We observed that, one of the most studied strategies in the recent years for weight loss is the ketogenic diet. Many studies have shown that this kind of nutritional approach has a solid physiological and biochemical basis and is able to induce effective weight loss along with improvement in several cardiovascular risk parameters. The question is whether there is scientific evidence in employing the ketogenic diet for weight loss and other health purposes? Additionally, is the ketogenic diet effective? We provide a scientific review on the ketogenic diet.
One interesting thing about the Ketogenic diet as compared to other fad diets that come and disappear with very limited rates of long-term success, is that, the ketogenic diet (or keto diet) has been practiced for more than nine decades (since the 1920s) and the foundation is centered on solid understanding of physiology and nutrition science.
Another significant thing is that, the keto diet is good for high percentage of people as it centered on many key, underlying causes of weight gain — including hormonal imbalances, especially insulin resistance coupled with high blood sugar levels, and the cycle of restricting and “binging” on empty calories due to hunger that so many dieters struggle with. In fact, these are some of the direct benefits of the keto diet. The ketogenic diet (or keto diet, for short) is a low carb, high fat diet that offers many health benefits. In fact, one study by Paoli A, 2014, demonstrates that keto diet can help with lose of weight and improve your health. Westman et al., 2018, on the other hand agrees that, Ketogenic diets may even have benefits against diabetes and cancer. Ułamek-Kozioł et al., 2019, further also agrees that, keto diet also supports epilepsy, and Alzheimer’s disease (Rusek et al., 2019)
Meaning of Keto diet?
Ketogenic diet means very low-carb diet plan that was originally designed in the 1920s for patients with epilepsy by researchers working at Johns Hopkins Medical Center. The idea behind it is to reduce the carbohydrate content and replace with fat. This reduction in carbs puts your body into a metabolic state called ketosis.
Paoli et al.,2013, study demonstrates that fasting , which includes — avoiding consumption of all foods for a brief period of time ( with intermittent fasting), including those that provide carbohydrates — helped reduce the amount of seizures patients suffered, in addition to having other positive effects on body fat, blood sugar, cholesterol and hunger levels.
According to Axe, 2019, long-term fasting is not a feasible option for more than a few days, therefore the keto diet was developed to mimic the same beneficial effects of fasting.
He notes: “Essentially, the keto diet for beginners works by “tricking” the body into acting as if its fasting (while reaping intermittent fasting benefits), through a strict elimination of glucose that is found in carbohydrate foods. Today the standard keto diet goes by several different names, including the “low-carbohydrate” or “very-low-carbohydrate ketogenic diet” (LCKD or VLCKD for short)”.
Mechanism of Action of the Keto diet
The main aim of the keto diet is to restrict the intake of all or most foods with sugar and starch (carbohydrates). These foods are broken down into sugar (insulin and glucose) in our blood once we eat them, and if these levels become too high, extra calories are much more easily stored as body fat and results in unwanted weight gain.
But, when glucose levels are averted due to low-carb intake, the body starts to burn fat instead and produces ketones that can be measured in the blood (using urine strips, for example).
Keto diets, just as other low carb diets, function through the elimination of glucose. Most of us live on a high carb diet, hence, our bodies normally run on glucose (or sugar) for energy. “We cannot make glucose and only have about 24 hours’ worth stored in our muscle tissue and liver. Once glucose is no longer available from food sources, we begin to burn stored fat instead, or fat from our food”, says, Axe, 2019.
He further explained that, “when you’re following a ketogenic diet plan for beginners, your body is burning fat for energy rather than carbohydrates, so in the process most people lose weight and excess body fat rapidly, even when consuming lots of fat and adequate calories through their daily food intake. Another major benefit of the keto diet is that there’s no need to count calories, feel hungry or attempt to burn loads of calories through hours of intense exercise.
In some ways, it’s similar to the Atkins diet, which similarly boosts the body’s fat-burning abilities through eating only low-carb foods, along with getting rid of foods high in carbs and sugar. Removing glucose from carbohydrate foods will cause the body to burn fat for energy instead”.
Providing the major differences between the classic keto and the Atkins diet is the former emphasizes healthier keto fats, less overall protein and no processed meat (such as bacon) while having more research to back up its efficacy.
He added: “those differences with Atkins outline some of the popular keto diet myths, such as it being another high-protein plan, recommending any type of fat and that barely any science research backs up the benefits. These are nutrition lies, plain and simple”.
So is the keto diet healthy? If it’s done Atkins style? No. But if relying on healthy fats, greens and organic meats? Very much so.
Ketosis: What is that?
“keto” means ketosis, which is the end product of following the standard ketogenic diet, which is why it’s also sometimes called “the ketosis diet” or “ketosis diet plan.” Ketosis is a metabolic state in which your body uses fat for fuel instead of carbs. It happens as a result of reduction of carbohydrates, thereby limiting your body’s supply of glucose (sugar), which is the main source of energy for the cells. The only way to enter ketosis is to follow a ketogenic diet. This is different from entering a glycolytic state, where blood glucose (sugar) provides most of the body’s fuel (or energy). Ketosis involves limiting carb consumption to around 20 to 50 grams per day and filling up on fats, such as meat, fish, eggs, nuts, and healthy oils (Masood et al., 2020).
Additionally, Erica et al., 2020, also emphasized that, It’s also important to moderate your protein consumption as ketogenic activity go beyond just reducing carbohydrates diets. This is because protein can be converted into glucose if consumed in high amounts, which may slow your transition into ketosis.
Another way to enter into ketosis is also by Practicing intermittent fasting according to a study by Anton et al.,2018. They note: “There are many different forms of intermittent fasting, but the most common method involves limiting food intake to around 8 hours per day and fasting for the remaining 16 hours”.
Axe, 2019, believes that, though, dietary fat (especially saturated fat) often gets a bad name, provoking fear of weight gain and heart disease, “it’s also your body’s second preferred source of energy when carbohydrates are not easily accessible”.
9 Keto Diet Types
Here are most common keto diet types:
- Standard ketogenic diet (SKD): consists of getting about 75 percent of calories from sources of fat (such as oils or fattier cuts of meat), 5 percent from carbohydrates and 20 percent from protein.
- Modified ketogenic diet (MKD): this keto meal plan reduces carbohydrates to 30 percent of their total calorie intake, while increasing fat and protein to 40 percent and 30 percent respectively.
- Cyclical ketogenic diet (CKD): For those finding it difficult to stick to a very low-carb diet every day, especially for months on end, you might want to consider a carb-cycling diet instead. Carb cycling increases carbohydrate intake (and sometimes calories in general) only at the right time and in the right amounts, usually about 1–2 times per week (such as on weekends).
- Targeted ketogenic diet (TKD): This eating plan simply tells you to follow the keto diet BUT allows you to add carbs around workouts. So on the days you exercise, you will be eating carbohydrates.
- Restricted ketogenic diet (RKD): Designed to treat cancer, this ketogenic meal plan restricts calories as well as carbohydrates. Chung et al.,2017 study demonstrates that calorie restriction and ketosis may help treat cancer.
- High-protein ketogenic diet (HPKD): This version of the keto diet is often followed by folks who want to preserve their muscle mass like bodybuilders and older people. Rather than protein making up 20 percent of the diet, here it’s 30 percent. Meanwhile, fat goes down to 65 percent of the diet and carbs stay at 5 percent. (Caution: folks with kidney issues shouldn’t up their protein too much, says Axe, 2019.
- Vegan ketogenic diet or vegetarian diet: Yes, both are possible. Instead of animal products, plenty of low-carb, nutrient-dense vegan and/or vegetarian foods are included. Nuts, seeds, low-carb fruits and veggies, leafy greens, healthy fats and fermented foods are all excellent choices on a plant-based keto diet. There’s also a similar plan called ketotarian, which combines keto with vegetarian, vegan and/or pescatarian diets for supposedly greater health benefits.
- Dirty keto diet: “Dirty” is the apt term, as these version of keto follows the same strict percentages (75/20/5 of fat/protein/carbs) but rather than focusing on healthy versions of fat like coconut oil and wild salmon, you’re free to eat naughty but still keto friendly foods like bacon, sausage, pork rinds, diet sodas and even keto fast food. “I do NOT recommend this”, says Axe, 2019.
- Lazy keto diet: Last but not least, the Lazy keto diet often gets confused with dirty keto … but they’re different, as the “lazy” refers to simply not carefully tracking the fat and protein macros (or calories, for that matter). Meanwhile, the one aspect that remains strict? Not eating over 20 net carb grams per day. Some people find this version less intimidating to start with or end with … but I will caution that your results will be less impressive.
Is Keto working?
Once ketone levels in the blood rise to a certain point, you enter into a state of ketosis — which usually results in quick and consistent weight loss until you reach a healthy, stable body weight. One gets to this fat-burning peak when the liver breaks down fat into fatty acids and glycerol, through a process called beta-oxidation.
Three primary types of ketone bodies exist in water-soluble molecules produced in the liver: acetoacetate, beta-hydroxybutyrate and acetone.
Ketones are the resultant effect when the body breaks down these fatty acids into an energy-rich substance that circulate through the bloodstream. Fatty acid molecules are broken down through the process called ketogenesis, and a specific ketone body called acetoacetate is formed and which supplies energy.
The end result of the “ketone diet” is staying fueled off of circulating high ketones (which are also sometimes called ketone bodies) — which is what’s responsible for altering your metabolism in a way that some people like to say turns you into a “fat-burning machine.” Axe, 2019, notes: “Both in terms of how it feels physically and mentally, along with the impact it has on the body, being in ketosis is very different than a “glycolytic state,” where blood glucose (sugar) serves as the body’s energy source”
So, is ketosis bad for you? Absolutely not. Axe, 2019, explained: “If anything, it’s the reverse. Many consider burning ketones to be a much “cleaner” way to stay energized compared to running on carbs and sugar day in and day out”. He further opined that, “this state is not to be confused with ketoacidosis, which is a serious diabetes complication when the body produces excess ketones (or blood acids)”.
He states that, the goal is to keep you in this fat-burning metabolic state, in which you will lose weight until you reach your ideal set point. Some research suggests this may be a novel approach to reverse diabetes naturally.
Keto Diet Recipes
Axe, 2019, provided the road map to start keto diet:
- Eat lots of different vegetables, especially: leafy greens, mushrooms, tomatoes, carrots, broccoli, cabbage, Brussels sprouts, spinach, kale, sea veggies, peppers, etc. Some of these should include keto fiber foods that help keep your net carbs low.
- Healthy food choices that are high in protein but low-carb or no-carb include: grass-fed meat, pasture-raised poultry, cage-free eggs, bone broth, wild-caught fish, organ meats and raw dairy products, such as raw goat cheese.
- If you’re vegan or vegetarian, never fear, as a vegetarian or vegan keto diet is very doable.
- Healthy fats, which are also low-carb or no-carb, include: olive oil, coconut oil, grass-fed butter, palm oil, nuts and seeds.
- Minimal fruits but berries and avocado (yes, it’s a fruit) are definitely allowed.
- Want some sweet without the carbs or artificial sweeteners? Go with stevia and monk fruit.
- Avoid processed and ultra-processed foods high in calories and bankrupt in terms of nutrients: those made with white flour or wheat flour products, added table sugar, conventional dairy, bread and other processed grains like pasta, sweetened snacks like cookies and cakes, most boxed cereals, sweetened drinks, ice cream and pizza.
Warnings on Ketogenic Diet
Once you start the ketogenic diet; your metabolism is likely to alter as it will put you into ketosis and turn you from a sugar burner to a fat burner. You will likely enter into the Keto flu symptoms. Other side effects include feeling tired, difficulty sleeping, digestive issues like constipation, weakness during workouts, being moody, losing libido and having bad breath. The interesting thing is that, these side effects don’t affect everyone and often only last for 1–2 weeks. There is also the tendency to build muscle on keto. However, symptoms go away as the body adjusts to being in ketosis.
If a ketogenic diet is being used for a child to treat epilepsy, close medical monitoring is necessary. If you’re very active and without much body fat, consider trying carb cycling or at least eating a modified keto diet that does not severely restrict carb intake.
How to know you entered into Ketosis
Tests such as Blood, urine, and breath tests can be determined to help you know you’ve entered ketosis by measuring the amount of ketones produced by your body. Additionally, a study by Bostock et al., 2020, explained that, symptoms such as: increased thirst, dry mouth, frequent urination, and decreased hunger or appetite are to be identified when one enters into ketosis.
Scientific Studies on Keto diet health benefits
- Weight loss
Weight loss is often the main significant benefits of opting for a keto diet. In fact, weight loss is regarded as the No. 1. benefits for obese people. The study conducted by Bueno et al.,2013, demonstrates that those following a keto diet “achieved better long-term body weight and cardiovascular risk factor management when compared with individuals assigned to a conventional low-fat diet (i.e. a restricted-energy diet with less than 30 percent of energy from fat).” Another study by Paolin et al.,2014, notes:
“One of the most studied strategies in the recent years for weight loss is the ketogenic diet. Many studies have shown that this kind of nutritional approach has a solid physiological and biochemical basis and is able to induce effective weight loss along with improvement in several cardiovascular risk parameters”.
Another study by Sumithran et al., 2013, agrees that, Keto diets are high in healthy fats and protein also tend to be very filling, which can help reduce overeating of empty calories, sweets and junk foods.
Keith et al.,2017, study which involved patients who suffered from obesity and lymphedema and who embarked on an 18-week ketogenic diet found that, Weight and limb volume was significantly reduced.
Interestingly, the benefits of keto diet extend beyond weight loss and tackles Polycystic ovary syndrome (PCOS) which affects women of reproductive age. Mavropoulos et al., 2005, pilot study included 11 women through 24 weeks of a low-carbohydrate ketogenic diet (20 grams or less per day). Among the five who completed the study, they lost 12 percent of their weight on average and reduced fasting insulin by 54 percent. Additionally, two women who previously experienced infertility problems became pregnant.
- Fights Type 2 Diabetes
This process of burning fat provides more benefits than simply helping to lose weight — it also helps control the release of hormones like insulin, which plays a role in development of diabetes and other health problems.
A study by Westman et al., 2018, demonstrates that, ketogenic diet can help in lose excess fat, which is closely linked to type 2 diabetes, prediabetes, and metabolic syndrome. One earlier study by Boden et al.,2005, is of the view that the ketogenic diet improved insulin sensitivity by a whopping 75%.
A new study by Walton et al.,2019, which involved a small study in women with type 2 diabetes also demonstrate that after 90 days on keto diet, there was significantly reduced levels of hemoglobin A1C, which is a measure of long-term blood sugar management.
Another study by Al-Goblan et al., 2014, also included 349 people with type 2 diabetes and revealed that those who followed a ketogenic diet lost an average of 26.2 pounds (11.9 kg) over a 2-year period. Additionally, there was also improvement in their blood sugar management, and the use of certain blood sugar medications decreased among participants throughout the course of the study.
- 3. Reduce Risk of Heart Disease
Paolin, 2014, study also affirmed that, keto diet can reduce the risk of heart disease markers, including high cholesterol and triglycerides. Despite being high in fat, the keto diet is unlikely to negatively impact your cholesterol levels . However, a study by Bueno et al.,2013, agrees that, it is capable of lowering cardiovascular disease. An earlier study by Dashti et al.,2004, assert that adhering to the ketogenic diet and keto diet foods list for 24 weeks resulted in decreased levels of triglycerides, LDL cholesterol and blood glucose in a significant percentage of patients, while at the same time increasing the level of HDL cholesterol.
- Protect Against Cancer
Freedland et al.,2008, study is of the view that keto diets may “starve” cancer cells. Allen et al., 2014, study also show that ketogenic diet is an effective treatment for cancer and other serious health problems.
- Fight Brain Disease and Neurological Disorders
Over the past century, ketogenic diets have also been used as natural remedies to treat and even help reverse neurological disorders and cognitive impairments, including epilepsy, Alzheimer’s symptoms, manic depression and anxiety. Liu and Wang, 2013, developed a related clinical diet for drug-resistant epilepsy called the medium-chain triglyceride ketogenic diet, in which MCT oil is extensively used because it’s more ketogenic than long-chain triglycerides. Also, another dietary therapy for epilepsy called Low Glycemic Index Treatment (LGIT) was developed in 2002 as an alternative to the keto diet. LGIT monitors the total amount of carbohydrates consumed daily, and focuses on carbohydrates that have a low glycemic index.)
Henderson et al.,2009, study also observed clinical improvement in Alzheimer’s patients fed a ketogenic diet, and this was marked by improved mitochondrial function.
Paoli et al.,2013 study revealed data that suggested the therapeutic use of ketogenic diets for multiple neurological disorders beyond epilepsy and Alzheimer’s, including headaches, neurotrauma, Parkinson’s disease, sleep disorders, brain cancer, autism and multiple sclerosis.
Their work further says that while these various diseases are clearly different from each other, the ketogenic diet appears to be so effective for neurological problems because of its “neuroprotective effect” — as the keto appears to correct abnormalities in cellular energy usage, which is a common characteristic in many neurological disorders. In one animal study conducted by Anson et al.,2003, keto diet could slow disease progression for both ALS and Huntington’s diseases. Another animal study by Ruskin et al., 2011,discovered a potential benefits of the low-carb, high-fat diet or intermittent fasting in delaying weight loss, managing glucose and protecting neurons from injury. Today, some researchers are of the view that, the ketogenic diet can also help patients with schizophrenia to normalize the pathophysiological processes that are causing symptoms like delusions, hallucinations, lack of restraint and unpredictable behavior. One study found that the keto diet lead to elevated concentrations of kynurenic acid (KYNA) in the hippocampus and striatum, which promotes neuroactive activity. Hence, Kraft & Westman, 2009, believe that, elimination of gluten as a possible reason for improved symptoms.
Axe, 2019, notes: “Although the exact role of the keto diet in mental and brain disorders is unclear, there has been proof of its efficacy in patients with schizophrenia. And, to boot, it works to reverse many conditions that develop as a side effect of conventional medications for brain disorders, like weight gain, type 2 diabetes and cardiovascular risks. More research is needed to understand the role of the ketogenic diet in treating or improving schizophrenia, as the current available studies are either animal studies or case studies, but the benefits of a low carbohydrate, high-fat diet in neurology is promising”.
- Live Longer
Now, there’s even evidence that a low-carb, high-fat regimen (as the keto diet is) helps you live longer, compared to a low-fat diet. In a study by the medical journal The Lancet that studied more than 135,000 adults from 18 countries, high carbohydrate intake was associated with higher risk of total mortality, whereas total fat and individual types of fat were related to lower total mortality. Total fat and types of fat were not associated with cardiovascular disease, myocardial infarction or cardiovascular disease mortality.
Dehghan et al., 2017, study opined that, saturated fat intake had an inverse association with the risk for suffering from a stroke, meaning the more saturated fat someone is consuming on a daily basis, the more protection against having a stroke they seemed to have. Wang et al., 2018, study is also of the view that, the keto diet also appears to help induce autophagy. The study which involved animal model, explained that, when rats are put on the ketogenic diet, autophagic pathways are created that reduce brain injury during and after seizures.
Keto Diet Plan for beginners
According to Axe, 2019, the exact ratio of recommended macronutrients (or your “macros”) in your daily regimen (grams of carbs vs. fat vs. protein) will differ depending on your specific goals and current state of health. For instance, your age, gender, level of activity and current body composition can also play a role in determining your carb versus fat intake.
He notes: “Historically, a targeted keto diet consists of limiting carbohydrate intake to just 20–30 net grams per day. “Net carbs” is the amount of carbs remaining once dietary fiber is taken into account. Because fiber is indigestible once eaten, most people don’t count grams of fiber toward their daily carb allotment”.
In other words, total carbs – grams of fiber = net carbs. That’s the carb counts that matter most.
On a “strict” (standard) keto diet, fats typically provide about 70 percent to 80 percent of total daily calories, protein about 15 percent to 20 percent, and carbohydrates just around 5 percent. However, a more “moderate” approach to the keto diet is also a good option for many people that can allow for an easier transition into very low-carb eating and more flexibility (more on these types of plans below).
The following is the recommendation based on Axe, 2019, keto rules:
- Do not protein load
Something that makes the keto diet different from other low-carb diets is that it does not “protein-load.” Protein is not as big a part of the keto diet as fat is. Reason being: In small amounts, the body can change protein to glucose, which means if you eat too much of it, especially while in the beginning stages, it will slow down your body’s transition into ketosis.
Protein intake should be between one and 1.5 grams per kilogram of your ideal body weight. To convert pounds to kilograms, divide your ideal weight by 2.2. For example, a woman who weighs 150 pounds (68 kilograms) should get about 68–102 grams of protein daily.
- Track your macros
Your “macros” are your grams of fat, protein and net carbs (not to be confused with calorie counting!). Tracking your macros and net carbs can be tricky, so I advise you download a keto app that includes a keto diet calculator. It will help keep you on track.
- Consider using some keto supplements for greater success
A popular keto supplement are exogenous ketones (popularly called “keto diet pills”) that may help you achieve results earlier as well as remain in that state. (Don’t confuse exogenous ketones with raspberry ketones, as the latter don’t raise ketone levels in the body or mimic endogenous ketones, so you wouldn’t use raspberry ketones in your regimen.)
Also, consider supplementing with the amino acid leucine, as it can be broken down directly into acetyl-CoA, making it one of the most important ketogenic amino acids in the body. While most other amino acids are converted into glucose, the acetyl-CoA formed from leucine can be used to make ketone bodies. It’s also present in keto friendly foods like eggs and cottage cheese.
- Drink water!
It’s important to also drink lots of water, the most important of all keto drinks. Getting enough water helps keep you from feeling fatigued, is important for digestion and aids in hunger suppression. It’s also needed for detoxification. Aim to drink 10–12 eight-ounce glasses a day.
- Do NOT cheat
Lastly, no cheat days and not even cheat meals on the keto diet! Why?! Because a meal with far too many carbs will take you right out of ketosis and put you back at square one.
That being said, if you do succumb and indulge in a cheat meal, expect a return of some of the keto flu symptoms … but also be comforted by the knowledge that if you’re reached ketosis in the past, your body will be able to get back soon again and perhaps more quickly than originally.
Conclusion and Recommendations
From the review, we observed that, there is extensive evidence in using keto diet for weight loss. Interestingly, the purpose of the Ketogenic diets developed were to help improve symptoms of epilepsy (specifically in children who didn’t improve from other treatments), but today very low-carb diets are used to help adults, too, including those suffering from many other chronic health problems like obesity, cancer and diabetes. The most important question to be addressed is whether the keto diet work? Yes! We have observed especially in weight loss for starters, due to lowered insulin levels and the body being forced to burn stored body fat for energy.
A sample keto meal plan for 1 week
We put here a sample ketogenic diet meal plan for one week:
- breakfast: veggie and egg muffins with tomatoes
- lunch: chicken salad with olive oil, feta cheese, olives, and a side salad
- dinner: salmon with asparagus cooked in butter
- breakfast: egg, tomato, basil, and spinach omelet
- lunch: almond milk, peanut butter, spinach, cocoa powder, and stevia milkshake (more keto smoothies here) with a side of sliced strawberries
- dinner: cheese-shell tacos with salsa
- breakfast: nut milk chia pudding topped with coconut and blackberries
- lunch: avocado shrimp salad
- dinner: pork chops with Parmesan cheese, broccoli, and salad
- breakfast: omelet with avocado, salsa, peppers, onion, and spices
- lunch: a handful of nuts and celery sticks with guacamole and salsa
- dinner: chicken stuffed with pesto and cream cheese, and a side of grilled zucchini
- breakfast: sugar-free Greek, whole milk yogurt with peanut butter, cocoa powder, and berries
- lunch: ground beef lettuce wrap tacos with sliced bell peppers
- dinner: loaded cauliflower and mixed veggies
- breakfast: cream cheese pancakes with blueberries and a side of grilled mushrooms
- lunch: Zucchini and beet “noodle” salad
- dinner: white fish cooked in coconut oil with kale and toasted pine nuts
- breakfast: fried eggs with and mushrooms
- lunch: low carb sesame chicken and broccoli
- dinner: spaghetti squash Bolognese
Always try to rotate the vegetables and meat over the long term, as each type provides different nutrients and health benefits.
Foods to avoid
Any food that’s high in carbs should be limited.
Here’s a list of foods that need to be reduced or eliminated on a ketogenic diet:
- sugary foods: soda, fruit juice, smoothies, cake, ice cream, candy, etc.
- grains or starches: wheat-based products, rice, pasta, cereal, etc.
- fruit: all fruit, except small portions of berries like strawberries
- beans or legumes: peas, kidney beans, lentils, chickpeas, etc.
- root vegetables and tubers: potatoes, sweet potatoes, carrots, parsnips, etc.
- low fat or diet products: low fat mayonnaise, salad dressings, and condiments
- some condiments or sauces: barbecue sauce, honey mustard, teriyaki sauce, ketchup, etc.
- unhealthy fats: processed vegetable oils, mayonnaise, etc.
- alcohol: beer, wine, liquor, mixed drinks
- sugar-free diet foods: sugar-free candies, syrups, puddings, sweeteners, desserts, etc.
Foods to eat
You should base the majority of your meals around these foods:
- meat: red meat, steak, ham, sausage, bacon, chicken, and turkey
- fatty fish: salmon, trout, tuna, and mackerel
- eggs: pastured or omega-3 whole eggs
- butter and cream: grass-fed butter and heavy cream
- cheese: unprocessed cheeses like cheddar, goat, cream, blue, or mozzarella
- nuts and seeds: almonds, walnuts, flaxseeds, pumpkin seeds, chia seeds, etc.
- healthy oils: extra virgin olive oil, coconut oil, and avocado oil
- avocados: whole avocados or freshly made guacamole
- low carb veggies: green veggies, tomatoes, onions, peppers, etc.
- condiments: salt, pepper, herbs, and spices
The writers are on a mission to provide you and your family with the highest quality nutrition tips, scientific herbs and healthy recipes in the world.
DISCLAIMER This post is for enlightenment purposes only and should not be used as a replacement for professional diagnosis and treatments. Remember to always consult your healthcare provider before making any health-related decisions or for counselling, guidance and treatment about a specific medical condition.
About the Authors
Prof. Raphael Nyarkotey Obu, is a renowned Naturopathic doctor, Chartered Management Consultant, and honorary Professor of Naturopathy, Nyarkotey College of Holistic Medicine, Tema Community 7 , and Lawrencia Aggrey-Bluwey, is an Assistant Lecturer with the Department of Health Administration and Education, University of Education, Winneba and a PhD student in Health Policy and Management, University of Ghana, Legon. Contact: 0541090045.
i. Wajeed Masood; Pavan Annamaraju; Kalyan R. Uppaluri, 2020. Ketogenic diet. StatPearls [Internet].
ii. Erica A. Melkonian; Edinen Asuka; Mark P. Schury, 2020. Physiology, Gluconeogenesis. StatPearls [Internet].
iii. Bostock, E., Kirkby, K. C., Taylor, B. V., & Hawrelak, J. A. (2020). Consumer Reports of “Keto Flu” Associated With the Ketogenic Diet. Frontiers in nutrition, 7, 20. https://doi.org/10.3389/fnut.2020.00020
iv. Anton, S. D., Moehl, K., Donahoo, W. T., Marosi, K., Lee, S. A., Mainous, A. G., 3rd, Leeuwenburgh, C., & Mattson, M. P. (2018). Flipping the Metabolic Switch: Understanding and Applying the Health Benefits of Fasting. Obesity (Silver Spring, Md.), 26(2), 254–268. https://doi.org/10.1002/oby.22065
v. Paoli A, Rubini A, Volek JS, Grimaldi KA. Beyond weight loss: a review of the therapeutic uses of very-low-carbohydrate (ketogenic) diets. Eur J Clin Nutr. 2013 Aug;67(8):789-96. doi: 10.1038/ejcn.2013.116. Epub 2013 Jun 26. Erratum in: Eur J Clin Nutr. 2014 May;68(5):641. PMID: 23801097; PMCID: PMC3826507.
vi. Paoli A. (2014). Ketogenic diet for obesity: friend or foe?. International journal of environmental research and public health, 11(2), 2092–2107. https://doi.org/10.3390/ijerph110202092
vii. Westman EC, Tondt J, Maguire E, Yancy WS Jr. Implementing a low-carbohydrate, ketogenic diet to manage type 2 diabetes mellitus. Expert Rev Endocrinol Metab. 2018 Sep;13(5):263-272. doi: 10.1080/17446651.2018.1523713. PMID: 30289048.
viii. Ułamek-Kozioł, M., Czuczwar, S. J., Januszewski, S., & Pluta, R. (2019). Ketogenic Diet and Epilepsy. Nutrients, 11(10), 2510. https://doi.org/10.3390/nu11102510
ix. Rusek, M., Pluta, R., Ułamek-Kozioł, M., & Czuczwar, S. J. (2019). Ketogenic Diet in Alzheimer’s Disease. International journal of molecular sciences, 20(16), 3892. https://doi.org/10.3390/ijms20163892
x. Chung, H. Y., & Park, Y. K. (2017). Rationale, Feasibility and Acceptability of Ketogenic Diet for Cancer Treatment. Journal of cancer prevention, 22(3), 127–134. https://doi.org/10.15430/JCP.2017.22.3.127
xi. Bueno NB, de Melo IS, de Oliveira SL, da Rocha Ataide T. Very-low-carbohydrate ketogenic diet v. low-fat diet for long-term weight loss: a meta-analysis of randomised controlled trials. Br J Nutr. 2013 Oct;110(7):1178-87. doi: 10.1017/S0007114513000548. Epub 2013 May 7. PMID: 23651522.
xii. Sumithran P, Prendergast LA, Delbridge E, Purcell K, Shulkes A, Kriketos A, Proietto J. Ketosis and appetite-mediating nutrients and hormones after weight loss. Eur J Clin Nutr. 2013 Jul;67(7):759-64. doi: 10.1038/ejcn.2013.90. Epub 2013 May 1. PMID: 23632752.
xiii. Keith L, Rowsemitt C, Richards LG. Lifestyle Modification Group for Lymphedema and Obesity Results in Significant Health Outcomes. American Journal of Lifestyle Medicine. 2020;14(4):420-428. doi:10.1177/1559827617742108
xiv. Mavropoulos, J. C., Yancy, W. S., Hepburn, J., & Westman, E. C. (2005). The effects of a low-carbohydrate, ketogenic diet on the polycystic ovary syndrome: a pilot study. Nutrition & metabolism, 2, 35. https://doi.org/10.1186/1743-7075-2-35
xv. Boden G, Sargrad K, Homko C, Mozzoli M, Stein TP. Effect of a low-carbohydrate diet on appetite, blood glucose levels, and insulin resistance in obese patients with type 2 diabetes. Ann Intern Med. 2005 Mar 15;142(6):403-11. doi: 10.7326/0003-4819-142-6-200503150-00006. PMID: 15767618
xvi. Walton CM, Perry K, Hart RH, Berry SL, Bikman BT. Improvement in Glycemic and Lipid Profiles in Type 2 Diabetics with a 90-Day Ketogenic Diet. J Diabetes Res. 2019 Aug 14;2019:8681959. doi: 10.1155/2019/8681959. PMID: 31485454; PMCID: PMC6710763.
xvii. Al-Goblan, A. S., Al-Alfi, M. A., & Khan, M. Z. (2014). Mechanism linking diabetes mellitus and obesity. Diabetes, metabolic syndrome and obesity : targets and therapy, 7, 587–591. https://doi.org/10.2147/DMSO.S67400
xviii. Dashti, H. M., Mathew, T. C., Hussein, T., Asfar, S. K., Behbahani, A., Khoursheed, M. A., Al-Sayer, H. M., Bo-Abbas, Y. Y., & Al-Zaid, N. S. (2004). Long-term effects of a ketogenic diet in obese patients. Experimental and clinical cardiology, 9(3), 200–205.
xix. Freedland SJ, Mavropoulos J, Wang A, Darshan M, Demark-Wahnefried W, Aronson WJ, Cohen P, Hwang D, Peterson B, Fields T, Pizzo SV, Isaacs WB. Carbohydrate restriction, prostate cancer growth, and the insulin-like growth factor axis. Prostate. 2008 Jan 1;68(1):11-9. doi: 10.1002/pros.20683. PMID: 17999389; PMCID: PMC3959866.
xx. Liu YM, Wang HS. Medium-chain triglyceride ketogenic diet, an effective treatment for drug-resistant epilepsy and a comparison with other ketogenic diets. Biomed J. 2013 Jan-Feb;36(1):9-15. doi: 10.4103/2319-4170.107154. PMID: 23515148
xxi. Henderson ST, Vogel JL, Barr LJ, Garvin F, Jones JJ, Costantini LC. Study of the ketogenic agent AC-1202 in mild to moderate Alzheimer’s disease: a randomized, double-blind, placebo-controlled, multicenter trial. Nutr Metab (Lond). 2009 Aug 10;6:31. doi: 10.1186/1743-7075-6-31. PMID: 19664276; PMCID: PMC2731764.
xxii. Ruskin, D. N., Ross, J. L., Kawamura, M., Jr, Ruiz, T. L., Geiger, J. D., & Masino, S. A. (2011). A ketogenic diet delays weight loss and does not impair working memory or motor function in the R6/2 1J mouse model of Huntington’s disease. Physiology & behavior, 103(5), 501–507. https://doi.org/10.1016/j.physbeh.2011.04.001
xxiii. Kraft, B. D., & Westman, E. C. (2009). Schizophrenia, gluten, and low-carbohydrate, ketogenic diets: a case report and review of the literature. Nutrition & metabolism, 6, 10. https://doi.org/10.1186/1743-7075-6-10
xxiv. Wang BH, Hou Q, Lu YQ, Jia MM, Qiu T, Wang XH, Zhang ZX, Jiang Y. Ketogenic diet attenuates neuronal injury via autophagy and mitochondrial pathways in pentylenetetrazol-kindled seizures. Brain Res. 2018 Jan 1;1678:106-115. doi: 10.1016/j.brainres.2017.10.009. Epub 2017 Oct 19. PMID: 29056525.
xxv. Rudy Mawer, 2020. The Ketogenic Diet: A Detailed Beginner’s Guide to Keto. https://www.healthline.com/nutrition/ketogenic-diet-101
xxvi. Josh Axe, 2019. Ketogenic Diet for Beginners Made Easy: The Ultimate Guide to “Keto”. https://draxe.com/nutrition/guide-to-keto-diet-for-beginners/