I am a stage four kidney disease patient. I am also a type one diabetic. I have had diabetes for 37 years. My Internist suggested the Keto diet for me, but there are so many if the foods on the Keto diet that I’m not able to eat because of my kidneys functioning at 22%. How do I reconcile this diet plan to work with my kidney disease? I’m not allowed any dairy, because of my high potassium. Is almond milk ok to drink? I’m not allowed avocados, mushrooms, spinach, tomatoes, greens, (beet or chard). No bacon, or pork. No melons, bananas, oranges, peaches, pears, some apples, pineapple. I can have berries of all kinds. will this still work for me?
'Cutting out carbs without advice can be dangerous, and can put you at risk of deficiencies in the long-term,' warns Dr Barclay. 'If you're looking to lose weight, burning fat may sound like the key to success, but in actual fact it comes with some risks, and may not be effective in the long term. The ketogenic diet is a short-term solution to a long-term health problem.'
Why higher fat and moderate protein? Fats have little to no effect on blood sugar and insulin levels. Protein does affect both blood sugar and insulin. If you eat too much protein for your ideal body weight or lean muscle mass (usually more than 1.5-2.0 grams/kg lean body mass), it can spark gluconeogenesis and raise blood sugar. Protein will also spike blood insulin levels temporarily, which can interfere with ketone body production. However, it is important to note that this is an individually driven parameter, as detailed in this excellent post from the Optimizing Nutrition blog.  
What’s going on is your body is trying to adjust to fat burning. So, this is a good thing. What you need to do is concentrate on getting more vitamins in the diet. Now, the one nutrient you need a lot of to keep the fatigue away and to help you in the metabolism is B5. B5 also helps the adrenals and metabolism along, and keeps that fatigue away. Promise!

AG Matcha 🍵 Special: – 1T matcha – 1/2c coconut milk – 1 1/2T @perfectketones C8 MCT oil – 1T raw cacao butter – 1T grass-fed butter – 1 scoop @perfectketones vanilla collagen – 12oz boiling water – 1/4t vanilla bean powder – blend _ Taking some time off coffee and replacing with this bad boy 🍵 this is the type of thing I’ll be having on my “modified carnivore” diet. Also oils, micro greens, leafy greens, avocado.
Eggs are a standout snack because they have one of the lowest energy-to-nutrient-density ratios of any food, as is noted in an article published in August 2016 in the journal Proceedings of the Nutrition Society. They’re rich in good fats (so long as you don’t skip the yolk!) and a solid source of high-quality protein: Each egg has 5 grams (g) of fat, 6 g of protein, and 0 g of carbohydrates, according to the Egg Nutrition Center. Plus, they’re inexpensive — about 20 cents per egg, the center says. Keep several hard-boiled eggs in your fridge, so you can easily grab one when you’re in need of a nutritious snack.
However, ALSO be aware that most doctors get very little training on nutrition and don't understand the general effect of foods on the body. They are also taught that ketosis is dangerous, and so they know even less about ketogenic diets. Hence, if you ask your physician about this diet, you may get push back and a scary "ketosis-is-dangerous" sermon.
So people saying that – despite the lack of scientific support – likely have a financial reason to say it. Some of these products are sold under something like a multi-level marketing arrangement, so sales people are entirely paid based on commission. For example, the company Prüvit sells drinkable ketones, called KETO//OS with a multi-level marketing structure.

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The nerve impulse is characterised by a great influx of sodium ions through channels in the neuron's cell membrane followed by an efflux of potassium ions through other channels. The neuron is unable to fire again for a short time (known as the refractory period), which is mediated by another potassium channel. The flow through these ion channels is governed by a "gate" which is opened by either a voltage change or a chemical messenger known as a ligand (such as a neurotransmitter). These channels are another target for anticonvulsant drugs.[7]

The first signs of ketosis are known as the “keto flu” where headaches, brain fogginess, fatigue, and the like can really rile your body up. Make sure that you’re drinking plenty of waterand eating plenty of salt. The ketogenic diet is a natural diuretic and you’ll be peeing more than normal. Take into account that you’re peeing out electrolytes, and you can guess that you’ll be having a thumping headache in no time. Keeping your salt intake and water intake high enough is very important, allowing your body to re-hydrate and re-supply your electrolytes. Doing this will help with the headaches, if not get rid of them completely.
Keto bombs are snacks that ketogenic dieters love because they’re healthy, delicious cheat foods that are high in fat, but virtually devoid of carbs and protein. I have a lot of videos on how to make keto bombs, but you don't have to have them with each meal. The goals would be to have one a day. Dumping a lot of butter or coconut oil into your coffee may not work for you. Some people can digest it, and some people can't.
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.
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]
Please note that I am not a medical or nutritional professional. I am simply recounting and sharing my own experiences on this blog. Nothing I express here should be taken as medical advice and you should consult with your doctor before starting any diet or exercise program. I provide nutritional information for my recipes simply as a courtesy to my readers. It is calculated using MacGourmet software and I remove erythritol from the final carb count and net carb count, as it does not affect my own blood glucose levels. I do my best to be as accurate as possible but you should independently calculate nutritional information on your own before relying on them. I expressly disclaim any and all liability of any kind with respect to any act or omission wholly or in part in reliance on anything contained in this website.
Eggs are a healthy, nutrient-dense food that has been incorrectly maligned for years. Cholesterol in food doesn’t increase cholesterol in your blood, so eat eggs liberally – they’re packed with protein and lutein, and they fill you up for hours. Make a healthy omelet with some cheddar, crumbled breakfast sausage, and shredded spinach and you’re already looking at over 30g of protein, just for breakfast! Spinach is a great source of magnesium and potassium, too. Add some sea salt and you’ve got a big dose of electrolytes that are so vital to maintaining energy and staving off headaches. Get the recipe and instructions
When you’re burning more ketones, you can start releasing a bit of acetone, which smells like nail-polish remover. Or you might release ammonia. Sometimes you get that sulfur smell. For all of these, increase vegetable consumption. Over time, you’ll be more efficient at burning ketones, and a lot less of this will happen. If you’re getting an ammonia smell, it means you’re eating too much protein and need to cut back. A sulfur odor means there’s a gut issue, and you need to regulate your gut bacteria; you should take a type of probiotic called Pro EM-1, which you can find online.
A lot of conflicting information has been circulated about the consumption of fat. People are sometimes concerned that adding fat to their diet will cause them to gain weight. This is not necessarily the case. Fat a neutral food. It is also satisfying. If you eat a low-fat meal, whether you have carbs or not, you will stay hungry. Fat allows you to feel full for longer. Furthermore, fat does not spike insulin and adding some healthy fat at meals will help you go longer between meals and really dip down into your fat stores to burn that fat off the body. Burning all that fat off the body is much healthier than holding onto it—which will lead to insulin resistance, diabetes, and all the dominoes that fall after that—cardiovascular disease, cancer, the list goes on and on.
“I really believe that the more informed you are about the benefits of a healthy bite versus the chain reaction that you’re going to put into effect in your body when you take that bite — you just suddenly don’t want to make that choice for yourself anymore. It’s beyond willpower at that point; it’s become a desire to do something good for yourself.” — Christie Brinkley
Protein is the other type that can also prevent you from getting into ketosis IF it’s too high. It is generally recommended that you keep your protein intake between 3-6 ounces per meal. High-protein diets, as in the Atkins Diet, can keep you from getting into ketosis. This is because your liver can only process a certain amount of protein. Anything more than around 30 grams per meal will then be converted into glucose (sugar).  So, ketosis is NOT a high protein diet. It is a moderate protein diet. We need some protein for supporting our structural body parts and their replacement. This includes muscle, joints, hair, nails, skin, and organs.
But people who started following the keto diet noticed weight loss for a few reasons: When you eat carbs, your body retains fluid in order to store carbs for energy (you know, in case it needs it). But when you’re not having much in the carb department, you lose this water weight, says Warren. Also, it's easy to go overboard on carbohydrates—but if you're loading up on fat, it may help curb cravings since it keeps you satisfied.

I want to give special mention one of the side effects of carb withdrawal because it can really be scary if you don't know what it is.  During the first week or so of cutting your carb intake, your blood sugar levels will fall, and you may experience a mild insulin overload and reactive hypoglycemia.  This usually happens to people who are severely insulin resistant.  It takes about 2-3 days to burn through all of your stored glycogen (carb energy stored in your muscles and liver), and after that you may get these low blood sugar symptoms of shakiness, dizziness, tremors, a pounding heart and more. (See the link above for more info). For those of you that have been living on a high-carb diet for a long time, the effects may be even more pronounced, as your blood sugar and insulin levels are probably chronically high.  
In 1921, Rollin Turner Woodyatt reviewed the research on diet and diabetes. He reported that three water-soluble compounds, β-hydroxybutyrate, acetoacetate and acetone (known collectively as ketone bodies), were produced by the liver in otherwise healthy people when they were starved or if they consumed a very low-carbohydrate, high-fat diet.[10] Dr. Russell Morse Wilder, at the Mayo Clinic, built on this research and coined the term ketogenic diet to describe a diet that produced a high level of ketone bodies in the blood (ketonemia) through an excess of fat and lack of carbohydrate. Wilder hoped to obtain the benefits of fasting in a dietary therapy that could be maintained indefinitely. His trial on a few epilepsy patients in 1921 was the first use of the ketogenic diet as a treatment for epilepsy.[10]
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.
A word of warning: be very wary of “keto” or “low carb” versions of cakes, cookies, chocolate bars, candies, ice cream, and other sweets. They will keep your cravings for a sugary taste, and can make you eat more than you need. They are oftan full of sugar alcohols – that can raise your blood sugar – and artificial sweeteners, whose health impacts are not yet known. Weight loss may also stall or slow. Learn more
"Plenty of people jump right in, thinking all they have to do is cut carbs and increase fat. All of a sudden, they hit a wall and get 'keto flu.' They feel tired, lethargic, and experience headaches," Wittrock says. "The primary reason they get these symptoms is lack of the three primary electrolytes: sodium, potassium, and magnesium. If you're deficient in any of these, you'll suffer mentally and physically. This is the single biggest reason people fail on the keto diet."
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!
When you eat a ketogenic diet, you switch your body’s fuel source to fat rather than the body’s usual source, glucose (1). From this fuel source switch, the hunger hormone, Ghrelin, is reduced which causes your appetite to decrease (1). Because of the reduction in appetite, it is easier to adopt an intermittent fasting approach or an approach that lessons unwanted eating behavior outside your desired hours (AKA curbs the late night munchies). Therefore, I recommend eating 4 bigger meals rather than 6 small meals on a Ketogenic Meal Plan.
First, I want to thank you for all of your dedication and work in providing this site. The difficulty of maintaining a healthy weight is a big problem for so many people. My personal question & issue in staying on Keto is my craving for fresh fruit. This a.m I had a large fresh peach along with my “Bullet Proof” coffee. Have I now sabotaged today’s Keto eating?
Why higher fat and moderate protein? Fats have little to no effect on blood sugar and insulin levels. Protein does affect both blood sugar and insulin. If you eat too much protein for your ideal body weight or lean muscle mass (usually more than 1.5-2.0 grams/kg lean body mass), it can spark gluconeogenesis and raise blood sugar. Protein will also spike blood insulin levels temporarily, which can interfere with ketone body production. However, it is important to note that this is an individually driven parameter, as detailed in this excellent post from the Optimizing Nutrition blog.  

Ready to head out the door and start buying groceries? Slow down there, chief. Go through the pantry, fridge, freezer, and secret stashes under the bed, and get rid of foods with any significant carb content. In the first few days, you could end up craving them—badly. This means fruit, too. Even carrots and onions are too high-glycemic to work with keto, Wittrock says.
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.
But the real reason why keto plans fail most of us is that they're not sustainable for the long term. Holidays, vacations, work functions … there's likely at least one scenario in which you'll find yourself eating higher-carb foods. And the same reasons why we see immediate weight loss on carb-restricted diets is the same reason why we see immediate weight gain after adding a seemingly harmless sandwich back into the mix: The water weight comes back instantly with glycogen storage.

I get many questions about intermittent fasting, the health benefits, the weight loss benefits, and the like. People normally use intermittent fasting for both the energy and mental clarity it can offer. But it’s not just good for that. It can offer breakthroughs of plateaus and even benefits in nutrient uptake in exercise. We go more in depth to intermittent fasting in Week 3 and 4, so keep your eyes peeled!
Nuts or nut butters and seeds: Remember some nuts are fairly high in carbs (like peanuts, cashews, and pistachios). Stay away from any nut butters that have added polyunsaturated oils or “vegetable oils.” Choose higher fats choices, such as almonds or macadamia nuts, and seeds high in omega 3s like flaxseed and chia. Nuttzo is a great choice for a blend of good nuts. We, of course, make a delicious keto nut butter with MCTs and macadamia nuts. If you’re interested how nuts can affect you on a ketogenic diet, check out our Full Guide to Nuts on the Ketogenic Diet.
Switching to a ketogenic diet plan can be uncomfortable at first because your body metabolism is refitting itself to burn fat instead of relying on glucose.  However, you can avoid most of the symptoms. Here's a list of all of the common side effects that will happen the first week or so of starting a ketogenic diet. Knowing about them allows you to take steps to minimize them, and save yourself some carb withdrawal misery. Dr. Mike Eades has a great analogy for this process in this blog post.  I highly recommend you read it.
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.
Take a 2 – 3 cups of lettuce, crumble in some bacon and dice a medium tomato. Mix that with two or three tablespoons of mayo, and toss after adding some splashes of hot sauce. Delicious, filling, full of fiber and healthy fats, and absolutely easy. I know the mayo sounds weird as a dressing, but trust us; it’s amazing! Add in some avocado chunks to boost potassium too!
The ketogenic diet — a high-fat and very low-carb eating plan — can be tough to start. After all, it’s likely a radical departure from the way you’re eating now (a typical standard American diet is high in carbohydrates and processed foods). But many people are trying the keto diet, which puts your body in a state of ketosis. That's what happens when your body’s carb-burning switch flips to a fat-burning one, a change that can cause weight loss and has even been credited with controlling diabetes. (1)
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