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]

Chocolate and avocados are a strangely fantastic combination. Adding avocado to dessert-type recipes gives them a smooth, silky texture without a pronounced flavor. That’s certainly the case with this pudding, which is crazy easy to make. Just add cocoa powder, avocado, stevia, vanilla extract and salt to a bowl and mix. Easy? Yes. Tasty? Also yes.
The ketogenic diet is a high-fat, adequate-protein, low-carbohydrate diet that in medicine is used primarily to treat difficult-to-control (refractory) epilepsy in children. The diet forces the body to burn fats rather than carbohydrates. Normally, the carbohydrates contained in food are converted into glucose, which is then transported around the body and is particularly important in fueling brain function. However, if there is little carbohydrate in the diet, the liver converts fat into fatty acids and ketone bodies. The ketone bodies pass into the brain and replace glucose as an energy source. An elevated level of ketone bodies in the blood, a state known as ketosis, leads to a reduction in the frequency of epileptic seizures.[1] Almost half of children and young people with epilepsy who have tried some form of this diet saw the number of seizures drop by at least half, and the effect persists even after discontinuing the diet.[2] There is some evidence that adults with epilepsy may benefit from the diet, and that a less strict regimen, such as a modified Atkins diet, is similarly effective.[1] The most common adverse effect is constipation, affecting about 30% of patients—this was due to fluid restriction, which was once a feature of the diet, but this led to increased risk of kidney stones and is no longer considered beneficial.[2][3]
There are many ways of implementing a low carbohydrate, ketogenic diet plans but most involve following a higher fat, moderate protein, low carb food plan.  (The Atkins diet is one of the most famous ketogenic diets, but certainly not the only one).  Many people think of ketogenic diets as high protein diets but this is incorrect. They are moderate protein diets.
In the 1960s, it was discovered that medium-chain triglycerides (MCTs) produce more ketone bodies per unit of energy than normal dietary fats (which are mostly long-chain triglycerides).[15] MCTs are more efficiently absorbed and are rapidly transported to the liver via the hepatic portal system rather than the lymphatic system.[16] The severe carbohydrate restrictions of the classic ketogenic diet made it difficult for parents to produce palatable meals that their children would tolerate. In 1971, Peter Huttenlocher devised a ketogenic diet where about 60% of the calories came from the MCT oil, and this allowed more protein and up to three times as much carbohydrate as the classic ketogenic diet. The oil was mixed with at least twice its volume of skimmed milk, chilled, and sipped during the meal or incorporated into food. He tested it on twelve children and adolescents with intractable seizures. Most children improved in both seizure control and alertness, results that were similar to the classic ketogenic diet. Gastrointestinal upset was a problem, which led one patient to abandon the diet, but meals were easier to prepare and better accepted by the children.[15] The MCT diet replaced the classic ketogenic diet in many hospitals, though some devised diets that were a combination of the two.[10]
A metabolic process called ketogenesis and a body state called ketosis are responsible. Ketosis is simply a normal metabolic pathway in which body and brain cells utilize ketones to make energy, instead of relying on only sugar (i.e., carbohydrate). In fact, humans developed an evolutionary ability to burn ketones as an adaptation to periods of food scarcity. 
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.
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.
One downside to a ketogenic diet for weight loss is the difficulty maintaining it. “Studies show that weight loss results from being on a low-carb diet for more than 12 months tend to be the same as being on a normal, healthy diet,” says Mattinson. While you may be eating more satiating fats (like peanut butter, regular butter, or avocado), you’re also way more limited in what’s allowed on the diet, which can make everyday situations, like eating dinner with family or going out with friends, far more difficult. Because people often find it tough to sustain, it’s easy to rely on it as a short-term diet rather than a long-term lifestyle.
"Healthy in fat, moderate in protein, and low in carbs, SunButter makes for a tasty addition to a keto diet," explains registered dietitian Toby Amidor, M.S., R.D. (Especially since you can't have peanut butter on the keto diet.) The sunflower seeds used in SunButter are also locally grown, roasted, and processed in a dedicated peanut-free and tree nut-free facility, she adds, meaning it's fair game if you have nut allergies.
For example; if you get into ketosis and release your stored fat in your fat cells, there is a chance you could end up with a fatty liver since all these fat flowing out has to come out through the liver.  The way to prevent this is to consume larger quantities of vegetables or salad as a way of keeping your liver flushed of fat. A recent study, in fact, found that the ketogenic diet reduced fat on the liver, inflammation, and fibrosis.6 
If you’ve decided to move forward in trying the keto diet, you will want to stick to the parameters of the eating plan. Roughly 60 to 80 percent of your calories will come from fats. That means you’ll eat meats, fats, and oils, and a very limited amount of nonstarchy vegetables, she says. (This is different from a traditional low-carb diet, as even fewer carbs are allowed on the keto diet.)

Staying in Ketosis long-term: Chronic Ketosis can cause fatigue, muscle soreness, insomnia and nausea. "Unless you have a medical condition that requires you to stay in Ketosis for long-term, you shouldn't stay in that state for a prolonged period without any carb ups," Mavridis suggests. And if you're a beginner, "it’s recommended that you go through the fat-adaptation phase so that your body becomes accustomed to burning both glucose and fat for fuel," says the nutritionist.

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.
Use fat as a lever.  We’ve been taught to fear fat, but don’t! Both keto and low carb are high fat diets. Fat is our source of energy as well as satiety. The key to understand, though, is that fat is a lever on a low carb or keto diet. Carbs and protein stay constant, and fat is the one you increase or decrease (push the lever up or down) to gain or lose weight, respectively. So if your goal is weight loss, eat enough fat to be satisfied, but there’s no need to “get your fats in” once you’re satisfied.
You may also be a great candidate for the Keto diet if you experience migraines, joint pain, muscle weakness or mental fatigue. In addition, "Keto diet can be beneficial for mental health conditions like depression, autism and Alzheimer's". Other than that, "you can also follow this diet plan if you're trying to get pregnant since it improves fertility", she notes.
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

"Since many of these foods are the primary source of fiber in our diets, many people that start the keto diet will notice constipation as a side effect of eliminating those carbohydrate-rich foods," Fillenworth says. "Fiber is crucial to maintaining consistent bowel movements, helps to keep our GI system healthy, and creates a feeling of fullness when eating." Women should aim for 25 grams of fiber per day to keep things ~regular~.


There are three instances where there’s research to back up a ketogenic diet, including to help control type 2 diabetes, as part of epilepsy treatment, or for weight loss, says Mattinson. “In terms of diabetes, there is some promising research showing that the ketogenic diet may improve glycemic control. It may cause a reduction in A1C — a key test for diabetes that measures a person’s average blood sugar control over two to three months — something that may help you reduce medication use,” she says.
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