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]

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.
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).
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!
To prevent side effects such as the keto flu, begin transitioning your meal plan gradually. Start by understanding how many carbohydrates you take in most days. Then begin slowly reducing your carbohydrate intake over a period of a few weeks while gradually increasing your intake of dietary fat to keep your calories the same. You should also make sure to seek guidance from a professional to make sure this plan works best for you and your health goals. “See a dietitian and adapt the diet to fit your long-term needs,” Spano recommends.
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]
A lot of people take their macros as a “set in stone” type of thing. You shouldn’t worry about hitting the mark every single day to the dot. If you’re a few calories over some days, a few calories under on others – it’s fine. Everything will even itself out in the end. It’s all about a long term plan that can work for you, and not the other way around.

As always, I’m late to the party. Thank you so much for this fantastic resource! I did this 6 years ago, lost 60 lbs. and maintained it for five years. But over the past year or so, my weight has gone up and down the same 18 lbs. To add insult to injury, I’m now borderline pre-diabetic (higher A1C than is healthy), my anxiety attacks have returned and so I’m on medication for that. It’s time to go back to what I know makes me feel better and get off the sugar and garbage once and for all.


Ha! Don’t even get me started Alisha! Mr. Hungry will eat whatever healthy low carb dinner I made and say it was delicious, then help himself to a pint of ice cream and eat THE WHOLE THING right in front of me! Now when I occassionally make low carb cookies or treats I let him have one and then it’s HANDS OFF because he can (and does) eat whatever he wants!
To prevent side effects such as the keto flu, begin transitioning your meal plan gradually. Start by understanding how many carbohydrates you take in most days. Then begin slowly reducing your carbohydrate intake over a period of a few weeks while gradually increasing your intake of dietary fat to keep your calories the same. You should also make sure to seek guidance from a professional to make sure this plan works best for you and your health goals. “See a dietitian and adapt the diet to fit your long-term needs,” Spano recommends.
The removal of many grains and fruits with such a large emphasis on fats can bring about its own set of gastrointestinal side effects. Keto constipation and diarrhea aren't uncommon. “If not done properly — with most of your carbohydrates coming from fiber-rich vegetables — you may not be getting enough fiber, which can lead to constipation,” says Chris Mohr, PhD, RD, a sports dietitian based in Louisville, Kentucky, and co-owner of MohrResults.com. (5)
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!
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.
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.
For any individual with diabetes, discussing dietary changes — especially those as dramatic as the ones the ketogenic diet requires — with your healthcare team is essential. Because carbohydrates are broken down into glucose in the blood, cutting carbohydrates from your diet could cause levels to crash rapidly depending on your current medication regimen. Such a change may require significant adjustments to medication and insulin to prevent dangerous side effects such as low blood sugar, called hypoglycemia. (8)
Hi I’m new to Keto. I have been reading about it, and understanding what to eat and what not to eat. My problem is I’m not sure if I’m doing it correctly. I’m constantly hungry whereas information reads that I will never be hungry. I use fats as required along with topping up with vegetables in my meals yet this does not fill me up. I haven’t experienced the Keto flu and I’ve even put on weight! I have been doing this for about 3 weeks now. Any ideas where I am going wrong.
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My Husband and I started doing Keto July 2018. We got over weight after we got out of the Marine Corps. It has been hard to workout because I became disabled, but my diet was not good. After our friend Amber recommended your site and support group, we found a lot of helpful information to get us started on a successful journey. So far it’s been one month and we have lost 18 pounds each!
During the 1920s and 1930s, when the only anticonvulsant drugs were the sedative bromides (discovered 1857) and phenobarbital (1912), the ketogenic diet was widely used and studied. This changed in 1938 when H. Houston Merritt, Jr. and Tracy Putnam discovered phenytoin (Dilantin), and the focus of research shifted to discovering new drugs. With the introduction of sodium valproate in the 1970s, drugs were available to neurologists that were effective across a broad range of epileptic syndromes and seizure types. The use of the ketogenic diet, by this time restricted to difficult cases such as Lennox–Gastaut syndrome, declined further.[10]
But generally speaking, if you plan to follow a ketogenic diet, you should aim to consume less than 10 percent of your total calories from carbohydrates per day. The remaining calories should come from 20 to 30 percent protein and 60 to 80 percent fat. That means if you follow a daily 2,000-calorie diet, no more than 200 of your calories (or 50 grams) should come from carbs, while 400 to 600 calories should come from protein and 1,200 to 1,600 should come from fat. (There’s a reason this plan is also called a high-fat, low-carb diet!)
Because the ketogenic diet alters the body's metabolism, it is a first-line therapy in children with certain congenital metabolic diseases such as pyruvate dehydrogenase (E1) deficiency and glucose transporter 1 deficiency syndrome,[34] which prevent the body from using carbohydrates as fuel, leading to a dependency on ketone bodies. The ketogenic diet is beneficial in treating the seizures and some other symptoms in these diseases and is an absolute indication.[35] On the other hand, it is absolutely contraindicated in the treatment of other diseases such as pyruvate carboxylase deficiency, porphyria and other rare genetic disorders of fat metabolism.[9] A person with a disorder of fatty acid oxidation is unable to metabolise fatty acids, which replace carbohydrates as the major energy source on the diet. On the ketogenic diet, their body would consume its own protein stores for fuel, leading to ketoacidosis, and eventually coma and death.[36]
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.

On average it takes most people about three days to get into ketosis.The sticks will confirm that ketones are being excreted through your urine. That’s all. They won’t change color at all for no ketones, then there is trace (light pink) and it goes up from there to dark purple. The darkness of the stick doesn’t matter. As long as you are showing even trace amounts, then you are in ketosis and good to go. In fact, if you are showing really dark on the stick, you may be dehydrated and need to drink more water (see #4.)
Fairly recently, the diet was introduced as a weight-loss diet by an Italian professor of surgery, Dr. Gianfranco Cappello of Sapienza University in Rome. In his 2012 study, about 19,000 dieters received a high-fat liquid diet via a feeding tube inserted down the nose. The study showed an average weight loss of more than 20 pounds in participants, most of whom kept it off for at least a year. The researchers reported a few minor side effects, like fatigue.

The Keto diet emphasizes weight loss through fat-burning. The goal is to quickly lose weight and ultimately feel fuller with fewer cravings, while boosting your mood, mental focus and energy. According to Keto proponents, by slashing the carbs you consume and instead filling up on fats, you safely enter a state of ketosis. That’s when the body breaks down both dietary and stored body fat into substances called ketones. Your fat-burning system now relies mainly on fat – instead of sugar – for energy. While similar in some ways to familiar low-carb diets, the Keto diet’s extreme carb restrictions – about 20 net carbs a day or less, depending on the version – and the deliberate shift into ketosis are what set this increasingly popular diet apart.
The good news is that snacks are totally allowed (and I're not just talking about carrot sticks.) There are plenty of packaged options out there designed for keto fans. FATBAR is one of them. These snack bars have 200 calories, 16 grams of fat, and four grams of net carbs. They're also plant-based and are made with almond or cashew butter, cocoa butter, coconut, pea protein, sunflower seeds, and chia seeds.
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]
Although many hypotheses have been put forward to explain how the ketogenic diet works, it remains a mystery. Disproven hypotheses include systemic acidosis (high levels of acid in the blood), electrolyte changes and hypoglycaemia (low blood glucose).[18] Although many biochemical changes are known to occur in the brain of a patient on the ketogenic diet, it is not known which of these has an anticonvulsant effect. The lack of understanding in this area is similar to the situation with many anticonvulsant drugs.[55]
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!
Swanson, a professor of neurology who has researched the impacts of ketogenic diets on inflammation in the brain, got curious about the ketogenic diet when trying to treat the inflammation that persists for days after a person suffers a stroke. When he tried inducing a ketogenic state in mice with stroke injuries, he said, “I was overwhelmed by the effect.” Blocking glucose metabolism worked to suppress inflammatory genes, which in turn helped stroke healing.
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.

Another difference between older and newer studies is that the type of patients treated with the ketogenic diet has changed over time. When first developed and used, the ketogenic diet was not a treatment of last resort; in contrast, the children in modern studies have already tried and failed a number of anticonvulsant drugs, so may be assumed to have more difficult-to-treat epilepsy. Early and modern studies also differ because the treatment protocol has changed. In older protocols, the diet was initiated with a prolonged fast, designed to lose 5–10% body weight, and heavily restricted the calorie intake. Concerns over child health and growth led to a relaxation of the diet's restrictions.[18] Fluid restriction was once a feature of the diet, but this led to increased risk of constipation and kidney stones, and is no longer considered beneficial.[3]
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.
If you’re a newbie planning your weekly keto diet plan, make the meals as easy as possible. A keto breakfast, for example, can take advantage of many classic breakfast foods, including eggs, bacon, sausage, and ham. Eggs are real winners in the keto world. They’re extremely versatile, easy to cook, and have just half a gram of carbs but 6 g of protein and 5 g of fat.
Positive science on ketosis coupled with personal successes passed by word-of-mouth have driven more people to explore the ketogenic diet, says Volek. More recently, the keto diet hints at having a promising therapeutic role in cancer, Alzheimer’s, Parkinson’s and polycystic ovary syndrome (PCOS). Research is still early in many areas, but Volek suspects there will more definitive answers on the wider scope of the diet’s benefits within the next decade.
Kale, mushrooms, onions, etc all have a surprising amount of carbs, but aren’t included in this three day kickstart. The weekly menu plans have specific serving sizes but it’s not necessary in this three day kickstart if you eat on plan and don’t deviate – as proven by the hundreds if not thousands of people who have had success with it. If you follow the three day kickstart as written you will get into ketosis.
Kale, mushrooms, onions, etc all have a surprising amount of carbs, but aren’t included in this three day kickstart. The weekly menu plans have specific serving sizes but it’s not necessary in this three day kickstart if you eat on plan and don’t deviate – as proven by the hundreds if not thousands of people who have had success with it. If you follow the three day kickstart as written you will get into ketosis.
In a recent study in the Journal of Sports Medicine and Physical Fitness, Weiss and his colleagues found that participants performed worse on high-intensity cycling and running tasks after four days on a ketogenic diet, compared to those who’d spent four days on a high-carb diet. Weiss says that the body is in a more acidic state when it’s in ketosis, which may limit its ability to perform at peak levels.
As always with weight loss, in the end it all comes down to taking less energy in than you burn. In the UK, the National Diet and Nutrition Survey says that on average, people get about half of their energy from carbohydrates. So by cutting out the source of half of your energy from your diet – even if some of that energy is replaced by fat – you are likely to reduce your energy intake, which leads to weight loss.
Other kinesiologists think the keto diet could have dangerous effects on athletic performance, and it's tough to know what potential side effects a long-term high-fat diet might have for a healthy person, since we don't have any solid study results yet. Low-carb diets like keto can make it easy to neglect key nutrients like magnesium, calcium, and potassium found in fresh, high-carb foods like beans, bananas, and oats.
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 :)
"It was extremely difficult," he recalls. "You spend your entire life hearing that fat makes you fat and causes heart attacks and strokes. Now, all of a sudden, you're eating 200 grams of fat per day. There is a huge psychological component to conquer before you can become successful with the keto diet. In the beginning, it's like trying to convince people 1,000 years ago that the world is in fact round, not flat."

Some athletes swear by the ketogenic diet, not just for weight loss but for improved performance in their sport, as well. But Edward Weiss, PhD, associate professor of nutrition and dietetics at Saint Louis University, doesn’t buy it. “I hear cyclists say all the time that they’re faster and better now that they’re on keto, and my first question is, 'Well, how much weight did you lose?'” he says.

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
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!

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

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.


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.
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