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]
To produce energy, the body typically uses carbohydrates. But after a few days on the keto diet, with its restrictive carb intake, your body cannot produce enough energy and looks for another source — breaking down stored fat to generate energy in a process called ketosis. It takes about a week for the body to start that shift from using carbohydrates or glucose, to using ketone bodies. The keto diet can help people lose weight. Some studies show those on the keto diet lose an average of five percent of their body weight, however the mechanisms are not clearly established.
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]
Hi Melissa! Thanks for this an awesome resource, thank you so much! A quick question – do you have any suggestions for doing keto with a milk allergy? I’m gluten and dairy free due to food sensitivities, but I’d love to try keto – the only problem is that 99% of the keto recipes/guides/meal plans that I’ve found a full of DELICIOUS but evil cheese! Thanks for your help :)

The first month or two on keto you may experience some strange periods (aka. Shark Week.) Don’t be alarmed. When you lose weight and your body detoxes from sugar and excess carbs, all kinds of hormonal changes (for the better) occur. Initially though, you may experience heavier periods than normal, more extreme PMS symptoms, etc. This is normal, and while it’s inconvenient it shouldn’t last more than a few months at the most.If your weight loss is rapid on keto (let’s hope), you may also lose more hair than normal for a month or two. It can be disconcerting, but it’s not permanent and will stop when your hormones regulate.
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.
Sharon M. Nickols-Richardson, PhD, RD, , Mary Dean Coleman, PhD, RD, Joanne J. Volpe, Kathy W. Hosig, PhD, MPH, RD, “Perceived Hunger Is Lower and Weight Loss Is Greater in Overweight Premenopausal Women Consuming a Low-Carbohydrate/High-Protein vs High-Carbohydrate/Low-Fat Diet,” The Journal of Pediatrics: Vol 105, Issue 9: 1433–1437; September 2005. http://www.sciencedirect.com/science/article/pii/S000282230501151X.
Magnesium citrate is an osmotic laxative, which relaxes your bowels and draws water into your intestines. It's an important mineral to help your organs function. Magnesium is obtained from green vegetables, nuts and whole-grain products. It's important to eat as many green vegetables and nuts as you are allowed to as your intake of whole-grain foods on the ketogenic diet will be severely limited.
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!
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Many ketogenic dieters also swear by MCT oil. (MCT simply stands for medium chain triglycerides.) MCT's energy-sustaining powers can be explained as follows: When MCT oil is metabolized in the body, it behaves more like a carbohydrate than a fat. Unlike other fats, MCT oil does not go through the lymphatic system. Instead, it is transported directly to the liver where it is metabolized so it releases energy like a carbohydrate and creates lots of ketones (which can be used for fuel) in the process.
I have one more question. You stress salt in this diet but I was wondering why you don’t recommend salted nuts. Is there a reason? I will just replace the almonds with string cheese if that is the case but I just can’t handle raw unsalted nuts. To me they taste like dirt! But I love salted ones so I was curious if we need the salt can I eat my salted almonds or pistachios? Just trying to figure out where the salt can be utilized. Thanks for all you help! Day 3 and going strong!
It sounds like you have used ground/mince beef that was too fatty and the fat has rendered out into the casserole. I tend to avoid low fat beef as we want plenty of healthy fat to keep us fuller for longer and all the benefits that come from a high fat diet, but I also avoid the highest fat beef as too much fat comes out in the cooking process for a dish such as this one.

This reminds me …… just after WWll, when there wasn’t a lot of meat available let alone any *special* foods to enjoy, my MoM used to cook up strips of bacon, then make creamed Mushrooms and supper would be bacon and creamed mushrooms on toast ….. ummmm it was so good! Your recipe not only brought back a memory but has also spurned me to make myself some bacon with creamed mushrooms on toast for my dinner tomorrow night 🤗

Having tempting, unhealthy foods in your home is one of the biggest reasons for failure when starting any diet. To maximize your chances of success with the keto diet, you need to remove as many triggers as you can. This crucial step will help prevent moments of weakness from ruining all your hard work.If you aren’t living alone, make sure to discuss with your family or housemates before throwing anything out. If some items are simply not yours to throw out, try to compromise and agree on a special location so you can keep them out of sight.

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
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’ll just have to search for some recipes that are low carb and dairy free! Week 5 of my keto menu plans is mostly dairy free and easily made completely dairy free. I have also started a pinterest board where I’m collecting low carb recipes that are also dairy free and I’ll be working on adding more recipes to that. You might also try searching for Paleo recipes, many of them are dairy free and can easily be made low carb as well! Hope that helps!


Initially you may be surprised that on keto diets you eat less frequently.  That’s because the fats are pretty satisfying. But as you normalize and adjust into a ketogenic state, that may change and your appetite may increase.  That’s fine and completely normal.  Use whatever diet you decide to follow as a starting point – it should be “written in pencil” so that you can make changes along the way.  Consider adding an extra meal, marginally increasing the size of the meals or just adding a shake between meals.  It’s up to you – just listen to your body.  For example for me, I added a low-carb “green powder” shake supplement to my regimen along with either flax seed oil or some nuts in order to satisfy my hunger.

Insulin is a hormone that lets your body use or store sugar as fuel. Ketogenic diets make you burn through this fuel quickly, so you don’t need to store it. This means your body needs -- and makes -- less insulin. Those lower levels may help protect you against some kinds of cancer or even slow the growth of cancer cells. More research is needed on this, though.
In one week my husband lost 1.5 kg because of Keto diet and recipes. Thank you for the insights and tips. I would like to have a complete recipe for meals everyday and hoping by subscribing I will receive try my mail. I will keep u posted. It takes 2 to tango. The one who wants to diet must be cooperative with the plan and execution while the other person who is preparing the food must be patient to the dieting person. Its not easy to change meals so patience is required

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.
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.
Implementing the diet can present difficulties for caregivers and the patient due to the time commitment involved in measuring and planning meals. Since any unplanned eating can potentially break the nutritional balance required, some people find the discipline needed to maintain the diet challenging and unpleasant. Some people terminate the diet or switch to a less demanding diet, like the modified Atkins diet (MAD) or the low-glycaemic index treatment (LGIT) diet, because they find the difficulties too great.[41]

The ketogenic diet—also known as "keto"—has become the latest big thing in weight-loss plans, touted recently by celebs like Jenna Jameson, Mama June, and Halle Berry. The diet involves cutting way back on carbohydrates, to 50 grams a day or less, to help the body achieve a state of ketosis, in which it has to burn fat (rather than sugar) for energy.

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]


[…] Your 3 Day Keto Kickstart and Menu Plan – I Breathe… I’m … – I am starting your 3 day kick start menu today (again) and was wondering, how do you calculate the carbs in sugar free syrup … I am excited to try your version of the keto diet! My husband started this last year and lost a bunch of weight. I then joined him and lost a bunch of weight too … […]

Epilepsy is one of the most common neurological disorders after stroke,[7] and affects at least 50 million people worldwide.[8] It is diagnosed in a person having recurrent unprovoked seizures. These occur when cortical neurons fire excessively, hypersynchronously, or both, leading to temporary disruption of normal brain function. This might affect, for example, the muscles, the senses, consciousness, or a combination. A seizure can be focal (confined to one part of the brain) or generalised (spread widely throughout the brain and leading to a loss of consciousness). Epilepsy may occur for a variety of reasons; some forms have been classified into epileptic syndromes, most of which begin in childhood. Epilepsy is considered refractory (not yielding to treatment) when two or three anticonvulsant drugs have failed to control it. About 60% of patients will achieve control of their epilepsy with the first drug they use, whereas about 30% do not achieve control with drugs. When drugs fail, other options include epilepsy surgery, vagus nerve stimulation and the ketogenic diet.[7]
Do you by chance have a shopping list for this 3 day beginning plan? I am a beginner and am so overwhelmed with information. The best part about your plans is they don’t require a tone of ingredients for 1 recipe. I don’t like when I have to but 15 things for 1 meal. I also love how you have something for breakfast and then can use it again for lunch (day 1 isn’t an example). Thank you so much for taking the time to put these together. Also, for all the information you provided.
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!
Children who discontinue the diet after achieving seizure freedom have about a 20% risk of seizures returning. The length of time until recurrence is highly variable but averages two years. This risk of recurrence compares with 10% for resective surgery (where part of the brain is removed) and 30–50% for anticonvulsant therapy. Of those that have a recurrence, just over half can regain freedom from seizures either with anticonvulsants or by returning to the ketogenic diet. Recurrence is more likely if, despite seizure freedom, an electroencephalogram (EEG) shows epileptiform spikes, which indicate epileptic activity in the brain but are below the level that will cause a seizure. Recurrence is also likely if an MRI scan shows focal abnormalities (for example, as in children with tuberous sclerosis). Such children may remain on the diet longer than average, and it has been suggested that children with tuberous sclerosis who achieve seizure freedom could remain on the ketogenic diet indefinitely.[45]

The ketogenic diet has recently become very popular, and many food companies want to cash in by putting a “ketogenic” or “low carb” label on a new product. Be very cautious of special “keto” or “low-carb” products, such as pastas, chocolate bars, energy bars, protein powders, snack foods, cakes, cookies and other “low carb” or “ketogenic” treats. Read all labels carefully for natural low carb ingredients. The fewer ingredients the better.


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!
Wondering what fits into a keto diet — and what doesn’t? “It’s so important to know what foods you’ll be eating before you start, and how to incorporate more fats into your diet,” says Kristen Mancinelli, RD, author of The Ketogenic Diet: A Scientifically Proven Approach to Fast, Healthy Weight Loss, who is based in New York City. We asked her for some guidelines.
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