A study with an intent-to-treat prospective design was published in 1998 by a team from the Johns Hopkins Hospital[20] and followed-up by a report published in 2001.[21] As with most studies of the ketogenic diet, no control group (patients who did not receive the treatment) was used. The study enrolled 150 children. After three months, 83% of them were still on the diet, 26% had experienced a good reduction in seizures, 31% had had an excellent reduction, and 3% were seizure-free.[Note 7] At 12 months, 55% were still on the diet, 23% had a good response, 20% had an excellent response, and 7% were seizure-free. Those who had discontinued the diet by this stage did so because it was ineffective, too restrictive, or due to illness, and most of those who remained were benefiting from it. The percentage of those still on the diet at two, three, and four years was 39%, 20%, and 12%, respectively. During this period, the most common reason for discontinuing the diet was because the children had become seizure-free or significantly better. At four years, 16% of the original 150 children had a good reduction in seizure frequency, 14% had an excellent reduction, and 13% were seizure-free, though these figures include many who were no longer on the diet. Those remaining on the diet after this duration were typically not seizure-free, but had had an excellent response.[21][22]
Increased Energy: Fat and ketone bodies can be utilized as a fuel source for nearly all of the cells in the body. Once the body begins to use ketones as its primary fuel source, there will be a noticeable increase in energy since you are avoiding the ups and downs associated with high-carbohydrate/high-glucose/high-insulin levels that result in feeling lethargic and tired throughout the day.
In the 1960s, medium-chain triglycerides (MCTs) were found to produce more ketone bodies per unit of energy than normal dietary fats (which are mostly long-chain triglycerides).[15] MCTs are more efficiently absorbed and are rapidly transported to the liver via the hepatic portal system rather than the lymphatic system.[16] The severe carbohydrate restrictions of the classic ketogenic diet made it difficult for parents to produce palatable meals that their children would tolerate. In 1971, Peter Huttenlocher devised a ketogenic diet where about 60% of the calories came from the MCT oil, and this allowed more protein and up to three times as much carbohydrate as the classic ketogenic diet. The oil was mixed with at least twice its volume of skimmed milk, chilled, and sipped during the meal or incorporated into food. He tested it on 12 children and adolescents with intractable seizures. Most children improved in both seizure control and alertness, results that were similar to the classic ketogenic diet. Gastrointestinal upset was a problem, which led one patient to abandon the diet, but meals were easier to prepare and better accepted by the children.[15] The MCT diet replaced the classic ketogenic diet in many hospitals, though some devised diets that were a combination of the two.[10]
Keto for Diabetes: The ketogenic diet can be an extremely effective therapeutic treatment for diabetes. Since type 2 diabetes is hallmarked by insulin resistance, a ketogenic diet may improve insulin-resistance, associated pathological state via the following: 1) lowering and stabilizing both blood glucose and insulin levels, 2) improving insulin sensitivity, and 3) providing an alternative fuel source through ketone production. Virta Health recently published a report showing patients could rapidly improve glycemic control through reductions in fasting blood glucose, HbA1c, and medication use after 10 weeks of treatment. Patients lost 7% of their body weight on average and reported less hunger. For more information, please visit our friends at Virta Health who are actively working with diabetics (https://www.virtahealth.com).
Take a multivitamin. “Because you are removing grains, the majority of fruit, some vegetables, and a significant amount of dairy from your menu, a multivitamin is good insurance against any micronutrient deficiencies,” says Jadin. Depending on what your individual overall diet looks like, Jadin says you might also need to add a calcium, vitamin D, and potassium supplement.
Kristin Parker is an American temporarily living in South Korea. Her role with Team Diet Doctor is customer service. If you have a question or a comment on our social media platforms, website or our Facebook group, she will likely be the one to answer you back! Kristin cooks for a family of four, including two hungry teenage sons. Her keto meal plan yields generous servings of substantial, hearty meals that they all like.

There exists great debate on how to quantify the macronutrient ratios and percentages for a traditional ketogenic diet. Despite numerous opinions, the common and ultimate objective is to develop a diet that is sustainable in achieving the desired outcome (i.e., a state of ketosis). As such, while it is suggested that 65–80% of the total calories come from fat, and 15–30% from protein, these numbers will be optimized according to every individual’s unique metabolic needs. For example, an individual who is trying to achieve a state of ketosis might have a different ratio of macronutrient requirements than someone who is using a ketogenic diet to improve their body composition. Once the body begins to use fat as its primary fuel source, metabolic “keto-adaptation” characterized by increased production of ketones takes place. It is important to note that there is no “optimal” level of ketosis, nor is there a standard macronutrient profile to achieve a ketogenic state, because factors such as activity level, body composition, and desired health and performance outcomes will influence these variables. Although individualized, Ketogenic.com currently offers a Keto Calculator that can help provide you with a starting point on your macronutrients.
Kristin Parker is an American temporarily living in South Korea. Her role with Team Diet Doctor is customer service. If you have a question or a comment on our social media platforms, website or our Facebook group, she will likely be the one to answer you back! Kristin cooks for a family of four, including two hungry teenage sons. Her keto meal plan yields generous servings of substantial, hearty meals that they all like.
Tracking protein is important for anyone who has adopted a ketogenic diet. Depending on activity level and other metabolic factors, some individuals may be able to tolerate more protein. As mentioned above, at a certain level protein can be glucogenic; so tailor it to your needs. However, we would say to lean towards more, not less, especially for older individuals trying to preserve muscle mass.
Diabetic Ketoacidosis: Diabetic ketoacidosis (DKA) is the variation of ketosis that is responsible for deterring society from considering the adoption of a keto diet for beginners. DKA occurs primarily in those suffering from Type 1 diabetes. The inability to secrete insulin prevents ingested carbohydrates (glucose) from entering our insulin-dependent cells (i.e., muscle and adipose tissue) as a substrate for energy production. Due to this induced cellular starvation, the body will begin to produce ketones at an uncontrolled rate.
Cognitive Enhancement: Ketones may be the preferred fuel source for the brain. Due to the brain’s preference to uptake and utilize ketones as fuel it is very common for individuals to report an increase in cognitive performance. This is even more common in individuals with some degree of insulin resistance, as their brain is likely unable to effectively utilize glucose as a sole fuel source due to the resistance.
The ketogenic diet is a medical nutrition therapy that involves participants from various disciplines. Team members include a registered paediatric dietitian who coordinates the diet programme; a paediatric neurologist who is experienced in offering the ketogenic diet; and a registered nurse who is familiar with childhood epilepsy. Additional help may come from a medical social worker who works with the family and a pharmacist who can advise on the carbohydrate content of medicines. Lastly, the parents and other caregivers must be educated in many aspects of the diet for it to be safely implemented.[5]
The ketogenic diet — a high-fat and very low carb eating plan — can be tough to start. After all, it’s likely a radical departure from the way you’re eating now (a typical standard American diet is high in carbohydrates and processed foods). But many people are trying the keto diet, which puts your body in a state of ketosis. That's what happens when your body’s carb-burning switch flips to a fat-burning one, a change that can cause weight loss and has even been credited with controlling type 2 diabetes, a small past study suggests. (1)
Quite simply, for the majority of people the answer is a resounding “yes!” Due to its high-fat nature, it is often perceived as a health risk, often deterring individuals from trying it. Despite this misconception, research has demonstrated that the ketogenic diet is safe for most people, providing you don’t have one of the following conditions (even if you have any of these conditions, the ketogenic diet may still be safe, but you would need to work very closely with your doctor):
The meal plan is designed to ensure you get three balanced, healthy meals a day that address fiber, satiation, and adequate protein intake. The greatest part of a ketogenic diet is the fact that it spares muscle loss, where a carb-based diet doesn’t. Weight lost in a high carb, calorie-restricted diet will often come both from muscle and fat, whereas with keto, you can burn fat without sacrificing muscle. This is referred to often as “body recomposition” and leaves you with a much more preferred physique after weight loss.

In order to maximize the benefits of a keto diet for beginners, self-experimentation to achieve an optimal level of ketosis is important. In addition to quantifying blood ketone levels, there are several biological changes that your body will experience to help identify a ketogenic state. These changes will be more robust for some, In contrast to the negative side effects often experienced while on other low-carbohydrate diets, a ketogenic state and “keto-adaptation” can elicit euphoric effects including:


The confusion between ketosis and ketoacidosis is a prominent reason why many individuals, particularly doctors, steer clear of the keto diet for beginners. It’s important to understand that these are two very DIFFERENT metabolic states. Ketoacidosis may occur in uncontrolled type 1 diabetics (DKA; diabetic ketoacidosis) due to insulin deficiencies. DKA is associated with both elevated blood glucose and ketone levels; due to little to no insulin production, blood glucose cannot enter insulin-dependent cells to be used for energy, and as such, cells become hungry, resulting in uncontrolled ketone production. In turn, a highly acidic environment is created that can have detrimental effects on an individual’s health, possibly resulting in death. It must be echoed that the ketogenic diet, which induces “nutritional” ketosis, is vastly different and should never be confused with DKA. To put this in perspective, a normal state of ketosis, as achieved via the keto diet for beginners may elevate ketones anywhere from 0.3–5mM, while DKA results in ketone levels of about 15mM or higher.
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When you’re eating the foods that get you there (more on that in a minute), your body can enter a state of ketosis in one to three days, she adds. During the diet, the majority of calories you consume come from fat, with a little protein and very little carbohydrates. Ketosis also happens if you eat a very low-calorie diet — think doctor-supervised, only when medically recommended diets of 600 to 800 total calories.
Infants and patients fed via a gastrostomy tube can also be given a ketogenic diet. Parents make up a prescribed powdered formula, such as KetoCal, into a liquid feed.[19] Gastrostomy feeding avoids any issues with palatability, and bottle-fed infants readily accept the ketogenic formula.[31] Some studies have found this liquid feed to be more efficacious and associated with lower total cholesterol than a solid ketogenic diet.[18] KetoCal is a nutritionally complete food containing milk protein and is supplemented with amino acids, fat, carbohydrate, vitamins, minerals and trace elements. It is used to administer the 4:1 ratio classic ketogenic diet in children over one year. The formula is available in both 3:1 and 4:1 ratios, either unflavoured or in an artificially sweetened vanilla flavour and is suitable for tube or oral feeding.[51] Other formula products include KetoVolve[52] and Ketonia.[53] Alternatively, a liquid ketogenic diet may be produced by combining Ross Carbohydrate Free soy formula with Microlipid and Polycose.[53]
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.
Fasting ketosis: Fasting ketosis, also referred to as starvation ketosis, played a major role in the development of the keto diet for beginners. The concept of fasting has been around for centuries and can be traced back to biblical times. By definition, fasting is the absence of caloric consumption for a period of time. This can range from several hours to several days and can have profound effects on the degree of ketosis. As the duration of the fasting increases, so does the production of ketones, and thus a deeper ketogenic state is obtained. As such, the mechanisms of ketone production are similar between fasting and dietary applications similar to keto diet for beginners, both of which result in lower and more stable levels of insulin and blood glucose accompanied by fat metabolism.
Rami co-founded Tasteaholics with Vicky at the start of 2015 to master the art of creating extremely delicious food while researching the truth behind nutrition, dieting and overall health. You can usually find him marketing, coding or coming up with the next crazy idea because he can’t sit still for too long. His favorite book is The 4-Hour Workweek and artist is Infected Mushroom.
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