Wondering what fits into a keto diet — and what doesn’t? “It’s so important to know what foods you’ll be eating before you start, and how to incorporate more fats into your diet,” says Kristen Mancinelli, RD, author of The Ketogenic Diet: A Scientifically Proven Approach to Fast, Healthy Weight Loss, who is based in New York City. We asked her for some guidelines.
Frederick F. Samaha, M.D., Nayyar Iqbal, M.D., Prakash Seshadri, M.D., Kathryn L. Chicano, C.R.N.P., Denise A. Daily, R.D., Joyce McGrory, C.R.N.P., Terrence Williams, B.S., Monica Williams, B.S., Edward J. Gracely, Ph.D., and Linda Stern, M.D., “A Low-Carbohydrate as Compared with a Low-Fat Diet in Severe Obesity,” N Engl J Med 2003; 348:2074-2081. http://www.nejm.org/doi/full/10.1056/NEJMoa022637.

Ketone esters: These are the raw ketones (in this case, beta-hydroxybutryate) that are not bound to any other compound. These exogenous ketones can be utilized quicker and potentially have a better effect at raising blood ketone levels as your body doesn’t have to cleave the BHB from any other compound. The downside? They typically have a foul taste and can cause an upset stomach.
I’ve been on and off of my Keto diet with the primary purpose of losing weight. I’m 30 years old, workout daily – I’m in decent shape but have some extra fat around the mid-section that I’d like to get rid of, I am hoping to lose ~20 pounds of fat. However, the problem is that I am an extremely picky eater with tremendous cravings for some of my favorite carb-heavy foods – I only eat a number of high-fat / low-carb foods that help me attain Ketosis, so cycling through them multiple times a week becomes excruciating. I find myself cheating on my diet every 2 – 3 weeks, which causes a 3 – 5 pound setback that takes me a few days to overcome and get back into ketosis.

Here's what I learned about the keto diet: You essentially swap a high-carb diet, which most Americans tend to eat, for a diet that's very high in fat (the healthy kinds), moderate in protein, and very low in carbohydrates. The idea is that you change the source from which your body gets its energy (and burns calories) from glucose (from carbohydrates) to ketones (from fat). This shift doesn't happen after one bulletproof coffee, though. It usually takes a few days of eating this way for your body to reach ketosis—where it's looking to fat as its first source of fuel. Once there, though, your body "will be burning fat all the time," says Dr. Axe. "It doesn't matter if you're working out or sleeping, or what you're doing, your body continues to burn fat in ketosis."


When the kidneys filter blood, metabolic substrates such as glucose and ketones are re-absorbed to prevent energy wastage. If blood levels of a metabolite exceed the capacity of the kidney to reabsorb them, then a ‘spillover’ effect occurs and the metabolite (i.e. glucose or ketones) appear in the urine. However, urine is not a very reliable measure. Firstly, whilst following a ketogenic diet, adaptation occurs over time that means more ketones are reabsorbed in comparison to the early phase of the diet9. Furthermore, at higher levels of ketones, the appearance in the urine does not correlate to levels in the blood10. Similarly, after consumption of exogenous ketones, urine ketone levels were not in proportion to the levels in the blood11 this may be because of the rapid onset of ketosis in comparison to when ketosis is achieved with fasting or diet. Therefore urine test strips are useful as a guide but have several disadvantages to their use to accurately quantify levels of ketosis. 

The researchers agree that the diet itself isn’t inherently dangerous. But, cautions Weiss, “If you have any medical condition, if you take any medicine at all – there are lots of things that change how medicines work in our bodies, and nutrition is definitely one of them. If you’re making a real change in your nutrition, you really should talk to your doctor.”
The brain is different as it is dependent on carbohydrates as a fuel source. This is because fats cannot easily cross the blood-brain barrier. The inability to make use of energy within fat poses a problem during periods where there is limited carbohydrate in the diet. If blood glucose levels fall to low, brain function declines. Relatively little energy is stored as carbohydrate (2,000 kCal) compared to fat (150,000 kCal). The body's store of carbohydrates runs out with a few days of carbohydrate restriction. Once glycogen is depleted, a cascade of hormonal signals causes the body to increase the release of stored fats (from adipose tissue). Signals include the fall in blood insulin, rise in a hormone called glucagon and an increase in cortisol (stress hormone) 1. The increase in blood fatty acids is a key trigger for ketone production (ketogenesis). Unlike fats, ketones are readily used as a fuel in the brain. Fatty acids are converted into ketone bodies in the liver, and ketones can provide up to 60% of the brain's energy requirements during starvation 2. The graph below shows how BHB (black triangles) builds up in the blood over many days until it reaches a level of around 6 mM.
Achieving ketosis is a pretty straightforward, but it can seem complicated and confusing with all of the information out there.4If you want to learn more about ketosis and the scientific process around it, you can visit a very in-depth discussion about on Dr. Peter Attia’s website. Here’s the bottom line on what you need to do, ordered in levels of importance:
Decrease your stress levels. The most common ways that people stress their bodies on a diet is by eating too little and exercising too much. Studies have found that exercising for more than an hour a day can drop our metabolic rate by 15%, and maintaining a caloric deficit of 25% can decrease our metabolic rate by 6%. In other words, don’t overdo it — you will slow your metabolism down and cause your own weight loss plateau.

The Keto diet emphasizes weight loss through fat-burning. The goal is to quickly lose weight and ultimately feel fuller with fewer cravings, while boosting your mood, mental focus and energy. According to Keto proponents, by slashing the carbs you consume and instead filling up on fats, you safely enter a state of ketosis. That’s when the body breaks down both dietary and stored body fat into substances called ketones. Your fat-burning system now relies mainly on fat – instead of sugar – for energy. While similar in some ways to familiar low-carb diets, the Keto diet’s extreme carb restrictions – about 20 net carbs a day or less, depending on the version – and the deliberate shift into ketosis are what set this increasingly popular diet apart.
I’m missing one key-step in this whole process … I understand (vaguely) how to get into ketosis via diet, starvation, or supplementation. But, my confusion really is with the supplementation method (such as XCT Oil, for example). If I supplement with these to get into ketosis quicker, but haven’t significantly altered to a high-fat diet, won’t I just shift back into glucose-use as soon as I burn out the supplemented ketones?? like within minutes / hours?
Moreover, recent studies show that the Inuit have evolved a number of rare genetic adaptations that make them especially well suited to eat large amounts of omega-3 fat.[57][58][59] And earlier studies showed that the Inuit have a very high frequency—68% to 81% in certain arctic coastal populations—of an extremely rare autosomal recessive mutation of the CPT1A gene—a key regulator of mitochondrial long-chain fatty-acid oxidation[60][61]—which results in a rare metabolic disorder known as carnitine palmitoyltransferase 1A (CPT1A) deficiency and promotes hypoketotic hypoglycemia—low levels of ketones and low blood sugar.[62] The condition presents symptoms of a fatty acid and ketogenesis disorder.[62] However, it appears highly beneficial to the Inuit[60] as it shunts free fatty acids away from liver cells to brown fat, for thermogenesis.[63][64] Thus the mutation may help the Inuit stay warm by preferentially burning fatty acids for heat in brown fat cells.[64] In addition to promoting low ketone levels, this disorder also typically results in hepatic encephalopathy (enlarged liver) and high infant mortality.[65] Inuit have been observed to have enlarged livers with an increased capacity for gluconeogenesis, and have greater capacity for excreting urea to remove ammonia, a toxic byproduct of protein breakdown.[57][66][67][68] Ethnographic texts have documented the Inuit's customary habit of snacking frequently [69] and this may well be a direct consequence of their high prevalence of the CPT1A mutation[70] as fasting, even for several hours, can be deleterious for individuals with that allele, particularly during strenuous exercise.[57][70] The high frequency of the CPT1A mutation in the Inuit therefore suggests that it is an important adaptation to their low carbohydrate diet and their extreme environment.[57][60][70]
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.
Though the hunger-reduction phenomenon reported during ketogenic diets is well-known, the underlying molecular and cellular mechanisms remain uncertain. Ketosis has been demonstrated to exert an anorexigenic effect via cholecystokinin (CCK) release while reducing orexigenic signals e.g., via ghrelin. However, ketone bodies (KB) seem to be able to increase food intake through AMP-activated protein kinase (AMPK) phosphorylation, gamma-aminobutyric acid (GABA) and the release and production of adiponectin. The aim of this review is to provide a summary of our current knowledge of the effects of ketogenic diet (KD) on food control in an effort to unify the apparently contradictory data into a coherent picture.
It has recently been proposed that the ARC is required for the coordination of homeostatic circadian systems including temperature and activity. Authors tested this hypothesis by injecting saporin toxin conjugated to leptin into the ARC of rats. Wiater et al. showed that the leptin-sensitive network is required for entrainment of activity by photic cues and entrainment of temperature by food but is not required for entrainment of activity by food or temperature by photic cues (Wiater et al., 2013).
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.”

THANK YOU! I’ve been doing Keto for 3 weeks and I don’t think this is the diet nor lifestyle for me. I’ve been having on and off Keto Flu that included painful headaches and constant bowel issues. I thought it would be over by the end of week 1, but I continued so I thought again at the end of week 2, but continued. It’s the end of week 3 and I’m not seeing any changes. I’m feeling just as tired if not more than when I wasn’t on Keto. My mood has been more snappy and aggressive than when I wasn’t on Keto. I just wasn’t happy. I already was super sensitive to salt & salty foods and now I’m even MORE sick of salt & salty foods. I missed my fruits and veggies like carrots which my pup & I often snacked on. I got super gassy and burped more these past 3 weeks than my entire life. My period was a mess and came 4 days earlier than normal and I haven’t had an odd period in over a year after getting diagnosed with mild PCOS. Attempting Keto really threw my body in for a loop and it’s been down hill ever since. I haven’t dropped in weight, the inches are still there, the bloating is still there. But now I have this fear of eating. I used to miss meals before and did IF for a while but now I miss even MORE meals and rarely eat which is just a recipe for weight gain when you’re consuming high fat. I’ve stocked my fridge with items I rarely ever bought: Sour Cream, Bacon, Cream Cheese, Heavy Whipping Cream. All because I needed to hit my fat macros.
I’ve been on Keto for o ver a year now and I am delighted about how I look and feel. I’m 71 years old and I have more energy now and no pain for the first time in such a long time. I lost 35 lbs in about 4 months and have kept it off with no trouble. I do follow it pretty strict but not afraid to eat a few no nos. My husband of 51 yrs passed away and I’m alone to take care of a 40 acre farm. Friends and neighbors are amazed at the work I am able to do. In fact they’re asking me about the Keto diet. I do hard labor on my farm and 2 days a week I do weight exercise. My blood sugar and trygicerides are low and soon will be off high blood pressure meds soon. Everyone says how great I look.
Chasing blood Ketones instead of focusing on hormone signals: "The higher the number means you have more Ketones circulating in your bloodstream, but that does not mean that you are better at burning fat for fuel," Mavridis points out. "You must be in nutritional Ketosis, which is described as being between 1.5 - 3.0 mol/L on the blood Ketone meter. You will know once you are fat-adapted from hormonal signals, and not from higher Ketones on the blood meter," she adds.
At the beginning of the year I was counting calories, I was losing weight but I was eating the same thing....every day....never deviating. I lasted 4 months. The lowest I ever hit was 325, starting from 347. I mean that is not bad, and I was losing weight, but I was so bored with my food. Since starting Keto, I am already down to 328 IN TWO WEEKS. I am shocked. I had to have my wife hide the scale, because I kept standing on it not believing what I was seeing. I am eating so well right now.
Pro Tip: On keto, you don’t need to fixate on a precise calorie count because weight loss comes from getting within your ideal calorie range. However, it will help to pay attention to your macronutrient proportions: 5 percent of calories from carbs; 20-30 percent from protein; and 70-80 percent from fat. Davoodi adds that drinking plenty of water to break down fat is particularly important on a high-fat diet like keto.

Pro Tip: Kick-start ketosis with a teaspoon or two of MCT oil or Brain Octane Oil. MCT oils are medium-chain triglyceride fats that bypass the lymphatic system entirely and are uniquely absorbed by the liver in much the same way as carbs. In the liver, they are quickly converted into ketone bodies rather than glucose (carbs), so they’ll expedite the keto process.


Wondering what fits into a keto diet — and what doesn’t? “It’s so important to know what foods you’ll be eating before you start, and how to incorporate more fats into your diet,” says Kristen Mancinelli, RD, author of The Ketogenic Diet: A Scientifically Proven Approach to Fast, Healthy Weight Loss, who is based in New York City. We asked her for some guidelines.
My goal with this blog is to help free you from the bondage that diets create. I want to help you learn to trust your body again and start loving the body you’re in. Because our worth is NOT determined by the size we are. Rather, let’s look at what type of human being we can be in this world. Compassionate, forgiving, loving, kind, generous, happy – these are the things that matter to me. These are things I want people to remember me by…not by how much I exercised or what I ate.
While guest starring on the Rachael Ray Show, the actress opened up about how she stays motivated through intense workouts: “No carbs. No dairy. No refined sugar. [It’s] eating real foods. It’s honestly high-fat, high-protein. I think that we’ve been brainwashed to think that fat is bad, but really, it’s what going to make you feel fuller longer. And your body can burn it and use it as fuel.”
The situation for Type II diabetics is different because some insulin production remains and some cells of the body can still respond to insulin. It is worth noting that insulin sensitivity can be different between the different tissues of the body such as liver, adipose tissue and muscle. A small amount of insulin release can help to prevent development of DKA unless the body is totally insulin resistant. Insulin resistance is a term used to indicate that for a given amount of insulin, the cells of the body are less responsive and take up less glucose. This means that blood glucose levels remain higher for longer when insulin resistant Type II diabetics eat a carbohydrate rich meal. Over time, the pancreas secretes more insulin to compensate for reduced insulin sensitivity, which can damage the insulin producing (beta) cells. Furthermore, having high blood glucose can lead to a number of side effects:

I know that “haters gon hate” on this article, and that’s okay! Everyone is entitled to their opinion, including me. And last time I checked, this was my blog 😉 I’m not saying keto never works for people, especially those who may suffer from specific ailments. But I want you to consider what I’ve talked about above before diving into this way of eating.
KETO WEIGHT LOSS is designed for ketogenic and low-carb dieters looking to increase fat burning power. When following these diets, the body goes through a transition from burning glucose (sugar) for fuel to burning fat for fuel. During this phase known as “keto adaptation”, you may feel unmotivated, tired and lose focus (sometimes known as the keto flu). KETO WEIGHT LOSS was created to help fight these unwanted side effects, while assisting your body in torching fat.*†
My son had dropped slight hints over the previous year that he was concerned about me being obese and what that could do to my health. I never really paid attention to him but in the back of my mind I knew he was correct. My retirement hobbies were seriously studying cooking indoors and outdoors... plus making Artisan sourdough bread. Plus I have a wine cellar that has enough inventory that restricts me from buying more. None of which is conducive to losing 106 pounds.
Recent studies indicate that mood disorders such as depression and anxiety can be linked to a range of physical changes in the brain, such as inflammation or change in gene expression71. Early results from animal studies have shown that ketosis could improve mood disorders, although the mechanism is still unclear. Rats fed exogenous ketones for several weeks showed reduced anxiety behaviours72. Similarly, endogenous and exogenous BHB alleviated depressive behaviour in mice subjected to stress73. This was found to be linked to altered epigenetic markers (modifications to DNA that affect the degree of gene expression) and an increased amount of brain derived neurotrophic factor (BDNF) in the brain. At this time, there are no trials investigating the effects of ketosis in human patients with mood disorders. 

As with any serious medical therapy, the ketogenic diet may have complications.[27] These are generally less severe and less frequent than with anticonvulsant medication or surgery.[27] Common but easily treatable short-term side effects include constipation, low-grade acidosis and hypoglycaemia if there is an initial fast. Raised levels of lipids in the blood affect up to 60% of children[37] and cholesterol levels may increase by around 30%.[27] This can be treated by changes to the fat content of the diet, such as from saturated fats towards polyunsaturated fats, and, if persistent, by lowering the ketogenic ratio.[37] Supplements are necessary to counter the dietary deficiency of many micronutrients.[3]
In a recent study in the Journal of Sports Medicine and Physical Fitness, Weiss and his colleagues found that participants performed worse on high-intensity cycling and running tasks after four days on a ketogenic diet, compared to those who’d spent four days on a high-carb diet. Weiss says that the body is in a more acidic state when it’s in ketosis, which may limit its ability to perform at peak levels.
I am so glad that I never went full board on the keto diet. I work from home. Because of this, I have the option to eat my bigger meal at lunch time rather than dinner/supper. What I noticed for me personally is that when I go to bed on a fully carbed meal, I am less likely to want to eat breakfast in the morning. So, I have moved my carbs to lunchtime and then a dinner that is lighter and less carbed out. I also go to the gym in the evening and just don’t care for a heavy meal sitting on my stomach because I feel like I have to work out just to burn that meal off.
During the 1920s and 1930s, when the only anticonvulsant drugs were the sedative bromides (discovered 1857) and phenobarbital (1912), the ketogenic diet was widely used and studied. This changed in 1938 when H. Houston Merritt and Tracy Putnam discovered phenytoin (Dilantin), and the focus of research shifted to discovering new drugs. With the introduction of sodium valproate in the 1970s, drugs were available to neurologists that were effective across a broad range of epileptic syndromes and seizure types. The use of the ketogenic diet, by this time restricted to difficult cases such as Lennox–Gastaut syndrome, declined further.[10]
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.
Before starting, ask yourself what is really realistic for you, Mattinson suggests. Then get your doctor’s okay. You may also work with a local registered dietitian nutritionist to limit potential nutrient deficiencies and talk about vitamin supplementation, as you won’t be eating whole grains, dairy, or fruit, and will eliminate many veggies. “A diet that eliminates entire food groups is a red flag to me. This isn’t something to take lightly or dive into headfirst with no medical supervision,” she says.

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.

Since the birth of my daughter 32 years ago, I have struggled with my weight. I remember when “fat free” was the only way to go. So for a year, I avoided fat like the plague and ended up with hair loss, gray dry skin and just an overall unhealthy look despite the fact I was at my healthy weight. Now we are suppose to eat massive amounts of fat according to the professionals. I have since learned that going from one of extreme to the other is not the answer and your blog has helped me to realize that I need to do what works for my body. It is as if you gave me permission to not listen to all the so called experts. I have started eating natural, If God made it I eat it. I no longer eat foods that come out of a box or that was created in a lab. I completely agree with your blog. Thanks for speaking out!

More recently, other hypothalamic appetite control regions have been identified, including those in the arcuate nucleus (ARC), the periventricular nucleus (PVN) and the dorsomedial hypothalamic nucleus (DMH) (Valassi et al., 2008). These are sites of convergence and integration of many central and peripheral signals, not just macronutrients, that are involved in food intake and energy expenditure mechanisms, e.g., a group of neurons in the ARC stimulating food intake via neuropeptide Y (NPY) and agouti gene-related protein (AGRP). These neurons interact with those producing the anorexigenic pro-opiomelanocortin (POMC) and the cocaine/amphetamine-regulated transcript (CART) (Williams et al., 2001). Thus, a more comprehensive, unified model should include macronutrients as well as many single amino acids and other signaling molecules.


Eat the right amount of protein. Too much protein can increase insulin levels and decrease ketone levels, while not consuming enough protein can cause you to burn muscle rather than fat. If you exercise, protein levels should be hovering around 0.8g – 1.0g protein per lean pound of body mass a day. This helps with muscle mass retention and growth. However, if you are not exercising – your protein intake doesn’t need to be as high. A protein intake of 0.6g – 0.8g of protein per lean pound of body mass is going to be fine for sedentary individuals.

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.


I tried keto last winter, but I focused too much on replicating the foods I could "no longer have". While it produced some results, it wasn't sustainable. Fast forward to the spring, and I was at my heaviest weight yet. Something had to change as I felt as though I was wasting my time being fat and unhappy (but with ice cream amiright?). So, I dove into keto again. This time, I focused more on natural foods rather than trying to remake the ones I couldn't have. This paired with intermittent fasting is the key to my success. I don't think I would have lost the weight as rapidly without IF.
Moreover, recent studies show that the Inuit have evolved a number of rare genetic adaptations that make them especially well suited to eat large amounts of omega-3 fat.[57][58][59] And earlier studies showed that the Inuit have a very high frequency—68% to 81% in certain arctic coastal populations—of an extremely rare autosomal recessive mutation of the CPT1A gene—a key regulator of mitochondrial long-chain fatty-acid oxidation[60][61]—which results in a rare metabolic disorder known as carnitine palmitoyltransferase 1A (CPT1A) deficiency and promotes hypoketotic hypoglycemia—low levels of ketones and low blood sugar.[62] The condition presents symptoms of a fatty acid and ketogenesis disorder.[62] However, it appears highly beneficial to the Inuit[60] as it shunts free fatty acids away from liver cells to brown fat, for thermogenesis.[63][64] Thus the mutation may help the Inuit stay warm by preferentially burning fatty acids for heat in brown fat cells.[64] In addition to promoting low ketone levels, this disorder also typically results in hepatic encephalopathy (enlarged liver) and high infant mortality.[65] Inuit have been observed to have enlarged livers with an increased capacity for gluconeogenesis, and have greater capacity for excreting urea to remove ammonia, a toxic byproduct of protein breakdown.[57][66][67][68] Ethnographic texts have documented the Inuit's customary habit of snacking frequently [69] and this may well be a direct consequence of their high prevalence of the CPT1A mutation[70] as fasting, even for several hours, can be deleterious for individuals with that allele, particularly during strenuous exercise.[57][70] The high frequency of the CPT1A mutation in the Inuit therefore suggests that it is an important adaptation to their low carbohydrate diet and their extreme environment.[57][60][70]
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.
Because tumor cells are inefficient in processing ketone bodies for energy, the ketogenic diet has also been suggested as a treatment for cancer.[58][59] A 2018 review looked at the evidence from preclinical and clinical studies of ketogenic diets in cancer therapy. The clinical studies in humans are typically very small, with some providing weak evidence for anti-tumour effect, particularly for glioblastoma, but in other cancers and studies, no anti-tumour effect was seen. Taken together, results from preclinical studies, albeit sometimes contradictory, tend to support an anti-tumor effect rather than a pro-tumor effect of the KD for most solid cancers.[60]
The ketogenic diet is usually initiated in combination with the patient's existing anticonvulsant regimen, though patients may be weaned off anticonvulsants if the diet is successful. There is some evidence of synergistic benefits when the diet is combined with the vagus nerve stimulator or with the drug zonisamide, and that the diet may be less successful in children receiving phenobarbital.[3]
So in the end, I ordered 1kg of pure BHB Magnesium from a supplier in China and I will be developing my own Ketone product with 30 servings as a lower price than all the competitors, and with more Magnesium, and Calcium in it than Sodium so that it tastes the best and actually helps with weight loss (which Magnesium is proven to do at the right amount). What the companies don’t tell you is that actually Sodium BHB is the cheapest, then Calcium BHB and then Magnesium BHB to source so I would be interested in knowing if what you wrote is actually true or just an excuse to make the product cheaper. Probably a mix of both.
I read your blog on the keto diet and at the end, I cried, because your story is amazing. I dieted all my life, from Atkins, Paleo, keto And Many other diets. I always thought losing weight, would make people love me more or be impressed by my weight lose. Finally at the age of 64, I realize I need to just love myself and not worry what others think of me. I Truely Thank You for your story , it is very inspiring I do follow the Clean Eating program now and do have my sugar fix once a week in celebration of my life, my happiness and mostly my health. I have never felt happier, then how I live my life now. Thank You for your inspiration.Pinterest .
A systematic review in 2018 looked at sixteen studies on the ketogenic diet in adults. It concluded that the treatment was becoming more popular for that group of patients, that the efficacy in adults was similar to children, the side effects relatively mild. However, many patients gave up with the diet, for various reasons, and the quality of evidence inferior to studies on children. Health issues include high levels of low-density lipoprotein (LDL), high total cholesterol, and weight loss.[23]
A survey in 2005 of 88 paediatric neurologists in the US found that 36% regularly prescribed the diet after three or more drugs had failed; 24% occasionally prescribed the diet as a last resort; 24% had only prescribed the diet in a few rare cases; and 16% had never prescribed the diet. There are several possible explanations for this gap between evidence and clinical practice.[33] One major factor may be the lack of adequately trained dietitians, who are needed to administer a ketogenic diet programme.[30]
Sorry, I guess I read your comment wrong. You are wondering what to do about sugar levels, weight, and enjoy life. Personally, I have found that eating mindfully and listening to YOUR body is your best resource. No diet can tell you what to do, only your body can do that. Do you feel good eating more carbs? Do you feel better eating less carbs? Do you feel better fasting or not? Your body will tell you what to do. Also, I want to ask, what is the reason for wanting to lose weight? Is it purely health? Have you had tests that tell you your health is bad? Sometimes we get stuck on a specific number for what we “want” to weigh, which actually has NOTHING to do with out health. I recommend the book, Health at Every Size if you want to learn more about that. All of us have a weight set point, and for some, that is higher..which may be hard to accept. If I were you, I would take the focus OFF of weight loss completely and focus on eating in a way that nourishes you and makes you feel good and happy. Life is too short to focus on what is “right” and “wrong.”
Including greens powder in your supplement regimen is an excellent way to boost your intake of nutrient-dense vegetable. Most greens powders come with a mixture of powdered plant-based nutrients from spinach, spirulina, chlorella, broccoli, wheatgrass and more that are all beneficial for health. Adding greens powder to your drinks, shakes, and smoothies is a good way to help optimise nutrition and promote fat loss, especially when on a keto diet.
Hey Alex, thanks for commenting and great to have you as a new listener! For this kind of thing, because it requires so going into detail, I'd suggest you book a consult with me by going to
It is true that, "The liver will make ketones from body fat, the fat you EAT, and from alcohol --- the ketone strips have no way of distinguishing the source of the ketones. So, if you test every day after dinner, and dinner usually contains a lot of fat, then you may very well test for large amounts of ketones all the time."This is why we recommend testing at the same time every day. The morning, before breakfast, is the best time because it will reflect what your body is doing, and not the previous meal. Unless someone tests negative in the morning, then we will recommend testing before bed.
More recently, other hypothalamic appetite control regions have been identified, including those in the arcuate nucleus (ARC), the periventricular nucleus (PVN) and the dorsomedial hypothalamic nucleus (DMH) (Valassi et al., 2008). These are sites of convergence and integration of many central and peripheral signals, not just macronutrients, that are involved in food intake and energy expenditure mechanisms, e.g., a group of neurons in the ARC stimulating food intake via neuropeptide Y (NPY) and agouti gene-related protein (AGRP). These neurons interact with those producing the anorexigenic pro-opiomelanocortin (POMC) and the cocaine/amphetamine-regulated transcript (CART) (Williams et al., 2001). Thus, a more comprehensive, unified model should include macronutrients as well as many single amino acids and other signaling molecules.
Recent studies indicate that mood disorders such as depression and anxiety can be linked to a range of physical changes in the brain, such as inflammation or change in gene expression71. Early results from animal studies have shown that ketosis could improve mood disorders, although the mechanism is still unclear. Rats fed exogenous ketones for several weeks showed reduced anxiety behaviours72. Similarly, endogenous and exogenous BHB alleviated depressive behaviour in mice subjected to stress73. This was found to be linked to altered epigenetic markers (modifications to DNA that affect the degree of gene expression) and an increased amount of brain derived neurotrophic factor (BDNF) in the brain. At this time, there are no trials investigating the effects of ketosis in human patients with mood disorders. 

Jump up ^ Fumagalli M, Moltke I, Grarup N, Racimo F, Bjerregaard P, Jørgensen ME, Korneliussen TS, Gerbault P, Skotte L, Linneberg A, Christensen C, Brandslund I, Jørgensen T, Huerta-Sánchez E, Schmidt EB, Pedersen O, Hansen T, Albrechtsen A, Nielsen R (September 2015). "Greenlandic Inuit show genetic signatures of diet and climate adaptation". Science. 349 (6254): 1343–7. Bibcode:2015Sci...349.1343F. doi:10.1126/science.aab2319. hdl:10044/1/43212. PMID 26383953.

Brain glucose and KB uptake was investigated in rats subjected to mild experimental ketonemia induced by 2 weeks on the KD or by 48 h fasting. To test this, researchers developed a carbon-11 labeled AcAc (11)C-AcAc for PET use. They found in rats that after 10 days of KD (11)C-AcAc brain uptake increased up to 8-fold, an increase comparable to those measured after 48 h of fasting (Pifferi et al., 2008).


Nutrient-sensitive neurons reacting to glucose but also to fatty acids (FAs) concentrations are present at many sites throughout the brain and may play a key role in the neural control of energy and glucose homoeostasis. Central administration of oleate, for example, inhibits food intake and glucose production in rats. This suggests that daily variations in plasma FA concentrations could be detected by the CNS as a signal that contributes to the regulation of energy balance (Moulle et al., 2014).

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 point of keto is to force your body to deplete its glucose (and the stored form, glycogen) so it will have to use body fat as a fuel source. It’s capable of making ketone bodies from your fat, which can replace glucose as an energy-storing molecule if necessary. To do that, you have to break apart fat molecules thus ‘burning’ the fat off. But here’s the thing: your body really really doesn’t want to run out of glucose. No glucose means starvation as far as it’s concerned—even if you're not feeling hungry, your body is still missing one of its key macronutrients. And when you’re (nutritionally) starving, your body will start to break down protein just to get those sweet, sweet carbs. Of course, you have a source of protein in your body already: your own muscles. “When in starvation mode, your body breaks down muscle in your body,” says Giancoli. “Ketosis is a way of trying to preserve that protein. It’s not ideal, but it’s your body’s way of saving you.”
I learned a long time ago not to be obsessed with diets for wt. loss. 3 weeks ago I reached a crisis with type II diabetes however and just knew I had to make drastic changes to get it under control. I found the keto diet to be the closest to an extreme decrease in carbs and decided to try it. I these 3 weeks my blood sugar has dropped from 175 to 300 down to 98 to 140. I’ve dropped my insulin from 4 short acting shots and one long acting each day to just the one long acting – and decreased that dose from 55 units to 30. Now I feel stuck on keto, but have the same issues with it that you speak of. Will be trying to tweak it as much as I can to satisfy tastes and convenience yet stay with better blood sugar control. Wt. loss would be nice, but not a main concern, lost 5 lbs so far, but may be just fluid as you say.

I also felt so much better. My body avhes and pains were i creasingly less i felt better, looked better and ate better. I didnt follow it to the tee though i ate low carbs and watched calories and fat intake and found that if i had a cheat day and ate carbs, i seeked to lose a few more pounds extra then normal. From your artical it sounds as though she really over did it on not eating carbs etc… maybe this is why your body reacted the way it did. I dont think thus should scare anyone away from Keto. I think each person needs to work keto diet the way they feel it works best for their body. I didnt monitor if I was in Ketosis or not., and I still lost weight fely great Nd my bloid work was awesome.
The metabolic theory states that the root cause of cancer is a defect in mitochondrial energy production or ‘an irreversible injuring in respiration’91. Once the cells ability to produce energy is compromised, this is hypothesised to lead to the subsequent accumulation of changes that make the cell cancerous92. A key change is decreased mitochondrial glucose metabolism in cancer cells. Cancer cells ferment glucose to lactate (which happens outside of the mitochondria) at a much higher rate than normal cells93, in a change called ‘The Warburg Effect.’ This implicates damage to the mitochondria and failure in energy production as a central process of cancer progression. 

Thanks for your comment. When I was reading this and you said. “I’ve been around this size all of my life” that says to me you are near your set point weight – the weight your body likes to be at. Is that maybe heavier than you would like? Perhaps. But does it mean you’re unhealthy? Certainly NOT!! Why do you feel the need to lose 50lbs? Is this a number you’ve made up in your head? A number you think you would feel better about yourself at?

About 20% of children on the ketogenic diet achieve freedom from seizures, and many are able to reduce the use of anticonvulsant drugs or eliminate them altogether.[3] Commonly, at around two years on the diet, or after six months of being seizure-free, the diet may be gradually discontinued over two or three months. This is done by lowering the ketogenic ratio until urinary ketosis is no longer detected, and then lifting all calorie restrictions.[45] This timing and method of discontinuation mimics that of anticonvulsant drug therapy in children, where the child has become seizure free. When the diet is required to treat certain metabolic diseases, the duration will be longer. The total diet duration is up to the treating ketogenic diet team and parents; durations up to 12 years have been studied and found beneficial.[9]
You’re funny. Why influence someone to not try something that works for so many people, just because you didnt like that it made you afraid to eat things. Come on, really? I recommend every single person interested in learning about this way of eating to do some actual research for themselves. Find credible sources. Dr. Stephen Phinney is a great source. He has a ton of science and research backing his statements up. I also recommend not knocking something until you try it for yourself and not believe all the fear inducing “opinions” you hear.
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.
The BBB, largely formed by the brain capillary endothelial cells, provides a protective barrier between the systemic blood and the extracellular environment of the CNS. Passage of FAs from the blood to the brain may occur either by diffusion or by proteins that facilitate their transport. Studies indicate that FATP-1 and FATP-4 are the predominant FA transport proteins expressed in the BBB based on human and mouse expression studies (Mitchell et al., 2011).

There are many ways in which epilepsy occurs. Examples of pathological physiology include: unusual excitatory connections within the neuronal network of the brain; abnormal neuron structure leading to altered current flow; decreased inhibitory neurotransmitter synthesis; ineffective receptors for inhibitory neurotransmitters; insufficient breakdown of excitatory neurotransmitters leading to excess; immature synapse development; and impaired function of ionic channels.[7]
I had the same experience as you with Keto. I lost over 40 lbs. but did not have any energy and I did not have the carefree enjoyment of my life with family, friends, or myself. Was not for me either. I still eat healthy as I am a critical care nurse and I workout 5-6 days a week. There is much less stress without Keto in my life and most definitely much more healthy foods and higher spirits! 🙂
The difference between ketosis and ketoacidosis is the level of ketones in the blood. Ketosis is a physiological adaptation to a low carbohydrate environment like fasting or a ketogenic diet. There are situations (such as treatment-resistant epilepsy) where ketosis can be beneficial to health. Ketoacidosis is an acute life-threatening state requiring prompt medical intervention; its most common form is diabetic ketoacidosis where both glucose and ketone levels are significantly elevated.

Wow! Amazing article. I don’t read blogs regularly, but I’ll be reading more of yours. I am on day 11 of a fast to get me into ketosis; 7 days bone broth and now on day-4 water only. Intentions are weight loss (10# down, 15# more to go) and immunity improvement/gut help. Planning 9 days of whey water, fermented veggies and mad probiotics when the water days are done (day 14?). After this fast I want to stay fat adapted, start training again and get down to 8% body fat. I believe you have cut that journey significantly with this article. Thank you.
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That’s what motivates most people to go keto. “It’s popular because in most cases it can produce very easy and effective weight loss — that’s the primary reason why people start it,” says Los Angeles–based Franziska Spritzler, RD, the founder of Low Carb Dietitian. There are some other researched benefits beyond weight loss, including possibly acting as a mood stabilizer in those with bipolar disorder (per a very small study in Neurocase) and lessening epileptic seizures (according to a study published in May 2016 in Epilepsy & Behavior).
A few variables were tested in conjunction with weight loss. One was initial insulin secretion, specifically to see if it had any affect on loss in each diet group. It did not. They had also checked a few genetic markers that were suspected to give dieters pre-dispositions to success either on low fat diets or low carb diets based on previous studies. However, genetics were shown to have no effect.
Thank you Jennifer for a great month. I feel so much better :) I haven’t worked out much at all but just listening to my body has made a huge difference. I noticed a difference the first week in that I no longer had that awful daily bloating. Plus because I am consuming more of the good fats, I no longer experience the sugar crashes and shaky feeling in between meals. What a game changer! Jaime W.
The day before admission to hospital, the proportion of carbohydrate in the diet may be decreased and the patient begins fasting after his or her evening meal.[18] On admission, only calorie- and caffeine-free fluids[36] are allowed until dinner, which consists of "eggnog"[Note 8] restricted to one-third of the typical calories for a meal. The following breakfast and lunch are similar, and on the second day, the "eggnog" dinner is increased to two-thirds of a typical meal's caloric content. By the third day, dinner contains the full calorie quota and is a standard ketogenic meal (not "eggnog"). After a ketogenic breakfast on the fourth day, the patient is discharged. Where possible, the patient's current medicines are changed to carbohydrate-free formulations.[18]
How it’s done: Warm up the LEVL or Ketonix meter by plugging it in. Blow into it and wait for the flashing light indicating it’s reading your acetone levels. The software or the color and speed of the flashing light would tell your reading: green for least acetone, red for most acetone, less flashing for less acetone per color, more flashing for more acetone per color.