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, œThe 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.


Your glycogen stores can still be refilled while on a ketogenic diet. A keto diet is an excellent way to build muscle, but protein intake is crucial here. It's suggested that if you are looking to gain mass, you should be taking in about 1.0 “ 1.2g protein per lean pound of body mass. Putting muscle on may be slower on a ketogenic diet, but that's because your total body fat is not increasing as much.5Note that in the beginning of a ketogenic diet, both endurance athletes and obese individuals see a physical performance for the first week of transition.

Aside from carb flu, be warned that staying in long-term, continuous ketosis may have drawbacks that may actually undermine your health and longevity. To stay on the safe side, I recommend undergoing a cyclic ketogenic diet. The "metabolic magic" that ketosis brings to the mitochondria actually occurs during the refeeding phase, not during the starvation phase.


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.
Paleo and keto can overlap, though there are some major differences in the core of each way of eating. The Paleo diet focuses on whole, natural foods that would have been available as food to our paleolithic ancestors. If it could have been hunted or foraged, then it would have been eaten. Some people on a Paleo plan also focus on what would have been growing in season, and in a certain region of the world for their genetic ancestors. Carbs are overall allowed in a Paleo plan, but they would come from whole foods like potatoes, sweet potatoes, fruits, honey, and other unprocessed sources.
It also interferes with some of the social aspects of food, considering how limiting it is. No cake on your birthday. No pie on Thanksgiving. No chocolate truffles on Valentine's Day. Boo to that! If you consider yourself someone who loves to eat and takes great joy in the social experience of a good meal, then the restriction of this diet may be emotionally unhealthy.
First, let's start with the fact that most of the food in your cabinets just won't work anymore. They're not keto. Period. Lock them up, throw them out, donate them to a neighbor “ whatever you have to do to get them out of the house. In the first week, when you're craving carbohydrates, these foods will be the death of your ketogenic diet. Purge your pantry of carbohydrate foods!
¢ Increasing muscle mass ” Jeff Volek, Ph.D., is a registered dietitian specializing in how a high-fat, low-carb diet can affect health and athletic performance. He's written many scientific articles on this topic, as well as two books, and he explains that ketones have a similar structure to branched-chain amino acids that can be useful for building muscle mass. Ketones spare these amino acids, leaving higher levels of them around, which can help promote muscle mass.
œYour liver produces ketones all the time, but the rate depends on carbohydrate and protein intake, says Jeff Volek, Ph.D., R.D., a professor of human sciences at Ohio State University. When the majority of your diet is made up of of carbs and protein, ketogenesis slows. Replacing carbs and protein with fat will put your body into ketosis, thus ramping up ketone production. This takes about three days to induce.
I like it “ and I'm surprised I like it. I'm only down 5 lbs. after a month but I'm down 3 inches on my waist and 2 inches on my hips. I do feel better physically and I love not being hungry! I used to be that person who could eat pasta like a lumberjack “ now I often don't even finish my food. I have had a hard time sticking to 20 net carbs, I usually end up in the high 20's somewhere, but I'm in ketosis according to the testing strips. It's much harder to stick to 20 net as a vegetarian. Everything you eat has some level of carbs and they do add up. But overall, this is the only thing I've lost any weight or inches on in about 7 or 8 years. Starvation used to work until I hit 45 and then, forget it, I could eat 700 calories a day and not lose a pound. I'm so excited *something* is actually working.
Those issues can be part of what's known as the œketo flu, Warren says. Other side effects of the keto diet, all of which are tied to carb withdrawal, can include lightheadedness, nausea, mental fog, cramps, and headaches, in addition to tiredness. Luckily, the keto flu doesn't usually last more than a week”which is coincidentally about when people start to see the number on the scale go down, says Warren.
This is an adaptation period, where we're essentially re-training our muscles and our brain to use fat as the primary fuel source instead of glucose. This adaptation can take a couple of weeks to a couple of months. As a hallmark of being keto-adapted and not just in ketosis, the skeletal muscles are able to burn fat directly for fuel, and the brain relies on the higher volume of ketones in the blood as its main source of energy.
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.
Taking your first step into the ketogenic diet is an exciting phase for your health. But before coming up with an actual ketogenic diet food list, it's important to first take a look at what you're eating now and take out anything that's unhealthy. This means that you have to remove sugars, grains, starches and packaged and processed foods from your diet. Basically, anything that won't add to your new eating regimen has to go. This is what I call a "pantry sweep."

Depending on how you choose your fats, the keto diet can contain an abundance of saturated fat, which raises levels of dangerous LDL cholesterol and causes atherosclerosis, the buildup of fats and cholesterol in the arteries. If you decide to go keto, have a doctor monitor your cholesterol levels monthly to ensure you remain within a healthy range.
I like it “ and I'm surprised I like it. I'm only down 5 lbs. after a month but I'm down 3 inches on my waist and 2 inches on my hips. I do feel better physically and I love not being hungry! I used to be that person who could eat pasta like a lumberjack “ now I often don't even finish my food. I have had a hard time sticking to 20 net carbs, I usually end up in the high 20's somewhere, but I'm in ketosis according to the testing strips. It's much harder to stick to 20 net as a vegetarian. Everything you eat has some level of carbs and they do add up. But overall, this is the only thing I've lost any weight or inches on in about 7 or 8 years. Starvation used to work until I hit 45 and then, forget it, I could eat 700 calories a day and not lose a pound. I'm so excited *something* is actually working.
Other experts say the long-term accumulation of ketones could be harmful. œThose ketones are emergency fuel sources, and we're not meant to run on them long-term, says Kristen Kizer, a registered dietitian at Houston Methodist Hospital. œKetones are negatively-charged molecules, which means they're acidic. When you build up ketone bodies in your system, you're building up acid. One of the ways your body buffers acid is by pulling calcium from your bones. Kizer also notes that the diet isn't very balanced and involves a very high intake of animal products, which generally do not protect against cancer, diabetes, or other diseases.
This means that if you have risk factors for heart disease ” such as elevated cholesterol levels, high blood pressure (hypertension), or a strong family history of the disease ” you should use caution when following this diet. The diet's heavy reliance on fat, especially saturated fat, can elevate cholesterol levels, further increasing your chances of developing heart disease in the future. (7)
Short for œketogenic diet, this eating plan is all about minimizing your carbs and upping your fats to get your body to use fat as a form of energy, says Scott Keatley, R.D., of Keatley Medical Nutrition Therapy. While everyone's body and needs are slightly different, that typically translates to: 60 to 75 percent of your calories from fat, 15 to 30 percent of your calories from protein, and 5 to 10 percent of your calories from carbs.

Fats are great if you want to add flavor and texture to your meals, and will help you feel full. Some people believe swear by coconut oil, and whether or not the claimed health benefits are actually present, it's one of the fats that you might want to add to your diet. Butter is an excellent choice, as is ghee (Indian clarified butter). Duck fat is highly prized. Avocado oil is a great choice when making dressings or sauces, as it's liquid at room temperature and has a mild flavor. The fats and oils listed here are primarily saturated, and they are the least likely to go rancid and produce free radicals and inflammation in the body (5, 6).
Oh man, this is a great read. Entertaining and full or resources and digestible content even though it is a long article. But I appreciate the research you went through it. I remember 5 years ago researching about Keto diet took forever because of how spread out the sources were. This is great work as a guide. Thanks for the article. Before reading this article I thought the requirements were too strict, but now that I read it, I am already doing a third of that list. I am trying IF right now, but I think this will help me with my satiety problem with meals, plus help me with weight loss. Thanks for the motivation and information Steve. I am starting my plan of attack and try a Keto diet.

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