8 Common Misconceptions About Ketogenic Diets
8 Common Misconceptions About Ketogenic Diets
Trashing ketogenic diets has become a trend in some areas. Most use the studies from years ago that reportedly “prove” their points. This post is intended to clear up the “8 common misconceptions about ketogenic diets” and inaccuracies of those studies and posts.
First of all I want to state that you can “prove” almost anything by searching studies. A study can have flawed techniques, later dis-proven by other studies, and much more but the study is still there. One example is the study linking stevia to infertility in mice from 1968. It has since been dis-proven many times but people will still do posts trashing stevia and point to that study as “Proof”. That is why Maria and I rely on only the latest science and look at every study with a critical eye (what were the methods, who funded the study, how was the diet formulated, how long was the study run).
We rely on outcomes much more than any study. Outcomes are “has my client improved as a result of my recommendations?”. That is what really counts and is why, in addition to some study examples, we will also list testimonies (outcomes) from clients.
1. What is a Ketogenic Diet?
This is one of the biggest areas of misunderstanding among bloggers and in scientific studies. Just like any diet or lifestyle you have to have a well formulated plan for it to be effective. With a ketogenic lifestyle this is as important as with any diet. That is why I like to say “Well Formulated Ketogenic Diet” when talking about this lifestyle.
A well formulated ketogenic diet consists of moderate protein and low carbohydrates. This is where many of the studies cited by the critics of ketogenic diets get it wrong.
Other studies will use too high of carb counts. They will have upwards of 100g of carbs a day in their “ketogenic” groups. These are not ketogenic diets and the participants are not in ketosis. Sometimes they will also count net carbs (subtract fiber), not total. This can also limit the number of people who will really experience ketosis. Too much fiber can kick people out of ketosis (more on this in a later post).
Also, the content of the fat is important. You could devise a diet with 70-80% of fat coming from transfat, but no-one would agree that that is a healthy diet. I have seen studies that have a large portion of the fat in their Ketogenic groups coming from Omega-6 oils like vegetable oil, soybean oil, etc. These are the fats we want to limit in our diets to reduce inflammation and oxidative stress. A well formulated ketogenic diet will have the majority of fats coming from saturated fats.
So with all these basic design flaws, the results of the studies are flawed and don’t apply as they are not well formulated ketogenic diets. You can literally eliminate about 3/4 of the studies based on this criteria (along with the next item on adaption time). There are very few studies that test a well formulated ketogenic diet. The good news is there are finally some new ones coming soon. (source)
2. Keto Adaption Time.
Another issue has do to with the adaptation period which can take 2-4 weeks or more (as long as 6-8 weeks for some). Every cell in our body can run on two fuel sources. Sugar (glucose) or Fat (ketones). But it can’t make the switch instantly and needs time to change to using fat as its fuel source. During this time you must remain on a ketogenic diet. If you go back to eating carbs the process is prolonged even further.
Most studies that claim to study ketogenic diets will only be conducted for 2 weeks or even a month, not enough time for the body to become fully keto adapted and see all the benefits that come from full keto adaption. It is kind of like assessing a drug addicts progress in recovery by only looking at their withdrawal period. The results are not applicable to the long term health status.
This is also where the majority of the claims about ketogenic diets side effects come from. During this time, there can be fatigue, headaches, withdrawal type symptoms, low energy, muscles cramps or weakness, gas, diarrhea, bloating and impaired mood or cognition. You can also see an increase in cholesterol, triglycerides and other blood markers. When your body changes to be a fat burner, the liver releases much of the salt (and associated water) that it holds onto with higher carb diets. So many of these symptoms can be alleviated with a well formulated ketogenic diet including the addition of extra salt, and potassium.
But this all passes with time and with a well formulated ketogenic diet. In fact, a ketogenic diet is the best way to reduce triglycerides, reduce A1c and increase HDL. (source, source, source) It will also greatly increases energy, moods, focus, reduces cramps, chronic pain and much more. You just have to get past the adaption period to see the results. Here is one of hundreds of examples from our clients.
“I know I have written you a few times and thanked you but really feel I needed to once more. I have been strict keto for just at 6 months and LOVE it! I recomend your websites and books all the time. I sometimes think I should print out cards to hand out with your info anyhow, here are a few difference I have noticed: no more red bumpy upper arms, less acne, no more hormonal mood swings, of course less weight, no HANGRY times, better hair, more stamina, more energy, no more naps, better sleep! I could go on and on but today I did my happy dance, while shopping for new clothes yet again I realized I am down 4 jean sizes which means I am now in the same size jeans I was in when I graduated high school! so I again say THANK YOU!! all the hard work and dedication of you and your family are not only helpfull but inspirational! you have a follower for life! with Love, Von”
3. The Brain Needs Sugar (glucose).
Many people will say that the “Brain needs sugar” to function properly. This is true if the body is in sugar burning mode. If on a well formulated keto adapted diet, the brain primarily runs on ketones. There is some glucose still required, but this can easily be supplied from protein (through gluconeogenesis and from the 20g or so of carbs you are getting). Not only is this a preferred fuel source for the brain but you will see improvements in cognition, mental acuity, focus, moods and much more. (source, source, source, source, source)
A recent study even found enhanced expression of genes encoding for mitochondrial enzymes and energy metabolism in the hippocampus, a part of the brain important for learning and memory with ketogenic diets. (source)
There are also many studies showing the benefits of ketogenic diet for Alzheimers (which is type 3 diabetes, insulin resistance of the brain). Switching the brain to run on ketones can have huge benefits in these cases. (source, source, source, source)
So once fully keto adapted and eating a well formulated ketogenic diet (with little to no carbohydrates), the brain can flourish. Memory and cognition improve, focus and moods are better and overall better mental acuity. Here is one of countless client testimonies.
“3 weeks in, and my partner and I have lost 5 kilos each. More importantly, I can now make it through a whole day at my emergency medical job without a single coffee or sweet biscuit to keep me alert when an emergency patient blows through our doors. I don’t think I’ve gone a day without coffee for 15 years! I feel like my thinking is clearer and sharper all day! Your activity pictures have inspired us to institute our own adventure Saturday, where we pack our Keto lunch and dinner and head off to explore lovely Australia. Thank you Maria! Your amazing meal plans have us loving life!” – Jenny
4. Studies Show Ketogenic Diets are Dangerous.
There are a couple items that are typically used by critics of ketogenic diets to demonstrate that they are “dangerous” for our health. Some of the most popular ones are elevated cholesterol (heart health), ketoacidosis and lack of vitamins and minerals. Lets take a look at each of these items.
Cholesterol and Heart Health
The first thing we need to know is that cholesterol has no correlation to coronary arteries disease (CAD). (source, source) The cause of CAD is inflammation. Also it is important to note when talking about cholesterol, that when you lose weight your cholesterol can be temporarily elevated. So you should test at least 6 months after your weight has stabilized (which none of the studies do).
So better predictors of CAD risk are inflammation markers like triglyceride-to-HDL ratio, CRP and A1c. The one thing this lifestyle has proven time and time again is that it drastically lowers triglycerides, raises HDL and lowers CRP and A1c. (Lots more on this HERE, and HERE)
Another area that is often cited as a risk of a ketogenic diet is ketoacidosis. Ketoacidosis is a state where ketone levels get so high (15 mmol or higher) that the body becomes very acidic and is life threatening. This is a very real condition that is very dangerous. But understanding how this occurs shows that it isn’t a concern for almost everyone doing a well formulated ketogenic diet.
THIS POST by Dr Attia explains it best. “This (nutritional ketosis) has nothing to do with what a diabetic patient is experiencing in DKA (diabetic KetoAcidosis), but does illustrate how poorly informed and quick to react the medical community is. DKA and nutritional ketosis (or keto-adaptation) have as much in common as a house fire and a fireplace.”
Lack of Vitamins and Minerals
Once again the “Well Formulated” aspect of this lifestyle is very important. Anyone on any diet can do it incorrectly and get low amounts of certain vitamins and minerals. A well formulated ketogenic diet can supply you with 100% of the RDA value for vitamins and minerals eating little carbs and no fruit. Here is an analysis:
3 Eggs Avocado Benedict
3 ounces Salmon
2 servings Keto Fudge
End eating Window
2 cups Chili with cheese and sour cream
Days Macro Totals
This is a pretty typical maintenance example of a ketogenic diet. We broke down all the vitamins and minerals we could find in ingredients tools online. Here are the totals for this day.
As you can see, many of the nutrients listed are at or well above 100% of the daily recommended allowances (RDA). Plus, in our paleo days and if you are on good well water, you get lots of calcium, magnesium and potassium (source). Magnesium and potassium are also supplements most of our clients take because our water and food supply doesn’t have as much as it once did.
This is just a one day snapshot. If the next day you eat some avocado, spinach and kale, you will easily make up difference in E and K. So this lifestyle can easily get you all the nutrient you need to be happy and healthy, without the added sugar and carbs of fruit and grains.
Once again, here is one of the many clients examples of outcomes from this lifestyle:
“OK….the day I have been so nervous about has come… The results of my lipid profile and cardiac calcium scan were in the mail. My triglycerides were 93!!!!!! The lowest they have EVER been and all my other labs were better than I expected. PLUS…There was no identifiable plaque in my heart or arteries, and the “age” of my arteries was 39!! Could this really be true?? (I am 65) Holy schmoly—the LOW CARB, MODERATE PROTEIN AND HIGH FAT way of eating works!!!! Doing the happy dance today!!!! Thanks Maria!!! I bless the day I was led to you!!! ” – Babara
“Within a month, John’s blood pressure and blood sugars were much improved, triglycerides had gone down 500 points.” – Marilyn
5. Ketogenic Diets Mess Up Your Hormones.
There are many claims that ketogenic diets can cause issues with moods, low energy, hormones, etc. Most of this is associated with the keto adaption time (see item 2). If you follow a well formulated ketogenic diet, these issues will not only go away after keto adaption, they will vastly improve over other diets.
Some women see shifts in their menstral cycle when switching to this lifestyle. This lifestyle is great for detoxing bad estrogens (plastics, soy, flaxseed, etc). What happens is as these bad estrogens are detoxed and the body returns to a more natural hormone balance, the cycle can shift to a more natural one. This will level out at the new cycle timing in a month or two.
Another thing that is pointed to is “lower thyroid function” with ketogenic diets. While many studies have shown that T3 can be lowered with a ketogenic diet, that isn’t necessarily a bad thing. The fact that T3 is lower in ketogenic dieters is probably part of the mechanism that protects lean mass when fat is being lost. (source) In addition, low T3 may possibly even be an indicator of a life extending effect. (source, source)
In the small percentage of cases where symptoms do occur due to thyroid changes and don’t go away after full keto adaption, the simple adding of selenium (2 or 3 brazil nuts a day) and iodine (kelp, etc.) can alleviate most symptoms.
Studies also show that a ketogenic diet acts as a mood stabilizer in bipolar illness (source). Beneficial changes in the brain energy profile have been observed in subjects who are on a ketogenic diet which is a significant observation because cerebral hypometabolism is a characteristic feature of those who suffer from depression or mania (source).
Our clients see drastic improvements in moods, hormones, and much more. Here is one example:
“Hi Maria, Attached is my before and after photo! I lost 50+ lbs last year! I used the Secrets of a Healthy Metabolism like my Bible. Every day your book guided me to better health. I lowered my high cholesterol, got rid of allergies, balanced my hormones and got rid of daily headaches by changing my diet and exercising the right way. Thanks for writing this book!” – Cindy
6. Ketogenic Diets Inhibit Growth in Kids.
It is often pointed to in studies that ketogenic diets are not healthy for kids as it can stunt growth. But every one of the studies that are cited for this were conducted on kids with epilepsy and cerebral palsy. It is well known that these conditions on their own can result in growth issues. (source, source) Having a group of kids with these issues that fall behind on growth chart and calling a cause of the ketogenic diet is simply a misunderstanding of their condition. Correlation doesn’t equal causation. Unfortunately there are no peer reviewed studies of ketogenic diets on kids without these conditions. But here is one of top scientists in this field (source):
For an outcome in this area I give you our testimony:
“Our sons Micah and Kai spent their first years (2 for Micah, 1 for Kai) in a nutritionally limited environment (orphanage in Ethiopia). The caregivers there did the best they could with the resources they had but in a country with over 2 million orphans under the age of 18, this is a challenge. When we brought Micah and Kai home they didn’t even register on the height weight charts (1% or less). We immediately started them on the same diet that we ate (a well formulated ketogenic diet). The only change is they had a more traditional 3 meals a day for their growing bodies.
Within 1 year on this well formulated ketogenic diet our sons had caught up to about 50% on the height weight charts. In 2 years they were 50-75%. They now grow like weeds and thrive.” – Craig and Maria Emmerich
7. Ketogenic Diets Should Only Be Done For Short Periods of Time.
Another misconception about ketogenic diets is that it is a short term fix for weight loss but shouldn’t be done for longer periods of time. Most of this relates to the perceived health risks of ketogenic diets (debunked above, cholesterol leads to heart disease, you don’t get enough nutrients, etc).
Inflammation is the stem of most diseases (including heart disease). It is also a fact that a well formulated ketogenic lifestyle is very low (if not the lowest) in inflammation. So why wouldn’t a lifestyle that greatly lowers inflammation not be applicable to a long, healthy life?
This lifestyle is just that, a lifestyle. It leads to both short term health (reversing metabolic syndrome, reversing autoimmune issues, losing weight, etc) and long term health (staving off Alzheimers, cancer, diabetes, coronary artery disease, etc.). There is absolutely no reason a well formulated ketogenic diet cannot be followed for life.
Here is one of many long term clients that continue to reap the benefits of this lifestyle years later:
“At the age of 62 I was told to quit working. I had been taking 8 high powered meds daily. Those pills barely masked the pain from an inoperable situation. My exhausted, painful body was carrying over 40 pounds extra weight. I was a mess. I struggled to work at a job I loved. As a cashier, I was able to see friends. Even though I didn’t go out after work because of pain, at least I could see people during the day. Reluctantly, I quit my job. My mind wasn’t ready to retire, but my body was.
At the age of 65, I found Maria. It’s been over 9 months since I started following her. After all this time, I still find improvements in my life. The most recent incident happened when I volunteered at a school book fair. Friends said they hadn’t seen me in quite a while. At least they thought they hadn’t. What was really happening was that they did not recognize me. It has been wonderful to hear all the compliments on how I look. Everyone was happy to see that I was no longer using a walker or a cane.
It is exciting to think of how much better I will be in another 9 months!” – Pam
8. Athletes and Very Active People Need More Carbs
It is common for critics to say athletes cannot do ketogenic diets because they need more carbs. This is also not true and many if not all athletes and active people do better on a well formulated ketogenic diet.
Once you are fully keto adapted, fat is now your bodies fuel source. You are able to use dietary fat and body fat equally. Even the most lean athletes will have 20,000 calories stored in fat cells. Glucose storage (stored as glycogen) is limited to the muscle and liver where on average you can only store about 2,000 calories. So athletes that are keto adapted will have a much larger fuel tank. This is especially valuable for endurance athletes.
Here are just a couple examples. This couple used a ketogenic diet to row a boat from Hawaii to California in 45 days! (source) This man won the Western States 100 (a 100 mile race) in Record time. (source) Here is more of the science behind this phenomenon. (source)
It has also been shown that a well formulated ketogenic diet can act to preserve muscle mass (while reducing body fat) (source). This is also important as many diets can rob you of valuable muscle mass.
Here is one of the many athletes (football player, distance athletes, fitness models, bodybuilders, etc.) that have thrived on a well formulated ketogenic diet:
“Growing up as a kid, I didn’t even realize that my food options were actually going to help me out one day. What can I say, I am a “meat eater.” I always got a lot of flack about not eating the bun or fries that came with my meal, but I just didn’t have the taste buds for that stuff. I just craved meat, especially meats fried in good oils. I wasn’t aware that my diet options would eventually affect my athleticism and structure as I got older and that I needed to be more aware of those things while in sports. I have eaten this way my whole life, but I feel so good when eating this way. It has helped my energy level and has also helped me “beef up” while going through high school and now into my college football career. We are put on a weight-lifting routine, and this diet has helped me to reach my goals and become in the best shape ever. And secondly, I do not drink. Hard to believe, I know. As a college student you would think I would be doing the partying and drinking. But I don’t consume alcohol in any form due to the detrimental effects it has on everything that I am trying to achieve. I feel like I am in the best shape of my life and full of energy, and it’s due mostly to my food choices, a low carb, high fat diet, and no alcohol intake. These things along with my weight program make me feel stronger than ever and able to achieve my goals.”
Testimony of the day!
“Just had family pictures taken yesterday. Our only before pictures are from November 2013 (about 2 months before becoming keto adapted). Feeling pretty amazed right now!” – Nicole
If you want to get started on a path to health and healing, click HERE. All my nutrition packages are on SALE NOW! You will not regret it!
Although I’ve been eating low carb for a long time, I’ve been trying to lower carbs and increase fat to be more in line with a keto diet. I am starting to see a lot of health benefits of the ketogenic diet, including better memory and mood. I was always told the brain needs glucose, so thanks for clearing that up on how it can be achieved on a keto diet!
Crain and Maria, you both continue to inspire me on this ketogenic journey. This post must have taken forever to compile, but it is so informative and helpful! Thank you for everything that you do. I am two months into my ketogenic lifestyle and reap benefits every single day. For example, before I started this I had to take 2 extra strength pain relievers every night just to help me get through the night. I haven’t taken a pain pill for about 4 weeks now! I have lost 14 pounds and continue to tweak, learn, and revamp as I go. I do all of this through the support of this blog and a couple of others. It amazes me (constantly) how easy this is, how healthy I feel, how much sense it makes and most importantly how wonderful it is to not constantly be thinking about food and exhibiting “hangry” beahviors. I purchased your keto-adapted e-book and refer to it like a bible. Again, thank you for your passion, integrity and enthusiasm.
Thank you Linda!! 🙂
Love this! I don’t want to come across critical because I LOVE everything you do, but just FYI, I’m thinking there’s several spelling errors in this and a place where “issues” should be “issue” and “were” should be “where” and it seems like the word should be alleviate instead of elevate in a few places. I could be wrong, but you might just want to give it a quick read over to check. You are welcome to delete this comment also if you’d like. 🙂
Thanks! I fixed them above. 🙂
one more – should be peer reviewed not peir reviewed 🙂
Thanks! I fixed above.
Hi Maria – Thank you for combining this information. There were some new facts in here for me. I’m interested in your comments on fiber. I follow your blog because my dd has been on the medical keto diet for her intractable epilepsy for a year+. I find recipe inspiration on your blog often. Thank you!
I read the PaleoMom article. Anyone actually considering this for medical treatment for their child should not use that blog article as a source. If parents are looking at it for epilepsy, it is important they consult professional doctors and dietitians. There are screenings that must be done before diet initiation. Certain very rare, not commonly screened, metabolic diseases trigger seizures and the diet can make them worse. And some common side effects are easily managed. For example, bi-citra or citra-k is now standard for preventing kidney stones.
I hope you don’t mind me commenting on your blog. On our parents forums, we do get desperate parents who do not have good access to health care trying to manage a medical diet on their own. It CAN be dangerous for those kids – the disease, the meds, and the diet can turn into a medical superstorm. But the diet is generally regarded as safe and highly effective for certain epilepsies. The likelihood of a medication working after two previous med failures is less than 2%. The diet success rates are phenomenal in comparison. (Please read the literature to understand success in this context. It’s complicated.) It is usually not a frontline medication, making the published stats even more stunning in my mind. I am not even going to touch comparing keto and medication side effects.
As for my kiddo, the diet is helping, but we don’t have perfect control, yet. It could be years that she is on the diet. We’re not concerned about that idea.
I agree that if a child has epilepsy and is on other medications, etc. you should work with your doctor. All I am pointing out here is that a keto diet for kids without epilepsy is healthy and comparing growth charts for studies done on kids with epilepsy and cerebral palsy and saying it applies to kids without these issues is not appropriate. Thanks! 🙂
Yes, your blog was well written, so I got that. Honestly, I’m not even sure about the data re: growth concerns for epilepsy in general. (No personal experience with cp). The epilepsy keto diet should be designed with enough calories and protein to grow. My team watches that closely. My dd is maintaining her growth curve, despite being on two meds with appetite suppressant as a side effect. I suspect the diet’s calorie budget is actually helping on that front. Pre-keto I gave her cheesecake to counter the appetite issue. We now do heavy cream yogurt “splits” with chopped nuts, dried fruit, stevia, and flavoring! Thanks again, and Happy Mother’s day!
Thanks! Happy Mothers day to you too!
My husband and I have been following this plan since January of this year. He is down 40 pounds and I am down 25 pounds. He is off blood pressure medicine and I no longer take any any pain meds for arthritis in my feet. We are both 60 and feel better than we have for 10 years. I wish those who criticize would humbly try the KETOGENIC diet and then write down their results. They would amaze themselves. Thanks Maria. You just keep on keeping on. Love all that you do.
great article. thank you so much for the reminders and summary again. I need that! thanks. 20 to size 12 pants. knees and feet feel awesome, sleep and poop great, and clear minded. thanks maria and craig. never felt better. and guess what riding my bike and walking have strengthened my knees and even feet. simple things i should have been doing all along. and now with no pressure to exercise like crazy (which you guys also say isn’t good, because of the cortisol) i am actually enjoying the exercise. thank you. thank you, thank you. for bringing this all to normal. grateful.
Awesome Janet! Thanks!
My husband and I have been grain-free, low carb, no added sugar for 2 1/2yrs now. We didn’t have a great deal of weight to lose, only a few lbs, and no major health issues. In view of this, I guess I still don’t see what is the big deal about ketosis, unless you have a lot of weight to lose, or diabetes, high bp etc. You have said yourself, Maria, that you are not doing it to lose weight, so what is the exact purpose of being in ketosis? I have commented on this before, but with the way we eat as mentioned above, we do not personally know even ONE other person who is grain free or doesn’t eat sugar. I continue to be the oddball @work and watch my co-workers poison themselves daily with breads and desserts. I also spend LOTS of time in the kitchen preparing “real” foods, and baking so that we can still have the occasional wrap/muffin etc. which honestly we would hate to have to give up completely. I guess what I am saying is, our diet sometimes seems hard enough and a big commitment without taking it a step further. Can anyone out there relate to this?
It is all about health. Inflammation is the cause of so many diseases (heart disease, cancer, diabetes, etc). This lifestyle greatly limits inflammation. Also, cutting out the chemicals helps our liver, etc. All about overall health. 🙂
But by cutting out wheat & other grains, sugar etc haven’t we already greatly reduced inflammation and chemicals?
Yes, that helps. But Keto helps even more. And some of the biggest benefit come from operating on ketones (look at brain section, Alzheimer’s, dementia, moods, focus)
I can relate to your post. I weigh 100 lbs( I’m only 4′ 11 “), sometimes less depending on the amount of carbs I eat. I have been eating low carb for 2 1/2 years and lost 5 lbs (yep, that’s it). My husband lost 20. Okay, so I went full on keto adapted 2 months ago and my weight hasn’t changed. (Not that it needs to) I did notice that my pants are loose and my shirts aren’t tight around my middle….my belly has decreased a little. These are all great things but no one notices since I have always been around my ideal weight anyway. I go to the gym at least 4 times a week for cardio/weights and have noticed that I am stronger I am looking more toned. Again, all great things that no one notices. I feel I have made sacrifices in giving up foods I love but spend so much more time cooking/baking at home to maintain this lifestyle. Don’t get me started on the comments I get when I tell people about the way I eat….they think I’m crazy. So much so I don’t talk about it anymore. When I go to family eating functions I always have to make food that I can eat. So, I said all that to say my main reason I put up with eating low carb is to one day down the road of life to reap the benefits…..to not suffer from the ailments that my parents do (high blood pressure, aches/pains, taking meds, gout, gall bladder issues, etc.) I am 45 right now and when I’m 20 years older I don’t want to suffer with any of these things that my parents do. Plus all my high school friends have gained weight over the years and I haven’t. I may not have some of the short term rewards others do on this diet (weight loss), but I will be waiting for my rewards as I age. I expect to live until I’m 100 on this lifestyle.
Well said. It isn’t all about the weight. 🙂
Very good responses, but I disagree with your portrayal of a “well formulated ketogenic diet.” When people are at a normal weight and body fat percentage, active, and eating at a maintenance calorie level, the diet may indeed be 70%-80% fat. However, when people are overweight or obese and adopting a hypocaloric diet to lose weight, the fat ratio may drop to the 50%-60% range and indeed still be well formulated. It is a bad idea for people to adopt general macronutrient ratios instead of determining what is actually required for themselves and their own circumstances.
Similarly, there are plenty of people for which 150g of protein a day may be entirely appropriate depending on their lean body mass, age, stage of muscular development, and physical activity level. As you likely know, Lyle McDonald’s research recommends that everybody consume at least 150g of protein the first two to three weeks of starting the ketogenic diet to compensate for increased gluconeogenesis at that time.
In my experience, those levels of protein and fat % will result in stalls in weight loss and healing. A well formulated ketogenic diet has always worked for my clients to get weight moving again and/or see additional improvements in health and healing.
Thank you so much, Maria, for being an amazing leader of a keto lifestyle. As a nutritionist myself, I have studied every health program from juice fasting to macrobiotics, high carb to low carb and everything in between. I have witnessed the best results with clients and family on a ketogenic diet for both weightless and most importantly incredible health improvements. I look forward to your future posts and delicious recipes!
I agree with Bob talking about the general, catch-all percentages. For me, that much fat causes stalls. To lose weight I need to drop it and increase my protein.
Good article over all though.
Is there benefit to a general low carb diet and not going full ketogenic?
There are definitely benefits vs. the standard american diet. Cutting out processed foods, sugars, etc. This is where Paleo can help a lot of people too. I find many clients hit a wall though and don’t realize how much better they can feel until going keto. 🙂
Thanks for all you do, Maria! Started the low carb WOE again in January. Switched to keto the end of March. The weight loss is slow but consistent, about 4.5 lbs. every 30 days, which, I suppose isn’t bad for this 67 year old broad! LOL I intend to get off my blood pressure meds and had, also, wanted to get off all acid blockers and get rid of my acid reflux. Thanks to you, I have been off the acid blockers with no rebound problems for the last two weeks! I bought your paper on supplements for intestinal health, which has really helped so very much! Thank you again, from the bottom of my heart! Oh and happy Moms’ Day!
That is awesome! Thank you! And happy mothers day to you too. 🙂
Do you agree with the use of oat fiber and glaucomannan since they are low carb and fiber? If not, why?
Glaucomannan is ok if included in your daily carb count. But too much fiber can lead to other problems so I would keep them limited. I try to stay away from all grains so no oat fiber for me. 🙂
What “problems” would you be concerned with consuming small amount of Oat Fiber? Such as adding into baked goods, as a mix with Almond Flour, etc. ?
You just made me feel so much better after seeing all of those negative claims that have been coming out. I really needed this information and you are definitely one of those life changing people in the world, especially for people in my generation (20s) who are overexposed to health claims and false information without backup. You come in with studies and full information and just make sense. Thank you so much.
I’ve been doing Keto since January of this year. I didn’t find Maria until about 2 months in, but devoured her book. I started using the supplements recommended in her book, and was able to train to walk a 5k relatively easy,compared to previous attempts . I finished the 5k last Sunday, with energy to spare!! AND was able to sit down with the family at a Mexican restaurant afterwards without falling off the wagon–not one chip!!! Not bad for someone who just wanted to sleep all day last year. Hubby is now on the diet with me, has lost over 20lbs; I have lost 35lbs and 25 inches.
Awesome! Way to go! 🙂
Hi Craig and Maria, you should do a post on what to do when you’ve gained weight and you feel really gross and down about it, sort of like an encouragement post?
#7 is wh a t I keep hearing. I say they are wrong and I am right.but they still say. Wrong
How do I get started? What foods or snacks do I buy to get started? Is there a book i can purchase? Any suggestions will help. I want to start immediately.
My book Keto-Adapted is a great place to start.
Otherwise, if you want to dive right in, my meal plan packages have everything you need and are really easy to follow all the way down to weekly grocery lists. And they are on sale right now too. 🙂
It seems even those pesky Paleo critics are fighting to keep a status quo. As I regularly point out to them, not everybody is young, pancreatic functions in tact, and still has estrogen flowing through their bodies. Carbs (especially fruit) to us are DEADLY. For all the railing against fat, sick people over in the Paleo community, they want to create MORE of them by keto-bashing? Remember when they bashed veganism? Maybe they should go back to that.
Very true. 🙂
Glucose being imperative for T4 to T3 conversion isn’t addressed here and everything written about T3 is highly speculative above.
Any thoughts? I’m truly concerned as I have EXTREMELY low T3 and not menstruating
It can be a complex issue for a small percentage of people with damages thyroid or metabolisms. For example, about 20-30% of T4 to T3 conversion occurs in the liver. So your liver enzymes are important. But as I state above, in these cases the right combination of supplements can help support function as your body heals.
As I read through this, I was confused about flax seed. I thought flax was good for you. I had been using it for the omega-3’s. I thought I had used it in some of your recipes, though I could be wrong. Is there new information on it? Thanks for this post. I read paleo mom’s article, a friend actually tagged me in it. I was thinking of tagging you, but you probably were way ahead of me. Thanks for your advice and wisdom!
I only have 1 or 2 recipes with flax. It is very estrogenic and raises the bad estrogen (there are 3 kinds). 🙂
This lists some of the most estrogenic foods. http://www.alternet.org/food/4-surprising-foods-packed-estrogen-chemical-linked-obesity-and-sexual-dysfunction
There are many recipes using it in previous cookbooks; perhaps you saw those.
Hi Maria and Craig,
I have been “off the wagon” for a while now and found out a few months ago that I have Hashimoto’s, with anti-bodies high at 593. Doc put me on 1/4 grain of Armour (my request over t4 only med). Now though, he doesn’t test any further than my TSH, which is “normal” at 2.7. I guess my question is have you had many clients with Hashi’s? Have they reported improvements?
I know you mentioned above that selenium and maybe iodine can be added in, but from what I have read from functional medicine docs is that iodine can be very problematic for Hashimoto’s, and selenium levels need to be checked before starting supplementation because too much can aggravate it too.
What do you think?
I have worked with many clients with Hashi’s, yes. This lifestyle (diet part especially) can be very helpful. And some supplement can help too, but yes, it is a good idea to check levels first. 🙂
Here is a recent client:
“Thanks Maria Wojcik Emmerich and keto adapted! Finally got rid of my hashimoto health issues and could not have done it without you.” – Nicole
Maria! Thank you for great article. Helped me have rebuttals for the negative feedback I can get in ketosis WOE. I have a question about protein. I see you have fixed amount by percentage … And I’ve read we should go by our LBM to determine macros. Also, I’ve read if we eat too much fat while in ketosis, our bodies will just burn the fat we eat and not burn the fat on our bodies. How do you or we determine what that fat percentage or Marcos to be.. Ie your calories to lose body fat. Yes, i feel way better on keto diet, but also want to lose the last 10% body fat that is stubborn. Is keeping carbs low – at 20 grams , sufficient for ketosis? How do we determine how much protein kicks us out? Sorry for long lost, but need to understand before jumping in fully. Thank you!!!
I talk about this in detail in my book Keto-Adapted. The percentages are easier to understand. If you want to calculate for your body, multiply your lean body mass times 0.7 and that is a good goal for daily protein grams (or times 0.5 if you have metabolic syndrome).
Lastly, how do I know if I have metabolic syndrome? I can’t lose weight no matter what- lol- is that the same?
Metabolic syndrome is high blood pressure, high blood sugars (pre-diabetes), etc. If you are getting stuck, then try lowering carbs to 20g a day or less (10g would be better).
Thanks for replying Maria! I have your book- love it. I didn’t see where to figure out calories? I can figure out carbs, protein, but how much fat to lose? Sorry I’m not understanding 🙁
For weight loss I keep clients around 1,000 to 1,400 calories a day. 🙂
Thank you Maria.. I don’t think I have Metabolic syndrome :). So will focus on lowering carbs more. I’m 5’2, 130.. Would 1200 cals with proper macros be too low? Also do you recommend days where you get cals to maintenance to help surprise metabolism or eating more days in workout days?
1200 is a good goal, yes. Yes, an overeating day (maybe once every week or two) can be a good thing. Just eat maybe 400 or so calories more than normal (with same ratios). 🙂
I forgot to mention I have low leptin.. Will this WOE help? Do I need to do anything different? Thank you again 🙂
This lifestyle is great for improving leptin levels. 🙂
Maria and Craig – you are amazing! Thank you for this article. I really appreciate all the work you both do to educate otheres and provide people with the opportunity to take control of their health. Truly inspiring!
Hi Maria! I have ordered my blood ketone meter and strips and was hoping you could tell me when I should be testing (times of day, fasted, after eating, etc.) I have heard varied answers and only trust YOU!
Thanks for all you do!
If you test in the morning in a fasted state, you will typically be the lowest for the day. As you eat keto (especially MCT oils) and after exercise your ketones will go up. So if you are showing ketosis in the morning, you should be good for all day (if eating a good keto diet). 🙂
Per the post above, where should ketones be in the morning? Mine are .3 usually– I’ve heard that having 1.5 upon waking is where true fat burning is best, but I have never been able to get mine that high.
I would say over 1 is best. 0.5 is technically in ketosis. So 1.5 would be a good optimum for fat burning. 🙂
Thank you so much! Also what date is your Supplement Class? I can’t wait for the webinar!!!!
Here are the details. 🙂
Thank you so much for all the helpful information. My family and I have been following this way of eating for years now and definitely have reaped the benefits. I even ate a keto diet while pregnant with both of my boys and know it has been a benefit to them despite all of the negative things people would say to me for doing so……you can imagine how many times I heard I wasn’t eating properly for a pregnant woman. And absolutely positively can’t wait until the cookbook comes out. We did the keto cleanse and all the recipes were fabulous and so we can’t wait for more. Thank you again so much for all you do.
Great post!! Love that you tackled all of those nasty keto myths floating around! Will be sure to share this post with my followers! Keep up the great work! 🙂
This is my second day and was wondering if there is a approximate amount grams of protein you should stay below ina day ,and does it depend on weight and level of exercize? also Carbs
I would shoot for 0.7 times your lean body mass in grams per day. Lean mass it total weight minus body fat percentage. 🙂
Maria, my daughter is 12 yrs old and has hypoglycemia and reflux/heartburn. Because of years of mis-diagnosis, she has a little motility issues when her food gets digested, and we deal with constipation and nausea. Do you think she would be a good candidate for the ketogenic diet? And what should her macros be? Thankyou.-christy
Yes, kids thrive with this lifestyle. My boys (4 and 6) have been ketogenic since we brought them home 4 years ago. This low inflammation lifestyle is great for healing GI issues. 🙂
Thank you for this awesome site! My son was diagnosed with ADHD and my husband with bipolar/anger issues. We are planning to start the Keto plan as a family, however, I am pregnant and rail-thin (despite eating all the carbs I want). Is it safe to do a Ketogenic diet while pregnant and does that mean I would lose weight?!
Keto is totally safe for pregnancy and while breastfeeding. Just try not to lose too much weight during that time as you store toxins in your fat cells and they get released when you lose weight. 🙂
I have a 16 year old daughter, keto about a year. She feels good and it helps her ADHD and mental clarity greatly. She recently had a fasting glucose test that was 265. She does not have diabetes. Carbs make her rise and then crash. Doctors say she cannot be on this diet that the long term effects are serious, liver damage etc, though they offer no other solutions. They say to increase her carbs. I am worried but I do not agree with them. What is your opinion?
Is that in mg/dl? That is really high fasting blood sugar. What did she eat prior to that test?
As for the liver damage, etc that is completely false and the latest science shows this lifestyle is great for liver health.
Yes. She had the 75 g glucose drink for the test. On a previous blood test after drinking 10 oz apple juice she was 200mg/dl. They say no diabetes because she has no other symptoms like antibodies. First the doc said there is no way not eating carbs should cause the glucose reading but now they are saying that is the reason. They want to slowly introduce carbs again even though it makes her feel bad. I want to just watch her, I figure if it is type 1 it will eventually get worse. Do you see any reason keto could be bad for her?
All of her blood work is normal, thyroid, bone marker, calcium, vitamin D and zinc. Despite how damaging the doctors say this diet is for her!
Ohh, ok. That wasn’t a fasting glucose test (testing glucose after not eating anything for 8 hours). That was a 2-hour glucose tolerance test (GTT). What happens is when you are keto adapted, your muscles naturally become more insulin resistant (called physiological insulin resistance). The muscles prefer burning ketones for fuel (over glucose) so they reject the glucose to leave it for other body parts that need it (brain, etc). So this makes you more sensitive to carbs/glucose being injected in large amounts like this. You could give her higher carbs for a couple days prior to test (to turn muscle back on to glucose) and then she will pass the test. But a much better way is to ignore that test and look at a better marker like A1c. 🙂
Her A1C is normal. I cannot thank you enough for your information. This has been so stressful. We have been sent to endo and neuro doctors and all they did is scare her. Ketosis and ketoacidosis seem the same to them. They do not have the knowledge for this. I have been following you for about a year and everything you say, and your books seem to make so much sense. We, fortunately, are not over weight but I was, and I say was, bipolar. The keto diet has totally stabilized me. My dad passed away this summer and I even kept level through that. My daughters ADHD is so much better. Thank you and keep doing what you are doing, you are helping so many people, like us. 🙂
Awe, thank you so much! And good for you for taking control of your families health! 🙂
Hi! I live in Costa Rica and I still haven’t found a Keto loving nutritionist, that being said, on just the information online that I have been reading and also read the Atkins book online I still feel I am not getting it right. I am 5’4 and I weigh 145 pounds I have 30% body fat and I am still confused how many grams of what I should be eating. I have been almost carb free ( no wheat, sugar or rice) for about 3 weeks and I feel great but I don’t feel I am burning fat! Can you give me some direction since i don’t have a nutritionist to go to!
I can certainly help with a consult!
I work with people all over the world!;)
Would the keto diet be helpful for someone with aches and pain due to some starting arthritis ?
Yes yes yes! http://mariamindbodyhealth.com/ibuprofen/
You mentioned rising ketones after exercise above. My ketones (BHB from blood) recently skyrocketed up to 4.0 mmol/L after a long (4 hr) fasted bike ride and my glucose was down at 59 mg/dl. That is apparently not the best method. I am shifting my approach to slower riding at max aerobic heart rate only (just conversational speeds) while in ketosis in the hopes that my power output will slowly rise at constant heartrate until I am fully LCHF adapted. Loved your last book. It seems that people either love the keto ideas or they hate them (or at least ignore them).
With relation to the current comment, I am trying to convince my wife to reduce/drop her carbs because she has acid reflux, meniscus failure, and is 125 lb overweight. Her mobility slows year by year but she is strong willed and I have not found a way to wean her off. It is almost like she prefers the painful winded/tired body so she can continue eating as she pleases. I am vexed because she agrees on the facts but not the execution.
Your message does more good than you know.
Thank you for your support!
Sometimes it is hard to hear it from those closest to you 🙁
Have you already written somewhere about your formula for tracking daily macros?
Yep. It is on my blog.
I am confused, if we eat all that fat that you recommend, why wouldn’t the body use this fat for fuel instead of stored fat? what does our body do with the ingested fat? Thanks so much.
Yes, if you over-ate fat it would. But I typically have clients on 1000-1400 calories a day so there is a deficit and your body can use bodyfat for fuel. 🙂
And the above example is for maintenance.
My doctor is trying to tell me that HF/LC or keto style eating may not be good for me because I have an ApoE mutation and he says that my body will not process fats correctly. Since I have metabolic syndrome, I obviously can’t consume carbs/starches, and I have to limit protein. Have you heard of this mutation and is it correct that I shouldn’t eat high fat? Thanks for everything you do to help people.
Hi, what APoE form do you have? ApoE4? If so, that is a misconception that they have to restrict fat. If the fear of the doctor is high cholesterol, then I would look at something that really causes disease risk (cholesterol doesn’t, inflammation does).
Yes I’m double E4, and they tell me alzheimers/dementia and heart disease are high risk for me. My labwork and weight loss aren’t perfect yet and they’re blaming the high fat part of my diet.
I’m also wondering if you have any references for baby care & keto. I’m particularly interested in possible homemade formula recipes. We are adopting a baby very soon and I do not want to feed it commercial formula (LOADED with sugars), and I know this will be a new battle with most physicians apparently not familiar with the natural ratio of macros in breast milk.
Thank you again for taking the time to respond.