After initiation, the child regularly visits the hospital outpatient clinic where he or she is seen by the dietitian and neurologist, and various tests and examinations are performed. These are held every three months for the first year and then every six months thereafter. Infants under one year old are seen more frequently, with the initial visit held after just two to four weeks.[9] A period of minor adjustments is necessary to ensure consistent ketosis is maintained and to better adapt the meal plans to the patient. This fine-tuning is typically done over the telephone with the hospital dietitian[18] and includes changing the number of calories, altering the ketogenic ratio, or adding some MCT or coconut oils to a classic diet.[3] Urinary ketone levels are checked daily to detect whether ketosis has been achieved and to confirm that the patient is following the diet, though the level of ketones does not correlate with an anticonvulsant effect.[18] This is performed using ketone test strips containing nitroprusside, which change colour from buff-pink to maroon in the presence of acetoacetate (one of the three ketone bodies).[44]
Natural fat, high-fat sauces – Most of the calories on a keto diet should come from fat. You’ll likely get much of it from natural sources like meat, fish, eggs etc. But also use fat in cooking, like butter or coconut fat, and add plenty of olive oil to salads etc. You can also eat delicious high-fat sauces including Bearnaise sauce etc., or garlic butter (recipes).
The ketogenic diet achieved national media exposure in the US in October 1994, when NBC's Dateline television programme reported the case of Charlie Abrahams, son of Hollywood producer Jim Abrahams. The two-year-old suffered from epilepsy that had remained uncontrolled by mainstream and alternative therapies. Abrahams discovered a reference to the ketogenic diet in an epilepsy guide for parents and brought Charlie to John M. Freeman at Johns Hopkins Hospital, which had continued to offer the therapy. Under the diet, Charlie's epilepsy was rapidly controlled and his developmental progress resumed. This inspired Abrahams to create the Charlie Foundation to promote the diet and fund research.[10] A multicentre prospective study began in 1994, the results were presented to the American Epilepsy Society in 1996 and were published[17] in 1998. There followed an explosion of scientific interest in the diet. In 1997, Abrahams produced a TV movie, ...First Do No Harm, starring Meryl Streep, in which a young boy's intractable epilepsy is successfully treated by the ketogenic diet.[1]

Without peer-reviewed clinical trials, many of the benefits remain anecdotal. 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.  
Which leads us to your personality. You need to be VERY strong willed to follow this diet. It follows very strict rules and you need to be able to commit to this. It makes it hard to eat out with friends or eat with friends in general. It’s hard to find food that fits this diet in common restaurants, but and this takes us to the next point, your health goals might be more important.
For those of you that have claimed to gain or plateau… have no fear! (LOL) I’ve been on some type of low carb/high protein diet since the Atkins diet first showed up in the 70’s… Believe me when I tell you it DOES work!! You just need to stick to it!! The heart association and other organizations will still tell you that fat is bad… IT’S NOT! Here’s some things to remember:

Before starting, ask yourself what is really realistic for you, Mattinson suggests. Then get your doctor’s okay. You may also work with a local registered dietitian nutritionist to limit potential nutrient deficiencies and talk about vitamin supplementation, as you won’t be eating whole grains, dairy, or fruit, and will eliminate many veggies. “A diet that eliminates entire food groups is a red flag to me. This isn’t something to take lightly or dive into headfirst with no medical supervision,” she says.


Help me please! Ketosis is the only thing that has ever helped to alleviate my chronic migraines but it is so hard for me to stick to because all of the plans I can find ( like this 3 day one ) use dairy products to fill most of the fat content. I am deathly allergic to dairy and soy products. How do I stay keto without all of the cheese and cream?!?!
The ketogenic diet achieved national media exposure in the US in October 1994, when NBC's Dateline television programme reported the case of Charlie Abrahams, son of Hollywood producer Jim Abrahams. The two-year-old suffered from epilepsy that had remained uncontrolled by mainstream and alternative therapies. Abrahams discovered a reference to the ketogenic diet in an epilepsy guide for parents and brought Charlie to John M. Freeman at Johns Hopkins Hospital, which had continued to offer the therapy. Under the diet, Charlie's epilepsy was rapidly controlled and his developmental progress resumed. This inspired Abrahams to create the Charlie Foundation to promote the diet and fund research.[10] A multicentre prospective study began in 1994, the results were presented to the American Epilepsy Society in 1996 and were published[17] in 1998. There followed an explosion of scientific interest in the diet. In 1997, Abrahams produced a TV movie, ...First Do No Harm, starring Meryl Streep, in which a young boy's intractable epilepsy is successfully treated by the ketogenic diet.[1]

Bear in mind that those macronutrient ratios refer to calories from fat, protein, and carbohydrate, not actual grams of each. Protein and carbs have 4 calories per gram and fat has 9 calories per gram, so it’s actually a relatively easy task to let your fat calories pile up to keto-appropriate proportions if you consume fattier proteins and embellish your food with an extra bit of pure fat. To illustrate, if a portion of a particular food has 10 grams of protein, 10 grams of fat, and 0 grams of carbohydrate, that portion contains 130 calories, 90 from fat and 40 from protein, and is about 69.2% fat and 30.7% protein (allowing for rounding).


Thanks for the prompt reply! I’ve successfully conquered day two and looking forward to seeing if the keto stix work in my favor on. Monday. I lost a fair amount doing ideal protein but the thought of going back to powdered foods is completely unappealing. I’m so happy to have a plan in place! We had the buffalo wings tonight and oh my gosh (!!!) they were delicious!! My husband wants me to make them again. The recipe couldn’t be more simple. Thank you for sharing your wonderful knowledge and amazing recipes!!!
The keto diet changes the way your body converts food into energy. Eating a lot of fat and very few carbs puts you in ketosis, a metabolic state where your body burns fat instead of carbs for fuel. When your body is unable to get glucose from carbs, your liver converts fatty acids from your diet into ketones, an alternative source of energy. Burning ketones in place of glucose reduces inflammation and spurs weight loss.[1] 
Selecting the right food will be easier as you become accustomed to the Keto approach. Instead of lean meats, you’ll focus on skin-on poultry, fattier parts like chicken thighs, rib-eye steaks, grass-fed ground beef, fattier fish like salmon, beef brisket or pork shoulder, and bacon. Leafy greens such as spinach, kale and lettuce, along with broccoli, cauliflower and cucumbers, make healthy vegetable choices (but you’ll avoid starchy root foods like carrots, potatoes, turnips and parsnips). You can work in less-familiar veggies such as kohlrabi or daikon.
Some athletes swear by the ketogenic diet, not just for weight loss but for improved performance in their sport, as well. But Edward Weiss, PhD, associate professor of nutrition and dietetics at Saint Louis University, doesn’t buy it. “I hear cyclists say all the time that they’re faster and better now that they’re on keto, and my first question is, 'Well, how much weight did you lose?'” he says.
Hi Kimberly – sorry I have no experience with menopause yet! Just follow the plan and you should see results, even if they are a bit slower than when you were younger! If you aren’t seeing good results, it could be the artificial sweeteners in your tea that are the culprit – some people find that to be the case and others don’t have a problem with it. Just be aware of it and try kicking the habit if your weight loss is super slow and see if it helps! But yes, it can stand in for part of your water throughout the day.
I love this menu plan! One of the things I find difficult in low carb dieting/eating is that most of the recipes given are so complicated. Yours are not. Another point is that most low carb bloggers and recipe writers? Sometimes forget that people all around the world read your recipes, and a lot of the items listed just can not be bought! Thank you for keeping it nice and simple
Love the set of instructions and advice; this will be what I point people at now when they want to know how to start. I avoided most “keto flu” symptoms by getting just 30 minutes a day of gentle exercise. Somewhere deep in “The Art & Science of Low Carb Living” it explains why. The Atkins books don’t mention it because their approach is to position fitness as an entirely optional thing.
A keto diet has shown to improve triglyceride levels and cholesterol levels most associated with arterial buildup. More specifically low-carb, high-fat diets show a dramatic increase in HDL and decrease in LDL particle concentration compared to low-fat diets.3A study in the long-term effects of a ketogenic diet shows a significant reduction in cholesterol levels, body weight, and blood glucose. Read more on keto and cholesterol >

I’m so excited to have come across your site!! You’ve seriously done so much work and I appreciate it! I’m researching this keto life and plan to jump in once we are back from vacation for a lifestyle change for myself and my husband too! Looking forward to learning more and loving your meal plans! Glad to see 12 weeks! I know I won’t get bored! Thanks so much!
A small Feb. 20, 2017, study looked at the impact of a six-week ketogenic diet on physical fitness and body composition in 42 healthy adults. The study, published in the journal Nutrition & Metabolism, found a mildly negative impact on physical performance in terms of endurance capacity, peak power and faster exhaustion. Overall, researchers concluded, “Our findings lead us to assume that a [ketogenic diet] does not impact physical fitness in a clinically relevant manner that would impair activities of daily living and aerobic training.” The “significant” weight loss of about 4.4 pounds, on average, did not affect muscle mass or function.

Hello. I’m a kept newbie. Started 6 days ago today. By day 4 I was down 10lbs. I’m following the 20 or less carbs a day, altho I more like less than 10 on most days. I have only wanted to harm someone for a cookie twice, and my bf for his fried potatoes once. I’m honestly shocked at how much food I really can eat with no carbs. And then on some days, shocked at how many carbs are in other things. Headaches and lack of energy are the only thing that I find bothersome, but i am pushing thru it. Thank u for a very detailed site. It’s helped me, and a coworker.

Great post! I’ve been following Maria Emmerich’s keto plan for a few months now. Ketosis is AMAZING! The energy, focus, and lack of hunger are what make this plan so easy to follow, and maintain long term. I would love love love for you to do 7 day meal plans. I love your recipies and implement them in my keto lifestyle already, but meal plans would ROCK! Great job.
Thank you! My inflammation seems to be all hormonne based from pregnancy. If i miss one cycle i get cysts & swollen joints. Taking Maca Root & going to start Magnesium to see if it helps with keeping regular. I find low carb just makes me feel better all round & hoping for weight loss by really keeping it to under 20g. It has to now become a lifestyle rather than just maintenance i think.
Thank you Mellissa. I guess I need to set up a Reddit account. Several people have directed me there for Keto forums for one reason or another. I try not to let it get me down but I have been fluctuating really badly since I started this WOE and I have a feeling it has a lot to do with the hormones not being balanced. I came off of a prepackaged, doctor recommended food plan that really knocked me outta whack and helped me discover that I do indeed have an under-active thyroid, which I have known most of my life because I have always felt hormonally off balance and could never lose weight. It is also genetic in my family but doctors never listened to me and at most would run the basic blood test to appease me which always came back normal…which is common…and when they did, they would lecture me about losing weight and hand me a prescription for diet pills or give me info on some fad diet. Now I am trying to fix it with Keto and natural remedies. I feel better than I ever have in my life on the energy front and that was almost an instant feeling after switching to Keto. I hope I balance out soon because I am 35-40 lbs down since mid-May (depending on my fluctuation for the week) and have about 100+ to go. The frustrating part is I have now lost the same 3-5 lbs repeatedly over the past 5-6 weeks and all I can think is that could have been 20-30 lbs closer to my goal weight! I even considered going back on that nasty diet even though I felt terrible because I did lose consistently. I have confirmed my macros with some others who are more experienced and they are just as boggled as I am about the bad fluctuation.
These affect your brain and spine, as well as the nerves that link them together. Epilepsy is one, but others may be helped by a ketogenic diet as well, including Alzheimer’s disease, Parkinson’s disease, and sleep disorders. Scientists aren’t sure why, but it may be that the ketones your body makes when it breaks down fat for energy help protect your brain cells from damage.
Still, it can be hard to get enough fat when you first start this diet. Butter, nuts, coconut and olive oils, and fatty cuts of meat are all on the menu. However, don't go overboard with polyunsaturated fats like soybean, corn, or sunflower oil. Keto dieters who increase their intake of those fats often end up with gastrointestinal distress that causes them to jump ship.
Cyclical ketogenic diet: The Bulletproof Diet falls into this category. You eat high fat, low carb (less than 50 grams of net carbs a day) five to six days of the week. On day seven, you up your carb intake to roughly 150 grams, during what’s called a carb refeed day. Carb cycling this way helps you avoid the negative effects some people experience when they restrict carbs long term, like thyroid issues, fatigue and dry eyes.[10] [11] Full ketosis isn’t for everyone, and adding carbs such as sweet potatoes, squash, and white rice one day a week keeps your body systems that need some amount of carbs functioning properly.
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