When your body burns its stores of fat, it can be hard on your kidneys. And starting a ketogenic diet -- or going back to a normal diet afterward -- can be tricky if you’re obese because of other health issues you’re likely to have, like diabetes, a heart condition, or high blood pressure. If you have any of these conditions, make diet changes slowly and only with the guidance of your doctor.
Ketogenic diet (“keto” diet for short) is a catch-all term for any diet that pushes your body into the natural metabolic state of ketosis, which means burning fat for fuel instead of carbohydrates. Though there’s no set formula for keto, generally, the diet works by cutting back on carbohydrates, to about 20 g of net carbs to start, and replacing those with mostly fat and a moderate amount of protein, according to the popular website Keto Connect. Net carbs are the total number of carbs minus the fiber and sugar alcohols, according to the Atkins website. (More on this diet later.)
There are numerous benefits that come with being on keto: from weight loss and increased energy levels to therapeutic medical applications. Most anyone can safely benefit from eating a low-carb, high-fat diet. Below, you’ll find a short list of the benefits you can receive from a ketogenic diet. For a more comprehensive list, you can also read our in-depth article here >
Full disclosure: I have followed a low-carb diet for nearly a decade and find no problem adhering to it. I’ve lost weight and all my cardiovascular biomarkers have improved. Moreover, I’ve studied the science and history behind low-carbohydrate diets, so beyond my personal experience, I bring an evidence-based perspective. (Previously, for 25+ years, I adhered faithfully to a “mostly plants” regimen of fruits, veggies, and whole grains, including my own homemade 7-grain bread, while exercising religiously. Yet during that time my blood lipids were unhealthy, and I never could shake an extra 10-20 pounds.)
A small Feb. 20, 2017, study looked at the impact of a six-week ketogenic diet on physical fitness and body composition in 42 healthy adults. The study, published in the journal Nutrition & Metabolism, found a mildly negative impact on physical performance in terms of endurance capacity, peak power and faster exhaustion. Overall, researchers concluded, “Our findings lead us to assume that a [ketogenic diet] does not impact physical fitness in a clinically relevant manner that would impair activities of daily living and aerobic training.” The “significant” weight loss of about 4.4 pounds, on average, did not affect muscle mass or function.
One study from 2005 followed 22 people with Type 1 Diabetes for 12 months. The difference here however is they consumed 70-90 grams of carbohydrates per day versus the restrictive less than 20 grams per day on the Ketogenic Diet. Remember my motto? Moderation is the key! The results were positive; less hypoglycemia, insulin requirements were reduced and their A1c dropped from 7.5% to 6.4%.
The only books based on the most recent updated Mediterranean and DASH research, include the brand new, high flavor and high impact The DASH Diet Mediterranean Solution and the previous best seller The DASH Diet Weight Loss Solution, both of which can help you harness the health benefits of the DASH diet for weight loss. The DASH Diet Younger You, is pumped up on plants to help you become and look younger from the inside out. It fully supports both vegetarians and meat eaters (as does the Med-DASH book), with meal plans and recipes, and are based on real, unprocessed, and additive-free foods. The essential companion, The Everyday DASH Diet Cookbook will make a great addition to your kitchen collection. These books stand alongside the top DASH diet resource, The DASH Diet Action Plan, to give you a fresh start to healthy eating.
The "all meat all the time" low-carb approach or strict veganism can be great options for people who thrive on clear diet rules (and those two are actually the most popular diets out there) but these extremes are not for everyone. If you prefer more of a moderate approach, the Flexitarian diet is the clear winner. The "flexible vegetarian" mindset allows you a healthy balance of plant-based foods, responsibly sourced meats, and quality fats. The best part? It's not super restrictive, so you have plenty of nutritious food options. (Start here: How to Adopt a Flexitarian Diet)
A study with an intent-to-treat prospective design was published in 1998 by a team from the Johns Hopkins Hospital and followed-up by a report published in 2001. As with most studies of the ketogenic diet, there was no control group (patients who did not receive the treatment). 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 twelve 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.
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. Few adverse effects have been reported, though cholesterol is increased and the diet has not been studied long term. Although based on a smaller data set (126 adults and children from 11 studies over five centres), these results from 2009 compare favourably with the traditional ketogenic diet.
At your favorite Greek restaurant, order lamb souvlaki. Have a bar-of-soap-size amount of lamb (or chicken if you prefer) and a baseball-size amount of couscous or rice. Go ahead and eat all of the vegetables that come with your order, and if there is a salad, top it with 1 tablespoon of dressing. Package up the remaining lamb and rice or couscous for Sunday's lunch. Serve with 1/2 glass (2 ounces) of wine.
Ketones are frequently produced in healthy individuals–sometimes this is due to fasting (even just overnight), or as a result of eating a very low carbohydrate diet. With normal blood glucose levels, the ketone concentrations observed during ketosis are generally not harmful. The ketones are simply a byproduct of fatty acid metabolism, serving up an alternative energy source when glucose stores are low.
Though the ketogenic diet is quite safe and even beneficial for diabetics, there is sometimes a chance a patient can develop diabetic ketoacidosis. Anytime you change your body’s primary energy source from carbohydrates to fat, your blood becomes flush with those ketones we talked about. And, anytime there are too many ketones, there is a potential risk for developing ketoacidosis. However, this is most likely to occur in those with type 1 diabetes. It can still happen in individuals with type 2 diabetes, although is it quite rare.
Yancy WS Jr, Westman EC, McDuffie JR, Grambow SC, Jeffreys AS, Bolton J, Chalecki A, Oddone EZ, “A randomized trial of a low-carbohydrate diet vs orlistat plus a lowfat diet for weight loss,” Arch Intern Med. 2010 Jan 25;170(2):136-45. http://www.ncbi.nlm.nih.gov/pubmed/20101008?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum&ordinalpos=2.
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.
Over 8–10 mmol/l: It’s normally impossible to get to this level just by eating a keto diet. It means that something is wrong. The most common cause by far is type 1 diabetes, with severe lack of insulin. Symptoms include feeling very sick with nausea, vomiting, abdominal pain and confusion. The possible end result, ketoacidosis, may be fatal and requires immediate medical care. Learn more