Long-term use of the ketogenic diet in children increases the risk of slowed or stunted growth, bone fractures and kidney stones.[3] The diet reduces levels of insulin-like growth factor 1, which is important for childhood growth. Like many anticonvulsant drugs, the ketogenic diet has an adverse effect on bone health. Many factors may be involved such as acidosis and suppressed growth hormone.[37] About 1 in 20 children on the ketogenic diet will develop kidney stones (compared with one in several thousand for the general population). A class of anticonvulsants known as carbonic anhydrase inhibitors (topiramate, zonisamide) are known to increase the risk of kidney stones, but the combination of these anticonvulsants and the ketogenic diet does not appear to elevate the risk above that of the diet alone.[38] The stones are treatable and do not justify discontinuation of the diet.[38] Johns Hopkins Hospital now gives oral potassium citrate supplements to all ketogenic diet patients, resulting in a sevenfold decrease in the incidence of kidney stones.[39] However, this empiric usage has not been tested in a prospective controlled trial.[9] Kidney stone formation (nephrolithiasis) is associated with the diet for four reasons:[38]
Hi I’m new to Keto. I have been reading about it, and understanding what to eat and what not to eat. My problem is I’m not sure if I’m doing it correctly. I’m constantly hungry whereas information reads that I will never be hungry. I use fats as required along with topping up with vegetables in my meals yet this does not fill me up. I haven’t experienced the Keto flu and I’ve even put on weight! I have been doing this for about 3 weeks now. Any ideas where I am going wrong.
Lunch: pat dry chicken and cut into cubes. Lightly (!) salt and pepper. Heat a skillet over medium heat, once hot add coconut oil and fry chicken cubes until brown from all sides. Remove chicken, and add crushed garlic, curry paste and fish sauce to pan. Stir until fragrant and remaining oil in pan and curry paste are well combined. Then add coconut milk and whisk until well combined. Simmer and reduce sauce until desired consistency (1-3 minutes). Pour sauce over chicken and sprinkle with sesame seeds. Serve with baby spinach.
"The keto diet is primarily used to help reduce the frequency of epileptic seizures in children. While it also has been tried for weight loss, only short-term results have been studied, and the results have been mixed. We don't know if it works in the long term, nor whether it's safe," warns registered dietitian Kathy McManus, director of the Department of Nutrition at Harvard-affiliated Brigham and Women's Hospital.
What's more, studies that have examined the efficacy of the ketogenic diet for weight loss have a few questionable similarities. First, they use the keto diet in conjunction with an extremely low-calorie plan (under 1,000 per day!), which makes it difficult to determine what caused the actual weight loss. Second, they all question the long-term impact on your heart of eating mostly saturated fat, not to mention how hard (and boring) it is to eat mainly coconut oil and butter for months on end.
The ketogenic diet is a medical nutrition therapy that involves participants from various disciplines. Team members include a registered paediatric dietitian who coordinates the diet programme; a paediatric neurologist who is experienced in offering the ketogenic diet; and a registered nurse who is familiar with childhood epilepsy. Additional help may come from a medical social worker who works with the family and a pharmacist who can advise on the carbohydrate content of medicines. Lastly, the parents and other caregivers must be educated in many aspects of the diet for it to be safely implemented.[5]
Another trigger of insulin is large quantities of protein. This was one of the issues with the Atkins diet. The optimum amount of protein per meal is about 3 to 6 ounces. Protein is needed for repairing and providing the raw material for muscle, tendons, joint cartilage, and even bone. Protein can also be used for fuel; however, too much protein triggers insulin which can be converted to sugar and then to fat. 
It can be tricky calculating the precise kind of diet that leads to a long life. Part of the problem is that (thankfully) we don't live our lives in highly controlled laboratory conditions. Until that terrifying day arrives and we all become well-studied lab rats, we have to rely on long-term observational data, usually in the form of surveys, to know more about which diets are the best long-term plans.
Think about what’s happening. Your cells are resisting insulin, causing your body to make a lot more. With all this extra insulin in your blood, you could experience low blood sugars. This is called hypoglycemia, a word made from hypo (low) and glycemia (glucose in the blood). Hypoglycemia is caused by too much insulin in the blood and is a prediabetic symptom. Signs of hypoglycemia include cravings for carbs and sweets, being irritable, moody or depressed, having vision problems, being hungry or dizzy, and the list goes on and on. Your brain is the first organ to feel the effects of low blood sugars.
There are vegetables that are high in carbs and others low in carbs. The keto diet recommends sticking to the ones low on carbs but encourages you to eat a lot of them. Best vegetables are all green ones to make it easy. And vegetables that grow above the ground (e.g. lettuce) are always better than the ones that grow below the ground (e.g. potatoes)
The ketogenic diet—also known as "keto"—has become the latest big thing in weight-loss plans, touted recently by celebs like Jenna Jameson, Mama June, and Halle Berry. The diet involves cutting way back on carbohydrates, to 50 grams a day or less, to help the body achieve a state of ketosis, in which it has to burn fat (rather than sugar) for energy.
Wilder's colleague, paediatrician Mynie Gustav Peterman, later formulated the classic diet, with a ratio of one gram of protein per kilogram of body weight in children, 10–15 g of carbohydrate per day, and the remainder of calories from fat. Peterman's work in the 1920s established the techniques for induction and maintenance of the diet. Peterman documented positive effects (improved alertness, behaviour and sleep) and adverse effects (nausea and vomiting due to excess ketosis). The diet proved to be very successful in children: Peterman reported in 1925 that 95% of 37 young patients had improved seizure control on the diet and 60% became seizure-free. By 1930, the diet had also been studied in 100 teenagers and adults. Clifford Joseph Barborka, Sr., also from the Mayo Clinic, reported that 56% of those older patients improved on the diet and 12% became seizure-free. Although the adult results are similar to modern studies of children, they did not compare as well to contemporary studies. Barborka concluded that adults were least likely to benefit from the diet, and the use of the ketogenic diet in adults was not studied again until 1999.[10][14]
The types of nutrients you need for health are vitamins, minerals, trace minerals, proteins (amino acids) and healthy fats (fatty acids). Nutrients are the helpful substances that build body tissue and organs and allow all the chemical reactions to occur in the body. Your body requires certain amounts of nutrients, and those are called Recommended Daily Allowances (RDAs). 
That is, until it's snack time—then, if you're on the keto diet, your'e basically SOL (unless, you know, you like having an entire steak for a snack). Think about it: All the best snacks are off limits on the keto diet (damn that fickle 70 percent fat, 25 percent protein, 5 percent carbs ratio). Granola bars, crackers, cookies—all off-limits on a keto diet.
Hi Kelly, All packaged foods will have a nutrition label that list the macros per serving, including fat, protein and cabrohydrates. Net carbs, which is what most people look at for low carb and keto, are total carbs (the amount on the label) minus fiber and sugar alcohols, as explained in the article above. I have a low carb food list here that gives you a full list of all the foods you can eat, and the net carbs in each. You can also sign up above to be notified about the meal plans, which are a great way to get started.

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Hunger is one way to know if you’re in fat burning, because the longer you do keto, the less hungry you’ll be.39,40 If you’re getting severe hunger with weakness and brain fog, you’re not quite into keto. Back off a bit. Don’t be doing 20-hour fasts. You need more fuel to give your body the energy it needs, and that includes energy to manufacture the enzymes to burn fat instead of glucose. Take it slow, add more fat to your first meal, and eat nutrient-dense foods. If you need more nutrients, try adding some nutritional yeast and electrolytes, and major amounts of potassium. These will help you fix insulin resistance and help you get into fat burning. Bone broth is great for a snack. It’s just nutrients without calories, period.
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 a keto 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.
The main criticisms include fears about fat intake and the process of ketosis.The argument over whether saturated fats are unhealthy has been settled in the research literature (they are not). If you need more info, there are several good books to read on this subject.  For more information about the type of fats to eat, see the saturated vs unsaturated fats page.  The right side column on that page has books which provide more information.
If you want to slam a protein shake post-workout, that's probably fine as long as you've got room for it in your macros. But shoot for one that is very low—like, zero—in carbohydrates. Pure isolates, such as Signature 100% Whey Isolate, are extremely low in carbohydrate. If you struggle to fit fat in during the day, toss a tablespoon of olive oil in with your shake. You won't taste it, and it gives a quick 13-14 grams of fat.
Children who discontinue the diet after achieving seizure freedom have about a 20% risk of seizures returning. The length of time until recurrence is highly variable but averages two years. This risk of recurrence compares with 10% for resective surgery (where part of the brain is removed) and 30–50% for anticonvulsant therapy. Of those that have a recurrence, just over half can regain freedom from seizures either with anticonvulsants or by returning to the ketogenic diet. Recurrence is more likely if, despite seizure freedom, an electroencephalogram (EEG) shows epileptiform spikes, which indicate epileptic activity in the brain but are below the level that will cause a seizure. Recurrence is also likely if an MRI scan shows focal abnormalities (for example, as in children with tuberous sclerosis). Such children may remain on the diet longer than average, and it has been suggested that children with tuberous sclerosis who achieve seizure freedom could remain on the ketogenic diet indefinitely.[45]
The ketogenic diet reduces seizure frequency by more than 50% in half of the patients who try it and by more than 90% in a third of patients.[3] Three-quarters of children who respond do so within two weeks, though experts recommend a trial of at least three months before assuming it has been ineffective.[9] Children with refractory epilepsy are more likely to benefit from the ketogenic diet than from trying another anticonvulsant drug.[1] There is some evidence that adolescents and adults may also benefit from the diet.[9]

Hi Stacey, I can’t give medical advice and definitely recommend following your doctor’s recommendations. You can ask him/her if low carb would be better suited for you. Also, you may want to double check with him/her if the kidney concern was related to high protein, because that is a common misconception about keto – it is not a high protein diet/lifestyle.
hi I have been following this diet have not had any sugar and I just want to know how am I going over the carbs I’m eating vegetables which I know are carbs but I’m not overdoing it. What is the best way to keep up with your carbs fats and proteins also do I need a scale? I feel like I lost weight this week but most of it was probably water weight I was in ketosis on Thursday and today it shows I’m not. Any help would be greatly appreciated
Drink lots of water. This is especially crucial on a low carb or keto diet. Why? When you eat carbohydrates, your body stores the extra as glycogen in the liver, where they are bound to water molecules. Eating low carb depletes this glycogen, which allows you to burn fat – but it also means you are storing less water, making it easier to get dehydrated. Instead of the traditional recommendation of 8 cups of water per day, aim for 16 cups when following a low carb lifestyle.
There is scientific evidence that supports the use of a ketogenic diet to help manage certain neurologic conditions. There are also medical, nutrition, and fitness professionals that recommend the eating program for patients and clients who have other health goals. But just because the program works for some, doesn't mean that it's the best diet for you.

The whole chicken we got was $1 per pound, which is a great deal! You can sub in thighs or legs if you find those to be cheaper. Try to get it with the skin on so your meat comes with some fat! In the videos we got 2 pounds of sausage at $3 per pound. That’s a deal we couldn’t pass up! You can substitute any sausage in for that(check for sugar) or you can opt for ground beef. Make sure you get 80/20 fat/protein ratio or higher(it will be listed on the packaging).


A computer program such as KetoCalculator may be used to help generate recipes.[46] The meals often have four components: heavy whipping cream, a protein-rich food (typically meat), a fruit or vegetable and a fat such as butter, vegetable oil or mayonnaise. Only low-carbohydrate fruits and vegetables are allowed, which excludes bananas, potatoes, peas and corn. Suitable fruits are divided into two groups based on the amount of carbohydrate they contain, and vegetables are similarly divided into two groups. Foods within each of these four groups may be freely substituted to allow for variation without needing to recalculate portion sizes. For example, cooked broccoli, Brussels sprouts, cauliflower and green beans are all equivalent. Fresh, canned or frozen foods are equivalent, but raw and cooked vegetables differ, and processed foods are an additional complication. Parents are required to be precise when measuring food quantities on an electronic scale accurate to 1 g. The child must eat the whole meal and cannot have extra portions; any snacks must be incorporated into the meal plan. A small amount of MCT oil may be used to help with constipation or to increase ketosis.[36]
Hi Cyn, The numbers are general guidelines but will vary depending on many factors, such as activity level, insulin resistance, weight and more. There is no single magic number, just conventional recommendations that are a good starting point. I will have a macro calculator coming soon that will help determine what is best for each person, but even then it’s an approximation. The only way to know for sure is to test. If keto is your goal, it’s usually best to start lower and then see if you can stay in ketosis when increasing.
Helen, We think this recipe would also work well in the oven! Here’s how we would cook it: 1) crisp the bacon on the stovetop; 2) for step 2 in the recipe above, add all ingredients to a 9 by 13-inch casserole dish, cover it with foil, and bake it at 350F until the chicken is fully cooked, about 30 to 45 minutes (the chicken should not be pink in the center, and it should shred easily with a fork); 3) remove and shred the chicken; 4) stir the shredded chicken into the creamy sauce along with the cheddar cheese; 5) top with bacon and scallion and serve. If you give it a try, please let us know how it goes!
Saturated fat is not harmful in the context of a low carb diet. This study from Johns Hopkins Medical School confirms this. The ketogenic diet plan is healthier because the higher saturated fat intake increases your HDL cholesterol, and at the same time, a lower carb intake decreases your triglycerides levels. These two factors are the major markers for heart disease, and the closer your triglyceride/HDL ratio is to 1, the healthier your heart. In reality, the cause of heart disease is a chronically high carbohydrate consumption, not a high saturated fat and cholesterol intake. I think the best way to learn this is to get a full blood test before you start a ketogenic diet plan, then do the diet faithfully for 3 months. Then have your blood work checked again. You'll see the difference and discover how much better you feel. 
Lisa, Yes, it is safe to put cream cheese in the pressure cooker, this is how we always make it. Alternatively, you can add the cream cheese once the chicken is cooked and you take it out of the pot to shred it, but you’ll need to leave the pot on “saute” and cook (stirring frequently) until the cream cheese mixture is melted into the sauce. (You may also need to add a splash more liquid if done this way.) If you try it this way, let us know how it goes!
Trying to lose weight with exercise and starting a keto diet at the same time can provide fast results for a "multiplier" effect. However, if you haven't exercised in more than 6 months, you should wait to start the keto eating plan. Begin an exercise program first so you are adapting to only one physical change at a time. After 2 weeks of working out 3-4 times per week, you should be ready to start the keto diet.

A question we frequently get asked is whether you have to defrost boneless, skinless chicken breasts before making this recipe, or if you can just use them frozen. If you forgot to pull the chicken out of the freezer in the morning, we have good news for you! Crack Chicken can easily be made with frozen chicken. If using an Instant Pot, just add 5 minutes on to the cooking time (for a total of 20 minutes on Manual High Pressure).
When you get to one meal a day, just make sure the meal is a robust one, containing all the needed nutrients to fortify your body with vitamins, minerals, amino acids, those important fatty acids, trace minerals—all of it. (This can be aided with green drink powders and high-quality electrolyte supplements that will help you get your daily requirements for potassium.)
There is scientific evidence that supports the use of a ketogenic diet to help manage certain neurologic conditions. There are also medical, nutrition, and fitness professionals that recommend the eating program for patients and clients who have other health goals. But just because the program works for some, doesn't mean that it's the best diet for you.

We understand that you may not have time to track all your macros, which is why we include the macros with each keto recipe.  However, try grabbing a handful of almonds for a keto snack and realizing even a big handful is over a "serving size" and greater than 200 calories.  If you are using the keto diet for weight loss, this may not fit into your macros of 1200-1500 calories per day.


A simple standby, but one that ketoers adore. 2 or 3 fried eggs and some bacon might not sound like much, but it’s full of protein that will keep you full and energized all morning. Take the opportunity on the weekend to lay your bacon strips on a single cookie sheet and bake in the oven for 20 minutes at 400 degrees. The result is the best bacon you’ve ever had, in a big batch, with no sitting over a popping, hissing frying pan.
This is the only way my kids will eat Brussels sprouts! It’s actually great for me because this dish is fast, easy and healthy, and it makes a lovely side. Quick-cooking Brussels sprout halves are available in the prepackaged salad aisle at the grocery store. They’re a timesaver if you can find them, but you can always just buy whole ones and slice them in half. —Teri Rasey, Cadillac, Michigan
You should check with your physician if you have any concerns about starting a ketogenic diet plan with pre-existing health conditions, especially if those conditions involve kidney or heart problems.  People with kidney disease should definitely consult with their physician about starting a ketogenic diet.  Other contraindicated conditions and health issues are listed here.  Make sure you check this list and rule these out before starting the diet.
Fat is the cornerstone of the keto diet, making up the bulk of calories. An individual consuming 2,000 calories per day would need to consume 144 to 177 grams of fat. Fats make up 70-80% of your calories. Since fat is the main source of nutrition on a ketogenic diet, it’s important to source high-quality, healthy fats, which you’ll read about below.

A systematic review in 2016 found and analysed seven randomized controlled trials of ketogenic diet in children and young people with epilepsy.[2] The trials were done among children and young people for whom drugs failed to control their seizures, and only one of the trials compared a group assigned to ketogenic diet with a group not assigned to one.[16] The other trials compared types of diets or ways of introducing them to make them more tolerable.[2] Nearly 40% of the children and young people had half or fewer seizures with the diet compared with the group not assigned to the diet. Only about 10% were still on the diet after a few years.[2] Adverse effects such as hunger and loss of energy in that trial were common, with about 30% experiencing constipation.[16]
In many developing countries, the ketogenic diet is expensive because dairy fats and meat are more expensive than grain, fruit and vegetables. The modified Atkins diet has been proposed as a lower-cost alternative for those countries; the slightly more expensive food bill can be offset by a reduction in pharmaceutical costs if the diet is successful. The modified Atkins diet is less complex to explain and prepare and requires less support from a dietitian.[54]
High-Fat Nuts and Nut Butters — Some nuts are fairly high in carbs (like cashews and pistachios), so it is best to keep your snack portions small. Stay away from any nuts or nut butters that have added carbs, polyunsaturated oils, or vegetable oils. Choose higher fat nuts and nut butters, such as almonds, pecans, or macadamia nuts. You can also make your own nut butter at home by using this recipe. (Feel free to use MCT oil instead of coconut oil for an extra energy boost.)
The “Slaw Hash” Which is a actually eggroll filling without the wrapper is delicious even without being keto. My husband requests it every other week and he isn’t even really fond of cabbage. I use shredded cabbage, a few finely sliced white mushrooms, sliced white onion, ground pork or turkey, soy sauce, white pepper, a cap-full of bombay sapphire gin (tastes sort of like sake, without having to add a TON of sake), and one shredded carrot.

One cup sliced cucumbers and 10 large olives makes for a great keto-friendly snack, with added benefits: “This is a great snack to help people in ketosis supplement their sodium levels." says Desiree Nielsen, R.D., author of Un-Junk Your Diet. When you're in ketosis, your body needs more sodium, and “without adequate sodium, people are at risk for dehydration, constipation, and more dangerous electrolyte imbalances," she adds.
This shopping list and meal plan can be heavily substituted to meet your needs. The first thing you’ll want to do is scan it over and make sure you like eating all of the foods listed here. Eating delicious foods is a big part of adhering to a diet long term! If there is a particular item you can’t stand just do a bit of research and find a substitution. Just make sure the item you decide to substitute in is similar in nutrition to the one you’re eliminating. This can be done with a quick google search or by using a website like My Fitness Pal.

Low carb recipes are essential for a keto diet! A few years ago, we started making keto recipes and after realizing just how delicious they are and how they make us feel, we never looked back! These low carb recipes will make you feel better, live better and eat better. Each recipe is absolutely delicious – we know because we only share the ones we absolutely love. You can also try our low carb breakfasts, low carb lunches, low carb dinners, low carb desserts and more!
Hey guys, just started the Keto diet and needed some comfort food!! This recipe is the “BOMB”!!! Even my husband and his buddy loved it done up in a Romaine wrap. I have used also Norigami wraps, and made “cloud bread” to toast in a pan and top with the ooey gooey scrumptious Crack Chicken, if y’all haven’t tried this recipe DO IT!!! Keep um comin’ gals!!!!
The less frequent the meals, the more protein you will need per meal. What happens as you eat fewer meals is that your body will compensate. That is, you’ll lose less protein and become more efficient at using it. If you consume two meals per day, the average protein per meal could be 7 to 8 ounces. If you have  one meal per day, the total daily protein amount could be 9 ounces.
Note: Are you a vegetarian or vegan and want to go on a ketogenic diet? It’s still possible! Just keep in mind that the dietary restrictions can sometimes be a little bit intense. Make sure to plan ahead and prepare to aid your success. To help out, we’ve published articles (with 7 day meal plans included) for both the vegetarian ketogenic diet and the vegan ketogenic diet.
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