It is possible to combine the results of several small studies to produce evidence that is stronger than that available from each study alone—a statistical method known as meta-analysis. One of four such analyses, conducted in 2006, looked at 19 studies on a total of 1,084 patients.[22] It concluded that a third achieved an excellent reduction in seizure frequency and half the patients achieved a good reduction.[3]

The history of keto goes much farther than an attempt to stem weight gain during our fat-fearing era. In 1921, it was observed that fasting decreased incidence of seizure in epileptic patients. The same year, reports noted cognitive improvement and reduced seizure activity in epileptics who fasted for two to three days (fasting has been used as far back as 500 B.C. to treat epilepsy).


Checking your ketone level is one way to know if you’re in ketosis. This metabolic state usually kicks in after three or four days of restricting your carbohydrate intake or going through periods of intermittent fasting. You don’t have to visit a doctor to measure your level. Pick up a ketone urine test from a nearby drug store, or use a blood sugar meter that’s capable of measuring ketones.
Move more. You’ll lose pounds faster if you increase your daily physical activity. Keep in mind you don’t have to go to the gym 6 times a week or jog every morning, just move more in your everyday life. For instance, take a short 2-minute break from sitting in your chair every hour, take the stairs instead of the elevator, walk to make errands if you can, get a standing desk, or take phone calls standing up and pacing around. These small calorie-burning movements add up at the end of the day.

Let’s hold up a sec. Allow me to introduce you to the DIETFITS Randomized Clinical Trial, published in February 2018 in the Journal of the American Medical Association. DIETFITS, which stands for Dietary Intervention Examining the Factors Interacting with Treatment Success, succeeded in busting a slew of dietary theories. Microbiome is responsible for everything? Nope. Predisposition to success on one diet based on genetics? Nah. Low carb over low fat? Uh-uh.

Your daily habits. Your daily habits will make or break your weight loss efforts. Consistency is the key to keto success. Are you eating clean keto foods or high-fat junk foods with low-quality ingredients? Are you watching out for hidden carbs? Are you exercising? Eating the right foods in the right amounts for your goals and adding more physical activity to your daily life are the most important pieces of a smooth and successful body transformation.


Ben – curious about your thoughts on this. I went into ketosis (using LOTS of coconut oil) but it raised my cholesterol and doc was worried about my lp(a) level (17mg/dL on VAP) even though crp was 0.5, trigs 51 and a1c was 5.2. Advised a low fat diet. Have you seen this before with folks on a lchf/ketosis diet and is there anything to be concerned about? Off to read your coconut oil article. Thank you!
Under these circumstances, as soon as the body’s limited reserves of glucose starts to run out, your entire body switches its fuel supply to run almost completely on fat. The levels of the fat-storing hormone insulin levels become very low, and fat burning increases dramatically. You thus get easy access your fat stores, and can burn them off. This is great for losing excess weight. Studies prove that keto diets result in more weight loss, faster. There are also more potential benefits.

But what does the science say? Results are mixed. In one Spanish study of 20 obese adults, participants were put on a low-calorie keto diet and lost an average of 40 pounds over four months. Another small experiment had a similar outcome. In a six-month Experimental & Clinical Cardiology study of 83 obese adults, those on the keto diet lost an average of 33 pounds, while lowering their bad (LDL) cholesterol levels and increasing their good (HDL) cholesterol.


Is it recommended to calculate our macros using the method suggested in the article to calculate yourself or by using the linked calculator? I get two different sets of numbers and am not sure which might be the better version. The main difference is amount of caloris and amount of protein to consume. The calculator gives me about 300 less calories, about the same amount of fat and carbs, but about 40 less protein than when I calculate myself.
Recently, many people have begun to question the usefulness of BMI as a general indicator. A sizable amount of people who may be overweight or even obese may be classified as such even though they have a high amount of muscle. Conversely, people with a “healthy” or low BMI may have a high level of body fat and actually be at a greater risk for developing health problems. [5, 6]
Food is your body’s primary source of energy, and three main nutrients in foods supply your body with this energy. These are carbohydrates, fat, and protein. Typically after eating a meal, your body will first break down carbohydrates from foods, and then fat and protein. Ketosis is a natural metabolic state that occurs when your body doesn’t have enough carbs (or glucose) for energy, so it burns fat instead.
This is because you get rid of the foods that cause high blood sugar, also known as glucose. Glucose is the easiest way for your body to get energy, but it can lead to energy crashes if you get too much in a short time. To get rid of the glucose and use it up, the body needs to produce insulin. As we produce more and more, our bodies become resistant to it, and this can lead to diabetes.
Great article! As someone who just started a “ketogenic diet” two weeks ago, I am opting to hold off on using ketone supplements for the following reason. You state how “Keto-adaptation occurs when you have shifted your metabolism to relying on fat-based sources, instead of glucose (sugar) sources, as your primary source of fuel.” If the goal is to “switch” our body’s energy supply to ketones and one uses supplemental ketones, how do they really ever know if their body has successfully accomplished this goal if they are using supplemental ketones? Aren’t they getting a false sense of ketosis if their blood or breath tests show them above 0.5 millimolar through the use of the supplements? I understand that it may take me longer to reach ketosis naturally but I guess I see it was worth it to truly reap all of the benefits that you outline in your article.
Improved insulin markers: In Type II diabetes, fasting insulin levels are often elevated, and insulin has less of an effect (meaning it takes longer for blood glucose to fall after the post-meal increas). Whilst evidence is not conclusive, some studies have claimed to demonstrate an improvement in insulin sensitivity with the ketogenic diet104. The evidence supporting a decrease in fasting insulin levels with a ketogenic diet has been demonstrated more consistently 104 , 105 .

If you prefer a more direct, customized approach, I'd be happy to help you via a personal one-on-one consult. Just go to https://bengreenfieldfitness.com/coaching. and then choose a 20 or 60-minute consult, whichever you'd prefer. I can schedule ASAP after you get that. Additionally, if I'm "out of your price range" (yes, yes, I know I can be a spendy guy to access) I have a team of coaches I've personally trained who can help you here: https://greenfieldfitnesssystems.com/product-cate…

Those issues are part of what's known as the “keto 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 the diarrhea and 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.
At the same time, you need to remember to increase the amount of fat that you eat. Also, it doesn’t mean a complete ban on carbs. You just need to reduce the amount that you eat to 15g or less per day. On average, we tend to eat around a third to a half more than that on a daily basis. Reducing carbs won’t be easy for some, which is why having delicious recipes to try first is the way to go.
I appreciate you sharing your story. In this day and age Keto is the holy grail for some. There are those of us though that do not respond well. I’m one of them. I couldn’t lose weight, I didn’t feel good (and that was after the Keto “flu”) and my periods were coming every 2 weeks (I’m 48 and peri-menopausal). What I did find, after the same soul searching, was that I do have some sort of weird physical reaction to wheat in any form. If I avoid it, I feel better. Whatever works, we’re all unique and what works for one will not work for all. That’s my big take away. I can appreciate that people have had success but something about going THAT low in my carbs created a stress response in my body. Also, I was needing to use my emergency Xanax a whole lot more. Thanks again for sharing!
Many low carbers continue to enjoy caffeine-containing beverages with no serious impact on their weight-loss efforts. However, there are some sensitive individuals ... and persons who are extremely insulin resistant may need to restrict or even eliminate all caffeine. If you have been losing successfully then find your weight loss stalled for a month or two, and you are following your program to the letter, you might consider stopping all caffeine for a while, to see if that will get things started again.

Came across this old pic yesterday and wanted to compare it to my recently uploaded pic. This was from when I was doing an all fruit / starch vegan diet. I also consumed gluten here and there.. thank God I got tested for food sensitivities or I would be in poor health still. Nothing against the vegan diet, but everyone’s body is different. People have had success with veganism and people who are insulin resistant haven’t. So glad I found Keto thanks to @jason.wittrock 💪🏻 - - - - - - - #waronsugar #keto #ketoquest #fitness #transformationtuesday #journey #fatloss #hardwork #progress #shred #workout #fitnesswomen #fitnessmotivation #bodybuilding #weightloss #weightlossjourney
Fortunately, Drs. Kevin Hall and Juen Guo had the same burning question. In 2017, they analyzed the data and published a meta-analysis of controlled feeding studies that compared diets of equal calorie and protein content with variations in carbohydrate and fat content. [24] By filtering out the diet data in this way, the researchers could finally find out whether restricting carbs or limiting calories is more important when it comes to weight loss.
I do need to lose weight, but I have ALWAYS been the biggest Keto nay-sayer. It defied everything I believe in. What turned the tables for me after a lot of research is that it's supposed to help with infertility and at this point, I'm desperate and will try anything. So, I gave it 30 days and said I would re-evaluate whether I want to continue. And let me tell you, I want to continue. This is what it's done for me so far:

The ketogenic diet is calculated by a dietitian for each child. Age, weight, activity levels, culture and food preferences all affect the meal plan. First, the energy requirements are set at 80–90% of the recommended daily amounts (RDA) for the child's age (the high-fat diet requires less energy to process than a typical high-carbohydrate diet). Highly active children or those with muscle spasticity require more calories than this; immobile children require less. The ketogenic ratio of the diet compares the weight of fat to the combined weight of carbohydrate and protein. This is typically 4:1, but children who are younger than 18 months, older than 12 years, or who are obese may be started on a 3:1 ratio. Fat is energy-rich, with 9 kcal/g (38 kJ/g) compared to 4 kcal/g (17 kJ/g) for carbohydrate or protein, so portions on the ketogenic diet are smaller than normal. The quantity of fat in the diet can be calculated from the overall energy requirements and the chosen ketogenic ratio. Next, the protein levels are set to allow for growth and body maintenance, and are around 1 g protein for each kg of body weight. Lastly, the amount of carbohydrate is set according to what allowance is left while maintaining the chosen ratio. Any carbohydrate in medications or supplements must be subtracted from this allowance. The total daily amount of fat, protein and carbohydrate is then evenly divided across the meals.[36]
The participants had an age range of 22 to 75 years with an average age of 46.8 years. They had a BMI range of 30 to 45 kg/m2. About 88% of the participants were female and 51% were of African origin; thus, it was considerably more diverse than the prior study. They were also free of cardiovascular and renal complications including type 2 diabetes, cardiovascular diseases, and kidney disease as well as significant weight-loss in the past six months.
The modified Atkins diet reduces seizure frequency by more than 50% in 43% of patients who try it and by more than 90% in 27% of patients.[3] Few adverse effects have been reported, though cholesterol is increased and the diet has not been studied long term.[47] Although based on a smaller data set (126 adults and children from 11 studies over five centres), these results from 2009 compare favourably with the traditional ketogenic diet.[3]
10 pound weight loss , chicken broth works to relieve . But have to be careful of salt intake . I retain fluid, Dr gave script for dieuretic before I even started Keto . I have had the retention problem for a long time , when I took the dieuretic on a normal high carb diet ( I would drop 4 lbs ) but would make me really tired , afraid if I take it now on Keto I will pass out. Any idea what I should try other than the chicken broth
I think there is a lot more to the story than ketosis or very low carb for everyone. In my own experience, high carb works much better. I tried very low carb for a long without really feeling amazing, I then switched back to high carb and quickly lost weight and leaned out. I still eat high carb and my strength is better and I'm even leaner now. I find it very difficult to overeat (I obviously eat very 'clean diet').
As a matter of fact, in animal models intracerebroventricular injections of long-chain FA reduced hypothalamic expression of NPY. NPY is an important orexogenic neuropeptide that is a downstream target of leptin and insulin in the hypothalamus. In some forms of hyperphagic obesity, characterized by elevated plasma leptin and insulin levels, the lack of action of insulin on NPY expression could explain the pathological condition. Central administration of oleic acid, fatty-acid synthase, or CPT-1 inhibitors prevents the rise in hypothalamic NPY mRNA induced by fasting (Obici et al., 2003). But glucose level is also involved in KD's food control mechanisms. According to glucostatic theory (Mayer, 1955) data indicates that ketosis did not influence FA glucose but instead stimulated the elevation of post-prandial glucose (Sumithran and Proietto, 2013) in non-diabetic subjects, while in diabetics there was a reduction of fasting glucose (Westman et al., 2008). It is important to note that carbohydrate availability may increase cellular levels of long-chain FA-CoA through an increase of malonyl-CoA, which inhibits oxidation of FAs.

The SS providing information to the brain mainly send information to the nucleus of the solitary tract (NTS). These signals are generated in the GIT and abdominal viscera, as well as in the oral cavity and provide information about mechanical and chemical properties of food. The information is transmitted via vagal and spinal nerve to the NTS. The ASs arrive to the median eminence through ARC or through the blood-brain barrier (BBB). All these afferents are integrated in a complex and not fully understood network.
There are many misconceptions about ketosis. The most common is mixing it up with ketoacidosis – a rare and dangerous medical condition that mostly happen to people with type 1 diabetes if they don’t take insulin. Even some health care professionals tend to mix up these two situations somewhat, perhaps due to the similar names and a lack of knowledge about the distinct differences.
You need to do a “common man’s” version of a good ketogenic nutrition program or discussion. Great article, and I leaned a few things. Those Ketone Salts and other supplements can get pricey. I eat a very low carb and high fat diet and meander in and out of ketosis during the week. A pure ketogenic diet is so restrictive that meals it can get very repetitive during the week. I’d like to learn more about cooking with oils and how temperature effects their qualities. I can only handle eating so much raw food, and I love to cook my greens and other vegetables in bacon fat and coconut oil. It will be next May before I can get my blood work performed (insurance reasons) so until then I’ll need to be careful and hold back on those after supper dark chocolate excursions! Thanks!!
Finally, exogenous ketones have been shown to decrease the levels of triglycerides and free fatty acids in the blood after one drink 107 ,106 ,11. There is also early data showing that ketone ester consumption decreases cholesterol biosynthesis in rodents, an effect which appeared to be conserved in humans114. It is unclear at this stage what the long term effects of exogenous ketone consumption on blood lipids and cholesterol would be, but this is an area of promising research. 
Day 1: It's 8:15 a.m. and my stomach is growling. It knows it's time for its breakfast, and I'm depriving it. I blended my protein coffee and ran out the door. My first thought is that the vanilla flavor is a nice complement to black coffee. But toward the end of the thermos, I realize that no matter how you dice it, vanilla bone broth protein coffee is not the same as a vanilla blonde roast with skim milk.
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., “A 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.
On the contrary, in the brain, as mentioned above, the increase of AMPK activity leads to higher food intakes. But the effect of AMPK in the brain is more complicated; mice lacking AMPKa2 in pro-opiomelanocortin neurons develop obesity, while the deficiency of AMPKa2 in agouti-related protein neurons results in an age-dependent phenotype. Thus, the conclusion is that even while AMPK is a regulator of hypothalamic functions, it does not act as a signal for energy deficit or excess (Claret et al., 2007). However, the picture is more complex than this (Figure ​(Figure3);3); BHB induces AgRP expression while increasing ATP and inhibiting AMPK phosphorylation (Cheng et al., 2008). Moreover, Laeger and colleagues have recently demonstrated that under physiological conditions BHB decreases AMPK phosphorylation and AgRP mRNA expression in GT1-7 hypothalamic cells (Laeger et al., 2012).
You could pick any of the countless diet books on the market, follow their plan to the last calorie, and lose weight. This is because — as study after study has shown — calories and dietary adherence matter more than anything for weight loss. You can gain or lose weight on any combination of foods. People have lost weight on twinkies, McDonalds, juice, plants, and obscene amounts of meat.
The original therapeutic diet for paediatric epilepsy provides just enough protein for body growth and repair, and sufficient calories[Note 1] to maintain the correct weight for age and height. The classic therapeutic ketogenic diet was developed for treatment of paediatric epilepsy in the 1920s and was widely used into the next decade, but its popularity waned with the introduction of effective anticonvulsant medications. This classic ketogenic diet contains a 4:1 ratio by weight of fat to combined protein and carbohydrate. This is achieved by excluding high-carbohydrate foods such as starchy fruits and vegetables, bread, pasta, grains and sugar, while increasing the consumption of foods high in fat such as nuts, cream, and butter.[1] Most dietary fat is made of molecules called long-chain triglycerides (LCTs). However, medium-chain triglycerides (MCTs)—made from fatty acids with shorter carbon chains than LCTs—are more ketogenic. A variant of the classic diet known as the MCT ketogenic diet uses a form of coconut oil, which is rich in MCTs, to provide around half the calories. As less overall fat is needed in this variant of the diet, a greater proportion of carbohydrate and protein can be consumed, allowing a greater variety of food choices.[4][5]
It’s a common misconception that the keto diet is a high-protein diet – it’s a moderate-protein diet where 20-25 percent of your calories come from protein. While it’s helpful to have a portion of protein at each meal to satiate you, you don’t want to overdo it. Too much protein can actually kick you out of ketosis, says Davoodi, through a process called gluconeogenesis, where your body converts extra protein into sugar. Your body will reach for the glucose first and no longer burn fat for fuel.
Notably, it can take several months to become fully ‘keto-adapted’ and performance can decline in the short term as these adaptations occur. It is also likely that individual responses to the diet vary. These factors make design and interpretation of sports science studies challenging and leave the door open for continued disagreement between scientists on each side of the debate. If you want to find out what each side has to say, we would recommend reading the comprehensive reviews by Louise Burke (who dislikes the use of the ketogenic diet)27 and Volek and Phinney (who promote the use of ketogenic diet)28. 
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 “stall” 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).
The diet gets billed as a miraculously enjoyable diet—eat all the fat you want, just cut out the carbs. But the ketogenic diet (also called keto) was never supposed to be fun. It was supposed to treat severe epilepsy. And as a medical treatment, it was only intended to be administered under the supervision of trained nutritionists and physicians. The professionals would be able to monitor patients for potential problems and ensure that their diet was actually keeping them in ketosis—a metabolic state where your body switches from using glucose as energy to using ketone bodies, which come from body fat. They needed those checkpoints because staying in true ketosis is exceptionally challenging for adults.
Also make sure that you know what foods have mostly carbs, fat, and protein, so you can make the right choices. For instance, it’s not just bread, pasta, chips, cookies, candy, and ice cream that contain carbs. Beans may contain protein, but they’re also very high in carbohydrates. Fruit and veggies also mostly contain carbs. The only foods that don’t contain carbs are meat (protein) and pure fats, like butter and oils.
Thanks for your comment. First off, I’m not influencing anyone to not try something. What I’m doing is giving people a safe space to say, “hey, this didn’t work for me, and that’s okay!” You have to remember, I’m writing this from MY perspective and how keto turned my eating into a disordered eating pattern. Yes, there are resources out there people can find to support keto, but there are also resources out there that show that keto isn’t for the average person. We can’t just look at one side, and that’s the conversation I’m trying to have.

The ketogenic diet tries to bring carbohydrates down to less than 5 percent of a person’s daily caloric intake – which means eliminating most grains, fruit, starchy vegetables, legumes and sweets. Instead, it replaces those calories with fat. That fat is turned into ketone bodies, which are an alternative energy source: besides glucose derived from carbohydrates, ketones from fat are the only fuel the brain can use.
Jump up ^ Bechtel PJ (2 December 2012). Muscle as Food. Elsevier Science. pp. 171–. ISBN 978-0-323-13953-3. Retrieved 19 May 2014. Freezing does stop the postmortem metabolism but only at about −18ºC and lower temperatures. Above −18ºC increasing temperatures of storage cause an increasing rate of ATP breakdown and glycolysis that is higher in the comminuted meat than in the intact tissue (Fisher et al., 1980b). If the ATP concentration in the frozen tissue falls below ~ 1 µmol/g no contraction or rigor can occur because they are prevented by the rigid matrix of ice.
If you have high triglycerides and low HDL, or you have any type of genetic issue that would cause you to have high sensitivity to saturated fats then the diet may not actually be for you. I think you should start by reading this: https://bengreenfieldfitness.com/article/nutritio… If you prefer a more direct, customized approach, I'd be happy to help you via a personal one-on-one consult. Just go to https://bengreenfieldfitness.com/coaching and then choose a 20 or 60-minute consult, whichever you'd prefer. I can schedule ASAP after you get that.
Losing weight has become a challenge to be solved through innovation, and the new diet gurus don’t take kindly to the scientific method. It’s in line with Dr. Atkins’s legacy; he was a huge proponent of alternative and unproven medical treatments beyond just his ideas about nutrition. You almost can’t blame him or the other diet gurus for leaning in on the techno-bullshit market; it’s hard to fill up a 300 page diet book on “eat a bit less and find a type of exercise that doesn’t make you hate life.”

Jump up ^ Yiu H. Hui (February 1985). Principles and issues in nutrition. Wadsworth Health Sciences Division. p. 91. Retrieved 2014-05-19. Eskimos actually consume more carbohydrates than most nutritionists have assumed. Because Eskimos frequently eat their meat raw and frozen, they take in more glycogen than a person purchasing meat with a lower glycogen content in a grocery store. The Eskimo practice of preserving a whole seal or bird carcass under an intact whole skin with a thick layer of blubber also permits some proteins to ferment into carbohydrates.

The current hypothesis is that the brain functions differently on ketones than on glucose, and this is what causes certain brains to reduce epileptic seizures. I would then also hypothesize that certain people who feel that “brain fog” lifted on ketosis is due to either placebo effect OR their brain actually functioning differently on ketones vs glucose.


I have been doing keto for about a month and although I have lost about 8 lbs I am finding the constipation to be more frequent. I have started to add more fiber back into my diet. I do think however that Keto has helped me jumpstart me in avoiding sugar and getting away from eating bread and pastas. I hope to continue by limiting my calories, monitoring the carbs and reducing some of the fats. My hope is to continue to eat healthy and add back some of those foods not suggested while on keto.
I’m honestly a little skeptical about it the idea of keto permanently. My brief glance at the literature seems to imply that it can have side effects of kidney stones, skeletal fractures, and slow the growth rate of children, but that was a study on kids with epilepsy (which it treated very effectively), so who knows how that applies to adults. And the other studies I found dealt with overweight and obese subjects, so it may be hard to find something on the long term effects on otherwise healthy adults.
Hello, I am doing IF 16:8 & my eating window is in the evening. I’m confused as to what to eat during those 8 hours. I’ve been eating 1 meal & a snack. Is this enough? I’ve been doing Keto dieting for 6 months. Initially lost 5 #. (Realize it was water #) Now I weigh more than I ever have, as of today!! Drink loads of water, eat healthy fats, mod protein & limited carbs, non processed. Can you help? Thanks!!
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