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.
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.
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]
Like those other guys, the keto diet follows strict guidelines on what you can and can’t eat, suggesting you limit your daily carb intake to 20 to 30 net grams while upping your fat like crazy. If all goes well, your body will stop getting all its energy from glucose and insulin produced by grains, sugars, and starches and instead start cranking out ketones to break down and burn up stored fat. Sound good? Of course, it does.
So, we have a situation where the body has way too much insulin in the blood—yet the insulin is not able to do its job in the cells, either. The cells are resisting it. As a result, the body keeps making more and more insulin. These hormones are on a constant feedback loop, sending and receiving messages of “Sugar is high—release more insulin. . . . Must lower blood sugar for the body to stay alive.”
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]
Keep up electrolytes. The major electrolytes in our bodies are sodium, potassium and magnesium. Because a low carb diet (especially a keto diet!) reduces the amount of water you store, this can flush out electrolytes and make you feel sick (called “keto flu”). This is temporary, but you can avoid or eliminate it by salting your food liberally, drinking broth (especially bone broth), and eating pickled vegetables. Some people also choose to take supplements for electrolytes, but it’s best to first consult a doctor that understands and supports keto/low carb lifestyles.

Keto Smoothies and Shakes — Some of our favorite keto smoothies are the Peanut Butter Caramel Milkshake, Blueberry Banana Bread Smoothie, McKeto Strawberry Milkshake, Cucumber Spinach Smoothie, Blackberry Chocolate Shake, and Keto Tropical Smoothie. Feel free to add your favorite low-carb protein powder to your shake or smoothie to help you meet your protein needs and build muscle.


When you eat tons of carbs, your blood sugar is consistently elevated, and then so is insulin. Insulin is a hormone that keeps your blood sugar in check by shuttling the glucose into cells, but when there’s a consistently high amount of insulin, your cells become resistant. This insulin resistance makes it easier to store fat, and chronically high levels of insulin also cause excessive inflammation in the body, which contributes to heart disease, high blood pressure, and potentially type 2 diabetes.
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]
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!
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.
There are so many tricks, shortcuts, and gimmicks out there on achieving optimal ketosis – I’d suggest you don’t bother with any of that. Optimal ketosis can be accomplished through dietary nutrition alone (aka just eating food). You shouldn’t need a magic pill to do it. Just stay strict, remain vigilant, and be focused on recording what you eat (to make sure your carb and protein intake are correct).
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