Con: Results can vary depending on how much fluid you drink. By drinking more water, you dilute the concentration of ketones in the urine and thus a lower level of ketones will be detected on the strips. The strips don't show a precise ketone level. Finally, and most importantly, as you become increasingly keto-adapted and your body reabsorbs ketones from the urine, urine strips may become unreliable, even if you're in ketosis.

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.


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.

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 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)
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)

Sharon M. Nickols-Richardson, PhD, RD, , Mary Dean Coleman, PhD, RD, Joanne J. Volpe, Kathy W. Hosig, PhD, MPH, RD, œPerceived Hunger Is Lower and Weight Loss Is Greater in Overweight Premenopausal Women Consuming a Low-Carbohydrate/High-Protein vs High-Carbohydrate/Low-Fat Diet, The Journal of Pediatrics: Vol 105, Issue 9: 1433“1437; September 2005. http://www.sciencedirect.com/science/article/pii/S000282230501151X.


Having tempting, unhealthy foods in your home is one of the biggest reasons for failure when starting any diet. To maximize your chances of success with the keto diet, you need to remove as many triggers as you can. This crucial step will help prevent moments of weakness from ruining all your hard work.If you aren't living alone, make sure to discuss with your family or housemates before throwing anything out. If some items are simply not yours to throw out, try to compromise and agree on a special location so you can keep them out of sight.

High-fat, low-carb diets can help diminish hunger and also boost weight loss through their hormonal effects. As described above, when we eat very little foods that supply us with carbohydrates, we release less insulin. With lower insulin levels, the body doesn't store extra energy in the form of fat for later use, and instead is able to reach into existing fat stores for energy.

Totally agree that it's not something for everyone, though. Even one of the authors I read said he sometimes sneaks a french fry or a bite of cheesecake/ice cream, though he's able to stop after just a little bit and it doesn't throw him off horribly. Of course, that's not license to eat junk all the time, but it does mean that once you're well-adapted, you can sometimes indulge.


If you start at 20g of carbohydrates a day, you should slowly move to 50 as you reach your goal. Once you reach your goal, you can up your carbs as you see how they effect your weight. If you eat fruit for a week and gain weight, cut back. You have to figure out what works best for you. Ketosis is usually reached by only consuming 50g of carbs or less each day so that should be your starting range. I would not move past this until you have reached your goal weight and started to exercise daily (more about exercise is at the bottom of this post).
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!

Add bone broth to your diet, which can help restore electrolytes that are lost during ketosis. When you follow a keto diet, even if you're drinking a lot of water, you will lose a lot of water weight and also flush essential electrolytes out of our system, including magnesium, potassium or sodium. Adding bone broth is a great way to replenish these naturally, in addition to getting other nutrients and amino acids.


¢ Standard ketogenic diet (SKD) ” SKD is the type I typically recommend for most people, because it is very effective. It focuses on high consumption of healthy fats: As I explain in my book, "Fat for Fuel," you should aim for having 70 to 85 percent of your total daily calories to come from healthy fats. For your protein intake, the general rule of thumb is to follow the formula of 1 gram of protein for every kilogram of your lean body mass.
¢ High-protein ketogenic diet ” This method is a variant of the SKD. In a high-protein diet, you increase the ratio of protein consumption to 10 percent and reduce your healthy fat consumption by 10 percent. In a study involving obese men that tried this method, researchers noted that it helped reduce their hunger and lowered their food intake significantly, resulting in weight loss.11
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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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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