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. 
Some athletes swear by the ketogenic diet, not just for weight loss but for improved performance in their sport, as well. But Edward Weiss, PhD, associate professor of nutrition and dietetics at Saint Louis University, doesn’t buy it. “I hear cyclists say all the time that they’re faster and better now that they’re on keto, and my first question is, 'Well, how much weight did you lose?'” he says.
Your game plan: Keep a bunch of easy snacks in the back of your mind so you’re prepared when hunger hits. Simplicity is key here, because when you’re hungry you won’t have the time or patience to run to the store and fix something up. That’s why we’ve focused this list of 10 keto-friendly snacks on ingredients you likely already have in your kitchen.
Take a 2 – 3 cups of lettuce, crumble in some bacon and dice a medium tomato. Mix that with two or three tablespoons of mayo, and toss after adding some splashes of hot sauce. Delicious, filling, full of fiber and healthy fats, and absolutely easy. I know the mayo sounds weird as a dressing, but trust us; it’s amazing! Add in some avocado chunks to boost potassium too!

After increasing water intake and replacing electrolytes, it should relieve most all symptoms of Keto Flu. For an average person that is starting a ketogenic diet, eating 20-30g of net carbs a day, the entire adaptation process will take about 4-5 days. My advice is to cut your carbs to fewer than 15g to ensure that you are well on your way into ketosis within one week. If you are experiencing any more keto flu symptoms, double check your electrolyte intake and adjust.
This is the only way my kids will eat Brussels sprouts! It’s actually great for me because this dish is fast, easy and healthy, and it makes a lovely side. Quick-cooking Brussels sprout halves are available in the prepackaged salad aisle at the grocery store. They’re a timesaver if you can find them, but you can always just buy whole ones and slice them in half. —Teri Rasey, Cadillac, Michigan
The less frequent the meals, the more protein you will need per meal. What happens as you eat fewer meals is that your body will compensate. That is, you’ll lose less protein and become more efficient at using it. If you consume two meals per day, the average protein per meal could be 7 to 8 ounces. If you have  one meal per day, the total daily protein amount could be 9 ounces.
A ketogenic diet focuses on minimal plant-based carbs, moderate amounts of clean protein, and high healthy fat consumption – the three keys to achieving nutritional ketosis. In ketosis, you’re essentially converting yourself from a “sugar burner” to a “fat burner.” With 40g or less net carbs per day, you’ll feel satisfied instead of hungry. The lower sugar helps reduce inflammation and fight chronic disease while keeping your insulin levels in tact, too. Great for people suffering from chronic conditions or anyone who wants to feel their best.
For breakfast, we are going to change it up a bit. Here’s where we introduce ketoproof coffee. Now, don’t get me wrong – I know some of you won’t like it. If you’re not a fan of coffee, then try it with tea. If you’re not a fan of the taste (which is very rare), then try making a mixture of the ingredients by themselves and eating it like that. So, why ketoproof coffee?
After initiation, the child regularly visits the hospital outpatient clinic where he or she is seen by the dietitian and neurologist, and various tests and examinations are performed. These are held every three months for the first year and then every six months thereafter. Infants under one year old are seen more frequently, with the initial visit held after just two to four weeks.[9] A period of minor adjustments is necessary to ensure consistent ketosis is maintained and to better adapt the meal plans to the patient. This fine-tuning is typically done over the telephone with the hospital dietitian[18] and includes changing the number of calories, altering the ketogenic ratio, or adding some MCT or coconut oils to a classic diet.[3] Urinary ketone levels are checked daily to detect whether ketosis has been achieved and to confirm that the patient is following the diet, though the level of ketones does not correlate with an anticonvulsant effect.[18] This is performed using ketone test strips containing nitroprusside, which change colour from buff-pink to maroon in the presence of acetoacetate (one of the three ketone bodies).[44]
First reported in 2003, the idea of using a form of the Atkins diet to treat epilepsy came about after parents and patients discovered that the induction phase of the Atkins diet controlled seizures. The ketogenic diet team at Johns Hopkins Hospital modified the Atkins diet by removing the aim of achieving weight loss, extending the induction phase indefinitely, and specifically encouraging fat consumption. Compared with the ketogenic diet, the modified Atkins diet (MAD) places no limit on calories or protein, and the lower overall ketogenic ratio (approximately 1:1) does not need to be consistently maintained by all meals of the day. The MAD does not begin with a fast or with a stay in hospital and requires less dietitian support than the ketogenic diet. Carbohydrates are initially limited to 10 g per day in children or 20 g per day in adults, and are increased to 20–30 g per day after a month or so, depending on the effect on seizure control or tolerance of the restrictions. Like the ketogenic diet, the MAD requires vitamin and mineral supplements and children are carefully and periodically monitored at outpatient clinics.[47]
This two-day keto meal plan comes from a registered dietitian who prescribes the diet for clients who are looking to reach a variety of health goals. Pegah Jalali, MS, RD, CDN, is an adjunct professor at New York University, works at the NYU Langone Comprehensive Epilepsy Center, and is a private practice dietitian at Middleberg Nutrition, a New York City health and wellness practice.
Sleep enough – for most people at least seven hours per night on average – and keep stress under control. Sleep deprivation and stress hormones raise blood sugar levels, slowing ketosis and weight loss a bit. Plus they make much it harder to stick to a keto diet, and resist temptations. So while handling sleep and stress will not get you into ketosis on it’s own, it’s still worth thinking about.

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?
Calories: The nutrient intake on a ketogenic diet typically works out to about 70-75% of calories from fat, 20-25% from protein, and 5-10% from carbohydrate on a daily basis.  However, these ratios don't work well at very low calorie or very high calorie daily totals.  And although calorie counting is not required, it is important to understand how macronutrient percentages can be affected by caloric intake, so you may want to read my page on calorie counting to get more information on this subject. Again, low or very high calorie intake will skew the percentages of macronutrients. It is also important to remember that fats are super high-calorie foods, especially if you have extra weight to lose and you are doing keto to lose weight. Read my plateau page if you are not reaching your weight loss goals.
'Cutting out carbs without advice can be dangerous, and can put you at risk of deficiencies in the long-term,' warns Dr Barclay. 'If you're looking to lose weight, burning fat may sound like the key to success, but in actual fact it comes with some risks, and may not be effective in the long term. The ketogenic diet is a short-term solution to a long-term health problem.'
In terms of weight loss, you may be interested in trying the ketogenic diet because you’ve heard that it can make a big impact right away. And that’s true. “Ketogenic diets will cause you to lose weight within the first week,” says Mattinson. She explains that your body will first use up all of its glycogen stores (the storage form of carbohydrate). With depleted glycogen, you’ll drop water weight. While it can be motivating to see the number on the scale go down (often dramatically), do keep in mind that most of this is water loss initially.
This bread has a few more carbs than you might be eating, but each bite is worth it, particularly if you have low potassium. The ingredients are simple: bananas (not too ripe), almond flour, walnuts, eggs, olive oil and baking soda. But you’ll be impressed by the scrumptious loaf that comes out of your oven. A warm slice of this with a pat of grass-fed butter makes a tasty keto snack or breakfast.
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).[17] The eggnog may also be cooked to make a custard, or frozen to make ice cream.[36]

The keto diet is one of the most effective that I’ve come across and one of the more straightforward (as opposed to easy!) to follow. In a nutshell, when you’re on a keto diet, you eat a very low-carb, high-fat diet. That means goodbye pasta and bread, hello cheese and oils. It’s pretty much the opposite of what we’ve been taught our entire lives. But it works if you follow the keto diet food list. Plus, you can make many favorite recipes keto-friendly.
Another trigger of insulin is large quantities of protein. This was one of the issues with the Atkins diet. The optimum amount of protein per meal is about 3 to 6 ounces. Protein is needed for repairing and providing the raw material for muscle, tendons, joint cartilage, and even bone. Protein can also be used for fuel; however, too much protein triggers insulin which can be converted to sugar and then to fat. 

Ready to head out the door and start buying groceries? Slow down there, chief. Go through the pantry, fridge, freezer, and secret stashes under the bed, and get rid of foods with any significant carb content. In the first few days, you could end up craving them—badly. This means fruit, too. Even carrots and onions are too high-glycemic to work with keto, Wittrock says.
Think about any social situations that will be encountered, and devise ways to handle those times when temptations to eat the "old" way will be high. You don't want to be blind sided when someone at the office brings in a box of your favorite chocolates and puts them right under your nose. Likewise, a beer with your friends usually turns into a date with potato skins and nachos. Think salad and steak instead.
Rethink the heavily-promoted idea that vegetables and whole grains are the healthiest foods to eat. They are not. Animal foods offer greater amounts of more easily-absorbed nutrients and vegetables and grains contain many natural toxins. I'm not saying don't eat vegetables, they do provide some benefit. I am saying give up the grains, the negative effect of these foods outweighs any nutritive value they have.
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]
"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.

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.)
Lisa, Yes, it is safe to put cream cheese in the pressure cooker, this is how we always make it. Alternatively, you can add the cream cheese once the chicken is cooked and you take it out of the pot to shred it, but you’ll need to leave the pot on “saute” and cook (stirring frequently) until the cream cheese mixture is melted into the sauce. (You may also need to add a splash more liquid if done this way.) If you try it this way, let us know how it goes!
When you consume lots of sugar and have higher levels of insulin on a continuing basis, your cells try to protect you and eventually start resisting or ignoring insulin. Remember, insulin is the key that allows glucose into the cell. So, your cells prevent insulin from working in order to prevent excessive sugar in the cell. This is your body saying, “If you’re going to keep eating sugar, I will block it at the cellular level.”
Typically packed in oil with heads removed, these are easily forked and eaten for a perfect low-carb snack. If you’re wondering what they taste like? They taste like a mild tuna, actually. They often come in flavors such as jalapeno and tomato sauces for some added delight. Don’t knock it till you try it, and they’re fairly inexpensive, so they’re worth a shot.
The less frequent the meals, the more protein you will need per meal. What happens as you eat fewer meals is that your body will compensate. That is, you’ll lose less protein and become more efficient at using it. If you consume two meals per day, the average protein per meal could be 7 to 8 ounces. If you have  one meal per day, the total daily protein amount could be 9 ounces.
But people who started following the keto diet noticed weight loss for a few reasons: When you eat carbs, your body retains fluid in order to store carbs for energy (you know, in case it needs it). But when you’re not having much in the carb department, you lose this water weight, says Warren. Also, it's easy to go overboard on carbohydrates—but if you're loading up on fat, it may help curb cravings since it keeps you satisfied.
The ketogenic diet is calculated by a dietitian for each child. Age, weight, activity levels, culture and food preferences all affect the meal plan. First, the energy requirements are set at 80–90% of the recommended daily amounts (RDA) for the child's age (the high-fat diet requires less energy to process than a typical high-carbohydrate diet). Highly active children or those with muscle spasticity require more calories than this; immobile children require less. The ketogenic ratio of the diet compares the weight of fat to the combined weight of carbohydrate and protein. This is typically 4:1, but children who are younger than 18 months, older than 12 years, or who are obese may be started on a 3:1 ratio. Fat is energy-rich, with 9 kcal/g (38 kJ/g) compared to 4 kcal/g (17 kJ/g) for carbohydrate or protein, so portions on the ketogenic diet are smaller than normal. The quantity of fat in the diet can be calculated from the overall energy requirements and the chosen ketogenic ratio. Next, the protein levels are set to allow for growth and body maintenance, and are around 1 g protein for each kg of body weight. Lastly, the amount of carbohydrate is set according to what allowance is left while maintaining the chosen ratio. Any carbohydrate in medications or supplements must be subtracted from this allowance. The total daily amount of fat, protein and carbohydrate is then evenly divided across the meals.[36]
Lisa, Technically Instant Pot doesn’t recommend cooking frozen chicken breasts; however, when we cook frozen chicken breasts in the Instant Pot, we usually add an extra 3 to 5 minutes to the cooking time. For the slow cooker, you could add all the ingredients as-is (just cook the bacon on the stove top first, add the bacon fat to slow cooker, and store cooked bacon in the fridge until serving). We recommend cooking on high 3 to 4 hours or cook on low 6 to 8 hours. Let us know how it goes if you give it a try!
The ketogenic diet achieved national media exposure in the US in October 1994, when NBC's Dateline television programme reported the case of Charlie Abrahams, son of Hollywood producer Jim Abrahams. The two-year-old suffered from epilepsy that had remained uncontrolled by mainstream and alternative therapies. Abrahams discovered a reference to the ketogenic diet in an epilepsy guide for parents and brought Charlie to John M. Freeman at Johns Hopkins Hospital, which had continued to offer the therapy. Under the diet, Charlie's epilepsy was rapidly controlled and his developmental progress resumed. This inspired Abrahams to create the Charlie Foundation to promote the diet and fund research.[10] A multicentre prospective study began in 1994, the results were presented to the American Epilepsy Society in 1996 and were published[17] in 1998. There followed an explosion of scientific interest in the diet. In 1997, Abrahams produced a TV movie, ...First Do No Harm, starring Meryl Streep, in which a young boy's intractable epilepsy is successfully treated by the ketogenic diet.[1]
Who says dessert can’t be keto-friendly? This sugar- and sugar alcohol-free treat is made from 100-percent stone-ground South American cocoa beans and sweetened with monk fruit and non-GMO soluble vegetable fiber, making it both low in carbs (just three net grams per ounce) and melt-in-your-mouth creamy. Throw in a handful of earthy, buttery almonds for good measure and you’ve got something that’ll appease your sweet tooth without ruining your diet.
Don’t let the kiddie lunchbox aesthetic fool you—these dehydrated little nuggets might look like they come from a children’s book, but there’s nothing made up about their magic. Whether you’re fiending for the pepper jack, gouda, or cheddar, they’re all shelf-stable, low-carb, high in protein and calcium, delightfully crispy, naturally gluten-free, and super fun to eat. Why? They’re just cheese!
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.
Sweeney does not stick to a specific macronutrient balance when he begins his own ketogenic diet plan. Instead, he maintains a diet that includes no more than 50 grams of carbohydrate per day. When he goes over 0.6 on the ketone meter (a device used to measure blood for the presence of ketones) he goes up to 70 grams of carbohydrates and takes a ketone supplement.

Each person on the keto diet will have different macronutrient needs. Jalali says that typically the diets are about 65-85 percent fat, 15-25 percent protein and about 5 percent carbohydrates. "Some of my patients/clients find it easier to keep track of the foods they consume over the day, others prefer to keep track per meal since it holds them more accountable."


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.
The keto diet is one of the most effective that I’ve come across and one of the more straightforward (as opposed to easy!) to follow. In a nutshell, when you’re on a keto diet, you eat a very low-carb, high-fat diet. That means goodbye pasta and bread, hello cheese and oils. It’s pretty much the opposite of what we’ve been taught our entire lives. But it works if you follow the keto diet food list. Plus, you can make many favorite recipes keto-friendly.

The beauty of salmon is that you can cook it with marginal interference. A simple sauce of butter, lemon juice, chopped garlic, and some salt and pepper will go a long way to enhancing the natural flavor of the salmon. Drizzle the sauce over 4-6 oz portions of fish, bake at 450F for 5 minutes per 1/2″ thickness of fish. In another bowl, toss the asparagus with olive oil, salt, and pepper, spread it out evenly on a cookie sheet, and roast in the oven at 450 for 20 minutes. Easy dinner (with leftovers if you plan ahead) that’s full of nutrition, protein, and healthy fat, while keeping your carbs low. Get the recipe and instructions
Make things yourself. While it’s extremely convenient to buy most things pre-made or pre-cooked, it always adds to the price per pound on items. Try prepping veggies ahead of time instead of buying pre-cut ones. Try making your stew meat from a chuck roast. Or, simply try to make your mayo and salad dressings at home. The simplest of things can work to cut down on your overall grocery shopping.
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