A systematic review in 2018 looked at sixteen studies on the ketogenic diet in adults. It concluded that the treatment was becoming more popular for that group of patients, that the efficacy in adults was similar to children, the side effects relatively mild. However, many patients gave up with the diet, for various reasons, and the quality of evidence inferior to studies on children. Health issues include high levels of low-density lipoprotein (LDL), high total cholesterol, and weight loss.[23]
I am in ketosis!!!! I got the keto test strips and did the test this morning!! I am so excited!!! I have been on/off of the diet since my birthday on Aug. 11th when the kids took me out to eat! But I got back on the ball, did the soup diet again, and the 3 day kickstart and by golly it worked. I am now going to skip to week 2 of the meal plans coz there are so many fresh veggies at the food pantry and out in my garden. I can’t wait to taste the jalapeno popper soup! I am a little leery about the jalapeno and cheese muffins. I’ll post my thoughts after I try them. A little rest and then I will get to doing the prep. I really wanted to do that on Sunday after shopping but it just didn’t work out that way.
Keto breath, on the other hand, is less of a side-effect and more of a major (not harmful) inconvenience (your breath literally smells like nail polish remover). Basically, when your body breaks down all that extra fat on the keto diet, it produces ketones—one of which is the chemical acetone (yes, the same stuff that's in nail polish remover), Keatley previously told WomensHealthMag.com.
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.
There are vegetables that are high in carbs and others low in carbs. The keto diet recommends sticking to the ones low on carbs but encourages you to eat a lot of them. Best vegetables are all green ones to make it easy. And vegetables that grow above the ground (e.g. lettuce) are always better than the ones that grow below the ground (e.g. potatoes)
One of the most common side effects of starting the ketogenic diet is the “keto flu.” This term describes the often unpleasant, fatigue-inducing symptoms that occur as the body adjusts from a high-carbohydrate to a low-carbohydrate diet. During the keto flu, the body’s stored glucose begins depleting, and the body starts adapting to producing and utilizing ketones as energy. (2)

When you eat tons of carbs, your blood sugar is consistently elevated, and then so is insulin. Insulin is a hormone that keeps your blood sugar in check by shuttling the glucose into cells, but when there’s a consistently high amount of insulin, your cells become resistant. This insulin resistance makes it easier to store fat, and chronically high levels of insulin also cause excessive inflammation in the body, which contributes to heart disease, high blood pressure, and potentially type 2 diabetes.


Mellissa, I didn’t read through all the comments … just half :) Wondering if this will work for someone who’s a diet controlled diabetic? The nutritionist said I should have 45 carb meals and 20 carb snacks … I’ve been gaining weight steadily BUT my blood sugars are awesome! I’m working with a double edge sword here. My biggest issue (other than always feeling bloated) is I have to have a good, hefty snack at midnight each night to keep my blood sugars within range in the morning. Needless to say my waistline no longer exists … buy hey … my blood sugars are good. *rolling eyes*
Early studies reported high success rates: in one study in 1925, 60% of patients became seizure-free, and another 35% of patients had a 50% reduction in seizure frequency. These studies generally examined a cohort of patients recently treated by the physician (what is known as a retrospective study) and selected patients who had successfully maintained the dietary restrictions. However, these studies are difficult to compare to modern trials. One reason is that these older trials suffered from selection bias, as they excluded patients who were unable to start or maintain the diet and thereby selected from patients who would generate better results. In an attempt to control for this bias, modern study design prefers a prospective cohort (the patients in the study are chosen before therapy begins) in which the results are presented for all patients regardless of whether they started or completed the treatment (known as intent-to-treat analysis).[18]
The ketogenic diet tries to bring carbohydrates down to less than 5 percent of a person’s daily caloric intake – which means eliminating most grains, fruit, starchy vegetables, legumes and sweets. Instead, it replaces those calories with fat. That fat is turned into ketone bodies, which are an alternative energy source: besides glucose derived from carbohydrates, ketones from fat are the only fuel the brain can use.
First reported in 2003, the idea of using a form of the Atkins diet to treat epilepsy came about after parents and patients discovered that the induction phase of the Atkins diet controlled seizures. The ketogenic diet team at Johns Hopkins Hospital modified the Atkins diet by removing the aim of achieving weight loss, extending the induction phase indefinitely, and specifically encouraging fat consumption. Compared with the ketogenic diet, the modified Atkins diet (MAD) places no limit on calories or protein, and the lower overall ketogenic ratio (approximately 1:1) does not need to be consistently maintained by all meals of the day. The MAD does not begin with a fast or with a stay in hospital and requires less dietitian support than the ketogenic diet. Carbohydrates are initially limited to 10 g per day in children or 20 g per day in adults, and are increased to 20–30 g per day after a month or so, depending on the effect on seizure control or tolerance of the restrictions. Like the ketogenic diet, the MAD requires vitamin and mineral supplements and children are carefully and periodically monitored at outpatient clinics.[47]

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^ Freeman JM, Vining EP, Pillas DJ, Pyzik PL, Casey JC, Kelly LM. The efficacy of the ketogenic diet—1998: a prospective evaluation of intervention in 150 children. Pediatrics. 1998 Dec;102(6):1358–63. doi:10.1542/peds.102.6.1358. PMID 9832569. https://web.archive.org/web/20040629224858/http://www.hopkinsmedicine.org/press/1998/DECEMBER/981207.HTM Lay summary]—JHMI Office of Communications and Public Affairs. Updated 7 December 1998. Cited 6 March 2008.

I am in ketosis!!!! I got the keto test strips and did the test this morning!! I am so excited!!! I have been on/off of the diet since my birthday on Aug. 11th when the kids took me out to eat! But I got back on the ball, did the soup diet again, and the 3 day kickstart and by golly it worked. I am now going to skip to week 2 of the meal plans coz there are so many fresh veggies at the food pantry and out in my garden. I can’t wait to taste the jalapeno popper soup! I am a little leery about the jalapeno and cheese muffins. I’ll post my thoughts after I try them. A little rest and then I will get to doing the prep. I really wanted to do that on Sunday after shopping but it just didn’t work out that way.


There are so many tricks, shortcuts, and gimmicks out there on achieving optimal ketosis – I’d suggest you don’t bother with any of that. Optimal ketosis can be accomplished through dietary nutrition alone (aka just eating food). You shouldn’t need a magic pill to do it. Just stay strict, remain vigilant, and be focused on recording what you eat (to make sure your carb and protein intake are correct).
Wow – that’s a lot of dairy! I’m gluten and dairy free, but I’ll watch your recipes to see what I can use. The thing that concerns me about the dairy is that casein in cheese has a molecular structure similar to gluten, difficult for my system to break that down. I wouldn’t be surprised if others with gluten issues also have the same problem. I, too, had the impression that fat = bad… but boy, am I really enjoying salads more with real vinaigrette, homemade with healthy oils. I’ve been low carb and almost sugar free for about two years because of a gut issue. But, I want to get back to cutting out the sugar… so I’ll be eager to see what you share.
Normal dietary fat contains mostly long-chain triglycerides (LCT). Medium-chain triglycerides are more ketogenic than LCTs because they generate more ketones per unit of energy when metabolised. Their use allows for a diet with a lower proportion of fat and a greater proportion of protein and carbohydrate,[3] leading to more food choices and larger portion sizes.[4] The original MCT diet developed by Peter Huttenlocher in the 1970s derived 60% of its calories from MCT oil.[15] Consuming that quantity of MCT oil caused abdominal cramps, diarrhoea and vomiting in some children. A figure of 45% is regarded as a balance between achieving good ketosis and minimising gastrointestinal complaints. The classical and modified MCT ketogenic diets are equally effective and differences in tolerability are not statistically significant.[9] The MCT diet is less popular in the United States; MCT oil is more expensive than other dietary fats and is not covered by insurance companies.[3]
The ketogenic diet for weight loss is based on the idea that driving the body into ketosis will maximize fat loss. Ketosis is a normal metabolic process that occurs when the body does not have enough glucose stores for energy. When these stores are depleted, the body resorts to burning stored fat for energy instead of carbs.  This process produces acids called ketones, which build up in the body and can be used for energy. (2)

There are so many tricks, shortcuts, and gimmicks out there on achieving optimal ketosis – I’d suggest you don’t bother with any of that. Optimal ketosis can be accomplished through dietary nutrition alone (aka just eating food). You shouldn’t need a magic pill to do it. Just stay strict, remain vigilant, and be focused on recording what you eat (to make sure your carb and protein intake are correct).
In many developing countries, the ketogenic diet is expensive because dairy fats and meat are more expensive than grain, fruit and vegetables. The modified Atkins diet has been proposed as a lower-cost alternative for those countries; the slightly more expensive food bill can be offset by a reduction in pharmaceutical costs if the diet is successful. The modified Atkins diet is less complex to explain and prepare and requires less support from a dietitian.[54]
Cauliflower is definitely my favorite low carb veggie Lora – it’s so versatile! But you can also enjoy loads of spinach, broccoli, swiss chard, zucchini, celery, eggplant, cucumbers, and even spaghetti squash! Kale, tomatoes, onions, garlic, mushrooms, even pumpkin in moderation. Potatoes are mostly a no no unless you are in maintenance mode and even then very sparingly!
Just like when you were on the birth control, keto messes with your hormones at first – but in a good way, as it’s regulating them. Stay the course and it should even out in a month or two. I had a month like yours and it felt like shark week lasted the entire time, but it eventually stopped. Here’s a link to some discussions on keto and shark week over on reddit that might help ease your mind! http://www.reddit.com/r/xxketo/search?q=shark+week&restrict_sr=on
MY HUSBAND AND I WENT ON LOW CARB IN JANUARY AND DOING WELL. I HAVE BEEN EATING AN APPLE A DAY AND ADDED STRAWBERRIES AND STRAWBERRIE VINAGRETTE DRESSING TO SALADS ,WHICH I LOVE. KEEPING AN EYE ON THE CARBS IN THAT. BUT I HAVE BEEN ON A PLATAU FOR A BIT AND FORGOT HOW KETOSIS WAS SUCH A BIG PART OF THIS, I AM INSPIRED TO REDUCE MY CARBS A BIT MORE AND SEE IF THAT HELPS. THANKS
Question 2: Half of my family, including me, cannot do spicy. Now when I say spicy, Mild Rotel is spicy to us. So, can you suggest a comparable substitute? For instance, your Classic Buffalo Wings sound absolutely delicious but Frank’s Hot Sauce is way too spicy. When we make wings we usually make them sweet and not spicy. But also in other recipes, spicy spices are utilized so I wondered if there is a comparable spice to use? Again, if you have already addressed this topic, please just point me in the right direction and I will educate myself.
Keeping your tastebuds entertained while following a keto diet does not have to be a struggle.  Some low-carb, high-fat dieters find that they have the most success with their diet when they eat consistent meals on a regular basis and do not deviate from their plan.  Others find that if their diet has too much repetition it will get boring and difficult to stick to.  Whether you choose to stick to a set of staple meals that you eat every week or you’d rather spice things up, there are plenty of amazing food choices on the ketogenic diet.
Hi Patricia, you can replace the avocado with any of the other snack options. I would omit the dessert rather than trying to sub for the avocado in it – or you can have 2 squares of Lindt 90% chocolate in place of it. Just be aware that there are a few grams of carbs in them so don’t overindulge and keep your carbs under 20g per day and you should be good to go!
“Eggs have a lot of vitamins like vitamin A, B complex, D, K, E, calcium, and zinc,” says Ryan Weaver, a personal trainer and keto enthusiast. “That’s why eggs are an excellent choice for breakfast when you follow the keto diet. To avoid getting bored, you can try different ways of preparing the eggs—boiled, fried, or baked. Also, you can combine the eggs with different foods like bacon, ham, cheddar cheese, butter, mayonnaise, so you get a different recipe each day although using the same main ingredient.”
This morning I calculated my keto and signed up on my fitness pal food calculator as you suggested on your website. More I read about keto more curious I get…. Last two days I ate without thinking much about portions, but today I used all your delicious recipes and made combination of meals for the day and followed my macro numbers to almost exact numbers and grams. Which meant less snacks in-between meals in my case. I also have been drinking around 120oz of water( including coffee and herbal mint tea) everyday! Can’t wait to see what happens at tomorrow morning weigh in!
hello, i am interested in trying the ketogenic diet. i have hypothyroidism and cannot seem to lose any weight no matter what i do or eat. i need to lose about 20 pounds. do you think this diet can help me to lose weight and would it be good for my low thyroid? also, i am not a very active person…i have herniated disc in my lower back and have to be careful how i move, bend, or stretch, etc. however, i can get on my indoor exercise bike and ride it for about 10 min. per day.
What's more, it's especially important to make sure your diet is well-planned when you're eating keto-style, because the foods you can choose from are limited. In addition to checking in with a dietitian if you're able, Stefanski recommends that you "talk to your doctor and make sure she or he is aware that you'll be starting a diet that completely changes how your body metabolizes energy." You might also want to check your most recent bloodwork levels for things such as cholesterol, vitamin D, and other indicators of health because these can change while on keto. That's because for some people, a prolonged keto diet can result in certain nutritional deficiencies or even high cholesterol. But most experts will tell you that the ketogenic diet is not a permanent lifestyle change (as could be the case for something like the 80/20 approach to eating or a Mediterranean eating style).
To get the most benefit from the Keto diet, you should stay physically active. You might need to take it easier during the early ketosis period, especially if you feel fatigued or lightheaded. Walking, running, doing aerobics, weightlifting, training with kettlebells or whatever workout you prefer will boost your energy further. You can find books and online resources on how to adapt Keto meals or snacks for athletic training.
Keep up electrolytes. The major electrolytes in our bodies are sodium, potassium and magnesium. Because a low carb diet (especially a keto diet!) reduces the amount of water you store, this can flush out electrolytes and make you feel sick (called “keto flu”). This is temporary, but you can avoid or eliminate it by salting your food liberally, drinking broth (especially bone broth), and eating pickled vegetables. Some people also choose to take supplements for electrolytes, but it’s best to first consult a doctor that understands and supports keto/low carb lifestyles.
Hi, I’m still a bit skeptical, I have seen some of my friends do the keto diet, and have had good results. Though I am still not sure about the idea of the fats being eaten. They say they eat meat with the fat and must do so, is this correct? Also isn’t this not good for the body especially for the kidneys? Second, can a diabetic do this diet? There are many questions running through my head.
Hi, before finding your AMAZING website (THANK YOU), I had been dipping my toe in the low carb diet thing. In the past two weeks, I did the 3 day induction and have made things from the week one meal plan. Although I have only lost 3-4 pounds (had a trip this past weekend where I was a bit lax), I have lost an inch on my waist!!! Crazy stuff!! Also, even though I was a bit lax, I felt the self control was really good, versus times in the past on other typical low fat/low cal diets. I truly want to THANK YOU for your time, energy, and patience with this wonderful work you provide.

Thank you. Needed this. Going to try. Been doing almost this. However on good days. I eat much less food. W maybe 40 to 60 carbs tops. But cant lose anymore. And go up 6 down7 or 8. Back up. Need to go down. 12. This is my 5th time losing over 100lbs. My last time. Its been off for over a year. I know this works. But u r right. Ppl will hate it. But suck it up. It sucks. Ive done it.
1. Eat less than 20g net carbs per day if you want to get into ketosis. Net carbs are calculated by subtracting the fiber grams (or sugar alcohols in some cases) from the total carb grams. Don’t guess – you’d be surprised how many grams of carbs there are in things you might have considered “free” like onions, garlic, tomatoes, and kale, just to name a few.
I was real proud of myself this morning. I adapted your your pancake recipe to make an awesome tasting bread for sandwiches. I left out the sugar and cinnamon and added a couple twists from my Italian seasonings grinder. I was sooooo good. Tasted like a Italian sandwich wrap. My husband loves it cause he really misses bread sometimes. Thank you for the recipe. I think I will have pancakes for breakfast. YUM!
I just want to say THANK YOU for putting together such an informative, encouraging, and realistic introduction to what it means to follow a Keto plan. I have finally decided that I can no longer put off giving myself a food makeover. Started following the Keto guidelines today, and I’m determined to stick with it. Your site gives me the confidence to be able to do it. Thank you!
Melissa I stumbled upon your site today and am so thankful that I did!!!! I’m starting this 3 day keto jump start today!!! I have 50 lbs to loose and I want my energy back and I want my life back!!!! Tired of being tired!! I love that you have gluten free recipes as my son was diagnosed with Aspbergers a year ago (high functioning autism) and I let my self go! I’ve got to get heathy so I can help my son so we can be on this journey together!!!! Thank you so much Melissa!!!

^ Freeman JM, Vining EP, Pillas DJ, Pyzik PL, Casey JC, Kelly LM. The efficacy of the ketogenic diet—1998: a prospective evaluation of intervention in 150 children. Pediatrics. 1998 Dec;102(6):1358–63. doi:10.1542/peds.102.6.1358. PMID 9832569. https://web.archive.org/web/20040629224858/http://www.hopkinsmedicine.org/press/1998/DECEMBER/981207.HTM Lay summary]—JHMI Office of Communications and Public Affairs. Updated 7 December 1998. Cited 6 March 2008.

We’re going full on fats with breakfast, just like we did last week. This time we’ll double the amount of ketoproof coffee (or tea) we drink, meaning we double the amount of coconut oil, butter, and heavy cream. It should come to quite a lot of calories, and should definitely keep us full all the way to dinner. Remember to continue drinking water like a fiend to make sure you’re staying hydrated.


Achieving optimal ketosis hinges on finding the right balance of macronutrients (or “macros” in keto-speak); these are the elements in your diet that account for the majority of your calories, a.k.a. energy—namely, fat, protein, and carbohydrates. By the way, it’s often “net grams” of carbohydrates that are counted toward your daily intake; “net” deducts the amount of fiber in a food from its carbohydrate total.
Hi Barb, That can definitely be it. Losing when you are close to goal can be more difficult. It could also be that your body’s healthy weight is a little higher than what you’d like – which doesn’t mean you can’t lose, but makes it more difficult. If just eating Keto foods isn’t working, double check the macros for your weight and see if the amount you’re eating needs to be adjusted. You’ll find more help and support in our support group here.
That’s why many health experts are concerned about people on the keto diet, especially those who try it without the guidance of a doctor or nutritionist. Doctors say that high-fat diets like this one may raise cholesterol levels, and some studies suggest that they increase the risk of diabetes. Some have even called it a “cardiologist’s nightmare.”
On a ketogenic diet, you’re generally eating a diet that’s high in fat (roughly 70 percent of your total calories come from fat), moderate in protein (about 20 percent of your calories), and low in carbohydrate (about 5 percent of calories). By limiting carbohydrates (to usually less than 45 grams for the average person), your body lacks the glucose (from carbs) that it normally uses for energy, so it eventually switches over to burning fat as its primary fuel source instead; through a metabolic process called ketosis, the liver converts the fat into fragments of fatty acids called ketones, which power the brain and other organs and tissues.
If you’re looking to get a jump start on your health and fitness goals this year, you may be thinking about trying the ketogenic diet. Maybe you’ve heard the phrase before — it’s a huge diet buzzword — but aren’t sure what it means. Here’s a primer: The ketogenic diet is an eating plan that drives your body into ketosis, a state where the body uses fat as a primary fuel source (instead of carbohydrates), says Stacey Mattinson, RDN, who is based in Austin, Texas.
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