Variations on the Johns Hopkins protocol are common. The initiation can be performed using outpatient clinics rather than requiring a stay in hospital. Often there is no initial fast (fasting increases the risk of acidosis and hypoglycaemia and weight loss). Rather than increasing meal sizes over the three-day initiation, some institutions maintain meal size but alter the ketogenic ratio from 2:1 to 4:1.[9]
It is very interesting to read about the keto/low card diet.I love to change my lifestyle as I an TYPE 2 Diabetic.I subscribed for a free printable low carb meal .The initial email stated that that I will receive an email for instructions to access the members area .Your free download will be there.However it is very deceiving ,I never got the 2nd email with instructions which is frustrating and not good .Hopefully this is not a way to get us to pay to get the printable version.
For most people, this eating style is a significant departure from the diet that they are comfortable eating. Most of us build meals around lean protein and carbohydrates, not fat. So before you decide to adopt the diet, it's smart to evaluate keto meals plans and think about whether or not you think you can stick to it for the long term. For example, if you are an eater who loves to include plenty of fresh fruits and vegetables at every meal, you might not be able to maintain this eating style.
Fiber isn't just good for keeping your gut moving — scientists feeding diets rich in fiber to mice are discovering that the carbs, which can't be absorbed by the body, can help protect aging brains from some of the damaging chemicals associated with Alzheimer's and reduce inflammation in the gut. They're confident that the health benefits of eating more fiber extend to humans too.
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]

"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.
The more likely result of a ketogenic diet plan, once you've adapted to it, is that you will feel much better and be much healthier. One of the long list of health benefits of a ketogenic diet is that it lowers your fasting blood sugar and insulin levels, helps reverse insulin resistant conditions such as type 2 diabetes, PCOS, fatty liver and Metabolic Syndrome, cools inflammation and in turn, leads to better overall health.
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All low-carbohydrate vegetables contain essential vitamins, minerals, fiber and antioxidants that are beneficial for our health. Cruciferous vegetables come with an extra health boost. They contain more vitamin K and A than many other vegetables, this is the reason why we put cruciferous vegetables on the list of top keto foods. The reason why crucifers vegetables like broccoli and cauliflower are at an edge over every other vegetable is because of sulforaphane. Sulforaphane is a compound that is created when we crush or chew cruciferous vegetables. Once it is digested, sulforaphane activates a cytoprotective (cell-protecting) pathway that protects the cells from oxidative stress and removes harmful toxins from the body. This is one of the primary reason why cruciferous vegetable consumption is linked to improved cognitive function and decreased cancer and heart disease risk. 
Keto bombs are fat cookies that ketogenic dieters love because they’re healthy, delicious cheat foods that are virtually devoid of carbs. I have plenty of videos on how to make keto bombs, but you have to eat them with a meal, not as a snack. The goal would be to stick to one a day. Go to my YouTube channel under Playlists, then Recipes; or to www.DrBerg.com under Recipes.
The easiest macro to calculate in the ketogenic diet is fat. Once you've got your carbs and protein set, simply fill the rest of your daily calorie needs with fat sources. If you find yourself wanting to gain a bit of weight, add approximately 500 calories, or 55 grams. If you want to lose weight, cut down on your fat intake by 200-500 calories, or 22-55 grams.
Hi Mel, Assuming that your ranch dressing doesn’t have sugar added, you don’t need to worry too much about limiting it, but within reason. This is my homemade ranch dressing recipe, which has 0.9g net carbs per 2-tbsp serving. It would be hard to find a store bought one with much less than that, even though some round anything less than 1g down to 0g, which isn’t truly accurate. Also, keep in mind that if weight loss is your goal, some people find that too much dairy can cause a stall. Finally, make sure you aren’t using all your “available” carbs on ranch dressing – have it with some low carb veggies!
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]
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
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.  
Sometimes we all have leftover chicken on hand that needs to be used up. Maybe you roasted a couple of chickens on the weekend to prep for the week ahead, maybe you had company over and grilled up too many chicken breasts, or maybe rotisserie chicken was on sale at your local grocery store and it was too good a bargain to pass up. Whatever the reason, we all can use a few ideas on how to use up leftover chicken.
In the worst form of diabetes (type 1), a condition called ketoacidosis can exist. This is completely different from ketosis. Ketoacidosis is a disease state where there is no more insulin and acids build up to high levels that are dangerous to one's health. But with ketosis, the pH in the body doesn't even get close to the high levels seen with ketoacidosis.

Don’t let the kiddie lunchbox aesthetic fool you—these dehydrated little nuggets might look like they come from a children’s book, but there’s nothing made up about their magic. Whether you’re fiending for the pepper jack, gouda, or cheddar, they’re all shelf-stable, low-carb, high in protein and calcium, delightfully crispy, naturally gluten-free, and super fun to eat. Why? They’re just cheese!
When you lose weight, fat cells shrink. In a fat cell, there are triglycerides and cholesterol. Now, as that fat cell shrinks, you can burn triglycerides, but you cannot burn cholesterol. So it will go into the blood, go to the liver, and come out through the bile. But you’ll be totally fine as long as your triglycerides are low. (If you’re not using those as fuel, then you’re eating too much sugar.)

Who says dessert can’t be keto-friendly? This sugar- and sugar alcohol-free treat is made from 100-percent stone-ground South American cocoa beans and sweetened with monk fruit and non-GMO soluble vegetable fiber, making it both low in carbs (just three net grams per ounce) and melt-in-your-mouth creamy. Throw in a handful of earthy, buttery almonds for good measure and you’ve got something that’ll appease your sweet tooth without ruining your diet.


That's because my intro to this seemingly new plan was when I worked in a hospital, where ketogenic diets were specifically used as a medical nutrition therapy for pediatric patients with seizure disorders, for whom medication was no longer effective. In other words: It was used as an absolute last resort for families who felt otherwise hopeless in the face of a neurological disease, and under strict medical supervision.
A systematic review in 2018 looked at sixteen studies on the ketogenic diet in adults. It concluded that the treatment was becoming more popular for that group of patients, that the efficacy in adults was similar to children, the side effects relatively mild. However, many patients gave up with the diet, for various reasons, and the quality of evidence inferior to studies on children. Health issues include high levels of low-density lipoprotein (LDL), high total cholesterol, and weight loss.[23]
With intermittent fasting, the whole goal is to burn off excess fat, right? Watch how you feel when you exercise. Do you feel best when you exercise after eating or if you exercise while fasting? Watch if your legs feel heavy or if you tire too easily. Some people do well with eating first, while some love that feeling of exercising when they have fasted and having to eat afterwards. 
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.

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.

Lisa, Technically Instant Pot doesn’t recommend cooking frozen chicken breasts; however, when we cook frozen chicken breasts in the Instant Pot, we usually add an extra 3 to 5 minutes to the cooking time. For the slow cooker, you could add all the ingredients as-is (just cook the bacon on the stove top first, add the bacon fat to slow cooker, and store cooked bacon in the fridge until serving). We recommend cooking on high 3 to 4 hours or cook on low 6 to 8 hours. Let us know how it goes if you give it a try!
Although there are many seed-based crackers available on Amazon, Davidson says these flaxseed crackers are a winning keto pick, because they're relatively low in carbs and provide a decent amount of fiber. They're also high in omega-3, a fatty acid that's beneficial for a healthy brain, skin, and heart. Davidson recommends adding some flavor and creaminess by spreading some Laughing Cow Cheese on top.
There are theoretically no restrictions on where the ketogenic diet might be used, and it can cost less than modern anticonvulsants. However, fasting and dietary changes are affected by religious and cultural issues. A culture where food is often prepared by grandparents or hired help means more people must be educated about the diet. When families dine together, sharing the same meal, it can be difficult to separate the child's meal. In many countries, food labelling is not mandatory so calculating the proportions of fat, protein and carbohydrate is difficult. In some countries, it may be hard to find sugar-free forms of medicines and supplements, to purchase an accurate electronic scale, or to afford MCT oils.[53]
After about two to seven days of following this eating routine, you go into something called ketosis, or the state your body enters when it doesn't have enough carbs for your cells to use for energy. Then it starts making ketones, or organic compounds that your bod then uses in place of those missing carbs—and oh, it also burns fat for more energy, says Beth Warren, R.D., founder of Beth Warren Nutrition and author of Living A Real Life With Real Food.
The original therapeutic diet for paediatric epilepsy provides just enough protein for body growth and repair, and sufficient calories[Note 1] to maintain the correct weight for age and height. The classic therapeutic ketogenic diet was developed for treatment of paediatric epilepsy in the 1920s and was widely used into the next decade, but its popularity waned with the introduction of effective anticonvulsant medications. This classic ketogenic diet contains a 4:1 ratio by weight of fat to combined protein and carbohydrate. This is achieved by excluding high-carbohydrate foods such as starchy fruits and vegetables, bread, pasta, grains and sugar, while increasing the consumption of foods high in fat such as nuts, cream, and butter.[1] Most dietary fat is made of molecules called long-chain triglycerides (LCTs). However, medium-chain triglycerides (MCTs)—made from fatty acids with shorter carbon chains than LCTs—are more ketogenic. A variant of the classic diet known as the MCT ketogenic diet uses a form of coconut oil, which is rich in MCTs, to provide around half the calories. As less overall fat is needed in this variant of the diet, a greater proportion of carbohydrate and protein can be consumed, allowing a greater variety of food choices.[4][5]
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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.
"I recommend only 5 percent of calories coming from carbs, which usually averages out to less than 30 grams," he says. "I understand why people get nervous and panic, thinking 'Can I even eat a salad?' This is why I recommend tracking only 'net carbs', which are total carbs minus fiber. For example, an avocado has 12 grams of carbs but 10 grams of fiber, which means it has 2 grams of net carbs. Also, green leafy vegetables are very nutritious and contain a lot of fiber, so you can almost eat them as much as you want and stay below your limit.
Insulin triggers include carbohydrates, sugars, excessive protein. Also, every time you eat, you trigger insulin – unless you eat fat only. Combining certain foods, in fact, really spikes insulin, such as combining protein with sugars—so meat with bread, meats with sugary condiments like ketchup, barbeque sauce, sweet chili sauce and chicken fingers—these are deadly for the blood sugar and really spike insulin like birthday cake. Also, certain compounds in fast food really spike insulin, especially MSG, which is added to all kinds of fast foods, not just Asian food.
These types of back-and-forth weight fluctuations can contribute to disordered eating, Kizer says, or can worsen an already unhealthy relationship with food. “I think this diet appeals to people who have issues with portion control and with binge eating,” she says. "And in many cases, what they really need is a lifestyle coach or a professional counselor to help them get to the bottom of those issues."
These samosas are genius! The dough is made from almond flour and mozzarella cheese, but it doesn’t taste — or feel — cheesy at all. Inside, there’s a delicious veggie filling of cauliflower and onion, seasoned with garam masala, cumin, fresh ginger and other spices. These little keto snacks are perfect when you’re craving Indian food. They’ve got all the flavor without the carbs.
Here's the reality: A high carb diet drives up blood sugar and insulin levels. All that sugar and insulin are inflammatory. The standard American diet offers lots of foods that are high sugar AND high in saturated fat, and in studies, these two factors were lumped together. So although saturated fat is healthy, it got the blame for the inflammation that causes heart disease because it was studied in combination with a high carb diet. A ketogenic diet plan which is high in saturated fat and very low in carbohydrate will REDUCE inflammation. (Reference here.)
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.
To make Crack Chicken in a slow cooker, add the chicken and cream cheese to the slow cooker. Whisk together the water, vinegar, chives, garlic powder, onion powder, crushed red pepper flakes, dill, salt, and black pepper in a small bowl and pour on top. Cook on LOW for 8 hours. Remove the chicken and shred it, and then add it back to the pot and stir in the cheddar. Cook the bacon in a skillet on the stovetop until crispy; cool the bacon and then crumble it on top.
This green yet under-utilized vegetable is highly nutrient dense. It would have only 25 calories while giving you 77% of the daily allowance of vitamin C and high levels of vitamin K, vitamin B 1, vitamin B 2 and B 6. It also rich in  omega-3 fatty acids, fiber, choline, biotin, phosphorus, magnesium, manganese, niacin, pantothenic acid and protein. 
Keto Bread Recipe - Four Ways - quick and simple way to make low carb, individual keto bread rolls, in ramekins and just a few healthy ingredients. You can either bake it in the microwave for 90 seconds or in the oven for 10-15 minutes. The the-easiest, the-best kept bread recipe I've ever tried. There are four different options available - you can make cheese keto bread,  broccoli ketogenic bread, bacon and spinach and feta. And of course you can leave it as it is, if you prefer plain kept bread  rolls.
We’re going full on fats with breakfast, just like we did last week. This time we’ll double the amount of ketoproof coffee (or tea) we drink, meaning we double the amount of coconut oil, butter, and heavy cream. It should come to quite a lot of calories, and should definitely keep us full all the way to dinner. Remember to continue drinking water like a fiend to make sure you’re staying hydrated.

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.
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.

Avocados are excellent sources of monounsaturated fats, which can lower your risk of heart disease and stroke by reducing your bad cholesterol levels, according to the American Heart Association. You probably already add slices of avocado to your salads and omelets, but have you tried ‘em solo? Langer suggests taking half of an avocado, drizzling it with olive oil and a bit of lemon juice, and sprinkling sea salt on top. Then dig right in.
Sometimes we all have leftover chicken on hand that needs to be used up. Maybe you roasted a couple of chickens on the weekend to prep for the week ahead, maybe you had company over and grilled up too many chicken breasts, or maybe rotisserie chicken was on sale at your local grocery store and it was too good a bargain to pass up. Whatever the reason, we all can use a few ideas on how to use up leftover chicken.
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!

Because people with type 2 diabetes are at an increased risk for cardiovascular disease, there’s a specific concern that the saturated fat in the diet may drive up LDL, or “bad,” cholesterol levels, and further increase the odds of heart problems. If you have type 2 diabetes, talk to your doctor before attempting a ketogenic diet. They may recommend a different weight-loss diet for you, like a reduced-calorie diet. Those with epilepsy should also consult their doctor before using this as part of their treatment plan.
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