Y. Wady Aude, MD; Arthur S. Agatston, MD; Francisco Lopez-Jimenez, MD, MSc; Eric H. Lieberman, MD; Marie Almon, MS, RD; Melinda Hansen, ARNP; Gerardo Rojas, MD; Gervasio A. Lamas, MD; Charles H. Hennekens, MD, DrPH, “The National Cholesterol Education Program Diet vs a Diet Lower in Carbohydrates and Higher in Protein and Monounsaturated Fat,” Arch Intern Med. 2004;164(19):2141-2146. http://archinte.jamanetwork.com/article.aspx?articleid=217514.
On the ketogenic diet, carbohydrates are restricted and so cannot provide for all the metabolic needs of the body. Instead, fatty acids are used as the major source of fuel. These are used through fatty-acid oxidation in the cell's mitochondria (the energy-producing parts of the cell). Humans can convert some amino acids into glucose by a process called gluconeogenesis, but cannot do this by using fatty acids.[56] Since amino acids are needed to make proteins, which are essential for growth and repair of body tissues, these cannot be used only to produce glucose. This could pose a problem for the brain, since it is normally fuelled solely by glucose, and most fatty acids do not cross the blood–brain barrier. However, the liver can use long-chain fatty acids to synthesise the three ketone bodies β-hydroxybutyrate, acetoacetate and acetone. These ketone bodies enter the brain and partially substitute for blood glucose as a source of energy.[55]

This week we’re introducing a slight fast. We’re going to get full on fats in the morning and fast all the way until dinner time. Not only are there a myriad of health benefits to this, it’s also easier on our eating schedule (and cooking schedule). I suggest eating (rather, drinking) your breakfast at 7am and then eating dinner at 7pm. Keeping 12 hours between your 2 meals. This will help put your body into a fasted state.


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.
I’ve only one question. I work in shifts and at 4.30 in the morning I can not eat my breakfast (lazy – I manage to get out of bed and into my car in 30 minutes ;-). Not even if I make it the day before…I just can’t swallow the stuff. But I have to eat something because I’m in my car for more than a hour. Can I have a liquid breakfast at those times?
Symptoms of the keto flu include headache, fatigue, dizziness, sleep problems, heart palpitations, cramps, and diarrhea. These side effects usually lessen and eventually resolve in about two weeks. (2) But to lessen the effects of any discomfort, simply consider slowly transitioning onto a ketogenic diet rather than rushing to change your eating habits. By slowly lowering your carbohydrate intake, while gradually increasing your intake of dietary fat over time, you can transition with less of a negative impact and potentially prevent the keto flu.
For patients who benefit, half achieve a seizure reduction within five days (if the diet starts with an initial fast of one to two days), three-quarters achieve a reduction within two weeks, and 90% achieve a reduction within 23 days. If the diet does not begin with a fast, the time for half of the patients to achieve an improvement is longer (two weeks) but the long-term seizure reduction rates are unaffected.[43] Parents are encouraged to persist with the diet for at least three months before any final consideration is made regarding efficacy.[9]
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.

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!
Hi, I know this is an old post but I did a very strict keto based diet back in May and lost 30 pounds in 2 months which was great, now I’m trying to keep this pounds off, especially after the holidays. I came across your site a while back and remembered an email that a friend sent me. The menu here is great but I wanted to know if there was an alternate to the cream cheese pancakes (not a big pancake fan). Thank you!!!
Thank you Mellissa. I guess I need to set up a Reddit account. Several people have directed me there for Keto forums for one reason or another. I try not to let it get me down but I have been fluctuating really badly since I started this WOE and I have a feeling it has a lot to do with the hormones not being balanced. I came off of a prepackaged, doctor recommended food plan that really knocked me outta whack and helped me discover that I do indeed have an under-active thyroid, which I have known most of my life because I have always felt hormonally off balance and could never lose weight. It is also genetic in my family but doctors never listened to me and at most would run the basic blood test to appease me which always came back normal…which is common…and when they did, they would lecture me about losing weight and hand me a prescription for diet pills or give me info on some fad diet. Now I am trying to fix it with Keto and natural remedies. I feel better than I ever have in my life on the energy front and that was almost an instant feeling after switching to Keto. I hope I balance out soon because I am 35-40 lbs down since mid-May (depending on my fluctuation for the week) and have about 100+ to go. The frustrating part is I have now lost the same 3-5 lbs repeatedly over the past 5-6 weeks and all I can think is that could have been 20-30 lbs closer to my goal weight! I even considered going back on that nasty diet even though I felt terrible because I did lose consistently. I have confirmed my macros with some others who are more experienced and they are just as boggled as I am about the bad fluctuation.
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!

Blanket statement: It’s always best to check with your doctor before starting on this regimen. With that said, “the keto diet isn’t recommended for those with liver or kidney disease, or someone with a medical condition, such as a gastrointestinal issue, who can’t metabolize high amounts of dietary fat,” says Sarah Jadin, a Los-Angeles based registered dietitian and founder of Keto Consulting, LLC. If you’ve had your gallbladder removed, the keto diet may be a no-go. Women who are pregnant or breastfeeding and people with certain rare genetic disorders shouldn’t try this diet.

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Without peer-reviewed clinical trials, many of the benefits remain anecdotal. For instance, Weiss himself has been on a low-carb high-fat (though not strictly ketogenic) diet for more than six months, and claims he does feel much better. But he’s clear about what he knows and what he doesn’t. He’s lost weight and his borderline pre-diabetes is gone.  
People use a ketogenic diet most often to lose weight, but it can help manage certain medical conditions, like epilepsy, too. It also may help people with heart disease, certain brain diseases, and even acne, but there needs to be more research in those areas. Talk with your doctor first to find out if it’s safe for you to try a ketogenic diet, especially if you have type 1 diabetes.
It is also worth considering that eating a well balanced, keto diet is actually very expensive. For most people, following a low carbohydrate diet, rather than a no carbohydrate diet, is much more practical – as it will also allow for the inclusion of fruit and all vegetables. This represents much better dietary balance and usually leads to people sticking with it for longer.
I just made this keto bread, and it is amazing! It’s better than most bread I’ve tasted! I made mine with bacon, American cheese, Brie, and Camembert (because I wanted to be extra). If you use bacon, cook it to how you normally like it in a seperate pan, as the bacon doesn’t cook much extra while baking. I think I used a little too much butter, but, oh boy, was it nice and moist!

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.
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.
Yes, your ketogenic diet menu plan also includes your restaurant meals. That doesn’t mean you will eat less. But eat intelligently so that your colleagues don’t even understand that you are dieting. For the main dish order a fish or meat. Avoid bread or having rice and instead order more vegetables and salad. Ask the cook or the chef to cook your food in olive oil or in coconut oil.
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.
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.
There are theoretically no restrictions on where the ketogenic diet might be used, and it can cost less than modern anticonvulsants. However, fasting and dietary changes are affected by religious and cultural issues. A culture where food is often prepared by grandparents or hired help means more people must be educated about the diet. When families dine together, sharing the same meal, it can be difficult to separate the child's meal. In many countries, food labelling is not mandatory so calculating the proportions of fat, protein and carbohydrate is difficult. In some countries, it may be hard to find sugar-free forms of medicines and supplements, to purchase an accurate electronic scale, or to afford MCT oils.[53]
"I recommend only 5 percent of calories coming from carbs, which usually averages out to less than 30 grams," he says. "I understand why people get nervous and panic, thinking 'Can I even eat a salad?' This is why I recommend tracking only 'net carbs', which are total carbs minus fiber. For example, an avocado has 12 grams of carbs but 10 grams of fiber, which means it has 2 grams of net carbs. Also, green leafy vegetables are very nutritious and contain a lot of fiber, so you can almost eat them as much as you want and stay below your limit.
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?
^ 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
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.
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]
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!)
The benefits above are the most common ones. But there are others that are potentially even more surprising and – at least for some people – life changing. Did you know that a keto diet can help treat high blood pressure, may result in less acne, may help control migraine, might help with certain mental health issues and could have a few other potential benefits?
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