar burned for energy) to survive; type-2 diabetes, especially, provides potential cancer cells with a high-sugar environment. This suggests not only that glycogen may contribute to cancer, but also that it may be cancer’s Achilles’ heel: If cancer cells become compromised when their host is in a ketogenic state, the body’s own immune responses may be able to effectively fight the disease.|Claims of benefits of the ketogenic diet for cancer, dementia, and Parkinson disease are not scientifically substantiated. Do Ketogenic Diets Improve Health? Ketogenic diets result in weight loss for those who successfully use this strategy to reduce overall caloric intake by limiting all carbohydrate-rich foods like breads, pasta, rice, cakes, cookies, and colas. Most fruits, legumes, and whole grains are also essentially off limit. Currently, long-term data on keto diets and cardiovascular, cancer, and other chronic disease risks are lacking, and low-carbohydrate diets have been linked to increased mortality. Who May Benefit From a Ketogenic Diet? Individuals wishing to lose weight using a very structured approach may benefit from a keto diet. For patients with prediabetes or type 2 diabetes, limiting carbohydrates to 5% of calories can help control blood glucose if it contributes to weight loss and weight maintenance. It is common to experience fatigue during exercise, poor mental energy, increased hunger, sleep disturbance, muscle cramps, constipation, nausea, and stomach discomfort. Over the long term, a diet in which only 5% of total calories come from carbohydrates makes it impossible to obtain optimum amounts of antioxidant phytonutrients from fruits and vegetables. In the first 2 weeks of the diet, there may be significant increases in urine production and fluid shifts that may require adjustment of medications for hypertension, heart failure, and diabetes. It is important to consult with a physician before trying a ketogenic diet. You should change your diet only under the supervision of a physician and a registered dietitian. Conflict of Interest Disclosures: Dr Heber reported receiving personal fees from Herbalife Nutrition. No other disclosures were reported. Source: Abbasi J. Interest in the ketogenic diet grows for weight loss and type 2 diabetes. 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. In a clinical setting, ketogenic diets limit carbs to 20 to 50 g per day, mostly from non-starchy vegetables. Very low-carb ketogenic diets restrict carbs to 30 g per day. The science stuff: Protein is kept high enough to maintain lean body mass, but low enough to preserve ketosis. Basically you are pushing carbs low enough that your body has no choice but to burn fat for fuel. So a true ketogenic diet can have a ratio of 75% to 90% calories from fat, 10% from protein, and 5% from carbs. But don’t stop reading just yet. In real life, diets labeled as “ketogenic” vary widely. What most people are doing is a modified ketogenic diet or modified Atkins. It doesn’t mean it’s not effective, but it’s not the same thing. Your ketone production may not be the same depending on how you are following the diet. There’s evidence that ketogenic diets can help with weight loss. In one older study, people on a ketogenic diet lost 2.2 times more weight than those on a low calorie, low fat diet. Another 2007 study compared a low carb diet to the Diabetes UK’s dietary guidelines. It found the low-carb group lost 15.2 pounds (6.9 kg), while the low fat group lost only 4.6 pounds (2.1 kg). However, there was no difference in HbA1c, ketone, or lipid levels between the groups. Also, those on the low-carb diet also decreased their calorie intake. Finally, there was no difference in fat or protein intake between the two groups. This is important to note if people are increasing their fat intake because they are following a keto diet. However, there are contrasting theories for these findings. Other ketogenic diet studies have found that the ketogenic diet may lead to reductions in appetite and food intake. If you dislike counting calories, the data suggests a ketogenic diet may be a good option for you. You can eliminate certain foods and don’t have to track calories. If you follow the keto diet, you still have to check labels and keep track of your total grams of carbs each day, which requires paying attention to food choices. However, keep in mind that many of the studies mentioned above had small sample sizes and only evaluated the short-term effects of the diet. Additional research is needed to determine how the diet may impact weight loss in the long run and whether weight is regained once a normal diet is resumed. Bottom Line: The ketogenic diet is an effective weight loss diet that’s well-supported by evidence. It is very filling and usually does not require calorie counting. One reason performance may not be affected, she suggests, is due to ketone measurement. Diabetics have to routinely measure their ketones; if levels are too high, it can indicate a major complication of diabetes. But many people who casually try a keto diet don’t measure ketones, so they may not actually be in a state of ketosis. Ford also points out that in the studies looking at ketosis and performance with negative results, the athletes are not often sufficiently fat-adapted (when the body is trained to tap fat stores for energy, which can take several months) or even in ketosis, making it hard to truly gauge whether the diet is effective when it comes to performance. Runners who may benefit from fat adaptation are those running long, long distances, like ultramarathons. Once you hit those later miles (30, 40, and beyond), your body needs to start tapping into fat stores. So if you’ve done any sort of fat-adapted training-not eating before a morning run, not fueling during an 18-miler-your body can better adjust, Kasparek says. The keto-buzz is everywhere you look these days. Nutrition coaches are offering keto plans, meal prep companies have debuted keto food lines, and well-renowned blogs are digging in to what this diet is and why people are so dang curious about it. A lot of celebrities are raving about the benefits they’ve seen from shifting to a ketogenic diet, including a few Kardashians, runway models, actors, and athletes. Naturally, when people in the spotlight adopt a specific lifestyle habit, the rest of society becomes interested to try it out too. As a compliment to our stance on keto, I’m hoping to help clear some noise around the keto diet with an exploration of its history, what (and who) it helps, what the long-term prognosis of a ketogenic diet looks like, and how the diet might fit into your life. FIRST THING’S FIRST: WHAT’S KETO? The ketogenic diet is an extremely high fat and low carb diet in which people methodically consume 75% of their calories from fat, 15-20% from protein, and 5-10% from carbohydrates.

If you're serious about sticking to this diet and experiencing all of its miraculous effects-including weight loss- remember to devote some time to meal prepping. In the process of learning how to make time for meal prep, I also discovered a handful of new favorite foods. Because let's face it, I couldn't live on eating whole avocados in one sitting and dousing everything in cheese and butter for 10 days. I had to get creative in the kitchen. To boost my daily fat intake, I experimented with foods I've never thought I'd love before going keto. Low-carb picks such as House Foods' tofu noodles (pictured above) and Keto Carne (zero-sugar beef jerky), as well as high-fat snacks such as Cacao Vita's single-origin cacao nibs, became my go-to kitchen staples. For breakfast, I found myself munching on two squares of 90-percent cacao with some almonds (see below) or two tablespoons of Kite Hill Chive Cream Cheese Style Spread (this stuff will make you forget about real cheese!). A ketogenic (“keto”) diet is an extremely carbohydrate-restrictive, high-fat diet. A ketogenic diet restricts carbohydrate intake to less than 25 to 50 grams per day in an attempt to enhance tissues to use fat or ketones (acids produced by the liver) as fuel during caloric restriction. Ketogenic diets typically recommend that only 5% of calories come from carbohydrates, along with 75% from fat and 20% from protein. Ketogenic diets were first used in the 1920s to treat diabetes prior to the discovery of insulin. These diets were also used to treat difficult-to-control epilepsy in children. Recently, ketogenic diets have been promoted as weight-loss diets and to control blood glucose in patients with prediabetes and type 2 diabetes. Keto diets may lead to weight loss in the short term, but that weight loss is similar to what is achieved with other dietary approaches over the long term. Keto diets may improve blood glucose in the short term in patients with type 2 diabetes, but there is inconclusive scientific evidence that these diets are superior to other weight-loss regimens in the long term. Whereas most keto dieters focus on meat, eggs, vegetables, and healthy fats, dirty keto dieters will eat anything as long as they can keep their carbs down. Do you count sugar alcohols on keto? It’s up to you. Erythritol, a common ingredient in keto-friendly baking, has a negligible impact on blood sugar and insulin levels, so it shouldn’t disrupt ketosis. Other sugar alcohols (sweeteners ending in -ol, like sorbitol and xylitol) are similar. In that sense, they don’t count against your carb limit. The one exception is malitol, which has a slightly higher glycemic index (a measure of a food’s effect on blood sugar), though it’s still well below table sugar. Many keto dieters choose to disregard the carbs in sugar alcohols. Diabetics are often advised to count half the carbs. Remember, though, even if you decide the carbs don’t count, consuming too many keto-fied desserts can still negatively affect your health and body composition goals. The calories in keto-friendly cookies, cakes, muffins, and the like do still matter.

A ketogenic (“keto”) diet is an extremely carbohydrate-restrictive, high-fat diet. A ketogenic diet restricts carbohydrate intake to less than 25 to 50 grams per day in an attempt to enhance tissues to use fat or ketones (acids produced by the liver) as fuel during caloric restriction. Ketogenic diets typically recommend that only 5% of calories come from carbohydrates, along with 75% from fat and 20% from protein. Ketogenic diets were first used in the 1920s to treat diabetes prior to the discovery of insulin. These diets were also used to treat difficult-to-control epilepsy in children. Recently, ketogenic diets have been promoted as weight-loss diets and to control blood glucose in patients with prediabetes and type 2 diabetes. Keto diets may lead to weight loss in the short term, but that weight loss is similar to what is achieved with other dietary approaches over the long term. Keto diets may improve blood glucose in the short term in patients with type 2 diabetes, but there is inconclusive scientific evidence that these diets are superior to other weight-loss regimens in the long term. Second, following the Ketogenic Diet means carefully tracking your macronutrients (protein, fats, carbs, and water), in addition to some micronutrients like vitamins and minerals. It can be an arduous task that makes simple calorie counting seem like a breeze. While most proponents of keto tout that calorie counting isn’t the main focus, the fact is that most people on this plan are also restricting calories. Any diet that creates a calorie deficit is likely to induce weight loss. While this makes it somewhat difficult to determine if the weight loss is the result of calorie restriction or from being in ketosis, The Cooper Institute’s position is that it is the former, not the latter. Third, there is a lack of long-term scientific data to support this diet. Most diet studies (as well as testimonials) are short-term, lasting only weeks or months. The short-term studies on Ketogenic diets have shown short-term weight loss as well as temporary improvements in important risk factors like HDL and LDL cholesterol levels, blood glucose, inflammatory markers, and waist circumference.

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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. To calculate net carbs, subtract fiber from total carbs. Some keto plans calculate net carbs for above-ground green vegetables and avocados but otherwise track gross carbs. Other plans subtract all fiber no matter the source. To avoid any confusion, the Keto Reset Diet recommends counting gross (total) carbs. What is keto flu? “Keto flu” refers to the headaches, lethargy, brain fog, irritability, and gastrointestinal symptoms that some people experience when transitioning to a keto diet. It’s probably caused by electrolyte imbalances and temporary “fuel shortages” as your body shifts to running off fat and ketones. How long does keto flu last? Not everyone experiences keto flu, and most people who do report that their symptoms resolve in less than a week. You can ease your transition by making sure you’re getting enough electrolytes (sodium, potassium, and magnesium), eating plenty of keto-friendly foods, and engaging in gentle, not overly strenuous, exercise. Read more: What Is Low Carb Flu, or Keto Flu? Is gluten-free the same as keto?|Looking for a new diet to kickstart serious weight loss? The keto diet is probably on your list of eating plans to consider. One of the most popular diet plans, the keto diet promises rapid weight loss by turning fat into energy (and let’s face it-who doesn’t need more of that?). Other benefits of the keto diet include clearer skin, better heart health, and lower cancer risk. ’ve been looking for, you’ve come to the right place to learn all about it. Here, we’ll go into more detail about what is the ketogenic diet, how it works, and what you can-and can’t-eat if you follow the keto diet. And before you ask, yes, we’ve even included some keto recipes for you to try, including desserts! Consider this the keto diet for beginners. What is the ketogenic diet? The ketogenic diet is similar to the ever-popular South Beach diet of long ago.

Following a strict diet for weight loss and then quickly reverting to old habits when the dietary changes are too restrictive can lead to what is known as weight cycling, or yo-yo dieting. Gaining and losing the same weight over and over can start to have a negative impact on your self-image and motivation, and potentially your health. For athletes, research on the keto diet highlights potential improvements in athletic performance, especially when it comes to endurance activities. An article suggests ketogenic-type diets may allow endurance athletes to rely mostly on stored fat for energy during exercise rather than having to refuel with simple carbohydrates during endurance training and competition while additionally improving recovery times. If you’re looking to lose weight, one benefit the ketogenic diet may offer is the ability to suppress appetite. A review of this form of eating suggests it may help decrease appetite, but how this actually happens needs to be studied further. When it comes to weight loss - a big possible draw of the plan for many individuals - the benefits of the ketogenic diet may not be much different from any other diet plan. “There is no magical weight loss benefit that can be achieved from this diet,” says Spano. For individuals with diabetes, adapting a very low-carbohydrate diet, such as the ketogenic diet, may offer some benefits when it comes to glucose management. For instance, a review found that dietary restriction of carbohydrate may reduce or eliminate the need for medication in individuals with type 2 diabetes. What is the keto diet? What is the keto diet? You may have heard the old low-fat weight-loss mantra, “Fat makes you fat.” It’s actually not that simple. Your brain and body benefit from healthy fats, regardless of what diet you follow. Eating keto means eating more fats and fewer carbs, which changes the way your body turns food into energy. Think of your body like a hybrid car. You’re built to rely on carbohydrates, like bread and pasta, for fuel. Your metabolism is designed to turn carbs into glucose for energy, and store the leftovers as glycogen in your cells. But just like a hybrid can run on gas or electricity, your body has another way to make energy: fat. If you eat very few carbs, more fat and moderate protein, your body enters ketosis: a metabolic state where you burn fat instead of carbs for fuel. In ketosis, your body produces ketones, an alternative source of fuel. Some like how they feel and like how they eat when they’re on a ketogenic diet. If it works for you, great. The diet that works for you is the one you feel good about. The reality is that many people who attempt the ketogenic diet cycle in and out of it. It was ranked second-to-last in the U.S. In short, while there is often at least short-term weight loss; the long-term effects on overall health are still relatively unknown. The potential drawbacks of this complicated diet include kidney damage, constipation, micronutrient deficiencies and social isolation (skipping family or social gatherings because of your diet?!). A strict keto diet requires close management by a health professional. If you feel good on a keto-inspired diet that’s great - just make sure you understand the big nutritional picture too. Vanessa Lennick is private-practice Registered Dietitian in Bismarck, ND. As a working mom-of-three, wife of a shift worker, and member of the ND National Guard, Vanessa is passionate about helping people find the diet that works for them - their goals, their lifestyle, their preferences. She warns not to try this (or any version of keto) before talking with a physician if you have diabetes and are insulin dependent, as it could lead to a too-low blood sugar level. How It Works This version of keto calls for upping the protein intake just a bit. Protein should make up about 30 percent of calories, with the other 65 percent coming from fat and 5 percent from carbs, Spritzler says. Aim to source your protein from both animals (meat, fish, and dairy) and plants (nuts and seeds), Spritzler suggests. Who It's Best For This is meant for those who need protein to help protect muscle mass, like bodybuilders and older people who need to prevent muscle breakdown, Spritzler says. It’s also a good option for those who show signs of a protein deficiency. Those signs include a loss of muscle or thinning hair, according to the subcommittee on the 10th edition of the federal recommended dietary allowances. If you’re trying out the keto diet you should take care to avoid sugary, starchy foods. Remember- carbohydrates should make up less than 5% of your entire calorie intake. Aim to have an absolute maximum of 50 grams of net carbs a day, but aim for 20 grams or less. Are there any ketogenic diet side effects? Immediately after starting the diet during the first week, some dieters may experience what is referred to as the “keto flu“. The keto flu is a term colloquially used to describe the general feelings of malaise some dieters feel at the beginning of the low-carb high-fat diet. Keto flu can be prevented or helped by focusing on getting plenty of sleep, increasing electrolyte intake, and reducing consumption of dehydrating drinks like caffeine and alcohol. But fear not! Starting out with keto has some positive benefits, too. During the initial adjustment phase most dieters report rapid weight loss - losing up to 10 lbs of body weight in 2 weeks or less. Given all the buzz, adopting a ketogenic diet may be the perfect weight loss plan, especially if you have diabetes, or want to try this approach to lose those troublesome extra pounds. After all, it’s a very low-carb meal plan that promises effective weight loss while also lowering your blood sugar to the point where you could possibly stop taking medication. By all accounts, the “keto” diet, as it’s widely known, may even reverse type 2 diabetes, at least for some lucky individuals. Another advantage to the keto diet: It can help reduce systemic inflammation, which can have a variety of negative effects on your entire body. You can create meals that are appealing and delicious when following a keto diet. Unlike some of the other popular low-carb diets, which typically are high in animal protein, the keto diet focuses on getting to the body to burn stored body fat instead of sugar as the main fuel. When body fat is broken down in the liver instead of glucose, s an energy byproduct known as ketones are produced. For everyone else, carbs are still probably your best bet, especially if you’re running at higher intensities than you would be when running 50 miles at a 15-minute/mile pace. “When you’re running at a lower intensity, you need to burn more fat as fuel,” Kasparek explains. Which brings us back to the main question: Does the keto diet work and should you try it? The bottom line is: If done right, runners who need to be able to tap into fat stores over long distances may benefit. But that’s not to say those benefits can’t be reaped by following a low-carb, high-fat diet that doesn’t put your body into ketosis instead. Runners who enjoy shorter distances at faster paces or who incorporate high-intensity workouts into their training are still better off eating a healthy, balanced diet that includes carbs. For weight-loss goals, Kasparek says, it’s possible to lose weight by tweaking a regular diet, say, by adding more healthy fat or cutting out processed foods. But there’s more than one way to lose weight, and one banana isn’t going to set you back-we promise. 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 extremely low level of carbs on the Keto Diet can cause what's known as the keto flu, which causes headaches, nausea, muscle cramping, and fatigue. Like the Paleo Diet, these unpleasant side effects generally subside after a few weeks. Drinking plenty of water and getting a full night's sleep should help. As with paleo, doing keto for more than a few weeks could lead to nutrient deficiencies according to Andy Yurechko, MS, RD, of Augusta University Medical Center in Georgia . He says lack of fiber is the biggest concern for keto fanatics, who may experience constipation. But it's possible to get fiber by eating lower-carb vegetables like broccoli and chia seeds. Both diets come with some unpleasant side effects, but Yurechko doesn't advise sacrificing fiber to try keto in the long run. Will Paleo or Keto help you lose more weight? ON PALEO, eating like your ancestors doesn't guarantee you'll lose weight. While the diet emphasizes plenty of foods that are good for weight loss, such as lean protein and fruits and vegetables, you would still need to eat fewer calories to drop a few pounds. So if you're binging on nuts and fruit, you could actually gain weight on the Paleo Diet. While ketosis isn't a magic recipe for weight loss, Konstantinos Spaniolas, Associate Director of the Stony Brook Metabolic and Bariatric Weight Loss Center in New York, says that people successfully lose weight on keto because they tend to eat less. The winner: The Keto Diet. With an important caveat: These results are often short-lived, says Kizer. Is Paleo or Keto the better diet? BOTH KIZER and Yurechko agree that Paleo is the better option in terms of overall health, simply because it's less restrictive and includes plenty of fruits, vegetables, and lean protein. What's more, she believes keto could cause people to obsess over their carb intake and develop an unhealthy relationship with food.

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. That’s why they’re not typically on the approved keto food list. You’re better off making your own sauces to control the calories, ingredients, sugars, and carbs. There are also plenty of pre-made options that are safe to use if you don’t have time to whip up something homemade to drizzle on your meals. Salad dressings and sauces can also have extra sugar you wouldn’t expect. If you’re out at a restaurant, avoid balsamics, vinaigrettes, honey mustard, and French or Thousand Island dressings since they tend to have more sugar in them. Since many traditional seasonings and sauces aren’t keto-friendly, herbs and spices will become your new best friends in the kitchen. Just make sure they don’t contain any sugars or high-carb fillers - some mixed spice blends do - and are purely the herb or spice itself before you take the spice jar home with you. As mentioned earlier, these sauces are usually packed with sugar and should be avoided at the grocery store and anytime you eat out. Think of keto as a tool to make it much easier to maintain a calorie deficit. Even keto, as awesome as it is, isn’t a ‘eat as much as you want and still lose weight’ magic bullet. 1. When not in ketosis, your liver and muscles are full of glycogen, about 1-2 pounds worth depending on your body size. For every 1 part of glycogen, your body holds on to 3 parts of water (source). When we enter ketosis, our body will use up that glycogen and shed the associated 3 parts of water. 2. When you cut out major food groups, primarily sugar, grains, and gluten, your inflammation (mild swelling throughout the body) will go down. Most people are sensitive to these foods, and when we eliminate them we stop chronic inflammation. You can read more about inflammation and the body here. 3. When you eat a carbohydrate-rich diet, lots of water is required in your digestive tract to break down the carbohydrates. Listen to your body’s signals and be patient. If you finished your meal and are still hungry, try drinking some water, brushing your teeth, distracting yourself with something fun to do, or just waiting 20 minutes for your brain to catch up. If you’re still hungry after that, try a salty, water-packed snack, like olives or pickles. 6. Carbs Are A Limit, Protein Is A Goal & Fat Is A Lever. The most important key to getting into ketosis is restricting carbohydrates, but there is more to it. Your other macros, which is short for macronutrients, play a role as well. Carbs are a limit. This means you set the maximum that you can consume per day - typically up to 20 to 30 grams per day for most people. If you go under this number, that’s okay! It’s not a hard goal, just a limit. Protein is a goal. A ketogenic diet can work wonders for people who are overweight, diabetic and prediabetic or just looking to improve their metabolism. It may not be as suitable for elite athletes or bodybuilders looking to add significant muscle mass. As with any diet, keto will only work if you are consistent and stick with your plan. The powerful health, nutritional, and weight loss benefits of a ketogenic diet have been proven through extensive research. Keto may also improve HDL cholesterol levels, often referred to as “good” cholesterol, better than diets that allow moderate carbohydrate consumption. The loss of extra weight and addition of healthier foods is also a driving force behind improved health. How does your DNA factor in? Unfortunately, not everyone metabolizes fats efficiently enough to experience the benefits of the ketogenic diet. A DNA health test can tell you how efficiently you metabolize fats and if the ketogenic diet is right for you.

The shift, from using circulating glucose to breaking down stored fat as a source of energy, usually happens over two to four days of eating fewer than 20 to 50 grams of carbohydrates per day. Keep in mind that this is a highly individualized process, and some people need a more restricted diet to start producing enough ketones. Because it lacks carbohydrates, a ketogenic diet is rich in proteins and fats. It typically includes plenty of meats, eggs, processed meats, sausages, cheeses, fish, nuts, butter, oils, seeds, and fibrous vegetables. Because it is so restrictive, it is really hard to follow over the long run. Carbohydrates normally account for at least 50% of the typical American diet. One of the main criticisms of this diet is that many people tend to eat too much protein and poor-quality fats from processed foods, with very few fruits and vegetables. Patients with kidney disease need to be cautious because this diet could worsen their condition. For more on what to eat and avoid, check out the Keto Food page and this Keto Shopping List. Ketogenic dieting is a big jump for some people. You’re literally switching over to a new metabolic substrate. That can take some getting used to. Make sure you are well-prepared with a Primal-aligned eating pattern in place for ideally several weeks before you ponder a journey into nutritional ketosis. Make a minimum commitment to six weeks of nutritional ketosis. You’ll want to allow ample time for the transition to new fuel sources. Six weeks will put the metabolic machinery in place and allow you to begin experiencing the most dramatic benefits of keto living. Get plenty of electrolytes. You’ll want lots of sodium, magnesium, and potassium. Try 3-5 grams sodium, 300-500 mg magnesium, and 1-3.5 grams of potassium each day on top of your normal food. Going keto really flushes out water weight, and tons of electrolytes leave with it. A quick search on Amazon turns up beautifully photographed ketogenic diet cookbooks, along with urine test strips and food products including ketogenic cocoa and ketogenic cookies. Meal delivery services-a trend in itself-are increasingly offering ketogenic meal options. Ayesta says. "There are 'cults' in a certain sense that I'm not a fan of and not supportive of." Although he rarely suggests the ketogenic diet to clients, if they come to him wanting to try the diet, Ayesta first does a full nutrition assessment. This includes evaluating any comorbidities that might indicate the ketogenic diet isn't safe for them, such as individuals who are pregnant-there's a lack of research on the ketogenic diet during pregnancy-or have fat malabsorption. He also makes it clear that the ketogenic diet isn't the only way to lose weight. When one of his clients does choose to do a ketogenic diet, Ayesta insists on seeing them weekly so he can monitor ketone levels, energy levels, and cognitive function. According to the authors, this may be dependent on circulating ketone levels, but a threshold level had yet to be determined. Research also shows benefits for improving insulin sensitivity and glycemic control, although the mechanisms aren't clear.1 A 12-month study that randomized 34 adults with HbA1c levels above 6% and BMIs above 25 to a very low-carb ketogenic diet or a moderate-carb, calorie-restricted, low-fat diet found that the low-carb group had greater weight loss and reduction of HbA1c. The low-carb subjects also were more likely to be able to reduce use of diabetes medications, with three discontinuing metformin. Studies-most of which compare ketogenic diets with low-fat diets-also have found that while LDL cholesterol tends to increase for some people following a ketogenic diet, small, dense LDLs tend to decrease.1,13,14 Triglyceride and HDL cholesterol levels also tend to improve. The ketogenic diet is popular because it works, at least in the short term. Just as Paleo books, cookbooks, and blog posts have flooded the market, today keto is picking up speed. That's true of many diet studies, the researchers noted, so study results likely look rosier than weight loss in the real world. Finally, a direct comparison of low-fat and low-carb dieting, published in February in the journal JAMA, found that over a year, there was no statistically significant difference in the amount of weight dropped. Low-fat dieters lost 11.7 pounds (5.3 kg), on average, and low-carb dieters lost 13 pounds (6 kg), on average. Keto diets "can help us lose weight, but compared to other diet strategies, they're not more helpful," said Melissa Majumdar, a dietitian at the Brigham and Women's Center for Metabolic and Bariatric Surgery, and a spokesperson for the Academy of Nutrition and Dietetics. Much of the weight lost in the initial stages of a keto diet is water weight, because carbohydrate stores in the body carry water molecules with them, Majumdar told Live Science. That can move the scale an exciting amount initially, but weight loss inevitably slows with time.

Unlike with calorie restriction, keto helps you lose weight by putting your body into ketosis. When you eat minimal carbohydrates, your body produces ketones for energy. Ketones are made in your liver from fatty acids found in food or your own body fat. Therefore, your liver actually burns fat to make ketones. Ketones are used for energy in lieu of carbs. As your body steadily burns fat as a fuel source, you will start to lose weight. You may be wondering if keto can target specific problem areas, such as belly fat. Burning belly fat is high on the priority list for many people. The fat in your belly is visceral fat, which is a dangerous type of fat that lives deep inside the abdomen, encasing your internal organs. Visceral fat is linked to heart disease and type 2 diabetes. Technically, you can’t spot-target fat areas for reduction. Your body decides where weight loss will occur. However, keto may be useful for eliminating stubborn belly fat. There are different variations of low carb, and the keto diet is a special type of low carb with added characteristics. Some people opt to count carbs diligently and some choose to simply focus on eat low carb/keto foods. What are net carbs? Net carbs is simply total carbs minus fiber and non-digestible sweeteners, like erythritol and allulose. We don’t have to count fiber and certain sweeteners in net carbs, because they either don’t get broken down by our bodies, are not absorbed, or are absorbed but not metabolized. Some people on a keto or low carb diet choose to count total carbs instead of net carbs. This makes it more difficult to fit in more leafy greens and low carb vegetables (which are filled with fiber), so you should only try that if you don’t get results with a net carb method. And, start with reducing sweeteners and low carb treats before deciding to do a “total carbs” method. Removing glucose from carbohydrate foods will cause the body to burn fat for energy instead. The major differences between the classic keto and the Atkins diet is the former emphasizes healthier keto fats, less overall protein and no processed meat (such as bacon) while having more research to back up its efficacy. In fact, those differences with Atkins outline some of the popular keto diet myths, such as it being another high-protein plan, recommending any type of fat and that barely any science research backs up the benefits. These are nutrition lies, plain and simple. So is the keto diet healthy? If it’s done Atkins style? No. But if relying on healthy fats, greens and organic meats? What does “keto” stand for exactly? Following a ketogenic diet puts your body into a state of “ketosis,” which is a metabolic state that occurs when most of the body’s energy comes from ketone bodies in the blood, rather than from glucose from carbohydrate foods (like grains, all sources of sugar or fruit, for example).

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