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In Asia, the normal diet includes rice and noodles as the main energy source, making their elimination difficult. Therefore, the MCT-oil form of the diet, which allows more carbohydrate, has proved useful. In India, religious beliefs commonly affect the diet: some patients are vegetarians, will not eat root vegetables or avoid beef. The Indian ketogenic diet is started without a fast due to cultural opposition towards fasting in children. The low-fat, high-carbohydrate nature of the normal Indian and Asian diet means that their ketogenic diets typically have a lower ketogenic ratio (1:1) than in America and Europe. However, they appear to be just as effective.[54]

Insulin is a hormone that lets your body use or store sugar as fuel. Ketogenic diets make you burn through this fuel quickly, so you don’t need to store it. This means your body needs -- and makes -- less insulin. Those lower levels may help protect you against some kinds of cancer or even slow the growth of cancer cells. More research is needed on this, though.


At the start of a keto diet for beginners, it is not uncommon for an individual to experience rapid weight loss. This may concern some people, but it is worth noting that not ALL weight lost is body fat. When we lower our carbohydrate intake our insulin lowers, causing us to excrete more water. Additionally, reducing carbohydrate intake causes the body to break down glycogen stores (to initially maintain blood sugar levels); glycogen is the storage form of glucose that is located in our liver and skeletal muscle. The loss of both water and glycogen accounts for most of the weight loss in the first few days. Don’t be discouraged! Soon after, total body water and glycogen levels will balance out.
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.
Because people with type 2 diabetes are at an increased risk for cardiovascular disease, there’s a specific concern that the saturated fat in the diet may drive up LDL, or “bad,” cholesterol levels, and further increase the odds of heart problems. If you have type 2 diabetes, talk to your doctor before attempting a ketogenic diet. They may recommend a different weight-loss diet for you, like a reduced-calorie diet, to manage diabetes. Those with epilepsy should also consult their doctor before using this as part of their treatment plan.
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]
Detrimentally, this results in high levels of both ketones and glucose. Extremely high ketone levels in the blood will elicit a dangerous biological environment that can even result in death. It must be clarified that DKA is very different than nutritional ketosis or fasting ketosis; ketone levels cannot be produced at such high levels in healthy individuals as they are with those in DKA.
In 1994, Hollywood producer Jim Abrahams, whose son's severe epilepsy was effectively controlled by the diet, created the Charlie Foundation for Ketogenic Therapies to further promote diet therapy. Publicity included an appearance on NBC's Dateline program and ...First Do No Harm (1997), a made-for-television film starring Meryl Streep. The foundation sponsored a research study, the results of which—announced in 1996—marked the beginning of renewed scientific interest in the diet.[1]
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.
In addition, there are medical conditions that should make you think twice about starting keto — or at least talk to your doctor before trying it out. Those include people on insulin, as well as those on oral and noninsulin injectable medications for high blood sugar or high blood pressure, says Hultin. Even struggling with GI issues may be a barrier to starting. “One of the side effects of a ketogenic diet is constipation, so if that’s a struggle, there’s serious reason not to go on this relatively low-fiber diet,” says Hultin. Last consideration: If existing personal dietary restrictions require you to avoid foods like soy, eggs, nuts, dairy, or seafood, a ketogenic diet may be too limiting for you. Coming from a place of elimination in an already restrictive diet can make it incredibly tough to follow, she says.
Keto and Traumatic Brain Injury (TBI): Research involving TBI has found that upon immediate trauma to the head, the brain takes up massive amounts of glucose. However, soon thereafter, the brain becomes resistant to taking up and utilizing glucose. This damage leads to insulin resistance and inflammation of brain tissue. The anti-oxidative and anti-inflammatory properties of ketones have been shown to not only reduce inflammation but to reduce glucose uptake in the brain as well. The ketogenic diet may also be a therapeutic treatment option for those individuals who have experienced long-term ramifications of a TBI by providing ketones as an alternative fuel source that can be readily taken up and utilized by the brain following these traumas.
If you get pushback, announce: “I’ve done my research, I’ve figured out it’s safe, and I really want to try this,” recommends Mancinelli. They don’t have to like what you’re doing, but it does help if they have your back. In a study published in September 2014 research in Obesity, having the support of friends and coworkers helped dieters more successfully lose weight and maintain that loss over a two-year period. (4) It also can’t hurt if everyone knows your goals on a keto diet so they’re less likely to push office treats or suggest splitting a side of fries when you're out to dinner.

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]
When dietary carbohydrate is broken down into the energy substrate glucose, thereby raising blood glucose levels, the pancreas is stimulated to secrete insulin (the hormone that stores fat and inhibits ketone production). However, when carbohydrate intake is restricted, insulin remains suppressed, and the body’s primary fuel source shifts from glucose to fat, priming the body to enter a state of ketosis. When fat oxidation/breakdown is increased to a certain extent, ketones are made in the liver through a process known as ketogenesis (i.e., keto + genesis = ketone formation). When carbohydrate intake is restricted, blood glucose and insulin levels decrease, which allows fat stores to be broken down rapidly for energy. Most cells in the body can utilize either fatty acids or ketones for fuel, including the brain, which has shown to be more efficient in the presence of ketones rather than glucose.
Wondering how u eat veggies without going over your carbs n how do you get all the fats in. I’ve put the requirements into my fitness pal(macros) but I’m still not losing. Mine are set at 5% carbs 25% protein n 70% fats. Don’t know what I’m doing wrong. I’m allergic to gluten some dairy n eggs. Any help would be great so I can start losing instead of gaining
Normal dietary fat contains mostly long-chain triglycerides (LCTs). Medium-chain triglycerides (MCTs) are more ketogenic than LCTs because they generate more ketones per unit of energy when metabolised. Their use allows for a diet with a lower proportion of fat and a greater proportion of protein and carbohydrate,[18] leading to more food choices and larger portion sizes.[4] The original MCT diet developed by Peter Huttenlocher in the 1970s derived 60% of its calories from MCT oil.[15] Consuming that quantity of MCT oil caused abdominal cramps, diarrhea, and vomiting in some children. A figure of 45% is regarded as a balance between achieving good ketosis and minimising gastrointestinal complaints. The classical and modified MCT ketogenic diets are equally effective and differences in tolerability are not statistically significant.[9] The MCT diet is less popular in the United States; MCT oil is more expensive than other dietary fats and is not covered by insurance companies.[18]
A: The most common ways to track your carbs is through MyFitnessPal and their mobile app. You cannot track net carbs on the app, although you can track your total carb intake and your total fiber intake. To get your net carbs, just subtract your total fiber intake from your total carb intake. I have written an article on How to Track Carbs on MyFitnessPal.
For patients who benefit, half achieve a seizure reduction within five days (if the diet starts with an initial fast of one to two days), three-quarters achieve a reduction within two weeks, and 90% achieve a reduction within 23 days. If the diet does not begin with a fast, the time for half of the patients to achieve an improvement is longer (two weeks), but the long-term seizure reduction rates are unaffected.[44] Parents are encouraged to persist with the diet for at least three months before any final consideration is made regarding efficacy.[9]

Try Googling “TDEE Calculator”. Once you plug in your stats, the site will calculate your total daily energy expenditure. This is a useful guide in determining how many calories to eat. From there, if you are trying to lose weight, just reduce your caloric intake, increase your expenditure (through exercising more), or use a combination of the two.
When you eat less than 50 grams of carbs a day, your body eventually runs out of fuel (blood sugar) it can use quickly. This typically takes 3 to 4 days. Then you’ll start to break down protein and fat for energy, which can make you lose weight. This is called ketosis. It's important to note that the ketogenic diet is a short term diet that's focussed on weight loss rather than the pursuit of health benefits. 
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.

^ Freeman JM, Vining EP, Pillas DJ, Pyzik PL, Casey JC, Kelly LM. The efficacy of the ketogenic diet—1998: a prospective evaluation of intervention in 150 children. Pediatrics. 1998 Dec;102(6):1358–63. doi:10.1542/peds.102.6.1358. PMID 9832569. https://web.archive.org/web/20040629224858/http://www.hopkinsmedicine.org/press/1998/DECEMBER/981207.HTM Lay summary]—JHMI Office of Communications and Public Affairs. Updated 7 December 1998. Cited 6 March 2008.

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).
I have been eating this way (very low carb, high fat, protein in between) for around 3 years now. I have found that for me I can MAINTAIN quite easily at an ideal weight and eating to satiety, but in order to actually LOSE weight, I have to at least have a very small calorie deficit. And though the change is gradual, it is sustainable and quite immediate (just little by little). The amount of that calorie deficit required in order to drop excess varies a lot from one individual to the next though, I think. I am particularly intolerant to hunger, and so I cannot overly emphasize how small of a deficit I will allow for. The nice thing about that though is that the hunger is far more pleasant in the absence of carbs.
The ketogenic diet is a mainstream dietary therapy that was developed to reproduce the success and remove the limitations of the non-mainstream use of fasting to treat epilepsy.[Note 2] Although popular in the 1920s and '30s, it was largely abandoned in favour of new anticonvulsant drugs.[1] Most individuals with epilepsy can successfully control their seizures with medication. However, 20–30% fail to achieve such control despite trying a number of different drugs.[9] For this group, and for children in particular, the diet has once again found a role in epilepsy management.[1][10]
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Because some cancer cells are inefficient in processing ketone bodies for energy, the ketogenic diet has also been suggested as a treatment for cancer.[59][60] 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.[61]
When in the hospital, glucose levels are checked several times daily and the patient is monitored for signs of symptomatic ketosis (which can be treated with a small quantity of orange juice). Lack of energy and lethargy are common, but disappear within two weeks.[17] The parents attend classes over the first three full days, which cover nutrition, managing the diet, preparing meals, avoiding sugar, and handling illness.[19] The level of parental education and commitment required is higher than with medication.[44]
After initiation, the child regularly visits the hospital outpatient clinic where they are seen by the dietitian and neurologist, and various tests and examinations are performed. These are held every three months for the first year and then every six months thereafter. Infants under one year old are seen more frequently, with the initial visit held after just two to four weeks.[9] A period of minor adjustments is necessary to ensure consistent ketosis is maintained and to better adapt the meal plans to the patient. This fine-tuning is typically done over the telephone with the hospital dietitian[19] and includes changing the number of calories, altering the ketogenic ratio, or adding some MCT or coconut oils to a classic diet.[18] Urinary ketone levels are checked daily to detect whether ketosis has been achieved and to confirm that the patient is following the diet, though the level of ketones does not correlate with an anticonvulsant effect.[19] This is performed using ketone test strips containing nitroprusside, which change colour from buff-pink to maroon in the presence of acetoacetate (one of the three ketone bodies).[45]
Thank you so much for the wonderful recipes on your site. I have visited in the past and have happened upon it again. I noticed you put in the post that if anyone had questions that we could ask and so I have a big one that I need advice on if you don’t mind. I have been living low carb for about 2 years now. My weight has fluctuated from 130 to about 118. I am 5’4″ and female, 45 years old and mom to 5 children. My weight went up to 134 which is very uncomfortable to me because I have struggled with an eating disorder and so I really went low carb in an attempt to drop some weight. Well I have, but the problem is that I am restricting too many calories now. I have gotten down to 108 but know that 800 calories Is not enough. My question is about balance. I would not mind gaining some back but have a fear of gaining too much again. I don’t want to go back there. I hiit train most days for about 25 mins. I use to do way too much. Do you have a plan that would balance my calories out so I can incorporate more Low carb options/keto and start eating normal again. I like your ideas and thought process behind all you post so I would appreciate any feed back you could give to me. Thank ML
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