Variations on the Johns Hopkins protocol are common. The initiation can be performed using outpatient clinics rather than requiring a stay in hospital. Often there is no initial fast (fasting increases the risk of acidosis and hypoglycaemia and weight loss). Rather than increasing meal sizes over the three-day initiation, some institutions maintain meal size but alter the ketogenic ratio from 2:1 to 4:1.[9]
Other forms of ketogenic diets include cyclic ketogenic diets, also known as carb cycling, and targeted ketogenic diets, which allow for adjustments to carbohydrate intake around exercise. These modifications are typically implemented by athletes looking to use the ketogenic diet to enhance performance and endurance and not by individuals specifically focused on weight loss.

It doesn’t matter to your body whether the fat it’s burning is from your existing reserves or from the high fat meal that you just ate. And the production of ketones doesn’t necessarily mean you are burning body fat. So when keto dieters add fat to their diet through bulletproof coffee or coconut oil, it is burnt as fuel instead of body fat – which defeats the object of the diet achieving weight loss.

So, in regards to #9….(guys, look away now) I have been keto for about a month and a half now. Shark week came and went as normal….Normally if I even get cramps, it’s for the first day or two of my period and they are never that bad. About a week later I started getting really really bad cramps…to the point they were waking me up in the middle of the night. Someone suggested constipation but I didn’t think that was it because I was still going…just not as much, which is normal on a keto/paleo plan. 9 days after my normal period ended, I started again and it was just like the previous when it came to flow. After the first 5 days which is when it should have ended, it started getting heavier and has stayed that way since. I am now on day 13 of this second period with no indication of an end in sight. I have not had this experience in years and that was due to birth control that I was taking at the time. I am miserable and in more pain than I have ever experienced. I have energy thanks to the keto but I am in far too much pain to even think about working out and it sucks! I know you said you went thru some irregularity yourself but was it anything like this? Do you know people that have experienced this? I have tried searching the web but everything that pops up talks about their periods disappearing or getting 2 in one month at most, not what I am experiencing which is probably going to be closer to a month before I end.
Hi! I’m contemplating taking on the Keto lifestyle change, but am concerned that preparing 1 meal for me and then a different meal for my DH and finicky 13yo DD will be an anchor around my neck. I already dislike cooking and my crew is not going to cooperate and join me in this journey. Any words of wisdom or is this going to be one of those “put on your big girl panties, Shawn, and deal with it” kind of situations. I just see myself being sabotaged from day one. Anyone else in a similar situation? How did you go about it?
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).

1) Fat weighs less than healthy muscle… EVEN IF you are not showing a loss in the scales… check your clothes.. they’ll be fitting better… If you lacked good muscle tissue.. eating the protein will rebuild that. If you were VERY out of shape, your body will feel GREAT with all the new muscle, but it DOES weigh more… that will not stop you from losing, you just need to stick it out… you will lose inches even if you’re not losing lbs…


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 >
Because people with type 2 diabetes are at an increased risk for cardiovascular disease, there’s a specific concern that the saturated fat in the diet may drive up LDL, or “bad,” cholesterol levels, and further increase the odds of heart problems. If you have type 2 diabetes, talk to your doctor before attempting a ketogenic diet. They may recommend a different weight-loss diet for you, like a reduced-calorie diet, to manage diabetes. Those with epilepsy should also consult their doctor before using this as part of their treatment plan.
I am brand new to this Keto diet stuff! I have been searching for the best blog or site and this is just outstanding! I can’t wait till I can buy your books. This is the first time I saw food ideas I actually liked (piky eater alert). I am going to try the 3 day start plan right after I get back from camping. Thank you so much for putting this all together and I will be trying more than just the 3 day I am sure!
The keto diet isn’t new, and it’s been around for nearly a century. It was originally developed to treat people with epilepsy. In the 1920s, researchers found that raised levels of ketones in the blood led to fewer epileptic seizures in patients. The keto diet is still used today to treat children with epilepsy who don’t respond well to anti-epileptic drugs.[2] 

I’ve never heard of this program, but am definitely willing to try it. I do have a question, however; in my faith, we do not eat pig meat in any way, shape or form, so can I eat turkey bacon or sausage instead (for breakfast meats)? I’m not a day person, having worked the midnight shift for almost 20 years, so the meat/breakfast just isn’t relevant–I’d prefer to eat dinner-type foods instead–but if it has to be done in order to lose (a huge amount of) weight, I’ll adjust.

Hello wanting to start this Keto diet asap. I have a quick question. I’m addicted to pop. Yes I’ve tried switching to tea and coffee. When I go one day without any pop I take a bad migraine. Its crippling I am in bed throwing up and movement sound lights everything makes it worse. The only way to get over them is by consuming a soda. I have talked to my Doctor she is no help at all. I don’t believe she has ever suffered from a migraine. I know my body will detox and I will get over it. Problem is I am a single mom of 3 young kids. Whom cant take care of them selves. I’m not sure how to kick the soda habit without leaving me begging for death for the next week. Any ideas how I can get threw this. Ive tried most otc meds.


In 1921, Rollin Turner Woodyatt reviewed the research on diet and diabetes. He reported that three water-soluble compounds, β-hydroxybutyrate, acetoacetate and acetone (known collectively as ketone bodies), were produced by the liver in otherwise healthy people when they were starved or if they consumed a very low-carbohydrate, high-fat diet.[10] Dr. Russell Morse Wilder, at the Mayo Clinic, built on this research and coined the term ketogenic diet to describe a diet that produced a high level of ketone bodies in the blood (ketonemia) through an excess of fat and lack of carbohydrate. Wilder hoped to obtain the benefits of fasting in a dietary therapy that could be maintained indefinitely. His trial on a few epilepsy patients in 1921 was the first use of the ketogenic diet as a treatment for epilepsy.[10]
If you want to slam a protein shake post-workout, that's probably fine as long as you've got room for it in your macros. But shoot for one that is very low—like, zero—in carbohydrates. Pure isolates, such as Signature 100% Whey Isolate, are extremely low in carbohydrate. If you struggle to fit fat in during the day, toss a tablespoon of olive oil in with your shake. You won't taste it, and it gives a quick 13-14 grams of fat.
My daughter and I started low carb dieting/no flour,no sugar 6weeks ago. During that time I lost a total of 4 lbs. It was so frustrating because it felt like I should be losing more. So, in our search to figure out what we were doing wrong we found this site. We started with the 3 day plan!!! It has been wonderful. Every single recipe you provide has been absolutely Delicious. I have felt the most satisfied on your plan and as of day #2 I have already lost 6 lbs. 6!!! I worked 6 weeks just to lose 4!!!
Looking for a bit of guidance / inspiration here!! I have been eating in a low carb manner for many years and due to increased blood sugar decided to try a Keto diet. I’ve been living on meat, eggs & cheese for the past 6 weeks or so & have never gotten into ketosis. I check the ketones with a blood monitor and never get higher than 0.3, not a high enough level to be in ketosis. All fruit and most veggies raise my BG so they have been eliminated from my diet. To complicate things I have had many surgeries & injuries that don’t allow me to get any exercise. Any suggestions?
I would get seriously scientific. I happen to be diabetic and test my blood sugar on a regular basis. I had to keep testing my blood sugar after I started Keto as it is a requirement for me. I was flabbergasted by the numbers that started turning up. It is an additional point of data and can sometimes be very eye-opening. My tester helped me discover certain keto friendly foods that I don’t tolerate. You can pick up a tester at the pharmacy. I can’t say that pricking your finger several times a day is fun but it will give you a good read on how your body is reacting to certain meals and ingredients.
A survey in 2005 of 88 paediatric neurologists in the US found that 36% regularly prescribed the diet after three or more drugs had failed; 24% occasionally prescribed the diet as a last resort; 24% had only prescribed the diet in a few rare cases; and 16% had never prescribed the diet. There are several possible explanations for this gap between evidence and clinical practice.[33] One major factor may be the lack of adequately trained dietitians, who are needed to administer a ketogenic diet programme.[30]
Today is day one! Breakfast was delicious. So happy I found your blog and thank you for the recipes and especially the shopping list! You’ve left me with no excuses and actually a little bit excited to begin this 21 day adventure. This is huge. I’ve done Paleo before, felt good, but it didn’t last long term. My body needs to be low carb, no sugar, so again, thank you.
Here are a few of the most common side effects that I come across when people first start keto. Frequently the issues relate to dehydration or lack of micronutrients (vitamins) in the body. Make sure that you’re drinking enough water (close to a gallon a day) and eating foods with good sources of micronutrients. To read more on micronutrients, click here >

When you’ve eaten all of the crustless spinach quiche and keto frittata recipes that you can, these keto everything bagels are another great breakfast staple. With their help, you don’t have to cut out your favorite breakfast sandwiches. You can also try a bread-less keto breakfast sandwich with chicken sausage patties as the “buns” when you’re craving a keto-approved breakfast option.
You may have heard by now that I finally wrote and published a “real” book called Keto for Life!!!  The reviews are in and people are loving it!  Already a best seller, you can learn more about what you’ll find inside Keto for Life by clicking here!  OR head over to Amazon to check out the reviews of Keto for Life before snagging a copy for yourself!
Alison Moodie is a health reporter based in Los Angeles. She has written for numerous outlets including Newsweek, Agence France-Presse, The Daily Mail and HuffPost. For years she covered sustainable business for The Guardian. She holds a master’s degree from Columbia University’s Graduate School of Journalism, where she majored in TV news. When she's not working she's doting on her two kids and whipping up Bulletproof-inspired dishes in her kitchen.
First, I want to thank you for all of your dedication and work in providing this site. The difficulty of maintaining a healthy weight is a big problem for so many people. My personal question & issue in staying on Keto is my craving for fresh fruit. This a.m I had a large fresh peach along with my “Bullet Proof” coffee. Have I now sabotaged today’s Keto eating?
The first signs of ketosis are known as the “keto flu” where headaches, brain fogginess, fatigue, and the like can really rile your body up. Make sure that you’re drinking plenty of waterand eating plenty of salt. The ketogenic diet is a natural diuretic and you’ll be peeing more than normal. Take into account that you’re peeing out electrolytes, and you can guess that you’ll be having a thumping headache in no time. Keeping your salt intake and water intake high enough is very important, allowing your body to re-hydrate and re-supply your electrolytes. Doing this will help with the headaches, if not get rid of them completely.
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.
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.
Join our community of “losers” today and subscribe free to IBIH newsletters to get notified when I post new keto recipes and updated keto diet menu plans! Also head over to the IBIH Facebook page where the cool kids hang out – and you’ll get access to my daily Amazon freebies, health and fitness tips, and other fun content I only post on Facebook! Finally, be sure to register for our new IBIH Community Forum where you can get daily support for the 5 Day Keto Soup Diet, 5 Day Keto Egg Fast Diet, Weekly Keto Diet Menu Plans, or just gab with fellow IBIH fans who are following a low carb or gluten free lifestyle!
No deep fryers or air fryers needed for these wings! Forget those greasy chicken wings you’d order at a restaurant and opt-in for these homemade guiltless garlic parmesan wings. You won’t find rancid vegetable oil, gluten or a deep frier here — just avocado oil, healthy pecorino romano and free-range, organic chicken for a twist on an otherwise unhealthy classic.
What a great post. I thought i would add about the selection of food you eat on keto and that everyone is different. Some food gives you energy and some doesnt, this varies person to person. I started and quit keto 3 times before i managed to find my balance. The first few times it made be poorly, from the shock of diet change. However, you can wean yourself into the diet which i did the last time when i had the most success.
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.
The ketogenic diet is calculated by a dietitian for each child. Age, weight, activity levels, culture and food preferences all affect the meal plan. First, the energy requirements are set at 80–90% of the recommended daily amounts (RDA) for the child's age (the high-fat diet requires less energy to process than a typical high-carbohydrate diet). Highly active children or those with muscle spasticity require more calories than this; immobile children require less. The ketogenic ratio of the diet compares the weight of fat to the combined weight of carbohydrate and protein. This is typically 4:1, but children who are younger than 18 months, older than 12 years, or who are obese may be started on a 3:1 ratio. Fat is energy-rich, with 9 kcal/g (38 kJ/g) compared to 4 kcal/g (17 kJ/g) for carbohydrate or protein, so portions on the ketogenic diet are smaller than normal. The quantity of fat in the diet can be calculated from the overall energy requirements and the chosen ketogenic ratio. Next, the protein levels are set to allow for growth and body maintenance, and are around 1 g protein for each kg of body weight. Lastly, the amount of carbohydrate is set according to what allowance is left while maintaining the chosen ratio. Any carbohydrate in medications or supplements must be subtracted from this allowance. The total daily amount of fat, protein and carbohydrate is then evenly divided across the meals.[36]

Also, when you eliminate sugar and high-carb foods from your daily diet, "your body is able to heal itself and detox from the accumulated inflammation that it is constantly fighting," That means less brain fog, improved cognition and brain health. Consequently, the improved mental clarity makes it easier for you to make smart food choices, adds the nutritionist.

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Gary D. Foster, Ph.D., Holly R. Wyatt, M.D., James O. Hill, Ph.D., Brian G. McGuckin, Ed.M., Carrie Brill, B.S., B. Selma Mohammed, M.D., Ph.D., Philippe O. Szapary, M.D., Daniel J. Rader, M.D., Joel S. Edman, D.Sc., and Samuel Klein, M.D., “A Randomized Trial of a Low-Carbohydrate Diet for Obesity — NEJM,” N Engl J Med 2003; 348:2082- 2090. http://www.nejm.org/doi/full/10.1056/NEJMoa022207.
If you talk to keto aficionados, you’ll find many save leftovers from dinner for the next day’s lunch. Cook once, eat twice—your keto diet menu for lunch is solved. If you don’t like leftovers or if you’re craving something different for lunch, the mid-day meal can be as simple as a scoop of chicken salad. Or, hit the salad bar at a local grocery store and top a bowl of greens with some good-fat goodies. You can also try one of these simple keto lunches:

A computer program such as KetoCalculator may be used to help generate recipes.[46] The meals often have four components: heavy whipping cream, a protein-rich food (typically meat), a fruit or vegetable and a fat such as butter, vegetable oil or mayonnaise. Only low-carbohydrate fruits and vegetables are allowed, which excludes bananas, potatoes, peas and corn. Suitable fruits are divided into two groups based on the amount of carbohydrate they contain, and vegetables are similarly divided into two groups. Foods within each of these four groups may be freely substituted to allow for variation without needing to recalculate portion sizes. For example, cooked broccoli, Brussels sprouts, cauliflower and green beans are all equivalent. Fresh, canned or frozen foods are equivalent, but raw and cooked vegetables differ, and processed foods are an additional complication. Parents are required to be precise when measuring food quantities on an electronic scale accurate to 1 g. The child must eat the whole meal and cannot have extra portions; any snacks must be incorporated into the meal plan. A small amount of MCT oil may be used to help with constipation or to increase ketosis.[36]


^ Jump up to: a b c d e f g h i j k l m n o p q r s Kossoff EH, Zupec-Kania BA, Amark PE, Ballaban-Gil KR, Bergqvist AG, Blackford R, et al. Optimal clinical management of children receiving the ketogenic diet: recommendations of the International Ketogenic Diet Study Group. Epilepsia. 2009 Feb;50(2):304–17. doi:10.1111/j.1528-1167.2008.01765.x. PMID 18823325
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:
You can have a completely smooth transition into ketosis, or…not. While your body is adapting to using ketones as your new fuel source, you may experience a range of uncomfortable short-term symptoms. These symptoms are referred to as “the keto flu.” Low-sodium levels are often to blame for symptoms keto flu, since the kidneys secrete more sodium when you’re in ketosis, says Volek. A few side effects:
The Johns Hopkins Hospital protocol for initiating the ketogenic diet has been widely adopted.[42] It involves a consultation with the patient and their caregivers and, later, a short hospital admission.[18] Because of the risk of complications during ketogenic diet initiation, most centres begin the diet under close medical supervision in the hospital.[9]
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.
If you’ve decided to move forward in trying the keto diet, you will want to stick to the parameters of the eating plan. Roughly 60 to 80 percent of your calories will come from fats. That means you’ll eat meats, fats, and oils, and a very limited amount of nonstarchy vegetables, she says. (This is different from a traditional low-carb diet, as even fewer carbs are allowed on the keto diet.)
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