Say hello to the pili nut! Boasting a higher fat and lower carbohydrate content than just about any other nut on the planet, this snackable wonder is your ketone-loving body’s new best friend. Hunter Gatherer’s handy multipack includes flavors like black pepper turmeric, spicy chili, and Himalayan salt and coconut oil, each wild harvested from pili trees in the mountains of the Philippines.
For patients who benefit, half achieve a seizure reduction within five days (if the diet starts with an initial fast of one to two days), three-quarters achieve a reduction within two weeks, and 90% achieve a reduction within 23 days. If the diet does not begin with a fast, the time for half of the patients to achieve an improvement is longer (two weeks) but the long-term seizure reduction rates are unaffected. Parents are encouraged to persist with the diet for at least three months before any final consideration is made regarding efficacy.
Keep in mind that the doctor is getting nutritional ketosis confused with a much more dangerous condition called ketoacidosis. These are two different conditions. Ketoacidosis is mostly a concern for Type 1 diabetics and others whose bodies are unable to make or process insulin correctly. Ketoacidosis usually develops when a person with type 1 diabetes develops an serious infection, has a heart attack or other debilitating illness. It is accompanied by dehydration, high blood sugars and is precipitated by the inability of the sick patient to administer proper amounts of injected insulin.
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 may also want to buy some Ketostix Reagent Strips so that you can check to see if you are in ketosis for the first few weeks. However, after the first 3-4 weeks on the plan, the goal is to become "keto-adapted". Once adapted, the body should be burning the ketones for fuel. The stick shouldn't register as deep purple if you are using the ketones as a fuel source. And they now have blood ketone meters available to track blood ketones at home. This is a much more accurate way to track your individual ketone levels. See my ketosis page for more information.
It's only when you combine lots of fat and lots of carbohydrates in your diet that you get into trouble. The sugar from the carbohydrates drives up your insulin levels, and those high insulin levels cause the body to mishandle the way fats are metabolized. More fat is stored or circulates in the blood. This causes the metabolic syndrome and weight gain associated with insulin resistance and starts the health problems that should be associated with a high carb diet, not a ketogenic diet plan.
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.
Calories: The nutrient intake on a ketogenic diet typically works out to about 70-75% of calories from fat, 20-25% from protein, and 5-10% from carbohydrate on a daily basis. However, these ratios don't work well at very low calorie or very high calorie daily totals. And although calorie counting is not required, it is important to understand how macronutrient percentages can be affected by caloric intake, so you may want to read my page on calorie counting to get more information on this subject. Again, low or very high calorie intake will skew the percentages of macronutrients. It is also important to remember that fats are super high-calorie foods, especially if you have extra weight to lose and you are doing keto to lose weight. Read my plateau page if you are not reaching your weight loss goals.
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.
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:
That’s why many health experts are concerned about people on the keto diet, especially those who try it without the guidance of a doctor or nutritionist. Doctors say that high-fat diets like this one may raise cholesterol levels, and some studies suggest that they increase the risk of diabetes. Some have even called it a “cardiologist’s nightmare.”
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.
Normal dietary fat contains mostly long-chain triglycerides (LCT). Medium-chain triglycerides are more ketogenic than LCTs because they generate more ketones per unit of energy when metabolised. Their use allows for a diet with a lower proportion of fat and a greater proportion of protein and carbohydrate, leading to more food choices and larger portion sizes. The original MCT diet developed by Peter Huttenlocher in the 1970s derived 60% of its calories from MCT oil. Consuming that quantity of MCT oil caused abdominal cramps, diarrhoea and vomiting in some children. A figure of 45% is regarded as a balance between achieving good ketosis and minimising gastrointestinal complaints. The classical and modified MCT ketogenic diets are equally effective and differences in tolerability are not statistically significant. The MCT diet is less popular in the United States; MCT oil is more expensive than other dietary fats and is not covered by insurance companies.
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.