FAQ: Low-carb & keto
Some questions about low carb and keto are very common. Here you can find answers to them. To jump down to each category of questions, just click the topic:
- Weight loss
- Diabetes and blood sugar
- Food, hunger and cravings
- The science behind low carb
- Common fears about low carb
- Low-carb side effects
- Ketosis, ketones and ketogenic diets
- Can XYZ follow a low-carb diet?
- How much should I eat?
- Sugar addiction
- Places to learn more
I’m not losing weight as fast as I want to or I have plateaued. What to do?
There are a few things you can think about in order to lose weight, where the ones that might have the greatest impact are:
However if your weight loss stops for many weeks or even months, or if you want to speed it up, here are more things to consider: How to Lose Weight
Do people who stop a low-carb diet and return to their old eating habits regain weight fast? Can low-carb diets cause “carb intolerance”?
When following low-carb diets people lose more weight than on other diets (on average). So it is logical that when people return to their old diet they regain more. It is simply a bigger step in the wrong direction, compared to going off other diets.
There’s no evidence for the speculation that low carb would cause carb intolerance.
However, a temporary “cheat day” may lead to filling up stored sugars in the body (glycogen), which binds more water, adding weight. This water weight (perhaps 1-2 pounds) quickly disappears within days when you go low carb again.
How do I STOP losing weight?
For some people it is very easy to drop a significant amount of weight on low carb. Normally weight loss stabilizes within the normal weight range, as long as you eat when hungry and don’t starve yourself.
However, if you’re concerned that you’re losing too much weight, then you have several options:
- Eat often, at least three times per day, including plenty of protein, and lift weights to put on muscle.
- Eat slightly more carbs (like low-glycemic fruits, sweet potato etc.) to put on a bit more fat.
To summarize there’s normally no need to stop a low-carb diet to stop losing weight. This will happen anyway, as you reach what your body perceives is the right weight for you.
Should you want to, is it possible to gain weight on low carb?
It’s very hard to gain fat mass. But it’s clearly possible to add lean mass, like muscle. Check out our guide here:
Diabetes and blood sugar
Is a low-carb diet good for people with diabetes type 2?
Yes. In diabetes type 2, the body has a hard time to handling all the sugar in the body. The body produces a lot of the hormone insulin, to take control high levels of sugar in the blood by depositing the sugar in the cells. More and more insulin can be required for this, in a vicious cycle resulting in insulin resistance and consequences of high insulin (including weight gain).
By following a low-carb diet, you reduce blood sugar levels, insulin levels and your need for medication. So yes, a low-carb diet can be very beneficial for patients with diabetes type 2. It can even start reversing the disease.
Note though – this is very important – that if you are taking medications, especially insulin, you need to monitor your blood sugar levels closely when starting a low-carb diet, and adapt (lower) doses as appropriate to avoid low blood sugar. You should of course consult with your doctor, ideally he or she has knowledge about how to reduce medications on a low-carb diet.
- How to reverse type 2 diabetes – the quick start guide
- How to reverse your type 2 diabetes (the longer guide)
Is a low-carb diet good for people with diabetes type 1?
Yes. It can help stabilize blood sugar levels, and reduce the need for high insulin doses (also helping with weight loss if needed, as a bonus).
Be very careful when starting a low-carb diet, as you’ll have to adapt your insulin doses. Big changes may be needed, e.g. a reduction by 30-70% depending on your specific situation. This can only be done by testing sugars and adapting insulin doses to your specific needs.
Learn more: Type 1 diabetes
Should I be worried about low blood sugar on low carb or while intermittent fasting?
Generally, you don’t have to be worried as long as you feel fine. Sugars can be slightly lower than normal on a low-carb diet, especially when you are in ketosis. In this situation the brain can rely on ketones for fuel and does not have quite the same need for glucose. So if you feel great you probably have all the blood sugar that your body needs.
If you’re not feeling well, you should eat something straight away, and break any fast.
If you’re on medication, like insulin, low sugars is a sign that you may have to reduce doses (especially if you get any symptoms).
High blood sugar in the morning – why?
Elevated blood sugars more or less exclusively in the morning is a common concern. This is known as “the Dawn Phenomenon” and occurs due to hormonal effects in the morning. It may actually be even more pronounced on a low-carb diet, compared to other diets.
Many people get surprised as their average blood sugar (measured as A1c) goes down nicely on low carb, blood sugar is great during the day… but morning sugar may stays elevated.
This is normally a natural phenomenon, caused by a morning elevation of cortisol and other hormones that cause the liver to release glucose, thus raising blood sugar levels. This can be thought of as a way for the body to prepare you for getting active again, after sleeping.
Food, hunger and cravings
Can I eat XYZ?
There are a few foods that don’t contain too much carbohydrate, but which might not be optimal for health, craving and weight loss reasons. These include:
- Dairy products such as milk, yoghurt and cheese. Fattier ones such as butter and heavy cream are better. Learn more
- Sweeteners such as aspartame, sucralose, acesulfam-K and stevia. Tend to keep one’s sweet tooth alive, possibly causing cravings and overeating. In some cases they also contain quite a lot of carbs. Learn more
- Nuts – some contain quite a lot of carbs, and they can easily cause overeating due to unconscious snacking. Low-carb nuts guide
- Oils that are high in omega-6s, ex. canola and soybean oil, might be inflammatory and not optimal for health.
- Alcoholic beverages that contain quite a lot of carbs. The best options are low-carb wine and pure spirits. Low-carb alcohol guide
- Fruit. This is candy from nature, that contains a lot of sugar. Low-carb fruits guide
- Low-carb cookies/bread/pasta. This is not a good idea, given that the vast majority of these low-carb “carb substitutes” are packed with carbs. Examples:
I’m constantly hungry and craving food in between meals. What should I do?
You’re not supposed to have to be hungry between meals on a low-carb diet. Here’s what you should try: Eat more food at meals. Especially eat more fat.
Add more fat to your meals, until you feel satisfied. Add butter to food. Add olive oil to salads. And perhaps check out our low-carb condiments recipes for more inspiration.
Also make sure to have some delicious and high-quality source of protein with most meals.
You’re not supposed to be hungry all the time. If you are, you’re not eating enough. You’re not eating enough fat.
If I’m lowering carbs and even limiting protein… What do I eat?
Usually, there is no need to limit protein, it is fine to eat a “normal” amount. Just don’t overdo it with protein, remember that LCHF is supposed to be a low-carb and high-fat diet, not a high protein diet.
For a standard low-carb meal, you remove the carb-heavy ingredients, like rice. You then add some vegetables and some healthy oil or fat-based sauce. But there are plenty of other options.
Here are many delicious examples of what a meal can look like: Low-carb recipes.
I’m craving carbs. Can I have a cheat meal – or a cheat day – once in a while?
Only you can decide – cheating can be a good idea for some, and a terrible idea for others. It also matters how you cheat. Check out our guide:
I’m really struggling with cravings for carbs, even when I’m not hungry. What should I do?
Do you need to eat resistant starch on low carb to feed your gut bacteria?
Unknown, but there appears to be some potential benefits of doing so
I have high cholesterol. How can I lower it?
First of all, you may not need to worry about lowering your cholesterol. Without a doubt there has been too much of an emphasis on total cholesterol during the last few decades. Total cholesterol, by itself, says very little about your future chance of health.
That said, if your cholesterol is abnormally high – e.g. over 400 mg/dL (10 mmol/L) – you may want to do something about it. If so check out our guide, focusing on elevated cholesterol on a low-carb diet.
Is it really bad to have high cholesterol?
In the absence of other risk factors a raised total cholesterol is not necessarily a bad thing. Several studies even show that women with high cholesterol live longer than women with low cholesterol.
The risk of heart disease is more influenced by many other things, like smoking, blood pressure, and blood sugars. When it comes to cholesterol it’s important to not just look at the total level, but also at the rest of the cholesterol profile, e.g. HDL (high is good) and triglyceride (low is good) levels.
What do to if your doctor wants to put you on statins?
Statins are mainly a good idea to reduce risk of heart attacks in people who already have heart disease (although the benefit might be much smaller than you would guess).
In people without earlier heart disease the risk of side effects from statins (like muscle pain, weakness and doubling the risk of diabetes) often outweighs the chance of benefits. Ask your doctor how big the benefits are likely to be for you.
There are also steps to greatly improve your cholesterol profile even without taking medications. See this guide about lowering cholesterol naturally.
It’s likely that statins are way overprescribed, to people who do not benefit from them, in order to increase profits. Perhaps you’d like to watch one of these documentaries for some perspective on it:
I’m taking this medication, will it prevent weight loss?
There are certain medications that might make it harder to lose weight, but not necessarily prevent weight loss. The most important are:
If you’re doing everything right and not losing weight while on one of these drugs, it might be a good idea to consult your physician to see if it would be possible for you to either lower your dose or quit the medication all together.
The science behind low carb
Is there scientific proof that LCHF is good for weight/blood sugar/cholesterol/blood pressure?
Yes. Learn more
Why are so many Americans obese?
Because many people eat too much ultra-processed food and highly-refined carbs. Learn more
Does insulin play a role in weight gain / loss?
Yes, insulin – the fat-storing hormone – plays a crucial role in weight gain and the development of common obesity. It’s a biochemical fact:
Why are Asian people thin, despite eating rice?
But it’s true that these countries traditionally had very lean populations. Probably because they don’t eat a lot of sugar or refined starch, plus a few other reasons. Learn more
Common fears about low carb
For our full guide to low-carb fears check out this guide:
I fear XXX…
What is the biggest fear that people have when starting a low-carb diet? We recently asked our members this question. Here are the results:
Other answers include some brave people having no fear at all, concerns about safety, losing sports performance as well as the fear of losing too much weight.
So what can be done? Here’s our guide to conquering these fears
Is saturated fat dangerous?
No. That’s an old and disproven theory. It’s been a mistake from the beginning. Learn much more in the interviews below, or check out our science page for references.
Will the brain stop working without carbohydrates?
Check out the video to the right for more details from some very smart doctors.
Can’t red meat give you cancer?
This is highly unlikely, although favoring unprocessed meat is the best choice. On the contrary, replacing meat with processed carbs may be one of the worst things that you can do for your health and weight.
Another interesting interview topic:
Read more: Do unhealthy meat eaters live shorter lives?
Is salt dangerous?
No. At least not in moderate amounts. Learn more
Can you get osteoporosis (weak bones) by eating low carb?
No. Learn more
What about gallstones and LCHF?
High fat food can give you short-term trouble if you already have gallstones. Low-fat food gives you gallstones in the long term. Learn more
Can you get hypothyroidism on a very low-carb diet?
No, hardly on a well-formulated low-carb diet, meaning that you replace the energy from carbs by eating more fat. In scientific studies on LCHF there are no problems with the thyroid and low-carb doctors generally report seeing no new thyroid issues in patients going strictly low carb.
However, starvation can lead to hypothyroidism, and if you remove carbs AND fat from your diet you will be starving. So you do need to eat carbs or fat to fuel your body.
Low-carb side effects
I’m getting XYZ side effect – should I be concerned?
There are a few side effects that are quite common during the first few weeks when your body adapts to a low-carb diet. These are usually temporary, and nothing to worry about (even if they can be unpleasant). These include:
- Induction flu
- Leg cramps
- Bad breath
- Heart palpitations
- Reduced physical performance.
However, if you use blood pressure medications and you feel dizzy, it might be because low-carb diets can reduce blood pressure and you may thus need to lower your medication.
If you want to learn more about how to treat these specific side effects and other less common ones, use this guide:
Ketosis, ketones and ketogenic diets
Is it dangerous to be in ketosis?
No, ketosis is a natural state, and normally safe.
People often confuse ketosis with ketoacidosis. This is a dangerous state, caused by a shortage of insulin, that mostly happens to people with type 1 diabetes who take too little insulin.
Why am I not in ketosis despite eating low carb?
The most common reason why people don’t achieve ketosis is due to too many carbs (maybe because of hidden carbs, or the dreaded carb creep, which is where you after a while eat more and more carbs without noticing).
Another big obstacle to getting in to ketosis is eating too much protein. To be in optimal ketosis, you should aim approximately for one gram of protein per kg desired body weight.
Insulin resistance can also make it harder to get into ketosis.
Do I need to be in ketosis to lose weight, or to burn fat?
No, you don’t have to be in ketosis to lose weight. And your body is always burning some fat, whether you are in ketosis or not. The difference is that in ketosis you burn more fat.
Can XYZ follow a low-carb diet?
Can people with diabetes eat low carb?
Yes. Diabetes is too much sugar in the blood, so by eating less carbohydrates that turn into sugar in the body, you can start reversing type 2 diabetes.
People with type 1 diabetes can also benefit from low carb.
However, you’ll have to monitor your blood sugars closely to avoid hypos, since the need for insulin drops on low carb.
Is a low-carb diet suitable for someone who has had a gastric bypass surgery?
Yes, very much so. Here’s just one of many happy people who have tried it: “What an amazing journey”
Can people that have had their gallbladders removed eat low carb?
Can kids eat low carb?
Sure. Children are better off ditching sugars, starches and refined junk food, and eating real food such as healthy fats, meat, poultry fish, vegetables, nuts and low-glycemic fruits and berries instead.
This is a very nutritious diet for their growing bodies. But there is usually no need for children to follow a strict low-carb diet. Just let them have real food.
Can women who want to get pregnant eat low carb?
Yes. It can even be a good way to boost fertility, since a common cause of infertility (PCOS) can be caused by too high insulin levels, caused by consuming too many dietary carbohydrates.
Can women eat low carb during pregnancy?
As far as known it seems to be safe to eat a LCHF diet with real food when pregnant. Many people have done so successfully. However, no scientific studies have ever investigated putting women on low-carb diets during pregnancy, meaning it’s hard to know for certain.
For this reason we recommend not doing a strict low-carb diet during pregnancy, unless there is a specific reason to do so. It may be wise to do a more liberal low carb diet with more than 50 grams of carbs per day.
When you’re eating real low-carb food such as natural fats, meat, poultry, fish, sea food, vegetables and berries you give both your own body and the baby enough nutrients to be healthy.
Learn more: Is low carb safe during pregnancy?
Can women eat low carb during breastfeeding?
A diet consisting of real, natural food is a great way to give both yourself and the baby plenty of nutrients to stay healthy and keep excessive weight off. However, we don’t recommend a strict low-carb diet, since it, in very rare cases, might cause a condition known as ketoacidosis.
Our recommendation is that women make sure that they eat at least 50 grams of carbs per day when breastfeeding to stay safe from this rare complication.
Can healthy, slim people eat low carb?
Yes, definitely. There will always be health benefits to eating real food and ditching refined food, sugars and starches. If you’re healthy and slim you can take a more liberal approach to your carb intake however.
How much should I eat?
OK… but how much should I eat?
The short answer is that you should eat when you’re hungry, and stop when you’re full.
You shouldn’t stuff yourself full, or go uncomfortably ravenous between meals. This is usually easy for people who stick to a low-carb diet with real food. Counting is usually overcomplicating things. It’s better to instead (re-)learn how to listen to our bodies.
Why don’t you advice people to count calories?
Because insulin is the main factor determining whether we lose or gain weight – not the amount of calories we consume in a day. By instead focusing on doing things that lower insulin – the fat storing hormone – you can reduce weight without calorie counting.
It’s much more effective to eat an LCHF diet, intermittent fast, sleep/de-stress and do resistance training (which all serve to reduce insulin) rather than spending time counting calories.
Counting and restricting calories is not only extra work and usually ineffective in the long term. It often also leads to hunger, and giving up.
How many carbs should I eat?
When trying to lose weight, the less carbs, the better. Ideally less that 20 grams of carbs per day (a strict low-carb diet).
People that are healthy and slim usually don’t have to go that low, they will be just as well off with moderate (20-50 grams) or liberal (50-100 grams) low-carb diets.
How much protein should I eat?
Once again, there is usually no need to count protein intake as long as you stick to natural low-carb food and eat until satisfied. If you’re losing weight (if that is your intention), there is no need to worry about having too much protein.
However, if you’re not being successful in losing weight, then you might benefit from counting and moderating intake to around one gram of protein per kg of desired body weight. If you’re an athlete or working out, then you might benefit from a little bit more protein.
How much fat should I eat?
If you’re limiting carbs and moderating protein, then you should eat enough fat to feel satisfied. Once again, you shouldn’t eat so little fat that you’re hungry between meals, but you shouldn’t force feed yourself until you’re stuffed either.
What is sugar addiction?
Are you struggling with cravings for food or sweets? Many, many people are. All over the world, people are unaware of the fact that they’ve become addicted. Addicted to something that’s added in almost everything. And there is no way to avoid it completely; you need to eat, in order to live.
In our video course, sugar-addiction expert Bitten Jonsson, RN, presents insights and advice on how to stop food and sugar cravings. She’s been helping people with addictions for decades, as well as battling with her own, to get them under control.
Do you experience a loss of control when you eat, especially sugary foods? Processed foods perhaps? Then take a look at the video and start taking the control back.
How do I know if I’m addicted to sugar?
It’s not entirely easy to know if you’re really addicted, of if you simply have some bad habits. Habits are relatively simple to change, but an addiction may even need professional help. At the very least an addiction requires other tools to bring it under control.
In this video our addiction expert Bitten Jonsson discusses using a simple 1-page screening test to discover if you could be addicted to sugar or other bad carbs.
What should I do if I’m addicted to sugar?
Watch our full sugar-addiction course to get required insights in how to get your addiction under control. There really are many things that need to be done right, to maximize your chances of success.
After having watched the course, here’s what to do today to get started:
- Join a support group on Facebook or elsewhere.
- Clean out your pantry (free guide via the low-carb challenge), and avoid exposure to junk food etc. as much as possible.
- Get shopping lists and meal plans, available by signing up for the low-carb challenge.
- If you need a distraction: take a walk and enjoy nature.
- Drink plenty of water, or coffee/tea with coconut oil in it between meals.
Best of luck!
This is the end of the Q&A page. Did you miss any important question? Feel free to ask it in the comments below, and we’ll consider adding it to this guide.
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