Another difference between older and newer studies is that the type of patients treated with the ketogenic diet has changed over time. When first developed and used, the ketogenic diet was not a treatment of last resort; in contrast, the children in modern studies have already tried and failed a number of anticonvulsant drugs, so may be assumed to have more difficult-to-treat epilepsy. Early and modern studies also differ because the treatment protocol has changed. In older protocols, the diet was initiated with a prolonged fast, designed to lose 5–10% body weight, and heavily restricted the calorie intake. Concerns over child health and growth led to a relaxation of the diet's restrictions. Fluid restriction was once a feature of the diet, but this led to increased risk of constipation and kidney stones, and is no longer considered beneficial.
So why is social media blowing up with all things #keto, all the time? Well, most of us eat too many carbs to begin with. About half of our calories should come from carbs, according to the USDA Dietary Guidelines for Americans. That's about 250 grams per day for a 2,000 calorie diet. When you consider all of the grain-based foods and sneaky sources of added sugar, it's easy eat a lot more than the recommended amount.
There are many scenarios that can cause constipation with the ketogenic diet. Most people assume it’s a fiber issue; but it’s not that simple. You want to compare what you were doing before ketosis and after. Look at the change in vegetable fiber consumption; if you don’t have enough gut bacteria to digest all these vegetables, they will cause bloating, constipation, gas and all kinds of digestive issues. Some people can digest vegetables and others can’t. Some people can’t digest cabbage or cruciferous veggies. So, you might have to switch to less fibrous vegetables, such as various kinds of lettuce, and especially kale and beet greens, for your potassium. Electrolytes greatly help with constipation, too. If you need more support getting electrolytes, try my electrolyte powder. It helps supply the 4,700 mg a day of potassium you need, which is hard to manage without eating loads of vegetables.
Keto diets rely on an extreme technique to (temporarily) move the scale down a few pounds, and basically eliminates all joy associated with eating real food and living life. Since restriction for life is downright impossible: Cut back on ultra-processed, high-carb foods like sugary beverages and tons of refined grains, and fill up on more nutritious carb choices, like veggies, fruit, legumes, low-fat dairy, and 100% whole grains to maximize long-term weight loss, health, and happiness.
Keto breath, on the other hand, is less of a side-effect and more of a major (not harmful) inconvenience (your breath literally smells like nail polish remover). Basically, when your body breaks down all that extra fat on the keto diet, it produces ketones—one of which is the chemical acetone (yes, the same stuff that's in nail polish remover), Keatley previously told WomensHealthMag.com.
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.