Frederick F. Samaha, M.D., Nayyar Iqbal, M.D., Prakash Seshadri, M.D., Kathryn L. Chicano, C.R.N.P., Denise A. Daily, R.D., Joyce McGrory, C.R.N.P., Terrence Williams, B.S., Monica Williams, B.S., Edward J. Gracely, Ph.D., and Linda Stern, M.D., “A Low-Carbohydrate as Compared with a Low-Fat Diet in Severe Obesity,” N Engl J Med 2003; 348:2074-2081. http://www.nejm.org/doi/full/10.1056/NEJMoa022637.
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 >
Hi Melissa! So I went on ideal protein to lose weight before my daughter’s wedding. It was great! I loved the products and of course I loved losing 64 pounds. HOWEVER, after the wedding I started to enjoy drinking again. And since July 2014, I have gained 34 pounds. I have yo-yo’d with IP but after the taste of real food it is very difficult for me to stay on track. I know it works but after 3 weeks losing 9 pounds I end up eating a whole pizza! Anyway, I love all of your insight to keto. How do you think your suggestions will work if I am throwing in a IP packet for snack instead of say almonds? I just want to feel better again and not spend $100 every week on IP. Thanks for your time and commitment to helping those of us who are weak!
I also have to tell you that you are HILARIOUS! I laughed so hard reading your lead up to the 3 day plan. Thank you for your guidance, honesty, outstanding sense of humor (we all need it), incredibly delicious recipes and your baffling organization. I truly don’t know how you get it all done. You make it “do-able” and fun. I’m actually excited to start!
Everyone’s protein requirements are different on a keto diet, and when you are just starting out it’s less important than getting adapted to less carbs – this kickstart is designed to get people into ketosis as quickly and painlessly as possible and it does that very well. If you want to customize for your own macros with less protein you can certainly do that. I am working on some new meal plans with even less protein that I’ll be rolling out in the next few weeks for more advanced keto dieters.
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.
You’re so welcome Jessica – you and me both! I’m looking forward to feeling good again and having my clothes fit right will be nice too! ha ha! Thanks to all of your feedback I’ll be posting 7 day menu plans every Saturday, and we’ll all hopefully be reporting our pounds lost so far progress in the comments. I’m so looking forward to it – hope you’ll join us!!!
As a note, you do need to check the carbohydrate content of everything you eat, especially processed foods such as sausages, cheeses and sauces. There could be hidden carbs in the products used to preserve or “pad out” these foods, so make sure you are buying the lowest carb options and counting the carbs they do contain to ensure you don’t go over your daily limit.

A systematic review in 2016 found and analysed seven randomized controlled trials of ketogenic diet in children and young people with epilepsy.[2] The trials were done among children and young people for whom drugs failed to control their seizures, and only one of the trials compared a group assigned to ketogenic diet with a group not assigned to one.[16] The other trials compared types of diets or ways of introducing them to make them more tolerable.[2] Nearly 40% of the children and young people had half or fewer seizures with the diet compared with the group not assigned to the diet. Only about 10% were still on the diet after a few years.[2] Adverse effects such as hunger and loss of energy in that trial were common, with about 30% experiencing constipation.[16]

I’d like to add to your last point because my uterus hated me for a week! I have the IUD (Mirena) and I honestly don’t remember when my last period was, guesstimating I’d say 8 months ago. Since having the IUD I only spot and rarely have a period (I’ve had it since 2014), but OMG my hormones must’ve been all over the place because I not only got a heavy period but I had it for 9 days straight!
Hello! I recently lost 125 lbs following a keto diet. It’s starting to creep back on. My question is, have you tried a product like Keto OS? I want to eat Keto strictly, minus one meal a week. I feel that I will maintain better this way. I don’t want to knock myself out of ketosis and take days to get back in, though. My hope was that I can go full Keto, have one meal “off” a week and follow up with Keto OS to put me right back in and stay in for another week. Thoughts? Will this work? Thank you!
He is convinced that carbohydrate-heavy, low-fat diets are a major reason we're seeing high rates of diabetes, high blood pressure, obesity, and cancer. That's because a diet high in sugar can quickly raise insulin levels in the body. Over time, those spikes can lead to insulin resistance and eventually to long-term health issues like high blood pressure, Type 2 diabetes, inflammation, and obesity.

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)

The modified Atkins diet reduces seizure frequency by more than 50% in 43% of patients who try it and by more than 90% in 27% of patients.[3] Few adverse effects have been reported, though cholesterol is increased and the diet has not been studied long term.[47] Although based on a smaller data set (126 adults and children from 11 studies over five centres), these results from 2009 compare favourably with the traditional ketogenic diet.[3]

Please help!!! Love your plan, it is a dream come true, I’m in ketosis and have lost 10 lbs the first week on the 3 day plan, I’m still in ketosis but have not lost 1 lb in the last 4 days??? Is this suppose to happen or am I doing something wrong…the only thing different from the beginning is that I am not hungry and have eaten alot less, does that matter? Am I suppose to eat high calories to lose? Do I need to move on to the 7 day plan now? And how long is,it safe to stay in ketosis? Do I want to,be there all of the time? Please help I have been so happy on this plan losing this way eating foods I love, I have tried every other diet out there with no success…thank you for all that you are doing to help so many people lose weigjt, eat healthier and feel better…you are my answered prayer
Hey folks, I am a 55 year old guy whos used to be in good shape, so was wondering if I could use the Keto diet to lose fat and gain muscle, obviously I would have to increase caloric intake as I am weight training and performing cardio so was wondering about supplements, vits and minerals as well whey protein, as I am trying to lose body fat and build muscle I need extra calories.. plus creatine and NO pre work out and a post work supplement…
But people who started following the keto diet noticed weight loss for a few reasons: When you eat carbs, your body retains fluid in order to store carbs for energy (you know, in case it needs it). But when you’re not having much in the carb department, you lose this water weight, says Warren. Also, it's easy to go overboard on carbohydrates—but if you're loading up on fat, it may help curb cravings since it keeps you satisfied.
OMG! I have a household of 9. 3 of us are Keto. EVERYONE in the house asks for this recipe on the regular! I add a little heavy cream into the ground beef with the cream cheese and make the recipe for 16 servings (have dad, hubby and 18 yo son in the house.) I like to carmalize the onion and garlic in bacon grease as well. This recipe is an easy “go to” that pleases anyone in the house as well as a great idea when we have extra company. This is probably our favorite keto recipe to date!
So I’m late to the party, but I just found your blog last week. I can’t thank you enough for these simple, easy to follow recipes, meal plans, and shopping lists! They are so helpful and I appreciate the time you put into this. I did the 3 day kickstart for 5 days, mostly because I still had leftover food, and I’ve lost 5 lbs. so far! I’ve never done low carb before, and usually eat a mainly vegetarian diet, so this is very different for me, I think I purchased more meat in the past week then I have in the past year! I am strictly following the plan, but do you think after I’ve lost the weight I’ve wanted to, transitioning back to a vegetarian diet (with eggs and dairy) is possible or just a recipe for disaster?
Hi Melissa! I’ve been on track for 4 days now and have actually been feeling pretty good except for fatigue. I’ve been follwing the plan to a “T” but after 4 days I don’t think i’m in ketosis yet. Could some people take a few days longer than others? I’m going to test again in a couple days (or how often should you test? Does morning have more ketones than evening?) and hopefully I am up. Sometimes it is hard to read the strips but I know I am negative to minimal ketones at this point.
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.

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.
The first modern study of fasting as a treatment for epilepsy was in France in 1911.[12] Twenty epilepsy patients of all ages were "detoxified" by consuming a low-calorie vegetarian diet, combined with periods of fasting and purging. Two benefited enormously, but most failed to maintain compliance with the imposed restrictions. The diet improved the patients' mental capabilities, in contrast to their medication, potassium bromide, which dulled the mind.[13]
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.
Beyond just fat loss, ketosis has an additional benefit in that it spares muscle when you’re eating at a deficit. On a normal diet, when you eat fewer calories than you need for the day, your body breaks down muscle and fat in nearly equal amounts to make up for the difference. With keto, your body is primed to burn mostly fat, particularly if you’re meeting your protein goal for the day. This results in a better metabolism and more total fat lost. Low carb recipes offer:

I love this! I am an amateur powerlifter and I have recently started using the keto diet as there is only so much gained by being a fat powerlifter but working out my macros was driving me nuts as I also work as a disability support worker and need to take meals and so on to work with me. Thanks to this I can now have better control of the macros to bring my weight down without doing to much harm to my lifts! Thank you for this!


I’ve never really thought of myself as a coach Monica but thank you! (note to self: buy an obnoxious whistle to wear around my neck at all times) I’m so happy to hear that you are excited and optimistic about losing weight with the plans! I am looking forward to hearing about your progress as you move through the weeks! I’m with you on the avoiding bad decisions – if I get too hungry and don’t have on plan stuff available, that’s always a recipe (no pun intended) for disaster!
I love this! I am an amateur powerlifter and I have recently started using the keto diet as there is only so much gained by being a fat powerlifter but working out my macros was driving me nuts as I also work as a disability support worker and need to take meals and so on to work with me. Thanks to this I can now have better control of the macros to bring my weight down without doing to much harm to my lifts! Thank you for this!
Achieving ketosis is a pretty straightforward, but it can seem complicated and confusing with all of the information out there.4If you want to learn more about ketosis and the scientific process around it, you can visit a very in-depth discussion about on Dr. Peter Attia’s website. Here’s the bottom line on what you need to do, ordered in levels of importance:
Around this time, Bernarr Macfadden, an American exponent of physical culture, popularised the use of fasting to restore health. His disciple, the osteopathic physician Dr. Hugh William Conklin of Battle Creek, Michigan, began to treat his epilepsy patients by recommending fasting. Conklin conjectured that epileptic seizures were caused when a toxin, secreted from the Peyer's patches in the intestines, was discharged into the bloodstream. He recommended a fast lasting 18 to 25 days to allow this toxin to dissipate. Conklin probably treated hundreds of epilepsy patients with his "water diet" and boasted of a 90% cure rate in children, falling to 50% in adults. Later analysis of Conklin's case records showed 20% of his patients achieved freedom from seizures and 50% had some improvement.[10]
What she said…I, too, get overwhelmed when I think of trying to put a keto diet together. The basic concepts are clear, but the stumbling block is what to make, and how to combine recipes to get the magic numbers for the day. I would appreciate menu plans very much…and thank you for this post which has me determined to get started on a keto way of eating.

You’re so welcome Jessica – you and me both! I’m looking forward to feeling good again and having my clothes fit right will be nice too! ha ha! Thanks to all of your feedback I’ll be posting 7 day menu plans every Saturday, and we’ll all hopefully be reporting our pounds lost so far progress in the comments. I’m so looking forward to it – hope you’ll join us!!!
Because some cancer cells are inefficient in processing ketone bodies for energy, the ketogenic diet has also been suggested as a treatment for cancer.[58][59] A 2018 review looked at the evidence from preclinical and clinical studies of ketogenic diets in cancer therapy. The clinical studies in humans are typically very small, with some providing weak evidence for anti-tumour effect, particularly for glioblastoma, but in other cancers and studies, no anti-tumour effect was seen. Taken together, results from preclinical studies, albeit sometimes contradictory, tend to support an anti-tumor effect rather than a pro-tumor effect of the KD for most solid cancers.[60]

I too started Atkins years ago- back in the ‘80’s. I did well as long as i stuck to it. But, it’s a tough road and restaurants and snack food companies are not very low carb friendly. It’s all too easy for me to grab something quick & the donuts in the break room do me in everytime!!! I read your post this morning & It inspired me. I also am 57 and have been discouraged lately with my weight and lack of ability to stay away from carbs. But, I am going at it again – and this time with a vengeance. Thanks again for your post – very inspiring & appreciated. By the way – I found that Mellissa’s website the best for keto. Her recipes are simply delicious and not over complicated or time consuming. She also has a great sense of humor. It’s nice to know she goes through the same trials we do – and what it’s like to mess up !! !!. Thank you Mellissa for your articles, recipes, humor and your perseverance!!


You may also be a great candidate for the Keto diet if you experience migraines, joint pain, muscle weakness or mental fatigue. In addition, "Keto diet can be beneficial for mental health conditions like depression, autism and Alzheimer's". Other than that, "you can also follow this diet plan if you're trying to get pregnant since it improves fertility", she notes.
Aude, Y., A. S, Agatston, F. Lopez-Jimenez, et al. “The National Cholesterol Education Program Diet vs a Diet Lower in Carbohydrates and Higher in Protein and Monounsaturated Fat: A Randomized Trial.” JAMA Internal Medicine 164, no. 19 (2004): 2141–46. doi: 10.1001/archinte.164.19.2141. jamanetwork.com/journals/jamainternalmedicine/article-abstract/217514.
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!
The modified Atkins diet reduces seizure frequency by more than 50% in 43% of patients who try it and by more than 90% in 27% of patients.[3] Few adverse effects have been reported, though cholesterol is increased and the diet has not been studied long term.[47] Although based on a smaller data set (126 adults and children from 11 studies over five centres), these results from 2009 compare favourably with the traditional ketogenic diet.[3]
Long-term use of the ketogenic diet in children increases the risk of slowed or stunted growth, bone fractures and kidney stones.[3] The diet reduces levels of insulin-like growth factor 1, which is important for childhood growth. Like many anticonvulsant drugs, the ketogenic diet has an adverse effect on bone health. Many factors may be involved such as acidosis and suppressed growth hormone.[37] About 1 in 20 children on the ketogenic diet will develop kidney stones (compared with one in several thousand for the general population). A class of anticonvulsants known as carbonic anhydrase inhibitors (topiramate, zonisamide) are known to increase the risk of kidney stones, but the combination of these anticonvulsants and the ketogenic diet does not appear to elevate the risk above that of the diet alone.[38] The stones are treatable and do not justify discontinuation of the diet.[38] Johns Hopkins Hospital now gives oral potassium citrate supplements to all ketogenic diet patients, resulting in a sevenfold decrease in the incidence of kidney stones.[39] However, this empiric usage has not been tested in a prospective controlled trial.[9] Kidney stone formation (nephrolithiasis) is associated with the diet for four reasons:[38]
The modified Atkins diet reduces seizure frequency by more than 50% in 43% of patients who try it and by more than 90% in 27% of patients.[3] Few adverse effects have been reported, though cholesterol is increased and the diet has not been studied long term.[47] Although based on a smaller data set (126 adults and children from 11 studies over five centres), these results from 2009 compare favourably with the traditional ketogenic diet.[3]
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?
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?
Just a followup to my earlier post with some quick numbers – I have been keeping carbs under 15 per day and the fat around 75-85%, with protein about 25% or less. I have not lost one pound while on the Keto diet, but I do feel that it is a much more natural way to eat. I don’t snack, I only eat 3 meals daily, I just cannot get into the habit of snacking and I’m not hungry enough to be bothered with additional food.

I don’t see how this will be within the allowed protein retirements. I found this blog through the Senza app and have found most “meal plans” have a lot of protein and not enough fat. I should be eating 80g of protein a day. One string cheese is 6g and 2 eggs are 12g, plus the 25g protein per 6oz serving most meat contains. If I ate this 3 day start up plan, is be WAY over my protein and under on my fat. She even addressed that this isn’t a high protein diet but I don’t see how it’s not when almost every meal and stack contains at least 20g protein.

Since this is my full-time job, donations really help me keep afloat and allow me to post as much to the website as I do. While I do really appreciate any donation you want to give, you can enter $0 in the amount given to download it for free! I’ve added in $5 as the suggested price. I think that’s a very fair price considering other websites are charging in the hundreds of dollars and I’ve seen what they are like on the inside.
Thank you, thank you, thank you! Thank you for taking the guesswork out of putting a plan together. Thank you for putting in the time, your dedication and commitment helping people you don’t even know. I get overwhelmed putting a plan together. What I think is healthy is not! I am starting the 3 day kickstart this week. I am putting my shopping list together. While doing so, I find myself asking- are these ingredients enough for 1 person or more? Should I increase the quantity of items to feed the family? I have a family of 5 and we all need to eat healthier. More specifically, my husband and I will be doing Keto. The kids (14, 18 & 20’year olds) will most likely do the dinners and snacks. Thank you for your help with this. Sorry in advance if you already answered these questions. I went through other comments and didn’t notice if it had been addressed. Thanks again!
"Plenty of people jump right in, thinking all they have to do is cut carbs and increase fat. All of a sudden, they hit a wall and get 'keto flu.' They feel tired, lethargic, and experience headaches," Wittrock says. "The primary reason they get these symptoms is lack of the three primary electrolytes: sodium, potassium, and magnesium. If you're deficient in any of these, you'll suffer mentally and physically. This is the single biggest reason people fail on the keto diet."

8. All brands are not created equal. Sometimes (but not always) you have to pony up for the name brand over the generic because the carbs are less – this is generally true with cream cheese for example. When buying heavy cream, go organic if you can find it because some brands use thickeners that add carbs. Buy your cheese in blocks or slices rather than in shreds – the shredded cheese is coated with food starch to avoid clumping and that adds carbs.

Your body is going to be like an angry child having a tantrum – IT WANTS SUGAR AND CARBS NOW, but you aren’t going to give it any are you? ARE YOU??? Just like with children, the key is to distract, distract, distract (oooh shiny!). Give it something else desirable, (bacon, cheese, etc.) even if it isn’t what it really wants. Don’t give in thinking you’ll feel better if you just eat a little bit of carbs – there is no compromising!
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]
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.

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]


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]
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.
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?

Lots of apps and website offer keto diet challenges—basically, a blueprint for the keto diet with a fixed starting and ending point (they typically last for a week to a month, though some may be longer). Speaking of apps, plenty of keto-centric ones are right at your fingertips (a.k.a., your smartphone), like the KetoDiet app, which can help you calculate your macros and track your keto diet effectively.
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