What's more, it's especially important to make sure your keto diet plan is well thought out when you're eating this way because the foods you can choose from are limited. In addition to checking in with a dietitian if you're able, Stefanski recommends that you "talk to your doctor and make sure she or he is aware that you'll be starting a diet that completely changes how your body metabolizes energy." You might also want to check your most recent bloodwork levels for things such as cholesterol, vitamin D, and other indicators of health because these can change while on keto. That's because, for some people, a prolonged keto diet can result in certain nutritional deficiencies or even high cholesterol. But most experts will tell you that the ketogenic diet is not a permanent lifestyle change (as could be the case for something like the 80/20 approach to eating or a Mediterranean eating style).
After increasing water intake and replacing electrolytes, it should relieve most all symptoms of Keto Flu. For an average person that is starting a ketogenic diet, eating 20-30g of net carbs a day, the entire adaptation process will take about 4-5 days. My advice is to cut your carbs to fewer than 15g to ensure that you are well on your way into ketosis within one week. If you are experiencing any more keto flu symptoms, double check your electrolyte intake and adjust.
After about two to seven days of following the keto diet, you go into something called ketosis, or the state your body enters when it doesn't have enough carbs for your cells to use for energy. That's when you start making ketones, or organic compounds that your bod then uses in place of those missing carbs. At this point, your body also starts burning fat for more energy, says Beth Warren, RD, founder of Beth Warren Nutrition and author of Living A Real Life With Real Food.
When you approach your normal body weight, the weight loss will slow. Just remember, a “normal” body weight differs from person to person depending on our genetics and environmental exposures and may not fit what we see in the popular media. The weight loss won’t go on forever. As long as you follow the advice to eat when you are hungry, you will eventually stabilize your weight.
Variations on the Johns Hopkins protocol are common. The initiation can be performed using outpatient clinics rather than requiring a stay in hospital. Often, no initial fast is used (fasting increases the risk of acidosis, hypoglycaemia, and weight loss). Rather than increasing meal sizes over the three-day initiation, some institutions maintain meal size, but alter the ketogenic ratio from 2:1 to 4:1.[9]
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. Several possible explanations exist for this gap between evidence and clinical practice.[34] One major factor may be the lack of adequately trained dietitians who are needed to administer a ketogenic diet programme.[31]

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.
Wilder's colleague, paediatrician Mynie Gustav Peterman, later formulated the classic diet, with a ratio of one gram of protein per kilogram of body weight in children, 10–15 g of carbohydrate per day, and the remainder of calories from fat. Peterman's work in the 1920s established the techniques for induction and maintenance of the diet. Peterman documented positive effects (improved alertness, behaviour, and sleep) and adverse effects (nausea and vomiting due to excess ketosis). The diet proved to be very successful in children: Peterman reported in 1925 that 95% of 37 young patients had improved seizure control on the diet and 60% became seizure-free. By 1930, the diet had also been studied in 100 teenagers and adults. Clifford Joseph Barborka, Sr., also from the Mayo Clinic, reported that 56% of those older patients improved on the diet and 12% became seizure-free. Although the adult results are similar to modern studies of children, they did not compare as well to contemporary studies. Barborka concluded that adults were least likely to benefit from the diet, and the use of the ketogenic diet in adults was not studied again until 1999.[10][14]

Because the ketogenic diet alters the body's metabolism, it is a first-line therapy in children with certain congenital metabolic diseases such as pyruvate dehydrogenase (E1) deficiency and glucose transporter 1 deficiency syndrome,[35] which prevent the body from using carbohydrates as fuel, leading to a dependency on ketone bodies. The ketogenic diet is beneficial in treating the seizures and some other symptoms in these diseases and is an absolute indication.[36] However, it is absolutely contraindicated in the treatment of other diseases such as pyruvate carboxylase deficiency, porphyria, and other rare genetic disorders of fat metabolism.[9] Persons with a disorder of fatty acid oxidation are unable to metabolise fatty acids, which replace carbohydrates as the major energy source on the diet. On the ketogenic diet, their bodies would consume their own protein stores for fuel, leading to ketoacidosis, and eventually coma and death.[37]


After increasing water intake and replacing electrolytes, it should relieve most all symptoms of Keto Flu. For an average person that is starting a ketogenic diet, eating 20-30g of net carbs a day, the entire adaptation process will take about 4-5 days. My advice is to cut your carbs to fewer than 15g to ensure that you are well on your way into ketosis within one week. If you are experiencing any more keto flu symptoms, double check your electrolyte intake and adjust.
As mentioned, there are a few reasons why the keto diet usually equals weight-loss gold, says Keatley. For starters, people usually reduce their daily caloric intake to about 1,500 calories a day because healthy fats and lean proteins make you feel fuller sooner—and for a longer period of time. And then there’s the fact that it takes more energy to process and burn fat and protein than carbs, so you're burning slightly more calories than you did before. Over time, this can lead to weight loss.
Now that ketogenic diets have become popular, many keto hybrid diets have sprung up, including plant-based versions. (One is “ketotarian,” which is predominantly plant-based but includes the option of eggs, ghee, and fish and shellfish.) While this approach can be healthy, Hultin cautions against trying keto as a vegan. “Because you can’t eat beans or lentils on a ketogenic diet, and nuts and seeds are even limited due to their carbohydrate content, you’re really just left with some tofu and will need to rely on low-carb protein powder,” she says. There is a good possibility this won’t pan out. “I don’t see this as a sustainable diet due to the extreme restrictions,” she says.
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.[18] Few adverse effects have been reported, though cholesterol is increased and the diet has not been studied long term.[48] Although based on a smaller data set (126 adults and children from 11 studies over five centres), these results from 2009 compare favorably with the traditional ketogenic diet.[18]

Achieving optimal ketosis hinges on finding the right balance of macronutrients (or “macros” in keto-speak); these are the elements in your diet that account for the majority of your calories, a.k.a. energy—namely, fat, protein, and carbohydrates. By the way, it’s often “net grams” of carbohydrates that are counted toward your daily intake; “net” deducts the amount of fiber in a food from its carbohydrate total.
If you’re looking to get a jump start on your health and fitness goals this year, you may be thinking about trying the ketogenic diet. Maybe you’ve heard the phrase before — it’s a huge diet buzzword — but aren’t sure what it means. Here’s a primer: The ketogenic diet is an eating plan that drives your body into ketosis, a state where the body uses fat as a primary fuel source (instead of carbohydrates), says Stacey Mattinson, RDN, who is based in Austin, Texas.
Yes, they're technically a fruit, but we think olives deserve a shout-out all of their own, since they're also a great source of healthy fats and are one of a few keto-approved packaged foods. Plus, they're a great source of antioxidants, will satisfy your craving for something salty, and are blissfully low-carb. “About a palm's worth only has 3 grams of net carbs,” Sarah Jadin, RD, told Health in a previous interview.
Everyone has to find their nutritional sweet spot for producing enough ketones and staying in ketosis, but “the core principle of the diet is to keep carbohydrate intake low enough, so your body continues producing ketones at elevated levels,” says Volek. “Your body adapts to this alternative fuel and becomes very efficient at breaking down and burning fat.”
Keto for Epilepsy: The ketogenic diet originated in the 1920s as an effective treatment for children suffering from drug-resistant epilepsy. Since then, its highly successful applications have expanded to treat adult epileptic patients as well. This was an important progression in treatment because, despite the introduction of anticonvulsant drugs in the 1930s, at least one third of patients suffering from epileptic seizures are still fully resistant to anticonvulsant drug therapy.[26] Early studies found that, when placed on a ketogenic diet, 12% of children suffering from epileptic seizures experienced full remission and 42% saw a reduction in seizures.[27]

As with other customized properties of the diet, the consumption of dairy is individualized. If digestive or glycemic problems develop due to the lactose and casein in dairy, then dairy may need to be avoided. If you can tolerate it, opt for lower carbohydrate dairy like cheese, heavy whipping cream, and butter, rather than higher carbohydrate products like milk.


I eat relatively healthy and fairly low carb (I am already gluten free). I am interested in getting into Ketosis for the the health benefits, but am quite thin for a guy and don’t want to lose any weight. I look at the sample diet above and am pretty sure I would drop weight quickly (I consume about 2,500+ calories daily now). I eat 3 meals plus 2-3 snacks (snacks mostly of nuts (with raisins that would have to go), greek yogurt (would switch to plain), peanut butter, cheese and fruit (would need to reduce qty)). Would eating straight up butter be ok for additional calories also once I am in Ketosis?

On a ketogenic diet, your entire body switches its fuel supply to run mostly on fat, burning fat 24-7. When insulin levels become very low, fat burning can increase dramatically. It becomes easier to access your fat stores to burn them off. This is great if you’re trying to lose weight, but there can also be other, less obvious benefits, such as less hunger and a steady supply of energy (without the sugar peaks and valleys we can get from high carb meals). This may help keep you alert and focused.


This article was reviewed by Jes Harvey, RD, on November 7, 2019. Harvey is a registered dietitian specializing in the ketogenic diet for children and adults. She is a certified specialist in Pediatric Nutrition and educates children with epilepsy on the ketogenic diet as an anti-seizure medication. Harvey also manages a private nutrition practice consulting adults on the ketogenic way of eating.
Physicians of ancient Greece treated diseases, including epilepsy, by altering their patients' diet. An early treatise in the Hippocratic Corpus, On the Sacred Disease, covers the disease; it dates from c. 400 BC. Its author argued against the prevailing view that epilepsy was supernatural in origin and cure, and proposed that dietary therapy had a rational and physical basis.[Note 3] In the same collection, the author of Epidemics describes the case of a man whose epilepsy is cured as quickly as it had appeared, through complete abstinence of food and drink.[Note 4] The royal physician Erasistratus declared, "One inclining to epilepsy should be made to fast without mercy and be put on short rations."[Note 5] Galen believed an "attenuating diet"[Note 6] might afford a cure in mild cases and be helpful in others.[11]
Meat products make up a big part of the keto diet, but experts stress the importance of choosing quality. "Since the keto diet is based a lot on animal proteins, it's important to buy organic poultry and grass-fed, organic beef," says Aimee Aristotelous, RD. "Not only do organic selections help with limiting environmental toxins, but grass-fed options of red meats even change the composition of fats." The result, she explains, is that your body is able to better absorb those healthy fats.
The Atkins diet and ketogenic diet are often used synonymously; however, they are different. While both diets lower carbohydrate consumption, the Atkins diet allows for a period in which both protein and carbohydrate intakes are increased (while fat intake is lowered) beyond what would classify as ketogenic. The goal of the ketogenic diet is to shift the body into utilizing fat/ketones as its primary fuel source. By doing so, the body creates a metabolic substrate called ketone bodies. However, due to the increase of both carbohydrates and protein as well as lowered intake of fat, the Atkins diet is metabolically different from a keto diet for beginners and often does not result in a consistent state of ketosis.
Breath Ketone Analysis: This method analyzes an individual’s breath to determine whether or not they are producing ketones, specifically, acetone. While this method has also been found to be an effective indicator, more research needs to be done to examine how this compares to blood testing. Studies investigating breath analyzers have found that these devices serve as a reliable indicator of ketosis.[19]
Implementing the diet can present difficulties for caregivers and the patient due to the time commitment involved in measuring and planning meals. Since any unplanned eating can potentially break the nutritional balance required, some people find the discipline needed to maintain the diet challenging and unpleasant. Some people terminate the diet or switch to a less demanding diet, like the modified Atkins diet or the low-glycaemic index treatment diet, because they find the difficulties too great.[42]
Blood Ketone Meter: Measuring ketone levels in the blood more accurately measures and indicates an individual’s metabolic state of ketosis. Similar to measuring blood glucose levels, this method also uses a blood meter and a chemo-sensitive strip made specifically to measure ketones in the blood called beta‑hydroxybutyrate (βHB). As with blood glucose measurements, a blood sample can be acquired from a finger prick. The ketone level displays on the meter within a few seconds of a sample placement on the strip.
This plan is very high on protein. I’ve learned that high healthy fat is what’s needed, not high protein.. as I am now kicked out of ketosis due to high protein intake (insulin’s fault). Given the fact i didn’t eat a bowl of salad per day (my tummy doesn’t digest salad well at all – i get bloated), but i do eat broccoli (i don’t get bloated from those strangely enough), cauliflower, asparagus, mushrooms… tomatoes (rarely, though). So, my question is… are you in ketosis following the menu you’ve presented? I’m 5 months into Keto and the last 3 weeks i am not in ketosis. My carb intake is 20-30g… but my protein is pretty high.
The best part of low carb eating is that you can still have rich, savory foods – dieting isn’t really a part of the lifestyle. Your body regulates your hunger naturally, so keeping your carbs low is the main concern. Being able to do that while still enjoying roast, fish, and big, healthy salads is what makes low carb so easy to stick with, and keep the weight off for good.
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Just because you're not eating all your fave carb-y foods, that doesn't mean you're going to go hungry. You'll be loading up on healthy fats (like olive oil and avocado), along with plenty of lean protein like grass-fed beef and chicken, and leafy greens or other non-starchy veggies. (Check out this printable keto diet grocery list, plus this additional comprehensive list of keto foods recommended by nutritionists, to get started.)

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.

Although studies have shown that the keto diet can reduce seizures for children with epilepsy, there is no evidence indicating that keto helps with other brain disorders or improves mental cognition, according to Harvard Health Publishing. Some studies show that keto may lower blood sugar for people with type 2 diabetes, but there is not enough long-term research to determine whether it’s safe and effective for diabetics.
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