A survey in 2005 of 88 paediatric neurologists in the US found that 36% regularly prescribed the diet after three or more drugs had failed; 24% occasionally prescribed the diet as a last resort; 24% had only prescribed the diet in a few rare cases; and 16% had never prescribed the diet. There are several possible explanations for this gap between evidence and clinical practice. One major factor may be the lack of adequately trained dietitians, who are needed to administer a ketogenic diet programme.
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)
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.
Insulin is needed to help cells absorb nutrients such as potassium, magnesium and amino acids (protein). In fact, almost every nutrient is influenced by insulin. Potassium is needed for energy, for balancing sodium in the body, and for all kinds of other important things. We need amino acids for our hair, nails, skin, joints and muscles. We need magnesium for a healthy heart. See where I am going?
During the 1920s and 1930s, when the only anticonvulsant drugs were the sedative bromides (discovered 1857) and phenobarbital (1912), the ketogenic diet was widely used and studied. This changed in 1938 when H. Houston Merritt, Jr. and Tracy Putnam discovered phenytoin (Dilantin), and the focus of research shifted to discovering new drugs. With the introduction of sodium valproate in the 1970s, drugs were available to neurologists that were effective across a broad range of epileptic syndromes and seizure types. The use of the ketogenic diet, by this time restricted to difficult cases such as Lennox–Gastaut syndrome, declined further.
Infants and patients fed via a gastrostomy tube can also be given a ketogenic diet. Parents make up a prescribed powdered formula, such as KetoCal, into a liquid feed. Gastrostomy feeding avoids any issues with palatability, and bottle-fed infants readily accept the ketogenic formula. Some studies have found this liquid feed to be more efficacious and associated with lower total cholesterol than a solid ketogenic diet. KetoCal is a nutritionally complete food containing milk protein and is supplemented with amino acids, fat, carbohydrate, vitamins, minerals and trace elements. It is used to administer the 4:1 ratio classic ketogenic diet in children over one year. The formula is available in both 3:1 and 4:1 ratios, either unflavoured or in an artificially sweetened vanilla flavour and is suitable for tube or oral feeding. Other formula products include KetoVolve and Ketonia. Alternatively, a liquid ketogenic diet may be produced by combining Ross Carbohydrate Free soy formula with Microlipid and Polycose.
You should check with your physician if you have any concerns about starting a ketogenic diet plan with pre-existing health conditions, especially if those conditions involve kidney or heart problems. People with kidney disease should definitely consult with their physician about starting a ketogenic diet. Other contraindicated conditions and health issues are listed here. Make sure you check this list and rule these out before starting the diet.
Debbie, Congrats on your weight loss, that’s awesome! We haven’t tried this recipe with bone-in chicken thighs, but if you want to use them to make this recipe we recommend cooking the thighs in the oven and then pulling the meat off the bone, shredded it, and mixing it with the sauce. The objective with this recipe is to cook the chicken (any way you like, poached, baked, grilled, or even rotisserie) until it can be shredded, and then mix the shredded chicken with the creamy sauce. To cook the creamy sauce on the stovetop, we recommend crisping the bacon in a saucepan and then removing it and adding the water and spices. Once the water is simmering, add the cream cheese a bit at a time (slightly softened would probably work best), whisking until it’s incorporated. Cooked this way, you may need to add a splash more liquid (water or broth, if you prefer) to the sauce, because some of the liquid will evaporate off as the cream cheese melts down. Finally, stir in the cooked shredded chicken and shredded cheddar, and serve! If you try it this way, please let us know how it goes!
Hi Gigi, Low carb and keto is about the balance of macronutrients eaten (fat, protein and carbs), not specifically meat or lack thereof. Most people on keto do eat meat, though some people do vegetarian keto. Fat is actually necessary for many body processes. There is no issue for the kidneys with a high fat diet, but if you eat too much protein that isn’t great for the kidneys. It’s a common misconception that keto is high protein (it isn’t). Keto is great for diabetics as it naturally helps stabilize insulin. All of this being said, please know I’m not a doctor and you should consult your doctor on any medical questions or before starting any diet. If you have more questions that aren’t medical questions, I recommend our low carb & keto support group here.
Yes, too much lean protein—think turkey and chicken—even lean fish—if you’re consuming that and vegetable only, without fat there, you are at risk of throwing yourself out of ketosis. Even eating egg whites without yolks greatly spikes insulin. So look to fatty proteins. Fatty cuts of beef, chicken WITH skin, fattier cuts of beef, lamb, and game. Chuck as opposed to 10% lean sirloin.
"I recommend designing the meal around the fat and protein sources, since the carbohydrates are very limited. For example, if someone is having tuna for lunch, they may consider adding mayo to it. I also think a common mistake made on the diet, is individuals focus on reducing carbohydrates, but they do not increase their fat adequately. This may make it difficult to go into ketosis, especially if they are consuming too much protein. Some adults can be on a stable ketogenic diet consuming 50 net carbs whereas some may need to restrict to 15 net carbs."
Hi Maya. I LOVE your site!! Interesting, informative with fab recipes and ideas. Hubby and I have just started eating low carb and I have to say, we are not finding it too difficult and I already feel sooo much better!! I find the hardest part is choosing low carb veg, I feel as if we are not eating enough. Any suggestions on how to get more veggies into our diet?
For the purpose of this keto meal plan, you will be making food for Monday morning through Sunday night. This should provide a full, 7 day comprehensive meal plan for you to follow. On Sunday you will make breakfast and lunch for the 5 day work week as well as the first dinner. Then mid week you will make a second dinner. The weekend is more of a free for all with less set parameters. This is the time to experiment and try new things. I am going under the assumption that you have more time to cook and prepare on the weekend and also that you might have leftover food from the week. If your weekends are totally slammed, consider just premaking all 7 days of food by tweaking the quantities in the recipes.
The symptoms of keto flu are headaches, body aches, cravings, brain fog and fatigue. Well, just think about what you’re trying to do. You’re converting your ENTIRE cellular machinery to fat burning. What you need to do to avoid and heal the keto flu is get more electrolytes and more B vitamins. These are the cofactors that help in developing the machinery to burn fat effectively without draining your body. For the B vitamins, try nutritional yeast. However, nutritional yeast does not have B5—so you may have to take a B5 supplement. I recommend my electrolyte powder. It has 1,000 mgs of potassium and will help you get to that 4,700 mgs you need to create this machinery to burn fat faster and get into ketosis!
No fruit but some berries. Apples have too many carbs. Pineapples will create massive insulin spikes. Never consume fruit juices: Valuable phytonutrients are bound to the fiber, and these are lost; plus the juice is cooked, removing many other nutrients. You’re basically just drinking concentrated fructose. You can get away with one-half to one cup of berries a day.
Jump up ^ Ketogenic "eggnog" is used during induction and is a drink with the required ketogenic ratio. For example, a 4:1 ratio eggnog would contain 60 g of 36% heavy whipping cream, 25 g pasteurised raw egg, saccharin and vanilla flavour. This contains 245 kcal (1,025 kJ), 4 g protein, 2 g carbohydrate and 24 g fat (24:6 = 4:1). The eggnog may also be cooked to make a custard, or frozen to make ice cream.
Stay hydrated. As carb intake is lowered, the kidneys will start dumping excess water being retained as a result of the former higher carb intake. Make sure to drink enough water to replace what gets lost. The old 6-8 glasses is a good rule, I guess, although just drinking to thirst will probably do the trick. If you find yourself getting headaches and muscle cramps, you need more water, and more minerals such as salt, magnesium and potassium, because the water loss also takes minerals with it. (See my low carb diet side effects page for more info).
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.
What else happens when we break down muscle glycogen? We lose water weight! Our muscles store about 3 grams of water for every gram of glycogen, meaning we can lose quite a bit of weight right away when we tap into glycogen stores for fuel. That's why someone who loses weight in "just one week!" from a low-carb plan is likely losing water weight, not necessarily real weight that stays off over time.
There is scientific evidence that supports the use of a ketogenic diet to help manage certain neurologic conditions. There are also medical, nutrition, and fitness professionals that recommend the eating program for patients and clients who have other health goals. But just because the program works for some, doesn't mean that it's the best diet for you.
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.