[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"

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.

The ketogenic diet works by eliminating carbohydrates from the diet and keeping the body's carbohydrate stores almost empty, therefore preventing too much insulin from being released following food consumption and creating normal blood sugar levels. This can help reverse œinsulin resistance, which is the underlying problem contributing to diabetes symptoms. In studies, low-carb diets have shown benefits for improving blood pressure, postprandial glycemia and insulin secretion. (7) Therefore, diabetics on insulin should contact their medical provider prior to starting a ketogenic diet, however, as insulin dosages may need to be adjusted.

When you're first getting started, it can be helpful to use a blood or breath ketone meter. What these meters do is measure the amount of ketones (the energy source your body is switching to) in your blood or your breath. Knowing those amounts and seeing how they increase or decrease depending on what you're eating daily can often be a motivating and helpful indicator of the transition occurring in your body.


One of the most common side effects of starting the ketogenic diet is the œketo flu. This term describes the often unpleasant, fatigue-inducing symptoms that occur as the body adjusts from a high-carbohydrate to a low-carbohydrate diet. During the keto flu, the body's stored glucose begins depleting, and the body starts adapting to producing and utilizing ketones as energy. (2)
Our bodies are incredibly adaptive to what you put into it “ when you overload it with fats and take away carbohydrates, it will begin to burn ketones as the primary energy source. Optimal ketone levels offer many health, weight loss, physical and mental performance benefits.1There are scientifically-backed studies that show the advantage of a low-carb, ketogenic diet over a low-fat diet. One meta-analysis of low-carbohydrate diets showed a large advantage in weight loss. The New England Journal of Medicine study resulted in almost double the weight loss in a long-term study on ketone inducing diets.
At the core of the classic ketogenic diet is severely restricting intake of all or most foods with sugar and starch (carbohydrates). These foods are broken down into sugar (insulin and glucose) in our blood once we eat them, and if these levels become too high, extra calories are much more easily stored as body fat and results in unwanted weight gain. However, when glucose levels are cut off due to low-carb dieting, the body starts to burn fat instead and produces ketones that can be measured in the blood (using urine strips, for example).
Exogenous ketones, or ketones that are produced in a lab and then consumed, have been compared to jet fuel, both as a fuel for the brain and body, and as a flavor comparison. It's like kick-starting ketosis, or enhancing it, since you wind up with vastly more ketone bodies in circulation with a concurrent drop in blood glucose. The best, most effective, and safest version of exogenous ketones currently available are ketone salts. They can potentially get you into ketosis faster, and help you reap the benefits of a low carb diet, but they're still relatively new to the market (12).

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.
Lots of apps and website offer keto diet challenges”basically, a blueprint for the keto diet with a fixed starting and ending point (they typically last for a week to a month, though some may be longer). Speaking of apps, plenty of keto-centric ones are right at your fingertips (a.k.a., your smartphone), like the KetoDiet app, which can help you calculate your macros and track your keto diet effectively.
œOne of the best meal planning tips I've ever received is to structure breakfast and lunch so that you don't have to think too much about it, says Emily Bartlett, co-founder of Real Plans. œIf you're okay with repetition, it's ideal to have a simple selection of recipes for breakfast”including some that can be taken on the go. For lunch, go ahead and use your leftovers with a fresh green salad, and be sure to include a dressing that you really love.
When you're first getting started, it can be helpful to use a blood or breath ketone meter. What these meters do is measure the amount of ketones (the energy source your body is switching to) in your blood or your breath. Knowing those amounts and seeing how they increase or decrease depending on what you're eating daily can often be a motivating and helpful indicator of the transition occurring in your body.
It's always good to go into the grocery store with a game plan so you don't buy things you'll regret later. I also like to keep things as simple as possible. Going through Pinterest, every recipe seems to have a bazillion ingredients, take hours & a culinary degree to make, or require random ingredients that are annoying to find and super expensive.
Are you ready to take the guesswork out of that stressful weeknight meal planning? Peace, Love and Low Carb - Low Carb and Gluten Free Weekly Meal Plans are low carb, gluten free, and keto friendly. All recipes include a color photo and complete nutritional analysis. Comes with a printable grocery list, snack list, tips for meal prepping and suggestions for substitutions.
Here are a few of the most common side effects that I come across when people first start keto. Frequently the issues relate to dehydration or lack of micronutrients (vitamins) in the body. Make sure that you're drinking enough water (close to a gallon a day) and eating foods with good sources of micronutrients. To read more on micronutrients, click here >

Other forms of ketogenic diets include cyclic ketogenic diets, also known as carb cycling, and targeted ketogenic diets, which allow for adjustments to carbohydrate intake around exercise. These modifications are typically implemented by athletes looking to use the ketogenic diet to enhance performance and endurance and not by individuals specifically focused on weight loss.
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.
A related clinical diet for drug-resistant epilepsy is called the medium-chain triglyceride ketogenic diet, in which MCT oil is extensively used because it's more ketogenic than long-chain triglycerides. (13a) Another dietary therapy for epilepsy called Low Glycemic Index Treatment (LGIT) was developed in 2002 as an alternative to the ketogenic diet. LGIT monitors the total amount of carbohydrates consumed daily, and focuses on carbohydrates that have a low glycemic index.) (13b)
The biggest shifts in your daily habits will be how you food shop and how you cook, and recipes that are ketogenic need to be followed rather than just low-carb. You will require the healthy fats in order to get into ketosis and have enough energy without the carbs. And you will be considerably more energetic and healthier when cooking your own keto-friendly food rather than buying supposedly keto foods off the shelf. So visit my page on keto recipes as well as keto snacks (including fat bombs!), and get started on a ketogenic meal plan!

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.
Thanks for reaching out. I don't currently have any meal plans, but I am working on some and hope to have them up soon. I completely understand your fear, but on Keto, we don't count calories. That's not to say you want to start eating 5000 calories a day, but if you remember to keep your macros balanced with both fat and protein you won't even have to worry about counting calories. I don't ever look at calories and honestly have no idea how many calories I eat on any given day. I know when I first started my calories were pretty low but after I had got the hang of it, they went up to like 1500 a day. After about two months I didn't watch my calories at all. The number I pay the most attention to is fat. I have to get plenty of fat, or I will stall, and I don't feel as good. I will be sure to email you when I have my plans up so you can take a look at them.
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)
œEggs have a lot of vitamins like vitamin A, B complex, D, K, E, calcium, and zinc, says Ryan Weaver, a personal trainer and keto enthusiast. œThat's why eggs are an excellent choice for breakfast when you follow the keto diet. To avoid getting bored, you can try different ways of preparing the eggs”boiled, fried, or baked. Also, you can combine the eggs with different foods like bacon, ham, cheddar cheese, butter, mayonnaise, so you get a different recipe each day although using the same main ingredient.
A lot of changes are happening in your body and you're going to feel it! The first five to seven days can be pretty rough, but your body is getting over its dependency on sugar. During this time of transition it is essential that you supplement electrolytes. Your body is flushing out lots of water, and with that goes electrolytes. The Keto Flu can be greatly reduced if you add sodium, potassium and magnesium to your diet. Check out our supplements page for a list of electrolyte supplements we recommend. Stay on course and you'll start feeling better in no time!
To be confident about being in ketosis, especially at the beginning when you're not quite sure how you should feel, it's best to measure your ketone levels. By monitoring your ketone levels, you can assure that you're doing the diet correctly and make dietary adjustments based on what you measure. People also respond to diet and exercise differently, so the best way to cater the keto diet to your own biology is to measure.
I have read your article and lots of other stuff on Keto, but I still don't understand why it has to be so high in fat? I am on a calorie controlled diet which should also be pushing me into ketosis (Optifast + veges) nutritionist suggestion to go hard for a month. But after that was looking at moving to a Ketogenic diet. I am just having a hard time with understanding why it has to be high fat. Can you help me understand? Also love your writing style (particularly referencing Ace Ventura).

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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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