Implementing the diet can present difficulties for caregivers and the patient due to the time commitment involved in measuring and planning meals. Since any unplanned eating can potentially break the nutritional balance required, some people find the discipline needed to maintain the diet challenging and unpleasant. Some people terminate the diet or switch to a less demanding diet, like the modified Atkins diet (MAD) or the low-glycaemic index treatment (LGIT) diet, because they find the difficulties too great.[41]
In short, no. Apples even have too many carbs. Pineapples hugely spike insulin. Never consume fruit juices. The fiber is bound to the phytonutrients and the juice is cooked, removing many nutrients. You’re basically just drinking concentrated fructose + corn syrup. As an adult, I wouldn’t consume much fruit, period—except maybe ½ cup berries a day. Fructose consumption can lead to a fatty liver, insulin resistance and can spike insulin MORE THAN GLUCOSE!
Some people don't do well in ketosis. As I mentioned above, 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.  Although there is evidence that many people do well with reducing carb intake, I don't recommend going much lower than 10-20 carbs per day. The ketogenic is a very low carb diet, but it is not a zero carb diet. If you find (after at least a month on the diet) that you are one of the people who doesn't feel well at very low carb levels, adding enough carbohydrate in the form of sweet potatoes and other starchier vegetables back into your diet should bring you out of ketosis and resolve the issues. If you stay away from grains and rely on vegetables, a moderately higher carb content (60-100 grams/day) should result in health benefits. You won't be in ketosis of course, but still, you should feel better.  (I think grain consumption is one of the root causes of illness, but also acknowledge that everyone is different.)

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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).


Fears about fat: Most people have trouble on a ketogenic diet plan because they are scared to increase the amount of fat they eat, especially saturated fat. The message that fat is bad has been pounded into the collective American consciousness for the last 30 years. It's hard to unlearn the message that fat makes you fat, and saturated fat especially is very bad for you. I understand that message has been repeated over and over, but it is a lie. 
A study with an intent-to-treat prospective design was published in 1998 by a team from the Johns Hopkins Hospital[19] and followed-up by a report published in 2001.[20] As with most studies of the ketogenic diet, there was no control group (patients who did not receive the treatment). The study enrolled 150 children. After three months, 83% of them were still on the diet, 26% had experienced a good reduction in seizures, 31% had had an excellent reduction and 3% were seizure-free.[Note 7] At twelve months, 55% were still on the diet, 23% had a good response, 20% had an excellent response and 7% were seizure-free. Those who had discontinued the diet by this stage did so because it was ineffective, too restrictive or due to illness, and most of those who remained were benefiting from it. The percentage of those still on the diet at two, three and four years was 39%, 20% and 12% respectively. During this period the most common reason for discontinuing the diet was because the children had become seizure-free or significantly better. At four years, 16% of the original 150 children had a good reduction in seizure frequency, 14% had an excellent reduction and 13% were seizure-free, though these figures include many who were no longer on the diet. Those remaining on the diet after this duration were typically not seizure-free but had had an excellent response.[20][21]
The day before admission to hospital, the proportion of carbohydrate in the diet may be decreased and the patient begins fasting after his or her evening meal.[18] On admission, only calorie- and caffeine-free fluids[36] are allowed until dinner, which consists of "eggnog"[Note 8] restricted to one-third of the typical calories for a meal. The following breakfast and lunch are similar, and on the second day, the "eggnog" dinner is increased to two-thirds of a typical meal's caloric content. By the third day, dinner contains the full calorie quota and is a standard ketogenic meal (not "eggnog"). After a ketogenic breakfast on the fourth day, the patient is discharged. Where possible, the patient's current medicines are changed to carbohydrate-free formulations.[18]
Chasing blood Ketones instead of focusing on hormone signals: "The higher the number means you have more Ketones circulating in your bloodstream, but that does not mean that you are better at burning fat for fuel," Mavridis points out. "You must be in nutritional Ketosis, which is described as being between 1.5 - 3.0 mol/L on the blood Ketone meter. You will know once you are fat-adapted from hormonal signals, and not from higher Ketones on the blood meter," she adds.
On a ketogenic diet, your entire body switches its fuel supply to run mostly on fat, burning fat 24-7. Insulin levels become very low, and fat burning increases dramatically. It becomes easy to access your fat stores to burn them off. This is great if you’re trying to lose weight, but there are also other less obvious benefits, such as less hunger and a steady supply of energy. This may help keep you alert and focused.
With a ketosis diet, you tend to eliminate more calcium than usual. Additionally, foods such as cruciferous vegetables, spinach, iced tea or chocolate all have a high quantity of oxalates. Oxalates are naturally occurring substances found in a wide variety of foods; they play a supportive role in the metabolism of many plants and animals, including humans. Oxalates combined with calcium can cause kidney stones.
Advocates for the diet recommend that it be seriously considered after two medications have failed, as the chance of other drugs succeeding is only 10%.[9][30][31] The diet can be considered earlier for some epilepsy and genetic syndromes where it has shown particular usefulness. These include Dravet syndrome, infantile spasms, myoclonic-astatic epilepsy and tuberous sclerosis complex.[9][32]
Ketones are triggered by an absence of carbohydrates and sugar. There are specific steps to take to get your body into ketosis, but essentially, when carbohydrates are eliminated, the body will transfer over to using ketones. But I don’t recommend removing carbohydrates completely because I want you to be consuming lots of vegetables. One reason it is so crucial to take in lots of vegetables, and especially lots of vegetables high in potassium, such as kale, beet greens and collard greens, is because it will help you keep all this fat you’re dumping off the body off your liver. You can get a fatty liver when you start dropping lots of weight, as you will once you begin running on ketones instead of glucose. So think VEGETABLE CARBOHYDRATE ONLY.

Option 3: "Make your own keto 'lunchable' with cubes of grilled chicken, a slice of nitrate-free ham, cheese cubes, pickle slices, a hard-boiled egg, a few raw grape tomatoes, raw veggies like cauliflower or broccoli, a few almonds or walnuts, guacamole, and ranch dressing," says Stefanski. (Looking for something meat-free? Here are 29 Vegetarian Keto Recipes for Plant-Based Eaters.)
"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~.
Meal prepping is the secret to eating on a tight budget. It allows you to buy the items that are on sale, in bulk, and prepare them for quick access throughout the week. The meal prep detailed here took us about 2 hours of “active time” and another 3 hours of “passive time”. The passive time was mostly waiting for the chicken to cook/cool. The items we prepped for this meal plan are:
I get many questions about intermittent fasting, the health benefits, the weight loss benefits, and the like. People normally use intermittent fasting for both the energy and mental clarity it can offer. But it’s not just good for that. It can offer breakthroughs of plateaus and even benefits in nutrient uptake in exercise. We go more in depth to intermittent fasting in Week 3 and 4, so keep your eyes peeled!
Lemon juice contains citrates (the substance that gives citrus fruits their sour taste). When you’re low on citrates, you’re at risk for kidney stones. Add the lemon juice to your kale shake or drink it in water. Try to consume at least one lemon per day (lemon juice or the fruit of the lemon).34 I also recommend taking my electrolyte mix because it contains minerals in their citric form, as in potassium citrate, helping to bind oxalate stones and neutralize uric-acid stones.35,36
For a snack that needs zero preparation, reach for the olive jar, Griffin suggests. Olives are mostly made up of fat, specifically healthy monounsaturated fat, Berkley Wellness points out. Plus, as research published in the Journal of Agricultural and Food Chemistry notes, they're loaded with antioxidants, and are low in calories and carbs. Keep in mind that olives can contain a lot of sodium, though — sometimes as much as 42 milligrams in one olive, according to Berkley Wellness.
"Sunflower seeds are a great snack option whether you follow a keto diet or not," says registered dietitian Katey Davidson, M.S., R.D. Although all sunflower seeds are an excellent source of healthy unsaturated fats, protein, and vitamin E, many companies use flavorings to season their products which can be high in both salt and sugar, says Davidson. She recommends Terrasoul Superfoods because they aren't flavored or salted. And with only 6 grams of carbs and 1 gram of sugar (per one 1/4 cup), you won't have to worry about these seeds throwing you out of your hard-earned ketosis. However, Davidson says you'll want to aim to eat just a handful of seeds, which is considered a serving. (Related: This keto smoothie recipe is delicious even without a ton of fruit.)
We all know fat is more filling than carbs, but every now and then you get a hankering for something to snack on and you NEED some low carb snacks. Whether it’s salty, sweet or frosty, we all need a moment to enjoy something in between meals. Being on a diet shouldn’t mean all snacks are thrown out the window, being on a diet means learning what your body needs and how to best provide for it. If your body is craving something salty, there are ways of indulging without setting yourself back. There are ways of eating even brownies and cakes that won’t undo all your progress.
A computer program such as KetoCalculator may be used to help generate recipes.[46] The meals often have four components: heavy whipping cream, a protein-rich food (typically meat), a fruit or vegetable and a fat such as butter, vegetable oil or mayonnaise. Only low-carbohydrate fruits and vegetables are allowed, which excludes bananas, potatoes, peas and corn. Suitable fruits are divided into two groups based on the amount of carbohydrate they contain, and vegetables are similarly divided into two groups. Foods within each of these four groups may be freely substituted to allow for variation without needing to recalculate portion sizes. For example, cooked broccoli, Brussels sprouts, cauliflower and green beans are all equivalent. Fresh, canned or frozen foods are equivalent, but raw and cooked vegetables differ, and processed foods are an additional complication. Parents are required to be precise when measuring food quantities on an electronic scale accurate to 1 g. The child must eat the whole meal and cannot have extra portions; any snacks must be incorporated into the meal plan. A small amount of MCT oil may be used to help with constipation or to increase ketosis.[36]
This is important because one of the primary triggers of insulin is eating. I am not talking about taking your supplements or drinking tea or even one cup of coffee in the morning but eating five to six times a day—and let’s not forget, snacking will spike insulin even if it’s healthy food. The more frequent the eating, the more there is chronic elevation of insulin, leading to insulin resistance.
If you haven't heard of biltong, they're those thick, flavorful strips of air-dried meat that put stringy, chewy, and additive-packed beef jerky to shame. These peppery little slabs are made from grass-fed beef, air-dried for 14 days, and spiced with a blend of cayenne and chili powder to add some heat without overwhelming your palate. They’re also sugar-free, full of protein, and super simple to toss in your bag.
Here are a few of the most common side effects that I come across when people first start keto. Frequently the issues relate to dehydration or lack of micronutrients (vitamins) in the body. Make sure that you’re drinking enough water (close to a gallon a day) and eating foods with good sources of micronutrients. To read more on micronutrients, click here >
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