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.
Lastly, if you're active, you might need to make some adjustments to take that into account. "For the first one to two weeks, temporarily reducing your exercise load can be helpful as your body adjusts to being in ketosis," he says. "Additionally, for those who have an intense workout schedule, carb cycling may be a good option." Carb cycling essentially means you'll increase your carb intake on the days you're doing exercise, ideally just two to three days per week. "While low-carb days may be around 20 to 30 grams of net carbs daily, high-carb days can range all the way up to 100 grams, although it can vary based on your size and activity level," says Dr. Axe. (Related: 8 Things You Need to Know About Exercising on the Keto Diet.)
Here’s what we do know: The keto diet may be useful in treating symptoms of epilepsy, a seizure disorder. “The use of keto in treating epilepsy has the most evidence,” Angelone says. One study conducted by Johns Hopkins Medicine, for example, followed epileptic patients on the keto diet and found that 36 percent of them had a 50 percent reduction in seizures after three months on the diet, and 16 percent were seizure-free. However, experts aren't entirely sure why the keto diet has this affect, she adds.
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]
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A keto diet should be moderately high in protein and will probably be higher in fat, since fat provides the energy that you are no longer getting from carbohydrate. However, too much dietary fat means your body won’t use body fat for energy. Adequate protein is important, but protein above what your body needs can also contribute to excess calories. Avoid low-fat diet products.

Conklin's fasting therapy was adopted by neurologists in mainstream practice. In 1916, a Dr McMurray wrote to the New York Medical Journal claiming to have successfully treated epilepsy patients with a fast, followed by a starch- and sugar-free diet, since 1912. In 1921, prominent endocrinologist Henry Rawle Geyelin reported his experiences to the American Medical Association convention. He had seen Conklin's success first-hand and had attempted to reproduce the results in 36 of his own patients. He achieved similar results despite having studied the patients for only a short time. Further studies in the 1920s indicated that seizures generally returned after the fast. Charles P. Howland, the parent of one of Conklin's successful patients and a wealthy New York corporate lawyer, gave his brother John Elias Howland a gift of $5,000 to study "the ketosis of starvation". As professor of paediatrics at Johns Hopkins Hospital, John E. Howland used the money to fund research undertaken by neurologist Stanley Cobb and his assistant William G. Lennox.[10]
Having too much protein: This is likely not an issue for most people, but for others having too much protein can negatively impact ketosis, due to its glucogenic effects. The level needed to achieve this is still unknown, but likely higher than we originally thought. To prevent this, try to eat whole foods as much as possible instead of isolated protein sources (i.e., straight protein shakes).
Carbohydrates have been linked to this skin condition, so cutting down on them may help. And the drop in insulin that a ketogenic diet can trigger may also help stop acne breakouts. (Insulin can cause your body to make other hormones that bring on outbreaks.) Still, more research is needed to determine exactly how much effect, if any, the diet actually has on acne. 

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.
Make things yourself. While it’s extremely convenient to buy most things pre-made or pre-cooked, it always adds to the price per pound on items. Try prepping veggies ahead of time instead of buying pre-cut ones. Try making your stew meat from a chuck roast. Or, simply try to make your mayo and salad dressings at home. The simplest of things can work to cut down on your overall grocery shopping.
One thing many people love about keto diet plans is that tracking your food is optional. "One of the biggest benefits of the ketogenic diet is that there's no need to meticulously track your calories as you may in other diets," notes Dr. Josh Axe, D.N.M., C.N.S., D.C., founder of DrAxe.com, best-selling author of Eat Dirt, and cofounder of Ancient Nutrition. "Because you're filling up on fat and protein, you're more likely to feel satisfied and energized all day long, which causes you to naturally eat less." This isn't to say that food tracking on a keto meal plan is discouraged. "Some people may find calorie counting a useful tool to be more mindful and aware of what they're eating, but it's not necessary on the ketogenic diet," says Dr. Axe, but there's no need to get too stressed about hitting a certain caloric goal, especially if you're not trying to lose weight. (Related: The #1 Reason to Stop Counting Calories)
By cutting carb intake significantly, we can drastically reduce insulin resistance, the precursor to type 2 diabetes. In addition, low carb diets, along with exercise, can be very effective at helping alleviate the symptoms and progression of type 2 diabetes. Beyond that, ketosis itself is appetite-suppressing, meaning your hunger will naturally check itself, increasing your caloric deficit and making you lose fat even faster. Read more about ketosis: What Is Ketosis, and How Long Does It Take to Get into Ketosis?
One thing many people love about keto diet plans is that tracking your food is optional. "One of the biggest benefits of the ketogenic diet is that there's no need to meticulously track your calories as you may in other diets," notes Dr. Josh Axe, D.N.M., C.N.S., D.C., founder of DrAxe.com, best-selling author of Eat Dirt, and cofounder of Ancient Nutrition. "Because you're filling up on fat and protein, you're more likely to feel satisfied and energized all day long, which causes you to naturally eat less." This isn't to say that food tracking on a keto meal plan is discouraged. "Some people may find calorie counting a useful tool to be more mindful and aware of what they're eating, but it's not necessary on the ketogenic diet," says Dr. Axe, but there's no need to get too stressed about hitting a certain caloric goal, especially if you're not trying to lose weight. (Related: The #1 Reason to Stop Counting Calories)
Thanks for trying to stick to the evidence! So often these “newer” diets and therapies are not fully researched and are of peoples opinions. As a physical therapist I try to keep up on what will help my patients. This article and website will be added to my resource list. It’s not possible to be the expert on everything, so thanks for putting out quality information.
A Cochrane systematic review in 2018 found and analysed eleven randomized controlled trials of ketogenic diet in people with epilepsy for whom drugs failed to control their seizures.[2] Six of the trials compared a group assigned to a ketogenic diet with a group not assigned to one. The other trials compared types of diets or ways of introducing them to make them more tolerable.[2] In the largest trial of the ketogenic diet with a non-diet control[16], nearly 38% of the children and young people had half or fewer seizures with the diet compared 6% with the group not assigned to the diet. Two large trials of the Modified Atkins Diet compared to a non-diet control had similar results, with over 50% of children having half or fewer seizures with the diet compared to around 10% in the control group.[2]
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]
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]
Note: Are you a vegetarian or vegan and want to go on a ketogenic diet? It’s still possible! Just keep in mind that the dietary restrictions can sometimes be a little bit intense. Make sure to plan ahead and prepare to aid your success. To help out, we’ve published articles (with 7 day meal plans included) for both the vegetarian ketogenic diet and the vegan ketogenic diet.
I have PCOS as well. Research a PCOS-specific diet. It often overlaps with Keto or Paleo recipes. But you have to also avoid holstein cow produced dairy products, red meat, pork, soy products (which are in almost every processed food) in addition to carbs and sugar. And absolutely avoid anything you can’t be sure doesn’t have extra hormones injected into it (like many mass-farmed meats). Vigorous exercise is also necessary to lose weight when you have PCOS (It’s much, much more difficult for us to lose weight than people with normal hormonal balances).

Keto for Cancer: Cancer is now being discussed as primarily a metabolic disease in which glucose can fuel its progression. Due to recent light shed on this subject, intensive investigations are underway and have begun to reveal that restricting carbohydrate intake can slow oncogenesis and that a full ketogenic-state may elicit even greater therapeutic benefits. Furthermore, research also suggests that fasting and the state of ketosis may increase the sensitivity of cancer cells to radiation and chemotherapy.
In the first week, many people report headaches, mental fogginess, dizziness, and aggravation. Most of the time, this is the result of your electrolytes being flushed out, as ketosis has a diuretic effect. Make sure you drink plenty of water and keep your sodium intake up.6One of the fathers of keto, Dr. Phinney, shows that electrolyte levels (especially sodium) can become unbalanced with low carb intake.

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]
It seems strange that a diet that calls for more fat can raise “good” cholesterol and lower “bad” cholesterol, but ketogenic diets are linked to just that. It may be because the lower levels of insulin that result from these diets can stop your body from making more cholesterol. That means you’re less likely to have high blood pressure, hardened arteries, heart failure, and other heart conditions. It's unclear, however; how long these effects last.
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.
The ketogenic diet may seem like the Jekyll to the Hyde-like low-fat craze of the 1990s. The bulk of current research finds that the middle ground between the two extremes is more beneficial for overall health. Make it easy for yourself: Eat at least two servings a week of fatty fish (salmon, sardines, mackerel) and cook with a variety of quality fats (olive oil, canola oil, avocado oil) throughout the week.
The answer to this question is often individualized and will depend on the metabolic state of each individual. One can enter a state of ketosis after an overnight fast. However, this slight elevation may not be high enough to allow for your body to efficiently utilize these ketones as a primary fuel source. Over time, as you become more adapted, your body will consistently be producing AND utilizing ketones. For some, this could take as little as one week, however, for others, it could take several weeks to accomplish. The length of time it takes to become keto-adapted also greatly depends on the composition of the ketogenic diet utilized (i.e., 20 grams versus 50 grams of carbohydrates per day) as well as personal activity level.
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.
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