[iv] Hussein M Dashti, MD PhD FICS FACS, Thazhumpal C Mathew, MSc PhD FRCPath, Talib Hussein, MB ChB, Sami K Asfar, MB ChB MD FRCSEd FACS, Abdulla Behbahani, MB ChB FRCS FACSI PhD FICS FACS, Mousa A Khoursheed, MB ChB FRCS FICS, Hilal M Al-Sayer, MD PhD FICS FACS, Yousef Y Bo-Abbas, MD FRCPC, and Naji S Al-Zaid, BSc PhD. "Long-term effects of a ketogenic diet in obese patients"
Reduced hunger. Many people experience a marked reduction in hunger on a keto diet. This may be caused by an increased ability of the body to be fueled by its fat stores. Many people feel great when they eat just once or twice a day, automatically ending up doing a form of intermittent fasting. This saves both time and money, while also speeding up weight loss.
In order to transition and remain in ketosis, aiming for about 30“50 net grams is typically the recommended amount of total carbs to start with. This is considered a more moderate or flexible approach but can be less overwhelming to begin with. Once you're more accustomed to œeating keto, you can choose to lower carbs even more if you'd like (perhaps only from time to time), down to about 20 grams of net carbs daily. This is considered the standard, œstrict amount that many keto dieters aim to adhere to for best results, but remember that everyone is a bit different.
The book contains a two week menu for beginners. (Face it, there's a 90% chance you won't follow it to the letter, but it does help set your thinking in the right direction.) For each individual week there's a shopping list which, by itself, will help you adjust your kitchen quite a bit. There are tips on the best sweeteners (Swerve over Splenda), the oils you'll need, produce, canned and bottled items, pantry items, and meats. Something to consider as you go along is that some items, like almond and coconut flour are expensive items to stock up on, but you'll use considerably less than non-keto recipes will use for regular flour. Do what you can afford. Just know that there are some must-have staples like coconut oil and olive oil.
In my book "Fat for Fuel," I sought to educate readers about the benefits of using healthy fats as a catalyst to bring about improved mitochondrial function, thus allowing you to achieve better health. In essence, the book answers WHY it is important for you to consume healthy fats. However, you still need to know HOW to prepare the right ketogenic foods in an appetizing way.
Some dairy products can be used in moderation, such as heavy whipping cream and most cheeses. This would depend on your individual sensitivity to dairy (some people digest it better than others) and on the particular type of food. Milk contains a relatively high amount of carbs (4 to 5 g per 100 ml) and should be limited or avoided, as well as store-bought yogurt. You can, however, have unsweetened almond milk or heavy cream. Make sure to check the labels carefully when buying dairy products, as some of them contain a rather high amount of carbs. Some people also find that eliminating dairy helps them to lose weight faster, which might be something you want to consider in case you stall.
The keto diet works for such a high percentage of people because it targets several key, underlying causes of weight gain ” including hormonal imbalances, especially insulin resistance coupled with high blood sugar levels, and the cycle of restricting and œbinging on empty calories due to hunger that so many dieters struggle with. Yet that's not a problem with what's on the keto diet food list.
The electrolyte minerals are sodium, potassium, magnesium, and calcium, and you need all four. Sports drinks are full of sugars, and only have low amounts of these minerals, so it's best to avoid them. Instead, focus on vegetables that contain high amounts of these minerals, and make sure to salt your food to taste. You can also make an electrolyte drink that contains all of these minerals. Lite Salt or No Salt is available in the grocery store as a salt substitute, and contains potassium. Magnesium and calcium powders are available in health food stores and online.
There are so many vegetables that you can use, and so many ways to prepare them, that an entire book could be written on the topic. Most vegetables that grow above the ground are high in fiber, vitamins, minerals, and antioxidants. They can be added to meat dishes, cooked on their own, or eaten as a salad. Vegetables are inexpensive, easy to prepare, and can be part of every meal. Most of them are quite low in carbohydrates, so it's hard to overindulge in this food group.
The book contains a two week menu for beginners. (Face it, there's a 90% chance you won't follow it to the letter, but it does help set your thinking in the right direction.) For each individual week there's a shopping list which, by itself, will help you adjust your kitchen quite a bit. There are tips on the best sweeteners (Swerve over Splenda), the oils you'll need, produce, canned and bottled items, pantry items, and meats. Something to consider as you go along is that some items, like almond and coconut flour are expensive items to stock up on, but you'll use considerably less than non-keto recipes will use for regular flour. Do what you can afford. Just know that there are some must-have staples like coconut oil and olive oil.
If you do try the diet outside of medical supervision, Kizer says it's important to test your urine with urinalysis ketone test strips to ensure your ketone levels don't become dangerously high. Ketone urine test strips are also used by people with diabetes to determine if they're at risk for ketoacidosis (DKA), a life-threatening complication that occurs when an individual doesn't have enough insulin in their body. (Healthy ketosis is considered 0.5 to 3.0 mM blood ketones.)
Christopher D. Gardner, PhD; Alexandre Kiazand, MD; Sofiya Alhassan, PhD; Soowon Kim, PhD; Randall S. Stafford, MD, PhD; Raymond R. Balise, PhD; Helena C. Kraemer, PhD; Abby C. King, PhD, œComparison of the Atkins, Zone, Ornish, and LEARN Diets for Change in Weight and Related Risk Factors Among Overweight Premenopausal Women, JAMA. 2007;297(9):969-977. http://jama.jamanetwork.com/art icle.aspx?articleid=205916.

A: The amount of weight you lose is entirely dependent on you. Obviously adding exercise to your regimen will speed up your weight loss. Cutting out things that are common œstall causes is also a good thing. Artificial sweeteners, dairy, wheat products and by-products (wheat gluten, wheat flours, and anything with an identifiable wheat product in it).


It can be very difficult to obtain some of the very high levels of blood ketones on this table - especially as you become "fat adapted" or "keto adapted" or whatever you want to call it. Once your body is efficient at using ketones, it makes only what it needs. Beginners may see very high levels of ketones, and then they see them drop off. This isn't because you are making a mistake and are out of ketosis - your body is no longer overproducing them.
I have been on keto for about 3 weeks now thanks for all the info what I have lost probably fluid but my main thing is my stomach going doen slowly..I have some medical pre diabetic. BP and 2 strokes.must lose at least 70 pounds but I sincerely fo not understand the macros how do you count them I am rating only 2 meals now though loving that staying full not hungry walk about 3 days a week..more during summer¦the grocery list I have down but can't quite undetstand the macros..very happy to have people to talk to thanks glad you are available
It usually takes three to four days for your body to go into ketosis because you have to use up your body's stores of glucose, i.e., sugar first, Keatley says. Any major diet change can give you some, uh, issues, and Keatley says he often sees patients who complain of IBS-like symptoms and feeling wiped out at the beginning of the diet. (The tiredness happens because you have less access to carbs, which give you quick energy, he explains.)
There are two major ways fasting is beneficial for overall health. First, it gives the body a break from digestion. Digestion is a surprisingly stressful activity, and if there is a longer period of time where your body can focus on simply using the nutrients it's been given already without having to handle more, digestion tends to improve, as well as energy levels.
The transition is rougher for some people than others, though it's worth it to KCKO, or Keep Calm and Keto On. Once you're keto-adapted, weight loss becomes easier, your body feels like it moves more smoothly, your energy levels and appetite are easily regulated, and your thoughts are clear and fast. Performance in the gym also begins to improve at this stage, since it sometimes suffers during the adaptation period.
It can be very difficult to obtain some of the very high levels of blood ketones on this table - especially as you become "fat adapted" or "keto adapted" or whatever you want to call it. Once your body is efficient at using ketones, it makes only what it needs. Beginners may see very high levels of ketones, and then they see them drop off. This isn't because you are making a mistake and are out of ketosis - your body is no longer overproducing them.
You're transitioning. Your body is equipped to process a high intake of carbs and a lower intake of fat. Your body needs to create enzymes to be able to do this. In the transitional period, the brain may run low on energy which can lead to grogginess, nausea, and headaches. If you're having a large problem with this, you can choose to reduce carb intake gradually.
Clinical improvement was observed in Alzheimer's patients fed a ketogenic diet, and this was marked by improved mitochondrial function. (14a) In fact, a European Journal of Clinical Nutrition study pointed to emerging data that suggested the therapeutic use of ketogenic diets for multiple neurological disorders beyond epilepsy and Alzheimer's, including headaches, neurotrauma, Parkinson's disease, sleep disorders, brain cancer, autism and multiple sclerosis. (14b)
On a ketogenic diet, your entire body switches its fuel supply to run mostly on fat, burning fat 24-7. Insulin levels become very low, and fat burning increases dramatically. It becomes easy to access your fat stores to burn them off. This is great if you're trying to lose weight, but there are also other less obvious benefits, such as less hunger and a steady supply of energy. This may help keep you alert and focused.
In order to transition and remain in ketosis, aiming for about 30“50 net grams is typically the recommended amount of total carbs to start with. This is considered a more moderate or flexible approach but can be less overwhelming to begin with. Once you're more accustomed to œeating keto, you can choose to lower carbs even more if you'd like (perhaps only from time to time), down to about 20 grams of net carbs daily. This is considered the standard, œstrict amount that many keto dieters aim to adhere to for best results, but remember that everyone is a bit different.
If you do try the diet outside of medical supervision, Kizer says it's important to test your urine with urinalysis ketone test strips to ensure your ketone levels don't become dangerously high. Ketone urine test strips are also used by people with diabetes to determine if they're at risk for ketoacidosis (DKA), a life-threatening complication that occurs when an individual doesn't have enough insulin in their body. (Healthy ketosis is considered 0.5 to 3.0 mM blood ketones.)

Although the exact role of the ketogenic diet in mental and brain disorders is unclear, there has been proof of its efficacy in patients with schizophrenia. And, to boot, the ketogenic diet works to reverse many conditions that develop as a side effect of conventional medications for brain disorders, like weight gain, type 2 diabetes and cardiovascular risks. More research is needed to understand the role of the ketogenic diet in treating or improving schizophrenia, as the current available studies are either animal studies or case studies, but the benefits of a high fat, low carbohydrate diet in neurology is promising.
The recipes themselves are divided into smoothies and breakfasts, appetizers and snacks, fish and poultry, meats, veggies and sides, desserts, and staples. Each individual recipe gives an overall "keto quotient" (how close it fits the idea balance of fats, carbs, and protein) as well as what each serving contains in calories and the fats, carbs, and protein for those servings. This makes life a lot easier if you are using a phone or tablet app to keep an eating record.
Net carbs are what we track when following a ketogenic diet. This calculation is pretty straightforward. Net Carbs = Total Carbs “ Fiber. For example, one cup of broccoli has 6g of total carbs and 2.4g of fiber. That would mean one cup of broccoli has 3.6g of net carbs. We count Net Carbs because dietary fiber does not have a significant metabolic effect.
¢ Reducing appetite ” Constant hunger can cause you to consume more calories than you can burn, which can eventually lead to weight gain. A ketogenic diet can help you avoid this problem because reducing carbohydrate consumption can reduce hunger symptoms. In one study, participants who were given a low-carbohydrate diet had reduced appetites, helping them lose weight easier.2
Historically, a targeted ketogenic diet consists of limiting carbohydrate intake to just 20“30 net grams per day. œNet carbs is the amount of carbs remaining once dietary fiber is taken into account. Because fiber is indigestible once eaten, most people don't count grams of fiber toward their daily carb allotment. In other words, total carbs “ grams of fiber = net carbs. That's the carb counts that matter most.
¢ Cancer: Early experimental research suggests that the keto diet may have anti-tumor effects, likely because it reduces overall calorie intake (and circulating glucose) for tumor growth. In one 2014 review of animal research, a ketogenic diet was found to be successful at reducing tumor growth, colon cancer, gastric cancer and brain cancer. More research on humans with larger sample sizes is needed, but it's definitely food for thought.
Thank you so much for the wonderful recipes on your site. I have visited in the past and have happened upon it again. I noticed you put in the post that if anyone had questions that we could ask and so I have a big one that I need advice on if you don't mind. I have been living low carb for about 2 years now. My weight has fluctuated from 130 to about 118. I am 5'4" and female, 45 years old and mom to 5 children. My weight went up to 134 which is very uncomfortable to me because I have struggled with an eating disorder and so I really went low carb in an attempt to drop some weight. Well I have, but the problem is that I am restricting too many calories now. I have gotten down to 108 but know that 800 calories Is not enough. My question is about balance. I would not mind gaining some back but have a fear of gaining too much again. I don't want to go back there. I hiit train most days for about 25 mins. I use to do way too much. Do you have a plan that would balance my calories out so I can incorporate more Low carb options/keto and start eating normal again. I like your ideas and thought process behind all you post so I would appreciate any feed back you could give to me. Thank ML

Once ketone levels in the blood rise to a certain point, you officially enter into a state of ketosis. This state results in fairly rapid and consistent weight loss until you reach a healthier (and stable) body weight. Overall, people enter into ketosis at different rates, usually after 3“4 days of fasting or following a very low-carbohydrate diet (20 grams of net carbs or less) that forces the need for an alternative energy source. (3)


You should know that the side effects of a ketogenic diet are still being studied. In addition, there have not been significant studies for long term dieters. There are plenty of people that have used the diet long term (10+ years) and very happy with it. It is up to the unique individual, so regular checkups with your doctor are recommended to check that "everything looks good".
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.
Aude, Y., A. S, Agatston, F. Lopez-Jimenez, et al. œThe 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.

When carbs go missing from a person's diet, the body uses up its glucose reserves and then breaks down stored fat into fatty acids, which, when they reach the liver, are converted into an organic substance called ketones. The brain and other organs feed on ketones in a process called ketosis, which gives the diet its name. Keto dieters eat lots of fat to maintain this state.


[i] Hussein M Dashti, MD PhD FICS FACS, Thazhumpal C Mathew, MSc PhD FRCPath, Talib Hussein, MB ChB, Sami K Asfar, MB ChB MD FRCSEd FACS, Abdulla Behbahani, MB ChB FRCS FACSI PhD FICS FACS, Mousa A Khoursheed, MB ChB FRCS FICS, Hilal M Al-Sayer, MD PhD FICS FACS, Yousef Y Bo-Abbas, MD FRCPC, and Naji S Al-Zaid, BSc PhD. "Long-term effects of a ketogenic diet in obese patients"

Another great keto flu cure is bone broth! This is also a great healer when you are actually sick with a cold or flu or just want something comforting. Instead of its high carb alternative chicken noodle soup or even worse, store bought chicken broth (which is typically loaded with MSG and other preservative junk), bone broth is a delicious way to alleviate your flu symptoms. Bone broth is a great way to hydrate & it is also packed with electrolytes, good for you sodium and potassium.
Instead of thinking about the total carbs you're eating, assess what those carbs provide to you. Do the majority of your carbs come from fruit and vegetables, with a payload of fiber and disease-fighting antioxidants? Fantastic. Or are you consuming them in the form of added sugars (cookies, candy, soda) or refined flour? If you are, you know what to do.

It can be very difficult to obtain some of the very high levels of blood ketones on this table - especially as you become "fat adapted" or "keto adapted" or whatever you want to call it. Once your body is efficient at using ketones, it makes only what it needs. Beginners may see very high levels of ketones, and then they see them drop off. This isn't because you are making a mistake and are out of ketosis - your body is no longer overproducing them.


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., œA 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.
Although a standard ketogenic diet is even more restrictive in terms of carb intake, a œmoderate keto diet (just as some folks have followed a modified Atkins diet) is another option that will very likely still be able to provide substantial weight loss results and other improvements in symptoms. Including slightly more carbs can be very useful for maintenance, allow for more flexibility, provide a higher fiber intake, and overall may feel more sustainable long term socially and psychologically.
¢ Cardiovascular Disease: This is definitely a point of confusion and controversy since a diet that relies so heavily on meat and fat is naturally thought to raise blood cholesterol and cause heart issues. However, some evidence suggests that this may not be the case. In fact, the keto diet may help improve triglyceride, HDL and LDL levels. A 2017 review looked at all of the available evidence around the ketogenic diet and cardiovascular health and found that the diet may be associated with some improvements in cardiovascular risk factors. Mind you, the authors also expressed their concerns with maintaining the diet in the long term, and they proposed that these benefits may not be long-lasting. It's clear that we need long-term studies to fill that gap.
Welcome to the Keto Fit Diet. We have been in the weight loss industry for over 10 years now and have gone through every possible thread of research combined with clinical studies and our background in the healthcare industry in order to create the most successful weight loss method available. We have all struggled with getting rid of those unwanted pounds, using whatever unsuccessful means we could find. We have all tried the œmiracle in a bottle supplements, magic tricks and ridiculous diets to achieve our health and weight goals only to come up short or lose motivation before we ever see any real results. Well after 10 years of research, trial, error, and experience we have finally found the perfect, easy to use, solution to achieving our health and weight loss goals; the Keto Diet.
If you need to eat more or fewer calories per day, you can adjust accordingly by simply taking out or adding a bit more of the ingredients already included in a recipe. For example, adding/removing a tablespoon of olive oil or butter will add/remove about 100 calories. If you like or dislike certain recipes, feel free to shift things around. Make sure to keep an eye on the calories so you're still falling within an acceptable range of your daily goal.

I have been on keto for about 3 weeks now thanks for all the info what I have lost probably fluid but my main thing is my stomach going doen slowly..I have some medical pre diabetic. BP and 2 strokes.must lose at least 70 pounds but I sincerely fo not understand the macros how do you count them I am rating only 2 meals now though loving that staying full not hungry walk about 3 days a week..more during summer¦the grocery list I have down but can't quite undetstand the macros..very happy to have people to talk to thanks glad you are available
Your body is still growing ” In one study, epileptic children experienced a reduction in symptoms and improved cognitive performance when a ketogenic diet was introduced.49 However, this may have a negative effect on the growth of their bodies in the long run, according to a study published in the journal Developmental Medicine & Child Neurology.50
In my book "Fat for Fuel," I sought to educate readers about the benefits of using healthy fats as a catalyst to bring about improved mitochondrial function, thus allowing you to achieve better health. In essence, the book answers WHY it is important for you to consume healthy fats. However, you still need to know HOW to prepare the right ketogenic foods in an appetizing way.

¢ Fighting inflammation ” The human body can use both sugar and fat as fuel sources. However, the latter is preferred because it is a cleaner, healthier fuel that releases far fewer reactive oxygen species (ROS) and secondary free radicals. By eliminating sugar from your daily food consumption, you're decreasing your risk of developing chronic inflammation throughout your body.


The ketogenic diet is based on the principle that by depleting the body of carbohydrates, which are its primary source of energy, you can force the body to burn fat for fuel, thereby maximizing weight loss. When you consume foods that contain carbohydrates, the body converts those carbohydrates into glucose, or blood sugar, which it then uses for energy. (1)
This also enables you to see what you were eating prior to a woosh of weight loss, or a stall, or even a gain. You can see possible triggers for these events, like having extra vegetables, or having too many nuts and cheeses. It also lets you see if you may have sensitivities. If you try a week without dairy but keep your calories the same, for example, you may or may not notice a spontaneous drop in weight.
There are variations of the ketogenic diet that are implemented for a variety of reasons. One of the top reasons these variations are used are for athletes who are not getting the necessary energy required for their intense workouts. There are also those who enjoy the benefits of ketosis, but they just do not feel the same without a carb refeed day every now and then.
Wondering how many carb foods you can eat and still be œin ketosis? The traditional ketogenic diet created for those with epilepsy consisted of getting about 75 percent of calories from sources of fat (such as oils or fattier cuts of meat), 5 percent from carbohydrates and 20 percent from protein. For most people a less strict ketogenic diet (what I call a œmodified keto diet) can still help promote weight loss in a safe, and often very fast, way.
After increasing water intake and replacing electrolytes, it should relieve most all symptoms of Keto Flu. For an average person that is starting a ketogenic diet, eating 20-30g of net carbs a day, the entire adaptation process will take about 4-5 days. My advice is to cut your carbs to fewer than 15g to ensure that you are well on your way into ketosis within one week. If you are experiencing any more keto flu symptoms, double check your electrolyte intake and adjust.

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Medical Disclaimer: The material on this site is provided for informational purposes only and is not medical advice. Always consult your physician before beginning any diet or exercise program.

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