A ketogenic diet for beginners

A keto or ketogenic diet is a very low-carb diet, which turns the body into a fat-burning machine. It has many proven benefits for weight loss, health and performance, as millions of people have experienced already.1  

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.


Get even more, custom meal plans, ask the experts and low-carb TV, with a free trial.

 


 
 

1. Introduction: What is keto?


45,449 viewsMake it simple to understand keto and do it right, using our new video course above.

The entire course with all parts is available here. Alternatively, just keep reading below.

 

What “keto” means

Ketosis

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.

Learn more about ketosis

 

ChecklistWho should NOT do a ketogenic diet?

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:

Keto diet foods: Natural fats (butter, olive oil); Meat; Fish and seafood; Eggs; Cheese; Vegetables that grow above ground
 

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.

Detailed list of what to eat on keto

 

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.

Foods to avoid on a keto diet: bread, pasta, rice, potatoes, fruit, beer, soda, juice, candy

 
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

More specific advice on what to eat – and what not to eat
 
 

What to drink

Low-carb drinks

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.

For more, have a look at our full guides to keto drinks and keto alcohol.

 

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:

 

Recipes

We have over 300 fantastic keto recipes. Below are a few popular examples:

 

 

Diet plans

Here are two weeks worth of recipes for breakfast, lunch and dinner on a keto diet:

14-day keto diet plan

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

 

Get started

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.

 

Folder

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:

Low-carb-for-beginners_folder_1803-2

 

countries3

Keto advice in 40 languages

Here you’ll find keto diet advice in 40 languages. First of all the entire Diet Doctor site is available in Spanish and Swedish as well. Press the note symbol for all other languages:7

 


 

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.

 

Keto and weight lossLose weight

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 20 high-quality scientific studies8 show that, compared to other diets, low-carb and keto diets result in more effective weight loss.

Keto and appetite controlAppetite control

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.9

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.

Keto and constant energy and brain performanceConstant 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.

Low carb and diabetes reversalControl blood sugar and reverse type 2 diabetes

A keto diet controls blood sugar levels, and is excellent for reversing type 2 diabetes. This has been proven in studies.10 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.

150+ success stories

How to reverse type 2 diabetes – the quick start guide

Low carb and diabetes reversalImproved health markers

There are many studies showing that low-carb diets improve important health markers, including the cholesterol profile (HDL, triglycerides), blood sugar levels, insulin levels and blood pressure.11

These commonly improved markers are connected to something called “metabolic syndrome”, and improvements in weight, waist circumference, diabetes type 2 reversal etc.

My health markers after 10 years on a keto diet

happystomach-800-roundedA calmer stomach

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

Low carb and weight lossIncreased physical endurance

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.

How to maximize endurance on a keto diet

Keto and epilepsyEpilepsy

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.12 It’s also being used as an experimental treatment for some people with Parkinson’s disease13.

 

Success stories

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 600 so far – for anyone to read.

Here are a few of them:

  • Keto and intermittent fasting: "I am completely blown away by the changes"
  • Reversing type 2 diabetes in only 2.5 months with keto and fasting
  • How Melissa lost 100 pounds with a keto diet, and kept it off for 15 years
  • A low-carb diet: Maintaining a 70-pound weight loss for five years

Categories

 

Top success story videos

  • My success story with Jim Caldwell
  • Open mic

More

 


 

4. How to get into ketosis

 

20 grams of carbs in two waysThere are many things that increase your level of ketosis. Here they are, from most to least important:

  1. 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.14  
    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.
  2. 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).15  
    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.
  3. Eat enough fat to feel satisfied.16 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.
  4. 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.
  5. 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.
  6. 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.
  7. 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.
Bottom line: To get into ketosis, restrict carbs to very low levels, preferably below 20 net carbs per day. This is by far the most important thing for ketosis to occur.

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.

KetoSupplements

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.17 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.

 
 

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:

Symptoms of ketosis: dry mouth, thirst, frequent urination

  • 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.18 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.19 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.

 
 

Measuring ketosis

ketone meters
There are three ways to measure for ketones, which all come with pros and cons:


 

1. Urine stripsketostix

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.20 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.21 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.22 Thus, the test may sometimes stop working – always showing a negative result – when you’ve been in ketosis for several weeks.

Order urine strips at Amazon


 

2. Breath-ketone analyzers

ketonixBreath-ketone analyzers are a simple way to measure ketones23 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.24 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.25 More expensive than urine strips, and higher cost upfront than a blood meter.

Order Ketonix

Video: Using breath-ketone analyzers


 

3. Blood-ketone metersBlood ketone meters: Precision extra and Keto-Mojo

Blood-ketone meters show an exact and current level of ketones in your blood.26 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.27

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.

Order the Keto-Mojo meter

Order the blood-ketone meter Precision Xtra with everything included, at Amazon


 

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.28 The numbers below refer to values when testing blood ketone levels.

 
The Ketone Zone

  • 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.29
  • 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.30 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

 

Optimal ketosis experimentStories about achieving long-term ketosis

Here are the three reports from a 2-month experiment in reaching optimal ketosis:

  1. Experiment: Optimal ketosis for weight loss and increased performance
  2. Four weeks of strict LCHF and ketone monitoring
  3. 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.31

Learn keto from the experts

  • Low-carb living
  • Keto-Adaptation and Performance

More

 

 

 
 

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.

Keto breakfastBreakfast

How should you start your keto day? If you love bacon and eggs dig in! If you don’t, some great keto breakfasts have no eggs at all.

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

meals-800-roundedMeals

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

cheap-800-rounded-1Keto on a budget

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

Eating more fat on ketoHow to eat more fat

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.

Here’s how to add fat back

bread-800-roundedBread

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

dining-out-800-rounded-ffDining out

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

keto cheatingKeto cheating

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

cheap-800-rounded-1Avoiding special products

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

 

More guides

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.

 

cheap-800-rounded-1Keto flu

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:

  • Headache
  • Fatigue
  • Dizziness
  • Light nausea
  • Difficulty focusing (“brain fog”)
  • Lack of motivation
  • Irritability

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 about keto flu and how to minimize it

Do you need electrolyte supplementation on a keto diet?

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:

Keto myths

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.32

There are several more common keto myths. Will keto kill your kidneys or destroy your bones? Will it stop your thyroid from working? Read all about them on our low-carb and keto myths page


 

8. Keto Q&A, troubleshooting and resources

Keto questions and answersThere 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 use our keto recipes and keto meal plans you’ll stay under 20 net grams of carbs per day, with no need to count.

Using our keto foods guidelines and visual guides will make it simple to estimate roughly how many carbs you eat in a day.

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

 

Resources to learn more

Get free video courses, keto recipes and news updates like over 300,000 people:

 

Top keto presentations

  • Improve chronic pain with a keto diet
  • How to formulate a low-carb keto diet

More

Keto interviews

  • The latest science behind a keto diet
  • All things keto with Keto Connect

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Keto and LCHF basics

Here are a few of our hundreds of keto TV videos, these ones are focussed on keto basics:

  • Keto for beginners: Introduction
  • Keto for beginners: In ketosis?

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Low-carb eventsUpcoming keto events

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

Websites

For more low-carb and keto sites, check out our recommended sites.

Books

The Art and Science of Low-Carbohydrate Performance by Stephen Phinney and Jeff Volek.

Podcasts

Excellent two-part podcast where the top ketogenic diet researcher Dominic D’Agostino is interviewed by Tim Ferriss: part 1 / part 2 (D’Agostino is also active on Twitter).

More

Ketogenic diet food list – what to eat
14-day keto diet plan

 

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  1. 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:

    Similar results have been found in meta-analyses of all studies, for example this recent analysis:

    PLOS ONE 2015: Dietary Intervention for Overweight and Obese Adults: Comparison of Low-Carbohydrate and Low-Fat Diets. A Meta-Analysis

    Here are many more studies on the topic:

    The science of low carb

    Hundreds of success stories that people have sent us: low-carb 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.

  2. There are three different ketones, or “ketone bodies” used as fuel by the body. They are:

    1. Acetone
    2. Acetoacetate
    3. Beta-hydroxybutyrate

    Ketones

    Learn far more than you’ll ever need about ketones here:

    Dr. Peter Attia: Ketosis – advantaged or misunderstood state? (Part I)

  3. 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.

    Another note: ketosis is why the old idea that “the brain needs carbohydrates” is simply wrong.

  4. 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.

  5. 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.

  6. Younger, fit people who exercise a lot may be able to tolerate a bit more protein than this, and still stay in ketosis.

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    Do you have another translation or a significant improvement of one of the earlier ones? E-mail us (more info).

  8. Randomized controlled trials, the gold standard of scientific research on diet and health.

    For example Shai 2008 or Bazzano 2014.

    Full list of studies with the most important findings explained

  9. Obesity reviews 2014: Do ketogenic diets really suppress appetite? A systematic review and meta-analysis

    Obesity 2007: The effects of a low-carbohydrate ketogenic diet and a low-fat diet on mood, hunger, and other self-reported symptoms.

  10. The superiority of a low-carb diet has for example been shown in these 3 studies: Daly 2005, Westman 2008 and Tay 2014.

    Full list of low-carb studies

  11. This has been shown in many studies. Here are two examples:

    Learn more

  12. 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.

    In brain cancer in particular the ketogenic diet looks like a promising addition to other treatments:

    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.

  13. 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.

  14. 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.

  15. 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.

  16. Here are two guides that may be helpful to you:

    Top 10 ways to eat more fat

    Keto fats and sauces – the best and the worst

  17. For example, the company Prüvit sells drinkable ketones, called KETO//OS with a multi-level marketing structure.
     

    Pruvitnow.com

  18. This can sometimes be measured as early as during the first day on a ketogenic diet:

    AJCN: Breath acetone is a reliable indicator of ketosis in adults consuming ketogenic meals. (2002)

  19. This has been clearly demonstrated in several scientific studies:

    Obesity Reviews: Do ketogenic diets really suppress appetite? A systematic review and meta-analysis (2014)

  20. 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.

  21. 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.

  22. 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:

    Diabetes 1985: Ketone Body Production and Disposal in Diabetic Ketosis: A Comparison with Fasting Ketosis

  23. Breath analyzers measure the ketone acetone.

  24. For example, the Ketonix meter reflects the following levels of acetone:

    • Blue – negative
    • Green – mild ketosis
    • Yellow – moderate ketosis
    • Red – deep ketosis

  25. For example, if you recently ate a lot of carbs e.g. a pizza, this can result in misleading high values on the Ketonix.

  26. Blood-ketone meters measure the ketone beta-hydroxybyturate (BHB).

  27. A meter with 10 ketone-test strips and 30 needles included, used to cost about $110 and then an additional $2 per test after that.

  28. The chart is from the excellent book The Art and Science of Low-Carbohydrate Performance by Professor Stephen Phinney and Jeff Volek. Highly recommended.

    perf

  29. Take insulin, eat carbs (if your blood glucose isn’t already high), and contact medical services immediately.

  30. Other possibilities include doing a strict keto diet while breastfeeding or on a class of diabetes medications called SGLT-2 inhibitors (e.g. Farxiga, Jardiance, Invokana).

  31. For more on this, here’s an interesting article from two of the top keto researchers in the world, Stephen Phinney and Jeff Volek:

    Virta Health: Keto-Adaptation – Some Clues to Its Complexity

  32. 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

    Learn more

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201 Comments

  1. 5 comments removed
  2. Rontin
    Awesome comprehensive guide. Thanks
  3. Rontin
    Is it worth buying those keto urine strips? Are they accurate?
  4. 1 comment removed
  5. Nicky
    Hi Ian, Have you tried cayenne pepper? If you build up to a teaspoon a day, it regulates the heart. Check it out, I think it's great...I have it every day, with turmeric and cinnamon for inflammation and strong immune system. Shot it quickly so you don't taste it...
  6. Ian Smith
    Hello Nicky,

    Thanks for the reply. And sorry I didn't thank you sooner - I haven't looked at the site for a while.

    In answer to your question, no, I've never tried cayenne pepper. But I shall and see what happens.

    Many thanks for your input.

    Ian

  7. Mystikalkat
    While I appreciate the information provided on this subject, it is very disappointing to to have struggle through all of the illiteracy. Ever heard of proof reading.
    Replies: #65, #86
  8. 1 comment removed
  9. Lucie
    Can you do this if you are already vegan?
  10. karen laurin
    hello im wondering how much weight most people lose in the first 2 weeks on the keto diet can someone help with this question thank you
    Reply: #66
  11. Shesays

    While I appreciate the information provided on this subject, it is very disappointing to to have struggle through all of the illiteracy. Ever heard of proof reading.

    Did you mean "to have to struggle" instead of "to to have struggle"?

    "Ever hear of proof reading" is a question and needs a question mark instead of a period, doesn't it?

    Replies: #71, #76
  12. Shesays

    hello im wondering how much weight most people lose in the first 2 weeks on the keto diet can someone help with this question thank you

    I lost 9 pounds the first week and 6 pounds the second week.

    Reply: #69
  13. Grey
    Hi, Thanks for all the great advice. I have been on keto seriously for a few weeks and it was going very well, then suddenly my acid reflux has come back very badly. I had gotten off all my meds months ago, and now I find I need them again.  I have a  BP Coffee for breakfast, salad or greens + fats & small protein for lunch and a green drink with avocado, spinach, celery & seeds for supper. I have added apple cider vinegar or sauerkraut before meals and this has helped a little bit. Daily probiotic as well. I feel really unwell and don't want to give up on this great diet. Can you help? Many Thanks
  14. Kate
    I'm really suffering with muscle cramps at night in my legs, and very sore muscles in the day time. I have been LCHF for 2 months, carbs not above 20 g in the last month. I have added magnesium, potassium and sodium. What can I be doing wrong?
    Reply: #100
  15. Chris
    With the 9 pounds and 6 pounds, what was your level of calorific burn / exercise routine like during this time?
  16. Kemi
    How do I maintain a keto diet with ulcer? It has been pretty difficult
  17. QuadMoore
    You beat me to it Shesays, thank you. Of course there are always folks who will have to nitpick at everything instead of just moving on.

    To answer someone's question about how much weight I've lost: a little over 30 lbs the first 3 weeks. I've added some more cardio and light weights as time went by. By the 5th week I've lost a little over 60lbs, but that's going back up with lean muscle building back up.

  18. Karla
    Kate, drink more water. It helped me with leg cramps and heart palpitations. It was in information or video on this site. Lots of info, in fact. Thanks for Diet Doctor.
  19. 1 comment removed
  20. Judy Moore
    We started the two week free diet plan and I have been feeding the recipes and food intake into the My Fitness Pal - according to their calculations, the total protein intake for day two is 102 grams which seems higher than what is recommended. Other sites I have investigating are recommending around 68-70. The recipe for the Hamburger Patties with creamy tomato sauce had 42 grams by itself, and the Salmon with chili sauce is another 47 grams - Is it supposed to be this high?
    Reply: #88
  21. Carolyn
    I am in America and I just ordered a free meter from Nova Max (with purchase of two boxes of strips) as Abbott did not have any available free meters according to their website. Go to novacares.com or google "Nova Biomedical meter offer." As others have said in the comments they make their money off the strips- a box of fifty was 19.99 making them .39 per strip. That was listed as a "special" price, and I purchased two boxes to get the meter so my total was 39.98, with free shipping. I have alcohol pads at home and the meter comes with the lancing device and lancets. Also it says there is a savings card that allows cash purchases of the boxes to be $20 at the pharmacy.
    Reply: #106
  22. June
    WOW...!! REALLYYYYYYYY...!!!
  23. 1 comment removed
  24. nancy
    Please how can I get the food menu plan.
  25. Ketoki
    https://play.google.com/store/apps/details?id=com.ionicframework.keto...

    Share our app! It is an app that helps you track your carbs for the day and input your weight. It its very quick and easy to use!

  26. Fatima Alsheikh
    Hi everyone....
    I want to ask about hibscus tea, is it allowed on restricted keto diet?!
  27. 1 comment removed
  28. Jennifer
    I've been doing a keto diet for exactly 6 months now. I just had my annual blood work done and my total cholesterol increased from 207 last April to 285 just now. My LDL also increased from 130 to 206. My HDL got better: it increased from 50 to 63. Triglycerides have always been good and remain good. I am 5'8" and a female. When I started a keto WOE, I weighed 175lbs and now I am down to 147. I am extremely happy with my weight loss, but don't know what to think about the elevated cholesterol levels. Am I doing something wrong? I really would like to continue a keto lifestyle, but worry about the cholesterol. Do you have any advice?
  29. nashra
    Hii
    Actually I'm suffering from thyroid problemssince last four years n I'm only 22 n I hv put on lot of weight in dese yrs it's almost 85+ . Will Ds diet helpful fr me to reduce weight?
  30. Precious
    Hello. pls am pregnant can I keto? my weight is 105 I want to weigh 80 throughout my pregnancy.
    Reply: #102
  31. Vl V.
    That's all great. But... I have come across a recommendation to rise testosterone level by implementing similar diet... but... I guess I will always be hungry, Ive tried at some point before to stay clear of starchy food and carbs overload but Ive lost enormous amount of kg and felt fatigued and near to pass out on a daily basis. It was awful. Im not going to go into what kind of problems I have been facing in details but with regard to hormonal balance... this diet makes sense but Im afraid that will not survive on it.
    By the way what would you say with regard to oats/oatcakes? Parsnip, sweet potato and squashes? Those are my staple foods + brown long rice occasionally/proso millet (and buckwheat rarely). I don't know if by eating zucchini I'd feel better. But I feel there is something wrong with grains definitely though.
    As regards fats, Im on the right track. Only healthy and as much as possible natural... in terms of fats I have no issues. Issues in terms of killing feeling of hunger after eating broccoli with fish = this is ridiculous meal. I dont want to be skinny, but how would you gain weight (muscle mass) by eating green veggies if you are constantly out of energy even to walk not to mention lift something. Thank you so much for any feedback on this matter.
  32. Jezzy
    wow, you're kind of a jerk Ever heard of that?
  33. Trisha
    I can not eat pork or crustations. Week one starts out with pork as a dinner and lunch. Can I get more recipes to substitute?
  34. Christine UK
    How do you measure 102 grams of protein iin meals for the day? If i wanted a piece of strak how do i know how much protein is in that piece of strak if it weigjs say 350g of meat? I grt very confused with MFP macros. I have my stats but struggle hoe yo trandlate it into food on my plate and how msny meals to eat in a day. I make up my own lchf and lost 2 stone but stuck for the last 5 months? Started approximstely April 2016. Can you explain how you figured it out?
  35. Alin
    Hello,
    My name is Alin, and I have been on the LCHF program for almost 4 months (02.06.2016 - 20.12.2016)
    The reason a begun the diet is because at a routine medical check i did an abdominal ecograph and was told dat i have a non-alcoholic fatty liver (steatosis), and a possible gilbert syndrome (my total bilirubin was 1.77 mg/dl), as well the many health related benefits, described on your site.
    Apart from that, i can say i am generally healthy.

    Before i started the LCHF program:

    Age - 28 years
    Height - 180 cm
    Weight - 80 kg

    TGP(ALT) - 21 U/L
    TGO(AST) - 30 U/L
    Colesterol total - 152 mg/dl
    HDL colesterol - 62 mg/dl
    LDL colesterol - 91 mg/dl
    Triglycerides - 53 mg/dl
    Creatinine serum - 0.93/dl
    Bilirubin total - 1.77 mg/dl
    Glucose - 81 mg/dl

    After LCHF (16.12.2016)

    Weight - 77 kg (3 kg lost in the first week)

    TGP(ALT) - 56 U/L
    TGO(AST) - 43 U/L
    Colesterol total - 240 mg/dl
    HDL colesterol - 81.8 mg/dl
    LDL colesterol - 140.8 mg/dl
    Triglycerides - 87 mg/dl
    Creatinine serum - 1.43 mg/dl
    Bilirubin total - 2.31 mg/dl
    Glucose - 108 mg/dl

    On the diet this values got worse, my face was burning from time to time an got all red.
    Other problems i encountered, but expected, wore constipation and muscle cramps (especially on my calves in the morning), but i managed them as best that i could with an increase intake of salt and fiber (psyllium husks), and water.

    The good thing that i found during the diet is that i felt lighter (on a normal carb diet i always felt bloated, horrible), not hungry, and surprisingly energetic, it felt good (aside from the burning face)

    For the moment i have quit the diet on my doctor advice, and i am now trying to understand where i got it wrong.

  36. Queenie Arthur
    I have been on a very low carb diet for over 5 years. Initially I lost 3 stone - so down to 9 stone. Maintaining this very strict regime, I find that over the last year or two, 1.5 stone has crept back on. What can I do to halt this? I could not eat less carbs!
  37. 1 comment removed
  38. Marie-Christine
    Bonjour !
    J'apprécie beaucoup votre site, mais je ne parle pas très bien anglais...
    Existe-t-il en français ?
  39. 1 comment removed
  40. JAKC
    I find the recipe quantities to be confusing. For example, on the left side of the recipe, under "Ingredients," the text reads: "1 + 1 serving (dinner + lunch)." But, on the right side of the recipe, under "Instructions," the text reads: "Instructions are for 4 servings. Please modify as needed." So I'm left wondering...did I just make 4 servings, meaning 2 dinners and 2 lunches? Or, did I make 1 serving of 1 dinner, and 1 serving of 1 lunch to eat the next day? I must know so that I can either eat half of what I've made for dinner, and the other half the next day at lunch (assuming I'm hungry while I eat), or, I can eat 1/4 of what I've just made for dinner, 1/4 for lunch, 1/4 for another dinner, and the last 1/4 for lunch again. Please answer when able.
  41. Hamed Elneel
    Hi
    The moderator needs to give counseling to many participants in this forum. Some have reached dangerously high level values of some health state indicators and should probably be advised to quit and seek medical help immediately.
  42. Fabian
    Loved the overview, it helped me preparing for my own experiment with Ketogenic diet. I recently blogged about my experience, maybe the article is interesting for a few people considering a Keto diet. http://www.life-sparring.com/blog/2017/03/15/keto-week-one
  43. Sandra Bluch
    I'm on day 6 and I'm gaining half pound a day. Im so disappointed. I'm not a quitter and will keep following this diet for 10 days. Does anybody gain weight on this diet?
  44. mini kiani
    What to eat to get pregnant
  45. Stasi
    239Stasi
    46 minutes ago
    So I started LCHF along with my Type 1 son to help him transition to better blood sugars etc. I have checked my ketones with our blood ketone Meter yesterday and the day before and came up with 5.6 & 6.0. I see most places state nutritional ketosis is up to 3.0. Are these levels of ketones "bad"? How can they be so high when others can barely get to a 1.0. I have been quite LC this week with mostly getting carbs from veggies, my creamer, and some strawberries etc. If this is bad, what do I do to fix it without knocking myself out of ketosis. Although I am doing LC to support my son I would like to see the weight losss and physiological benefits as well.
    Final question would having 6.0 ketones cause me to be dizzy, light headed and generally weak even with a BG of 82? This morning I woke up like this and was convinced my BG was low but it proved otherwise.

    Oh I am doing IF well and had been fasting from 6pm last night. Checked ketones at like 3-4am because I was up Checking on my son.

  46. Perry
    I have found that when I get leg cramps, I take 1 to 3 tablespoons of apple cider vinegar and within 1 minute the cramp is gone. If you have never tried apple cider vinegar your taste buds will hate you at first, but over time it gets better.
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