Make things yourself. While it’s extremely convenient to buy most things pre-made or pre-cooked, it always adds to the price per pound on items. Try prepping veggies ahead of time instead of buying pre-cut ones. Try making your stew meat from a chuck roast. Or, simply try to make your mayo and salad dressings at home. The simplest of things can work to cut down on your overall grocery shopping.
When it comes to starting the keto diet (or any diet for that matter), there's one thing all experts agree on. You *must* have a plan. "Never try to wing a keto diet," says Julie Stefanski, R.D.N., C.S.S.D., L.D.N., a dietitian based in York, PA, who specializes in the ketogenic diet. "Set a start date and get prepared by reorganizing your pantry, planning out meal and snack options, and purchasing appropriate foods and dietary supplements," she says. "The biggest reason people have a hard time sticking with keto is that people don't have enough interesting foods to turn to, and high-carb favorites win out over good intention. If you didn't buy foods at the grocery store that fit the guidelines, there won't be an easy option in the fridge when you really need it." (A great place to start is this List of High-Fat Keto Foods Anyone Can Add to Their Diet.)
Lots of apps and website offer keto diet challenges—basically, a blueprint for the keto diet with a fixed starting and ending point (they typically last for a week to a month, though some may be longer). Speaking of apps, plenty of keto-centric ones are right at your fingertips (a.k.a., your smartphone), like the KetoDiet app, which can help you calculate your macros and track your keto diet effectively.
Long-term use of the ketogenic diet in children increases the risk of slowed or stunted growth, bone fractures and kidney stones. 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. 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. The stones are treatable and do not justify discontinuation of the diet. 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. However, this empiric usage has not been tested in a prospective controlled trial. Kidney stone formation (nephrolithiasis) is associated with the diet for four reasons:
The problem is that, with a bit more time, the pancreas eventually stops compensating, becomes exhausted, and makes less and less insulin—allowing the sugar in your blood to go higher and higher. So, the first stage of insulin resistance is normal or low blood sugars due to excessive compensation of insulin. Then this is followed by higher and higher blood sugars as you lose the ability to compensate for the sugar with insulin. This is called diabetes.
A third study published this week in the journal PLOS Medicine that surveyed the eating habits of 471,495 Europeans over 22 years found that people whose diets had lower "nutritional quality" (i.e., fewer fresh vegetables, legumes, and nuts) were more likely to develop some of the most common and deadliest forms of cancer, including colon, stomach, lung, liver, and breast cancers.
The ketogenic diet is not a benign, holistic or natural treatment for epilepsy; as with any serious medical therapy, there may be complications. These are generally less severe and less frequent than with anticonvulsant medication or surgery. Common but easily treatable short-term side effects include constipation, low-grade acidosis and hypoglycaemia if there is an initial fast. Raised levels of lipids in the blood affect up to 60% of children and cholesterol levels may increase by around 30%. This can be treated by changes to the fat content of the diet, such as from saturated fats towards polyunsaturated fats, and, if persistent, by lowering the ketogenic ratio. Supplements are necessary to counter the dietary deficiency of many micronutrients.
Contrary to what social media hashtags would have you believe, there's not much to suggest that it will improve athletic performance. Keto also ranked dead-last (down with another joy-stealer, the Whole 30 Diet) on the U.S. News and World Report's Best Diets list. The lack of research on long-term outcomes, hard-to-follow regimen, and potential health hazards all alarmed the panel of experts.
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. A typical day of food for a child on a 4:1 ratio, 1,500 kcal (6,300 kJ) ketogenic diet comprises:
Your glycogen stores can still be refilled while on a ketogenic diet. A keto diet is an excellent way to build muscle, but protein intake is crucial here. It’s suggested that if you are looking to gain mass, you should be taking in about 1.0 – 1.2g protein per lean pound of body mass. Putting muscle on may be slower on a ketogenic diet, but that’s because your total body fat is not increasing as much.5Note that in the beginning of a ketogenic diet, both endurance athletes and obese individuals see a physical performance for the first week of transition.