You might be asking, “What’s a net carb?” It’s simple really! The net carbs are your total dietary carbohydrates, minus the total fiber. I recommend keeping total carbs below 35g and net carbs below 25g (ideally, below 20g).
The ketogenic diet is a very low-carb diet plan that was originally designed in the 1920s for patients with epilepsy by researchers working at Johns Hopkins Medical Center. (1) Researchers found that fasting — avoiding consumption of all foods for a brief period of time, 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. (4)
All grains—and foods that are made from grains, even whole grains—should be avoided because they contain too many carbs and will interfere with ketosis, slowing weight loss. That includes the following,
^ a b c d e f g h i j k l m n o p q r Kossoff EH, Zupec-Kania BA, Rho JM. Ketogenic diets: an update for child neurologists. J Child Neurol. 2009 Aug;24(8):979–88. doi:10.1177/0883073809337162. PMID 19535814
In more moderate amounts, foods that are high in protein but low- or no-carb, including grass-fed meat, pasture-raised poultry, cage-free eggs, bone broth, wild-caught fish, organ meats and some full-fat (ideally raw) dairy products.
Upon embarking on a ketogenic diet, many of us are faced with a dilemma: the foods we need to eat are far different from what we currently have in the pantry and refrigerator. This means getting rid of desserts, processed carbs and starches and replacing them with full-fat nutrition. This also means our grocery list and pantries will look quite different. Common foods on the ketogenic diet include,
A high carb diet (especially when it comes to dairy products and refined sugar) has been shown to trigger sebum (oil) production in the skin, which is a major cause of acne (18). Removing sugar from your diet may also help improve inflammatory skin conditions such as eczema and psoriasis (19). The healthy fats encouraged on the keto diet also provide the building blocks of healthy skin cells (20).
You can use my plan as a guideline to help you create something that fits into your life and schedule. Keep in mind that hitting your daily macros is the most important thing when it comes to dieting.
If we equate de facto ketogenic diets with high-protein diets (which is not always correct) then the risks proposed by critics of this type of dietary approach are essentially those of possible kidney damage due to high levels of nitrogen excretion during protein metabolism, which can cause an increase in glomerular pressure and hyperfiltration.12 There is not wide agreement between studies; however, some infer the possibility of renal damage from animal studies,99, 100 whereas others, looking at both animal models, meta-analyses and human studies, propose that even high levels of protein in the diet do not damage renal function.101, 102 In subjects with intact renal function, higher dietary protein levels caused some functional and morphological adaptations without negative effects.103 There may actually be renal-related effects, but on blood pressure rather than morphological damage. The amino acids involved in gluconeogenesis and/or production of urea in general have blood-pressure-lowering effects, whereas acidifying amino acids tend to cause a rise in blood pressure. Subjects with renal insufficiency, even subclinical, kidney transplant patients and people with metabolic syndrome or other obesity-related conditions, will be more susceptible to the hypertensive effect of amino acids, especially of the sulphated variety.104 The well-documented correlation between obesity and reduced nephron quantity on raised blood pressure puts subjects with T2D or metabolic syndrome at risk, even if in diabetics with kidney damage the effects are not always consistent with the hypothesis.12,105,106 In fact, although some authors have reported a positive influence of a reduction in protein intake from 1.2 to 0.9 g/kg, over the short term, on albuminuria in T2D,107 the same authors have subsequently stated instead that dietary protein restriction is neither necessary nor useful over the long term.108
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Many people choose this dairy-free keto diet meal plan because they have dairy intolerance. Another reason is because they are having weight loss stalls and a dairy-free meal plan can help them get over the stalls. If your current meal plan is not working for you, maybe it’s time to switch to a different meal plan to get different results.
That last item may surprise you, but for many people, it makes all the difference. Why? When carbs are cut, we rapidly deplete glycogen, the stored form of carbohydrate. For every gram of glycogen we lose, we lose 3 grams of water. Addition of the bouillon will help prevent dehydration and improve the way you feel on the diet. Water isn’t enough on keto; you need enough sodium, too.
I have been eating this way (very low carb, high fat, protein in between) for around 3 years now. I have found that for me I can MAINTAIN quite easily at an ideal weight and eating to satiety, but in order to actually LOSE weight, I have to at least have a very small calorie deficit. And though the change is gradual, it is sustainable and quite immediate (just little by little). The amount of that calorie deficit required in order to drop excess varies a lot from one individual to the next though, I think. I am particularly intolerant to hunger, and so I cannot overly emphasize how small of a deficit I will allow for. The nice thing about that though is that the hunger is far more pleasant in the absence of carbs.
The targeted ketogenic diet allows you to add extra carbs around workouts, surpassing the SKD 5% carb rule, and may be a better option for those who are extremely active and train more than twice per week. The easiest way to see if this is working for you is to keep testing your ketone levels when you add carbs after workouts and make sure that they don’t kick you out of ketosis.
Download My Fitness Pal app on your smart phone, change the macros to KETO ratio. Then log everything you eat. It will tell you if you’re in your macros or not, if you’re not, bump up the others to make it so or reduce what you’re over on.
This form rotates ketogenic days with high carb days, usually 5 ketogenic days, followed by 2 high carb days. Sometimes referred to as ketogenic carb cycling, this version of the keto diet can help maximize fat loss and build muscle.
You’ll quickly find that eggs are a staple for breakfast in low carb diets. Eggies are a simple solution for days of healthy breakfasts. Simply beat 8 eggs in a bowl, add in cheese and vegetables, and pour into muffin tins that have been lined with a strip of bacon. Cook at 350 for 30 minutes, or until a toothpick stuck in the middle comes out clean. Store in baggies for breakfast for up to 5 days.
No matter what your diet has been to this point, keto will be a big change. If you’re coming from a standard American diet (SAD) background, your carbs will go way down, protein may either go up or down, and fat will go way up. If you’re coming from a bodybuilding-style diet, your fat intake will jump to alarming levels, and your protein will likely drop significantly.
The ketogenic diet has been studied in at least 14 rodent animal models of seizures. It is protective in many of these models and has a different protection profile than any known anticonvulsant. Conversely, fenofibrate, not used clinically as an antiepileptic, exhibits experimental anticonvulsant properties in adult rats comparable to the ketogenic diet.[57] This, together with studies showing its efficacy in patients who have failed to achieve seizure control on half a dozen drugs, suggests a unique mechanism of action.[55]
The classic ketogenic diet is not a balanced diet and only contains tiny portions of fresh fruit and vegetables, fortified cereals and calcium-rich foods. In particular, the B vitamins, calcium and vitamin D must be artificially supplemented. This is achieved by taking two sugar-free supplements designed for the patient’s age: a multivitamin with minerals and calcium with vitamin D.[3] A typical day of food for a child on a 4:1 ratio, 1,500 kcal (6,300 kJ) ketogenic diet comprises:[27]
Carcinogenesis is a complex process involving multiple sequential mutations, which occur randomly in the DNA of normal cells over many years, even decades, until finally specific genes are mutated and cell growth becomes out of control resulting in the full neoplastic phenotype and often metastasis. There is evidence that hyperinsulinaemia, hyperglycaemia and chronic inflammation may affect the neoplastic process through various pathways, including the insulin/IGF-1 pathway, and most cancer cells express insulin and IGF-1 receptors. Insulin has been shown to stimulate mitogenesis (even in cells lacking IGF-1 receptors)50 and it may also contribute by stimulating multiple cancer mechanisms, including proliferation, protection from apoptotic stimuli, invasion and metastasis.51 The IFG1/insulin pathway may also enhance the promotion and progression of many types of cancer cells and facilitate cancer diffusion through angiogenesis.52 Insulin may act directly, but also indirectly through IGF-1, as it reduces hepatic IGF-binding protein-1 and -2 production,53 thereby increasing the levels of circulating, free active IGF-1, which may have a role in cancerogenesis due to its mitogenic and antiapoptotic activity.53 Considering the obvious relationship between carbohydrates and insulin (and IGF-1) a connection between carbohydrate and cancer is a possible consequence, and some links have been recognized since the 1920s when the Russo-German physician Dr A Braunstein observed that glycosuria falls off notably in diabetic patients who developed cancer.54 Later Warburg et al.55 of the Kaiser Wilheim Institute fur biologie described what was later known as the Warburg effect—where energy is predominantly generated by a high rate of glycolysis followed by lactic acid fermentation in the cytosol, even in the presence of plentiful oxygen.51, 55 The Warburg effect has been confirmed in many studies and today is a well-established hallmark of many types of cancers, and rapidly growing tumour cells typically have glycolytic rates up to 200 times higher than those of their normal tissues of origin.56 As stated above, the stimulus of the insulin/IGF-1 pathway is involved in cancer development, but also mitochondrial damage or dysfunction may have a role.18, 57, 58 Dysfunctional mitochondria may upregulate some oncogenes of the phosphatidylinositol 3-kinase/Akt mammalian target of rapamycin signalling pathway.58 Akt, a downstream of insulin signalling,59 is involved in changes in tumour cell metabolism and increases resistance to apoptosis; it also decreases β-oxidation and increases lipid synthesis in the cytosol.60 Hence, it seems a reasonable possibility that a very-low-carbohydrate diet could help to reduce the progression of some types of cancer, although at present the evidence is preliminary.61 In the 1980s, seminal animal studies by Tisdale and colleagues62, 63 demonstrated that a ketogenic diet was capable to reduce tumour size in mice, whereas more recent research has provided evidence that ketogenic diets may reduce tumour progression in humans, at least as far as gastric and brain cancers are concerned.64, 65, 66, 67 Although no randomized controlled trials with VLCKD have yet been conducted on patients and the bulk of evidence in relation to the influence of VLCKD on patient survival is still anecdotal,68, 69, 70 a very recent paper by Fine et al.71 suggests that the insulin inhibition caused by a ketogenic diet could be a feasible adjunctive treatment for patients with cancer. In summary, perhaps through glucose ‘starvation’ of tumour cells and by reducing the effect of direct insulin-related actions on cell growth, ketogenic diets show promise as an aid in at least some kind of cancer therapy and is deserving of further and deeper investigation—certainly the evidence justifies setting up clinical trials.
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For ideas and inspiration on how to reach your macros, take a look at our ever-growing library of keto recipes. If you don’t want to do all of the planning yourself, consider getting detailed shopping lists and months of meal plans made for you with Our Keto Academy >
Several lines of evidence point to beneficial effects of VLCKD on cardiovascular risk factors. In the past, there have been doubts expressed about their long-term safety and increased effectiveness compared with ‘balanced’ diets,25 and clearly negative opinions regarding possible deleterious effects on triglycerides and cholesterol levels in the blood.26 However, the majority of recent studies seem instead to amply demonstrate that the reduction of carbohydrates to levels that induce physiological ketosis (see above ‘What is ketosis?’ section) can actually lead to significant benefits in blood lipid profiles.15, 17, 27 The VLCKD effect seems to be particularly marked on the level of blood triglycerides,24, 28 but there are also significant positive effects on total cholesterol reduction and increases in high-density lipoprotein.24, 28, 29 Furthermore, VLCKD have been reported to increase the size and volume of low-density lipoprotein–cholesterol particles,29 which is considered to reduce cardiovascular disease risk, as smaller low-density lipoprotein particles have a higher atherogenicity. There are also direct diet-related effects on overall endogenous cholesterol synthesis. A key enzyme in cholesterol biosynthesis is 3-hydroxy-3-methylglutaryl–CoA reductase (the target for statins), which is activated by insulin, which means that an increase in blood glucose and consequently of insulin levels will lead to increased endogenous cholesterol synthesis. A reduction in dietary carbohydrate will have the opposite effect and this, coupled with the additional inhibition by dietary cholesterol and fats on endogenous synthesis, is likely to be the mechanism via which physiological ketosis can improve lipid profiles. Hence, there are strong doubts about the negative effects of dietary fats when they are consumed as part of a VLCKD, on cholesterol and triglycerides blood levels, whereas there are strong pointers to the beneficial effects of VLCKD on these cardiovascular risk parameters.27, 28
People sometimes get keto confused with high fat, high carb diets which are terrible for the body. Of course, when you eat a lot of fatty foods that are high in sugar, you’ll be getting yourself into trouble.
For lunch, I often fried turkey and beef meatballs or packed a tofu scramble. Dinner was usually a piece of salmon with veggies or two-egg omelet with cheese. Eating out was by far the hardest. But if you must hit up your local sushi joint, go with the Naruto roll, which wraps fresh fish in cucumber instead of rice. Remember, you can always ask your waiter to modify your meals.
On average people will lose 1-2 lbs. a week, but that doesn’t mean the scale will drop consistently. Take measurements as well as tracking your weight via scale, as often there can be changes in size but no change on the scale. If you’re still experiencing problems after 4-5 weeks, start looking into your dietary choices.
There are many ways in which epilepsy occurs. Examples of pathological physiology include: unusual excitatory connections within the neuronal network of the brain; abnormal neuron structure leading to altered current flow; decreased inhibitory neurotransmitter synthesis; ineffective receptors for inhibitory neurotransmitters; insufficient breakdown of excitatory neurotransmitters leading to excess; immature synapse development; and impaired function of ionic channels.[7]
^ a b c d e Zupec-Kania B, Werner RR, Zupanc ML. Clinical Use of the Ketogenic Diet—The Dietitian’s Role. In: Stafstrom CE, Rho JM, editors. Epilepsy and the ketogenic diet. Totowa: Humana Press; 2004. p. 63–81. ISBN 1-58829-295-9.
In order to transition and remain in ketosis, aiming for about 30–50 net grams is typically the recommended amount of total carbs to start with. This is considered a more moderate or flexible approach but can be less overwhelming to begin with. Once you’re more accustomed to this way of eating, you can choose to lower carbs even more if you’d like (perhaps only from time to time), down to about 20 grams of net carbs daily. This is considered the standard, “strict” amount that many keto dieters aim to adhere to for best results, but remember that everyone is a bit different.
On a “strict” (standard) keto diet, fats typically provides 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 this type of plan below).
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Now, the keto diet is often grouped with other high-fat, low-carb diets such as the Paleo or Atkins diets. But the reason these diets boast fat burning benefits in the first place is because they promote ketosis. Therefore, the ketogenic diet isn’t so much a “diet”, but more so the basis of these diets, and the biochemical reaction that occurs when you train your body to burn fat for fuel instead of carbs.
Healthy fats include saturated fats, monounsaturated fats and certain types of polyunsaturated fats (PUFAs), especially omega-3 fatty acids. It’s best to include all types in your diet, with an emphasis on saturated fats, especially compared to PUFAs.