A ketogenic diet for beginners
Here you’ll learn how to eat a keto diet based on real foods. You’ll find visual guides, recipes, meal plans and a simple 2-week get started program, all you need to succeed on keto.
1. Introduction: What is keto?
Make it simple to understand keto and do it right, using our video course above.
The entire course with all parts is available here. Alternatively, just keep reading below.
What “keto” means
The “keto” in a ketogenic diet comes from the fact that it makes the body produce small fuel molecules called “ketones”.2 This is an alternative fuel for the body, used when blood sugar (glucose) is in short supply.
Ketones are produced if you eat very few carbs (that are quickly broken down into blood sugar) and only moderate amounts of protein (excess protein can also be converted to blood sugar).
Ketones are produced in the liver, from fat. They are then used as fuel throughout the body, including the brain. The brain is a hungry organ that consumes lots of energy every day, and it can’t run on fat directly. It can only run on glucose… or ketones.3
On a ketogenic diet, your entire body switches its fuel supply to run almost entirely on fat. Insulin levels become very low, and fat burning increases dramatically. It becomes easy to access your fat stores to burn them off. This is great if you’re trying to lose weight, but there are also other less obvious benefits, such as less hunger and a steady supply of energy, keeping you alert and focused.
When the body produces ketones, it’s said to be in ketosis. The fastest way to get there is by fasting – not eating anything – but nobody can fast forever.
A keto diet, on the other hand, can be eaten indefinitely and also results in ketosis. It has many of the benefits of fasting – including weight loss – without having to fast.
A keto diet is normally very safe, but there are three groups that often require special consideration:
- Do you take medication for diabetes, e.g. insulin? More
- Do you take medication for high blood pressure? More
- Do you breastfeed? More
Are you a doctor or do you need your doctor to help you with medications on keto? Have a look at our low carb for doctors guide.
2. What to eat on a keto diet
Here are typical foods to enjoy on a ketogenic diet. The numbers are net carbs per 100 grams.4 To remain in ketosis, lower is generally better:
The most important thing for reaching ketosis is to avoid eating too many carbs. You’ll probably need to keep carb intake under 50 grams per day of net carbs, ideally below 20 grams. The fewer carbs, the more effective.
Counting carbs can be helpful at first. But if you stick to our recommended foods and recipes you can stay keto even without counting.
Try to avoid
Here’s what you should avoid on keto – foods containing a lot of sugar and starch. This includes starchy foods like bread, pasta, rice and potatoes. These foods are very high in carbs.
The numbers are grams of net carbs per 100 grams, unless otherwise noted.5
This means that on keto you’ll basically need to avoid sugary foods completely, as well as starchy foods like bread, pasta, rice and potatoes. Just follow our keto diet advice.
Furthermore, the food should primarily be high in fat, and only moderately high in protein (as excess protein can be converted to blood sugar in the body). A rough guideline is about 5% energy from carbohydrates (the fewer carbs, the more effective), 15-25% from protein, and around 75% from fat.6
What to drink
So what do you drink on a keto diet? Water is the perfect drink, and coffee or tea are fine too. Ideally, use no sweeteners, especially not sugar. A small amount of milk or cream in your coffee or tea is OK (but beware of caffe latte!). The occasional glass of wine is fine too.
Visual keto guides
For more on specific topics – like what fruits or nuts to eat on a ketogenic diet – check out our popular visual guides:
We have over 300 fantastic keto recipes. Below are a few popular examples:
Here are two weeks worth of recipes for breakfast, lunch and dinner on a keto diet:
Get 70+ prepared weekly keto meal plans, complete with all recipes, shopping lists and more, with our premium meal planner tool (free trial). Our prepared meal plans include vegetarian and dairy-free weeks, quick and easy weeks, etc.
Our meal planner includes the ability to change meals to any of our hundreds or recipes, skip meals, or even construct your own keto meal plans from scratch, using our recipes, and share them.
How low carb is keto?
The fewer carbs you eat, the more effective it is for weight loss, appetite suppression and type 2 diabetes reversal, etc. A keto diet is a very strict low-carb diet, containing less than 20 grams of net carbs per day, and thus it is highly effective.
Here are three possible examples of how low-carb meals can look, based on how many carbs you aim to eat in a day. Note that only the left plate is reliably ketogenic:
We recommend starting out by following the dietary advice as strictly as you can. When you’re happy with your weight and health, you could carefully try eating a few more carbs (if you want to). Learn more
For everything you need to get started – meal plans, shopping lists, daily tips and troubleshooting – just sign up for our free 2-week keto low-carb challenge.
Here’s our folder with basic keto advice. Feel free to print it out, put it on your fridge, or give it to your curious friends:
Keto advice in 40 languages
- Brazilian Portuguese
- Bulgarian (different version)
- Chinese, Chinese (Taiwan)
3. Why eat keto – the benefits
The benefits of a keto diet are similar to those of other low-carb diets, but it’s more powerful than liberal low-carb diets. Think of keto as a super-charged low-carb diet, maximizing the benefits.
Turning your body into a fat-burning machine has obvious benefits for weight loss. Fat burning is vastly increased, while insulin – the fat-storing hormone – levels drop greatly. This creates ideal circumstances in which fat loss can occur, without hunger.
More than 30 high-quality scientific studies show that, compared to other diets, low-carb and keto diets result in more effective weight loss.7
On keto you’ll gain a new control over your appetite. When your body burns fat 24-7, it has constant access to weeks or months of stored energy, dramatically reducing feelings of hunger. It’s a very common experience, and studies prove it.8
This makes it easy to eat less and lose excess weight – just don’t eat until you’re hungry. This makes intermittent fasting easy, super-charging efforts to reverse type 2 diabetes and speeding up weight loss. Plus, you’ll save tons of time and money by not having to snack all the time. Many people only feel the need to eat twice a day (often skipping breakfast), and some just once a day.
Not having to fight feelings of hunger can also potentially help with problems like sugar or food addiction, and possibly some eating disorders, like bulimia, as well. At least feeling satisfied can be part of the solution. Food can stop being an enemy and become your friend – or simply fuel, whatever you prefer.
Constant energy and mental performance
Ketosis results in a steady flow of fuel (ketones) to the brain, and you avoid big blood sugar swings. This often results in the experience of improved focus and concentration. Any brain fog will be long gone!
A lot of people use keto diets specifically for increased mental performance. Also, many people experience an increase in energy when in ketosis.
On keto, the brain doesn’t need carbs. It’s fueled 24-7 by ketones, a perfect brain fuel for focus and energy.
A keto diet controls blood sugar levels, and is excellent for reversing type 2 diabetes. This has been proven in studies.9 It makes perfect sense since keto lowers blood-sugar levels and reduces the negative impact of high insulin levels.
As a keto diet may even reverse existing type 2 diabetes, it’s likely to be even more effective at preventing it, or reversing pre-diabetes.
These commonly improved markers are connected to something called “metabolic syndrome”, and improvements in weight, waist circumference, diabetes type 2 reversal etc.
Keto can result in a calmer stomach, less (or no) gas, less cramps and pains, etc.
For quite a few people this is the top benefit, and it usually only takes a day or two to experience it. Learn more
Keto diets can vastly increase your physical endurance by giving you constant access to all the energy of your fat stores.
The body’s supply of stored carbohydrates (glycogen) only lasts for a couple of hours of intense exercise, or less. But your fat stores carry enough energy to easily last for weeks or even months.
The keto diet is a proven and effective medical therapy for epilepsy that has been used since the 1920s. Traditionally it was used primarily for children, but recently adults have benefited from it as well.
Using a ketogenic diet in epilepsy can allow people to take less or no anti-epileptic drugs, while still remaining seizure-free. This reduces drug side effects and thus increases mental performance. More
More possible benefits
The benefits above are the most common ones. But there are others that are potentially even more surprising and – at least for some people – life changing. Did you know that low carb often normalizes blood pressure, results in less acne, controls migraine, might help with certain mental health issues and helps with a lot more?
Follow the links below for more knowledge, stories and science:
Other potential benefits
There’s even science-based speculation that a keto diet could increase longevity and help treat or reduce the risk of cancer.11 It’s also being used as an experimental treatment for some people with Parkinson’s disease12.
We’re always happy to receive stories from people who’ve used a keto diet to revolutionize their health. We’ve been sent thousands of such stories, and we publish some of the most amazing ones – over 250 so far – for anyone to read.
Here are a few of them:
4. How to get into ketosis
- Restrict carbohydrates to 20 digestible grams per day or less – a strict low-carb diet. Fiber does not have to be restricted, it might even be beneficial.13
How much is 20 grams of carbs? Use our visual guide to find out. Or simply use our keto recipes and meal plans, they are designed to keep you under 20 grams with no counting required.
Note that quite often, just restricting carbs to very low levels results in ketosis. So this may be all you need to do. But the rest of the list below will help make sure that you’re successful.
- Restrict protein to moderate levels. On a keto diet you should eat the protein you need, but not much more. This is because excess protein is converted to glucose in the body, reducing ketosis.
If possible, stay at or below 1 gram of protein per day, per kg of body weight – about 70 grams of protein per day if you weigh 70 kilos (154 pounds).14
The most common mistake that stops people from getting into ketosis is too much protein. Our keto recipes are designed with the right amount of protein.
- Eat enough fat to feel satisfied.15 This is the big difference between a keto diet and starvation, that also results in ketosis. A keto diet is sustainable, whereas starvation is not.
When starving you’re likely to feel tired and hungry and give up, but a keto diet is sustainable and can make you feel great. So eat enough to feel satisfied, and if you’re hungry all the time, you should probably add more fat to your meals (like more butter, more olive oil, etc.). Our keto recipes have the needed fat included.
- Avoid snacking when not hungry. Eating more often than you need, just eating for fun and because there’s food around, reduces ketosis and slows down weight loss. Though using keto snacks will minimize the damage, and is fine when you’re hungry.
- If necessary, add intermittent fasting. For example, skip breakfast and only eat during 8 hours of the day, fasting for 16 hours (i.e. 16:8 fasting) . This is very effective at boosting ketone levels, as well as accelerating weight loss and type 2 diabetes reversal. It’s also usually easy to do on keto.
- Add exercise – adding any kind of physical activity while on low carb can increase ketone levels moderately. It can also help speed up weight loss and diabetes type 2 reversal slightly. Exercise is not necessary to get into ketosis, but it may be helpful.
- Sleep enough – for most people at least seven hours per night on average – and keep stress under control. Sleep deprivation and stress hormones raise blood sugar levels, slowing ketosis and weight loss a bit. Plus they make much it harder to stick to your chosen diet, and resist temptations. So while handling sleep and stress will not get you into ketosis on it’s own, it’s still worth thinking about.
Should you need to increase the effect, implement more steps from the list above, starting from the top.
No products required
Note what’s not on the list above: you likely do not need fancy expensive supplements, like MCT oil or ketone supplements. These supplements will in all likelihood not help you lose weight or reverse disease, there’s no evidence for that.
Ketone supplements for example, do not lower insulin or blood sugar, and they do not increase fat burning. Thus they hardly help with weight loss or type 2 diabetes reversal.
So people saying that – despite the lack of scientific support – likely have a financial reason to say it. Some of these products are sold under something like a multi-level marketing arrangement, so sales people are entirely paid based on commission.16 Thus they’ll likely tell you that their product is fantastic and has changed their lives and makes you lose weight etc., just like any other miracle supplement in the world. But that’s hardly true. Take all such stories with a grain of salt.
All these ketone supplements might do is possibly improve mental and physical performance for a short time. They do raise blood levels of ketones, an effect that can last for one up to a few hours.
So… I’m not saying don’t buy these supplements, perhaps you do want to try them for yourself, see how they make you feel. But you don’t need them to be successful on keto. And they are probably, for most people, a waste of money. Here’s our big test of keto supplements:
5. How to know you’re in ketosis
How do you know if you’re in ketosis? It’s possible to measure it by testing urine, blood or breath samples. But there are also telltale symptoms, that require no testing:
- Dry mouth and increased thirst. Unless you drink enough and get enough electrolytes, like salt, you may feel a dry mouth. Try a cup of bouillon or two daily, plus as much water as you need. You may also feel a metallic taste in your mouth.
- Increased urination. A ketone body, acetoacetate, may end up in the urine. This makes it possible to test for ketosis using urine strips. It also – at least when starting out – can result in having to go to the bathroom more often. This is the main cause of the increased thirst (above).
- Keto breath. This is due to a ketone body called acetone escaping via our breath.17 It can make a person’s breath smell “fruity”, or similar to nail polish remover. This smell can sometimes also be felt from sweat, when working out. It’s often temporary. Learn more
Other, less specific but more positive signs include:
- Reduced hunger. Many people experience a marked reduction in hunger.18 This may be caused by an increased ability of the body to be fueled by its fat stores. Many people feel great when they eat just once or twice a day, automatically ending up doing a form of intermittent fasting. This saves both time and money, while also speeding up weight loss.
- Increased energy. After a few days of feeling tired (the “keto flu“) many people experience a clear increase in energy levels. This can also be experienced as clear thinking, a lack of “brain fog” or even a sense of euphoria.
There are three ways to measure for ketones, which all come with pros and cons:
Urine strips are the simplest and cheapest way to measure ketosis. It is the first option for most beginners.
Dip the strip in your urine, and 15 seconds later the color change will show you the presence of ketones.19 If you get a high reading (a dark purple color), you’ll know that you’re in ketosis.
Pro: Ketone strips are available in regular pharmacies or via Amazon, and they’re very cheap. A strongly positive test reliably proves that you’re in ketosis.
Con: Results can vary depending on how much fluid you drink.20 The strips don’t show a precise ketone level. Finally, and most importantly, as you become increasingly keto-adapted and your body reabsorbs ketones from the urine, urine strips may become unreliable, even if you’re in ketosis.21 Thus, the test may sometimes stop working – always showing a negative result – when you’ve been in ketosis for several weeks.
2. Breath-ketone analyzers
Breath-ketone analyzers are a simple way to measure ketones22 in your breath. At $169 and up they are more expensive than urine strips. But they are cheaper than blood-ketone meters in the long run, as they are reusable any number of times.
These analyzers do not give you a precise ketone level when used on their own, but provide a color code for the general level.23 You can also hook it up to a computer or mobile phone (newer models) and get an exact ketone number via the app. Research shows that the device gives a decent correlation with blood ketones in most situations.
Pro: Reusable, simple test.
Con: Does not always correlate well with blood ketones. Not always accurate, and can in some situations show entirely misleading values.24 More expensive than urine strips, and higher cost upfront than a blood meter.
Blood-ketone meters show an exact and current level of ketones in your blood.25 They are the gold standard and the most exact way to measure your ketosis level. The major disadvantage, however, is that they are quite expensive, formerly at least $2 per test.26
Now a new startup, called Keto-Mojo, is offering blood ketone testing for as little as $1 per test. Early reviews are positive, and if you’re concerned about the price of testing, we recommend using the Keto-Mojo meter.
GOOD: Exact, reliable.
BAD: Still expensive (at least $1 per test). Requires pricking your finger for a drop of blood.
How to reach optimal ketosis
Getting into ketosis is not a black or white thing. It’s not like you’re either in ketosis, or out of ketosis. Instead, you can be in different degrees of ketosis, as this chart demonstrates.27 The numbers below refer to values when testing blood ketone levels.
- Below 0.5 mmol/l is not considered “ketosis”, although a value of, say, 0.2 demonstrates that you’re getting close. At this level, you’re still far away from maximum fat-burning.
- Between 0.5 – 1.5 mmol/l is light nutritional ketosis. You’ll be getting a good effect on your weight, but perhaps not optimal.
- Around 1.5 – 3 mmol/l is called optimal ketosis and is recommended for maximum mental and physical performance gains. It also maximizes fat burning, which can increase weight loss.
- Over 3 mmol/l is higher than necessary. It will achieve neither better nor worse results than being at the 1.5–3 level. Higher numbers can also sometimes mean that you’re not getting enough food (“starvation ketosis”). For type 1 diabetics, it can be caused by a severe lack of insulin that requires urgent attention.28
- 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.29 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
Here are the three reports from a 2-month experiment in reaching optimal ketosis:
- Experiment: Optimal ketosis for weight loss and increased performance
- Four weeks of strict LCHF and ketone monitoring
- Final report: Two months of strict LCHF and ketone monitoring
Do I have to reach optimal ketosis to experience the benefits?
In short, no. Many of the benefits, such as weight loss, are experienced at lower levels of ketosis (above 0.5).
However, you might need to reach higher levels of ketosis for high-level physical performance. There’s also a time element involved, it takes weeks or even a few months for the body to adapt completely.30
Learn keto from the experts
6. Keto guides
Keto can be really simple, but it helps to learn some basic new skills. How do you prepare easy and enjoyable meals, like keto breakfasts? Have you shunned fat for years and don’t know how to get more in your diet? How do you eat out and still stay keto?
These tips and guides will help you get new skills and answer all the common keto questions.
Have you been told that “breakfast is the most important meal of the day”? Ignore that! If you are not hungry when you wake up, feel free to skip breakfast or just have a cup of coffee. Reduced hunger is common on keto, so don’t worry about skipping any meal.
If you are hungry when you wake up but are short on time, many keto breakfasts are tasty, filling and fast. All keto breakfasts
Hmmm, what to eat for lunch or dinner? Daily meal planning can be as simple as meat, fish or chicken mains with a salad, or vegetable side – with melted butter, cheese, or a yummy full-fat sauce. We have hundreds of choices for delicious keto meals
Many people believe that keto is expensive, and it can be. After all, good quality food is often more costly than cheaper and unhealthier options. But there are many ways to make keto cheap, and in this guide you’ll learn all about it
For decades we have been told, wrongly, to fear fat. Now we know fat is satiating, healthy and makes food taste great.
Do you need tips and tricks for how to add fat back into your food? And just how much fat do you need each day? Tip: if you are constantly feeling hungry on a keto diet, eat more fat.
Bread is one of the most common things that people may miss on a keto diet. But fear not, there are plenty of good bread options that are very low in carbs, and that can be eaten even on a keto diet. Learn more
How do you eat keto at buffets, at a friend’s house or at fast-food restaurants? Avoid the starchy foods (like bread or pasta) and ask for additional natural fat, like butter or olive oil, if you need it. Learn more
To cheat or not to cheat? This guide will help you decide, and if you do decide to cheat, it will help you do it smarter
Another common mistake on a keto diet is being fooled by the creative marketing of special “low-carb” products. Remember: An effective keto diet for weight loss should be based on real food.
Low-carb products like chocolate, candy, pasta and bread often use all kinds of deceptive marketing, while being just junk food – including carbs – in disguise. Learn more
Do you want more keto guides? We have more keto guides!
7. Potential side effects of ketosis
When you suddenly switch your body’s metabolism from burning carbs (glucose) to fat and ketones you may have some side effects as your body gets used to its new fuel.
Symptoms can include headache, tiredness, muscle fatigue, cramping and heart palpitations. These symptoms are mild and short-lived for most people. Many feel fantastic right away, and if not, there are ways to minimize or cure any side effects.
Another option to reduce potential side effects is to gradually decrease your consumption of carbs over a few weeks. But with a slower start you’ll likely not see as dramatic results or feel the positive benefits as strongly.
Therefore we recommend you stop sugar and starches all at once. You will likely lose a number of pounds within days. While some of the initial rapid weight loss is water weight (reduced swelling), it’s still a highly motivating and inspiring way to start your keto journey.
Keep reading for more about common side effects and how to handle them.
Almost everyone who starts a keto diet will experience some symptoms of the “keto flu“. This is what you may feel, more or less, a couple of days into a keto diet:
- Light nausea
- Difficulty focusing (“brain fog”)
- Lack of motivation
These initial symptoms – should you experience them – usually disappear within a week, as your body adapts to increased fat burning.
The cause of the keto flu is that carb-rich foods can result in water retention (swelling) in the body. When you start a low-carb diet much of this excess fluid is lost. You may notice increased urination, and with that some extra salt is lost too.
This can result in dehydration and a lack of salt, before your body adapts. That’s the reason behind most of the symptoms of the keto flu.
You can reduce or even eliminate these symptoms by making sure you get enough water and salt. One simple way to do this is to drink a cup of bouillon or broth, 1-2 times per day.
More common keto side effects
Apart from the keto flu, there are five more relatively common side effects. They can also be avoided to a large extent, by making sure you get enough water and salt.
Beyond that, there are more specific treatments for all of these issues:
Less common keto side effects
These side effects only affect a small minority of people on a keto diet, and there are ways to handle them:
Most side effects of keto are minor and temporary. But there are a lot of myths, that scare people. Like the idea that your brain will cease functioning unless you eat lots of carbs. It’s a myth, based on a lack of understanding of the way the body works in ketosis (switching the fuel supply of the brain to ketones. Learn more
Another common mistake is mixing up normal ketosis – resulting from a keto diet – with the dangerous medical emergency ketoacidosis. They are two very different things. Ketoacidosis does not happen just from eating a keto diet.31
8. Keto Q&A, troubleshooting and resources
There are many common questions about keto, and we do our best to answer them all. Feel free to check out our full keto FAQ, or choose one of the questions below:
How much weight will I lose on keto?
Results vary widely. Most people lose 2-4 pounds (1-2 kg) during the first week. This is partially water weight. After this it’s common to lose about 1 pound (0.5 kg) of excess fat weight per week. However, some lose much faster (often younger men), some a bit slower (often women over 40).
You can speed up the process or break a weight loss plateau by following our top tips.
When you approach your normal body weight, the weight loss will slow. As long as you eat when you’re hungry you’ll eventually stabilize your weight even if you stay on a keto diet.
How do I track my carb intake?
If you want to count carbs exactly, the most popular way is with apps like MyFitnessPal or Chronometer.
What happens after I reach my health and weight goals on keto?
Once you reach your goals you can either keep eating keto (to maintain the effect), or you can try adding a bit more carbs. In the latter case the effect of the keto diet will be slightly weaker, and you may or may not regain some weight.
If you completely revert to your old habits, you’ll slowly return to the weight and health situation you had before. It’s like exercising – if you stop doing it, you’ll slowly lose the benefits. As you may expect, keto, like exercise, only works when you do it.
Further questions and answers
- Is a keto diet safe?
- How do you know when your body is in ketosis?
- What foods can you eat on a keto diet?
- Is a keto diet safe for the kidneys?
- What can you drink on the keto diet?
- Can I have fruit on a keto diet?
- What is a keto diet?
- What is ketosis?
Resources to learn more
Get free video courses, keto recipes and news updates like over 500,000 people:
Here are a few of our hundreds of keto TV videos, these ones are focussed on keto basics:
Do you want to meet other low-carb and keto fans and experts? Here’s an updated list of upcoming low-carb and keto events around the world
For more low-carb and keto sites, check out our recommended sites.
The Art and Science of Low-Carbohydrate Performance by Stephen Phinney and Jeff Volek.
Do you have any suggestions on how to improve this page about keto diets? Anything that is unclear or wrong? Any important information missing? Please let us know in the comments below.
Scientific studies now prove that compared to other diets, low carb or keto is more effective. Here are two of the top studies showing more weight loss and improvements in health markers on low carb or keto:
- New England Journal of Medicine 2008: Weight loss with a low-carbohydrate, mediterranean, or low-fat diet
- Annals of Internal Medicine 2014: Effects of Low-Carbohydrate and Low-Fat Diets: A Randomized Trial
Similar results have been found in meta-analyses of all studies, for example this recent analysis:
Here are many more studies on the topic:
Hundreds of success stories that people have sent us: keto success stories
It’s safe to say that millions have experienced the potential benefits, as strict low-carb diets have been popular all over the world for decades, if not more.
There are three different ketones, or “ketone bodies” used as fuel by the body. They are:
Learn far more than you’ll ever need about ketones here:
The brain consumes about 20% of the body’s required energy every day, despite only representing 2% of the body’s mass.
A good bonus for weight loss, if you can get your hungry brain to burn fat for you, 24-7.
Net carbs per 100 grams, i.e. what percentage of that food that is made up of digestible carbs.
100 grams = 3.5 ounces.
Net carbs (or “digestible carbs”) are total carbs minus fiber. Fiber is OK to eat since it doesn’t affect blood sugar levels. ↩
Net carbs per 100 grams, i.e. what percentage of that food that is made up of digestible carbs.
100 grams = 3.5 ounces.
Net carbs (or “digestible carbs”) are total carbs minus fiber. Fiber is OK to eat on keto, since it doesn’t affect blood sugar levels. ↩
Younger, fit people who exercise a lot may be able to tolerate a bit more protein than this, and still stay in ketosis. ↩
Randomized controlled trials, the gold standard of scientific research on diet and health.
This has been shown in many studies. Here are two examples:
- Volek J, et al. Carbohydrate Restriction Improves the Features of Metabolic Syndrome. Journal of Nutrition and Metabolism, 2005.
- Bazzano L, et al. Effects of Low-Carbohydrate and Low-Fat Diets: A Randomized Trial. Annals of Internal Medicine, 2014.
Here are a couple of pilot studies where a ketogenic diet was used in cancer patients. The conclusions are that an insulin-inhibiting diet is safe and feasible in selected patients with advanced cancer.
- Fine, EJ et al. Targeting Insulin Inhibition as a Metabolic Therapy in Advanced Cancer. Journal of Nutrition, 2012.
- Tan-Shalaby, JL et al. Modified Atkins diet in advanced malignancies – final results of a safety and feasibility trial within the Veterans Affairs Pittsburgh Healthcare System. Nutrition & Metabolism, 2016.
In brain cancer in particular the ketogenic diet looks like a promising addition to other treatments:
- Frontiers in Molecular Neuroscience 2016: Tumor Metabolism, the Ketogenic Diet and β-Hydroxybutyrate: Novel Approaches to Adjuvant Brain Tumor Therapy
NOTE: This is only an experimental additional treatment of selected cancers, with highly limited evidence. Many conventional cancer treatments (surgery, chemo etc.) are highly effective and they often offer excellent chances of a cure when used in early stages of the disease. To turn down such treatment would be a mistake that could easily be fatal. ↩
A small pilot study of five people with Parkinson’s disease showed clear improvement of symptoms on a ketogenic diet. There was no control group, so a placebo effect can’t be ruled out.
Vanitallie, TB et al. Treatment of Parkinson disease with diet-induced hyperketonemia: a feasibility study. Neurology, 2005. ↩
Fiber is digested by bacteria in the colon, and some of it is transformed into a fat called medium-chain triglycerides. This fat can be absorbed by the body and is very effective at turning into ketones. Thus eating more fiber (but still very low carb) could result in higher ketone levels in the blood. ↩
It might be beneficial to lower protein intake even more, especially when overweight, and then aim for 1 gram of protein per kg of desired weight. ↩
Here are two guides that may be helpful to you:
For example, the company Prüvit sells drinkable ketones, called KETO//OS with a multi-level marketing structure.
This can sometimes be measured as early as during the first day on a ketogenic diet:
This has been clearly demonstrated in several scientific studies:
The strips measure for the ketone type acetoacetate. The presence of this in your urine indicates that you’re been in ketosis during the hours before testing. ↩
By drinking more water, you dilute the concentration of ketones in the urine and thus a lower level of ketones will be detected on the strips. ↩
This happens when the body becomes more adapted to using ketones, meaning that they increasingly stay in the blood to be used as energy instead of being lost through the urine.
After 3 weeks the kidneys have been found to excrete ketones at one third the rate than after just 4 days despite having the same blood ketone levels:
Breath analyzers measure the ketone acetone. ↩
For example, the Ketonix meter reflects the following levels of acetone:
- Blue – negative
- Green – mild ketosis
- Yellow – moderate ketosis
- Red – deep ketosis
For example, if you recently ate a lot of carbs e.g. a pizza, this can result in misleading high values on the Ketonix. ↩
Blood-ketone meters measure the ketone beta-hydroxybyturate (BHB). ↩
The chart is from the excellent book The Art and Science of Low-Carbohydrate Performance by Professor Stephen Phinney and Jeff Volek. Highly recommended.
Take insulin, eat carbs (if your blood glucose isn’t already high), and contact medical services immediately. ↩
For more on this, here’s an interesting article from two of the top keto researchers in the world, Stephen Phinney and Jeff Volek:
By far the most common cause is having type 1 diabetes and taking too little insulin.
In rare cases ketoacidosis may also happen on a keto diet, but normally only when combined with other predisposing factors:
- Breastfeeding on a keto diet (don’t do a strict keto diet when breastfeeding)
- Medication with SGLT-2 inhibitors for type 2 diabetes