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 ketone bodies are possibly anticonvulsant; in animal models, acetoacetate and acetone protect against seizures. The ketogenic diet results in adaptive changes to brain energy metabolism that increase the energy reserves; ketone bodies are a more efficient fuel than glucose, and the number of mitochondria is increased. This may help the neurons to remain stable in the face of increased energy demand during a seizure, and may confer a neuroprotective effect.[55]

It’s important to remember that the goal of any dietary change is to promote a healthy lifestyle, so make sure to select a meal plan you can envision yourself following long term. If you know you will not be able to comply with such stringent carbohydrate restrictions for years to come, the ketogenic diet is most likely not the right choice for you.


For people with diabetes, rapidly rising ketone levels can signal a health crisis that requires immediate medical attention. When there is an absence or not enough of the hormone insulin (or the body is too resistant to insulin to allow it to drive glucose into the cells for energy), the body cannot use glucose for fuel. Insulin helps ferry glucose to our cells and muscles for energy. Instead, in this case, the body resorts to burning stored fat for energy through the process of ketosis, leading to a buildup of ketones in the body.

Probably, and there are a few reasons why, Keatley says. For starters, people usually reduce their daily caloric intake to about 1,500 calories a day because healthy fats and lean proteins make you feel fuller sooner—and for a longer period of time. And then there’s the fact that it takes more energy to process and burn fat and protein than carbs, so you're burning slightly more calories than you did before. Over time, this can lead to weight loss.

The day before admission to hospital, the proportion of carbohydrate in the diet may be decreased and the patient begins fasting after his or her evening meal.[18] On admission, only calorie- and caffeine-free fluids[36] are allowed until dinner, which consists of "eggnog"[Note 8] restricted to one-third of the typical calories for a meal. The following breakfast and lunch are similar, and on the second day, the "eggnog" dinner is increased to two-thirds of a typical meal's caloric content. By the third day, dinner contains the full calorie quota and is a standard ketogenic meal (not "eggnog"). After a ketogenic breakfast on the fourth day, the patient is discharged. Where possible, the patient's current medicines are changed to carbohydrate-free formulations.[18]
No matter what your diet has been before now, keto will be a big change. If you're coming from a standard American diet (SAD), your carbs will go way down, your protein may either go up or down, and your fat will go way up. If you're coming from a bodybuilding-style diet, your fat intake will jump to alarming levels, and your protein will likely drop significantly.
Your three day kick start seems to me to be almost zero carbs? Am I wrong? I have been doing 20g net carb where you can still get in quite a few veggies for 20g net carbs. Am I missing something? In the day one for instance the only veggies are celery (1g or carb) and then rommaine leaves? I suppose you are getting 2 g in cheese string, a bit in the eggs, etc? I have been tracking and getting to 20g net with veggies, fats and meats (measuring every single thing). So As long as you are at 20g no matter how you get there it should be ok?
Lastly, if you're active, you might need to make some adjustments to take that into account. "For the first one to two weeks, temporarily reducing your exercise load can be helpful as your body adjusts to being in ketosis," he says. "Additionally, for those who have an intense workout schedule, carb cycling may be a good option." Carb cycling essentially means you'll increase your carb intake on the days you're doing exercise, ideally just two to three days per week. "While low-carb days may be around 20 to 30 grams of net carbs daily, high-carb days can range all the way up to 100 grams, although it can vary based on your size and activity level," says Dr. Axe. (Related: 8 Things You Need to Know About Exercising on the Keto Diet.) 
You should really ask your OB and/or a dietician. You have an increased calorie need while breastfeeding, and since your body will take what it needs from YOU to make quality milk for baby, you need to be sure your nutrition is sufficient. You could be way too tired to have a good postpartum experience if your baby is very young. If your baby is older and has started some type of solid, it would probably be less of an issue.

Thank you for your reply! I kinda thought that was the case, just wanted to double check. I found a site that may make our lives even easier! You paste the recipe, enter the original recipe serving size, then enter how many servings you need and then convert! Check out this site http://mykitchencalculator.com/recipeconverter.html . Super helpful! Got the groceries, now wish me luck! Eek, I’m so excited. Thanks again so much.

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.


“The cleaner, the better when it comes to the keto diet,” says Jadin. Focus on “whole” and “unprocessed.” Also, strive for a mix of saturated and unsaturated fats for balance. Note: Tipping the scale toward too much protein is a common pitfall many people make on the keto diet. Mind your protein intake, since too much can kick you out of ketosis, says Jadin.
Potatoes and gravy are total comfort food — and luckily, there’s a keto version. These are made with cauliflower, which is quite low-carb, particularly when compared to potatoes. Made with cream, butter, rosemary and parmesan, this mash is creamy, full of flavor and smooth. You’ll finish it all off with a stock-based gravy, that would be perfect on a roast, too.
Carol- so sorry to hear about your stroke. I am not sure most doctors would approve of this diet due to most not being taught much on nutrition in med school, and most still believe in the old school high carb low fat way of eating. My experience has been a dramatic drop in my blood pressure in only a few weeks after starting this diet (172/105 down to 144/95!). I suggest giving it a trial of a few months to see how it may work for you.

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!
Hi Cyn, The numbers are general guidelines but will vary depending on many factors, such as activity level, insulin resistance, weight and more. There is no single magic number, just conventional recommendations that are a good starting point. I will have a macro calculator coming soon that will help determine what is best for each person, but even then it’s an approximation. The only way to know for sure is to test. If keto is your goal, it’s usually best to start lower and then see if you can stay in ketosis when increasing.
Check the nutrition labels on all your products to see if they’re high in carbs. There are hidden carbs in the unlikeliest of places (like ketchup and canned soups). Try to avoid buying products with dozens of incomprehensible ingredients. Less is usually healthier.Always check the serving sizes against the carb counts. Manufacturers can sometimes recommend inconceivably small serving sizes to seemingly reduce calorie and carb numbers.
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.
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.

Well, I managed to get to the store and get a few things to fire up this kickstart. I made the pudding today and it was a bit tangy so I decided to turn it into the Mousse instead. It was awesome and even though this is officially the 2nd day, I was ready for something chocolaty. I happened to have Hershey’s cocoa powder on hand, but I was wondering what “premium” powder you normally use? I have more questions building up, but I have not read the above questions yet. You may have answered them. This was more to tell you how much I liked the Mousse. I tried tofu mousse once and it was an epic fail!


A: The most common ways to track your carbs is through MyFitnessPal and their mobile app. You cannot track net carbs on the app, although you can track your total carb intake and your total fiber intake. To get your net carbs, just subtract your total fiber intake from your total carb intake. I have written an article on How to Track Carbs on MyFitnessPal.
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The remaining calories in the keto diet come from protein — about 1 gram (g) per kilogram of body weight, so a 140-pound woman would need about 64 g of protein total. As for carbs: “Every body is different, but most people maintain ketosis with between 20 and 50 g of net carbs per day,” says Mattinson. Total carbohydrates minus fiber equals net carbs, she explains.
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