Does keto work long term


How Long Should I Really Follow the Keto Diet For?

The ketogenic diet has come a long way from its humble beginnings.

Unless you’ve been living under a rock, you’ve probably heard of the ketogenic diet. You might have even tried it. This low-carbohydrate diet is high in fat and protein, which sounds scary, but it’s been shown to be effective as long as it’s followed correctly.

Initially developed in 1921 by Russel Wilder to treat epilepsy, this diet is now experiencing a resurgence. Celebrities like Gwyneth Paltrow, Lebron James, and Kim Kardashian have all gushed about the keto diet.

Like any plan that seriously reduces or completely cuts carbs, it’s not the easiest diet to stick to for a long period of time.

(Many people saw weight loss results in just their first week from following this “28-day Keto Challenge.”) Fortunately, you may not have to commit forever to reap the results.

We talked to experts to find out exactly how long you should follow the keto diet.

Remind me, what is the keto diet?

On the keto plan, your diet is composed of 70 percent fat, 25 percent protein, and 5 percent carbohydrates, says Samantha Lynch, R.D.N.

The goal of following a mostly fats diet is to put your body into ketosis. Studies show that it’s easy to get this wrong if you’re not following a proper plan. (Many have had success on this Keto plan here.)

When the body uses carbs as its primary source of fuel, it turns those carbs into a form of energy called glycogen. Ketosis slowly switches the body’s source of fuel from glycogen to ketones, thereby using fats as the body’s primary source of energy.

“When your body is relying on fat, there are a lot of ketone bodies—that’s the basic fuel source in the bloodstream—and the brain uses those very efficiently,” says Paul Salter, R.D., M.S., founder of Fit in Your Dress. As a result of this shift, the body enters a stage called ketosis. It now burns fat for fuel instead of carbs. The weight melts off quickly, and the results are often dramatic.

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How long does it take the body to get into ketosis?

Ketosis isn’t exactly easy to achieve. According to Salter, following the diet’s guidelines is paramount. This is because your body could snap out of its ketotic state at any point.

With the ketogenic diet, you have to meet these precise guidelines of eating—consuming this exorbitant amount of fat, a very small amount of carbohydrates—to actually see the benefits. If you do not eat to the guidelines, you actually don’t induce the state of ketosis to experience those benefits,” he says.

In order to see your body shift to ketosis and start experiencing benefits, you have to allow an adjustment period of a few weeks.

“The first two to six weeks are virtually the ketogenic adaptation phase, where your body is going through the adaptation of switching to relying primarily on fat versus glucose or carbohydrates,” Salter says.

He adds that to really see results, you should follow the diet for a minimum of three months.

Mark Sisson of The Daily Apple says there are four indicators that you’ve gone into ketosis:

  1. Higher energy levels: Without carbohydrates, your body now has a “super fuel” that makes you feel more energetic.
  2. No more cravings for sweets: Carbs are addictive, and if you’re eating them daily, you’ll continue to crave them. Once you eliminate them from your diet, you’re likely to find that you no longer desire them the way you once did.
  3. “Keto breath”: You might notice a hint of metal on your breath, which is also described as a “sweet rotten apple” scent. It’s subtle and may not last long, but in the meantime, make sure you’re drinking plenty of water to flush out any odors.
  4. Testing: To find out if you’ve entered ketosis, you can use urine test strips, a breath test, or a blood analysis.

What are some things to keep in mind while following the keto diet?

In order to achieve true ketosis and avoid any nutritional deficiencies, consult a registered dietitian or nutritionist prior to starting the keto diet.

It’s easy to develop an electrolyte imbalance while on the plan, Lynch says, as you are not allowed to consume many foods from which you gain electrolytes, such as certain grains, fruits, and vegetables.

Additionally, it’s important to pay attention to the kind of fat you consume.

“Because of the high amount of fat necessary, much more welcoming to all types of saturated and unsaturated fat,” Salter says.

Try to balance out your fat intake to include healthier fats as well. Lynch adds, “I think that people feel more satiated on a higher-fat diet. But it has to be done right and include healthy fats. Some healthy sources are avocado, olives, nuts, and fatty fish.”

So, how long should I follow the keto diet?

As is true for any diet, you should only begin to follow it if you can maintain it as a lifestyle change. All it takes is 28 days to see a huge transformation.

“If you want to keep the weight off, you’re going to have to eat well. You can’t go back to your old ways,” Lynch says. “A diet has an endpoint, and that’s the problem. With a lifestyle, there’s no end point. You have to put the work in.”

Salter echoes that sentiment, adding that there is no finite limit “as long as someone knows how to properly navigate carb-infested situations like social gatherings, vacations, and holidays, or are OK with the ramifications if they do rapidly introduce carbohydrates in a short period of time. Any diet needs to be something that can you do and maintain for far longer. certainly is. You just have to be diligent and educate yourself.”

How can I reincorporate carbohydrates into my diet?

It’s no secret that many people wind up gaining back the weight they lost as soon as they reincorporate certain foods.

“The vast majority of people who lose weight regain the weight they did lose within a year. So clearly we do have a weight maintenance problem,” Salter says.

He gives the example of someone lowering their daily calorie intake from 2000 to 1200. That person, he says, will lose weight but will not be able to sustain such a low-calorie intake.

“As a result, they’re going to give in to their hunger and the foods they’re craving and binge wildly, bringing their baseline calories up significantly,” he explains.

“If they can diligently and gradually bring their calories up by slowly introducing portions while simultaneously expanding their food selection, they can still maintain their weight loss and their health benefits, especially if exercise remains the focal point in their weekly regimen.”

Take it slow.

To add carbohydrates back into your diet, Salter advises starting off small. For example, start with one portion a day of 15 to 25 grams of high-fiber carbohydrates.

“Eat it either before or after exercise. That’s when your body is going to most efficiently use that carbohydrate source. It’s going to use it as fuel for your workout or replenish what your body burned during the workout,” he says.

He recommends following that pattern for five to ten days. Then, add the second portion to the opposite end of your workout as well. This way, you will consume a small number of carbohydrates both before and after your workout.

“Slowly move forward with that. Add a little more to the pre-workout. Add a little more to the post-workout meal,” he says.

“Once you get to a point where you’re comfortable with those meals, you can branch out. Add a little bit more to another meal of the day. It’s a very slow process. If you don’t slowly transition out of the ketogenic diet gradually, you’ll see the scale skyrocket. You’ll feel bloated and puffy, and that’s because there’s an overwhelming sensation of all these carbohydrates being returned.”

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How Long Is It Safe to Be in Ketosis?

In full transparency, there are no long-term studies on the ketogenic diet. An article out of Harvard Medical School says the early results on cardiovascular health are promising, but more extended research studies are needed.

Some people get thrown off by the “Keto Flu.” Don’t be fooled by the name. The Keto Flu isn’t a form of the flu. Instead, it’s a list of symptoms that resemble the flu. These symptoms sometimes occur when the body first goes into ketosis, but, according to Medical News Today, it’s not something you should be overly concerned about. Symptoms typically last a few days to a few weeks. (Consult with your doctor if you have any concerns).

For now, doctors tend to agree that as long as your bloodwork is at appropriate levels and your weight is within a healthy range, there’s nothing wrong with doing the keto diet long-term. Reading between the lines, we can tell you that ketosis is generally considered safe, but it’s not suitable for everyone. We recommend checking with your doctor before starting the ketogenic diet.

The biggest challenge you might face with the keto diet is sticking to it. With keto, there’s no such thing as a “cheat meal.” If you fall off the wagon and eat a donut or a bowl of pasta, you’ll fall out of ketosis – that fat-burning stage – and the process must begin again.

Just as important as your diet is your exercise program. To get the best results on the ketogenic diet, be sure to combine your eating plan with a fitness regime. Aaptiv features hundreds of workouts led by high-energy trainers. Sign up today for a free trial.

4/4 Photo: Stocksy/Nadine Greeff

And for sticking with keto for life

Even though Ketchum has written a book on keto, keeps on top of the scientific research about it, and has been living the keto life for years, she stresses that she is not a medical expert. “I read a lot of studies, but I’m not the person doing the research,” she says. Still, she has pretty compelling reasons for why the ketogenic diet works long-term.

“In my case, , I have a visual representation of why it works, which is my blood glucose meter,” she says. “I know that if I didn’t stick to the ketogenic diet, I would likely have developed Type 2 diabetes and be on insulin.”

“If I didn’t stick to the ketogenic diet, I would likely have developed Type 2 diabetes and be on insulin.” —Everyday Ketogenic Kitchen author Carolyn Ketchum

But even if you don’t have diabetes, Ketchum says it works in the long-term. “People use it for weight control, anxiety, and other neurological disorders, and also for sustained energy and to combat brain fog,” she says. “Carbs can make you feel fuzzy because they spike your blood sugar, then it drops and you feel tired, which makes it harder to focus.”

And even though the word “diet” has a temporary connotation, she says it’s absolutely sustainable—as long as you like the food. “The key is having recipes for dishes you love on hand,” she says. “Food is pleasure, celebration, and fun. So as long as there are some keto-friendly foods around when you’re socializing, you won’t fall off the wagon.”

Even though Ketchum is an all-out keto advocate and, for her, there’s no turning back, she does offer up one caveat: “Because the diet is newly popular, there haven’t been any substantial long-term studies done,” she says. “I would love for someone to do one, following people on keto for 20 years!” But as for herself, she hasn’t seen any negatives to the diet, only positives.

While the wait for more research is on, for now, the best barometer is likely yourself. As with any eating plan, it comes down to how what you’re eating makes you feel. When finding the best diet for you—and whether that includes a plate full of eggs, avocado, and a side of bone broth (or not)—you are your greatest advocate.

Here’s how the ketogenic diet stacks up against other popular eating plans. Plus, find out how popular diet plan Weight Watchers transformed into an all-out wellness lifestyle.

7 reasons you shouldn’t do the keto diet long-term

The keto diet might not be sustainable long-term. REUTERS/Henry Romero

  • The keto diet has become popular as many people claim it can help with weight loss.
  • The diet, however, might not be best for long-term health as the eating habits it promotes might lead to heart rhythm problems.
  • Eating a diet high in fat and low in carbs might also make exercising more difficult.

The ketogenic diet has become popular with people looking to lose weight and improve their health. It involves significantly reducing carbohydrate intake while increasing the amount of fat and protein you eat. This puts the body into a state called ketosis, where fat is burned for energy instead of carbs.

The diet has plenty of fans and there is evidence it can help with weight loss by increasing satiety. There may, however, be risks to following a ketogenic way for an extended period of time. Though researchers do not know for certain the long-term effects of the keto diet, there has been research done on the long-term effects of consuming high-fat, low-carb diets.

INSIDER consulted with medical experts and nutritionists to find out if there are any reasons you shouldn’t stick with the keto diet long-term.

Cutting out carbs long-term has been linked to heart rhythm problems

New research presented by the American College of Cardiology has linked low-carb diets to an increased risk of developing atrial fibrillation (AFib).

The study compared the medical records of almost 14,000 people over 20 years and found that people who get a low percentage of their daily calories from grains, fruits, and starchy vegetables are significantly more at risk of developing AFib.

This condition causes the heart to beat irregularly and puts sufferers at five times the typical risk of stroke and heart attack.

Though the research does show a relationship between carb intake and AFib, it doesn’t show clear cause and effect. More investigation is needed into whether cutting carbs can have a negative effect on your heart health.

Your ability to exercise might suffer

Without enough carbs, it can be hard to have the energy to exercise. Andrew Harnik/AP

One of the central premises of the ketogenic diet is that switching the body’s main energy source from carbohydrates to fat is a positive change. In reality, however, this benefit may depend on how active you are.

“Biologically, the body prefers to burn carbohydrate for fuel and store fat, especially during periods of physical activity. This is because it spends less energy burning carbs for fuel than it does burning fat,” registered dietician Rachel Fine told INSIDER.

If you’re supplying the body with inadequate amounts of carbohydrates, physical performance and exercise ability can suffer as the body struggles to maintain energy needs while breaking down fat, explained Fine. This can make you feel sluggish during workouts and can mean the keto diet isn’t a good long-term fit for athletes or people with highly physical jobs.

People with gallbladder problems should avoid eating high amounts of fat for long periods of time

The gallbladder stores and concentrates bile, which is made by the liver. Bile is essential for fat metabolism. A high-fat diet can aggravate existing gallbladder disease (GBD) and may increase a person’s risk of developing GBD.

“Especially if your gallbladder has been surgically removed, you may have trouble digesting all the fat you eat on the keto diet. Weight gain, bloating, and other digestive discomforts would be the first signs you would notice with this,” said Gittleman.

The symptoms of a poorly functioning gallbladder might not be evident until you increase your fat consumption. If you notice digestive problems after limiting carbs and increasing fat intake, it might be a sign that the keto diet isn’t a good fit for you long-term.

Being keto long-term may lead to vitamin deficiencies

Bananas have carbs but are also a great source of vitamin B and C. Reuters/Guillermo Granja

Followers of a strict keto regimen might opt out of consuming carbohydrate-rich fruits and vegetables in an effort to keep their carb counts within a ketogenic range. Unfortunately, focusing solely on limiting carbs can lead to vitamin deficiencies in the long-run.

“The keto diet is often lacking in water-soluble vitamins and may result in deficiencies with long-term use. Those vitamins include all B-vitamins, which are essential for the health of the nervous system and energy metabolism. Vitamin C is also water-soluble and is well-known to support the immune system and healthy skin and hair,” registered dietician Cathy Posey told INSIDER.

Whole grains, beans, legumes, and fruits like bananas and oranges are rich in B and C vitamins but can be high in carbs. Lower carb, vitamin-rich options include Brussels sprouts, spinach, broccoli, raspberries, and blueberries. If you’re determined to stay on the keto diet long-term, you may also want to use vitamin supplements to make sure you’re getting everything you need to stay healthy.

Read more: 10 subtle signs you have a vitamin deficiency

A long-term keto diet could have a negative impact on your gut and digestion

Many nutrient-dense and fiber-rich foods such as quinoa, beans, lentils, fruit, brown rice, and sweet potatoes are not permitted on a keto diet due to their higher carbohydrate content. For many people, excluding foods higher in fiber can lead to digestive issues like constipation and diarrhea.

Additionally, restricting higher-carb foods like starchy vegetables and whole grains may not promote good gut health.

“Many of the plant-based foods limited on the keto diet are good sources of prebiotic fibers. Prebiotics feed our probiotics, the beneficial bacteria in our gut. This is essential for the health of our microbiome, which has been shown to be heavily involved in supporting our immune system and reducing inflammation,” registered dietician Melissa Mitri told INSIDER.

Focusing on eating fat-rich foods might compromise your health long-term

There’s a difference between “good” fats and “bad” fats.

All fats are not created equal. Unfortunately, some people may see the ketogenic diet’s emphasis on high-fat foods as a free pass to adopt unhealthy eating habits, such as over-indulging in processed meats and saturated fats.

“Many people follow a keto diet without regard to the type of fat they are consuming. All fats are high in calories, but saturated fat and trans fat raise the “bad” LDL cholesterol in your blood and can cause plaque to build up in your arteries,” said Fine.

Posey also told INSIDER that people on the keto diet often don’t make enough of an effort to eat fats that benefit brain and cardiovascular health or to choose fats that are unrefined or unprocessed. This can mean that sticking to a keto diet long-term can actually increase your risk of cardiovascular problems or high cholesterol if you’re not eating the right kinds of foods.

Read more: There’s a big difference between good and bad fat — here’s how to pick the best heart-healthy fats

Rather than consuming large amounts of saturated fats such as butter, ghee, palm oil, coconut oil, and bacon fat, keto dieters might want to consider focusing on unsaturated fats such as those found in avocado, nuts, olive oil, and fish. When done correctly, there is evidence that following the keto diet may improve cardiovascular health.

You might not want to do the keto diet long-term if you have a history of pancreatitis or high triglycerides

The ketogenic diet typically involves replacing carbohydrates from low-fat sources like grains, fruits, vegetables with greater amounts of fat from both plant and animal sources. This means that people who have medical conditions affected by fat intake should avoid following the keto diet, especially in the long term.

“High triglycerides circulating in the blood for a prolonged period of time can lead to acute pancreatitis. The high-fat keto diet is a known cause of acute pancreatitis because it causes an increase in circulating fats,” author and nutritionist Ann Louise Gittleman, Ph.D., told INSIDER.

In recent years, the ketogenic diet has found widespread popularity as more people learn about the health and weight loss benefits of ketosis. However, there’s still some confusion surrounding how ketosis works, and how to get into ketosis in the first place.

Below, you’ll learn how to get into ketosis, and how to maintain a fat-burning metabolic state.

What Is Ketosis?

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Ketosis occurs when your body has little to no access to carbohydrates, its preferred fuel source. In the absence of carbs, it begins breaking down and burning fat stores for energy instead.

When your body is in ketosis, fats are broken down and ketone bodies — aka ketones — are created for you to use for energy. Being in a state of ketosis can have many health benefits including:

  • Curbed hunger and weight loss
  • Improved blood sugar and insulin levels
  • Better mental clarity and improved energy levels
  • Less chance of inflammation
  • Reducing risk of chronic diseases, including heart disease
  • Decreased insulin resistance and the prevention of type 2 diabetes

How to Get Into Ketosis

The goal of the keto diet is to enter a fat-burning metabolic state known as ketosis. If this is your first time trying the keto diet, follow these steps to help you enter ketosis.

One quick note on transitioning into a ketogenic state: The first time you attempt to enter ketosis, you may experience a few negative side effects known as keto flu. These symptoms can include lethargy, brain fog, headaches, and other short-term symptoms that should go away in about a week.

Step 1: Limit Your Carb Intake

On the keto diet, you will need to drastically decrease your carbohydrate intake. On keto, roughly 5-10% of your daily calories will come from carbs. This comes out to about 30-50 grams of carbs per day, a fraction that you would see in a standard American diet.

On keto, the majority of these carbs will come from vitamin-rich, keto-friendly foods including leafy green vegetables and low-sugar fruits. Be sure to check out the full list of foods to eat on a ketogenic diet.

Step 2: Increase Your Fat Intake

One of the most common mistakes people make when starting the keto diet is underestimating how much fat they’ll need. Other low-carb diets like Atkins encourage a low-carb approach coupled with a high-protein intake. By contrast, keto is a high-fat diet with moderate protein consumption to preserve muscle mass.

On a keto meal plan, roughly 70-80% of your calories need to come from fat in order to boost ketone production. Choose fat sources such as MCT oil (medium-chain triglycerides), olive oil, coconut oil, avocados, avocado oil, nuts, and seeds.

Step 3: Increase Your Physical Activity Level

As you exercise, your body uses up glycogen stores (or stored glucose) for energy. For decades, many athletes followed the “carbo loading” advice of nutritionists, eating plenty of high-carb foods prior to workouts or competition. However, if you avoid eating carbohydrates prior to hitting the gym, you may experience post-exercise ketosis.

Step 4: Try Intermittent Fasting

Throughout history, humans were able to go for prolonged periods without food. During these periods, people entered a ketogenic state.

To replicate this evolutionary process, you can experiment with intermittent fasting. New research shows that fasts lasting more than 12 hours, or prolonged periods of a low-calorie diet, can help flip the metabolic switch, putting you in a fat-burning state.

Take a look at this guide on the different types of intermittent fasting for more information.

Step 5: Take Exogenous Ketone Supplements

When nutritional ketosis is not enough, sometimes supplements can help you enter a ketogenic state. Exogenous ketones, which are those not produced by the body (i.e. endogenous ketone bodies), are ketone supplements that can increase the number of ketones your body uses for fuel by supplying them directly to your bloodstream via supplementation.

Perfect Keto’s Exogenous Ketone Base can be taken any time of day, helping you increase your blood ketone levels while transitioning into ketosis or after a carb-heavy meal. This supplement contains the ketone body known as BHB (beta-hydroxybutyrate), the most abundant ketone in the body. It’s also the body’s most preferred energy source in the absence of glucose.

How to Maintain Ketosis

Keto is not meant to be a short-term diet — it’s meant to be a lifestyle. And part of any healthy lifestyle is making room for real-life situations such as celebrations, special events, travel, and vacations.

If you’re traveling, visiting your family for the holidays, or enjoying a few cocktails at happy hour, you may not be able to maintain a ketogenic state 100% of the time. But if you follow the below tips, you’ll be able to maintain a fat-burning state most of the time and get back into ketosis after a few too many carbs.

Calculate Your Macros on a Keto Diet

Remember the golden ketosis formula: Low carb, adequate protein, and high fat.

The exact amounts of carbs, proteins, and fats can vary per person, so you’ll have to do some experimenting to find out what works best for you.

For a standard ketogenic diet, it typically comes to around 70% fat, 25% protein, and 5% carbs.

To get a more accurate estimate of your individual maco goals (accounting for your body weight, BMI, and physical activity level) use the keto macro calculator to find your personalized macros on keto. That way, you’ll know the exact grams of total carbs, protein, and fat you should consume.

Track Your Carbs to Stay in Ketosis

Carb intake should be kept very low (and your fat intake high) so your body utilizes its natural fat-burning capabilities. You won’t ever reach ketosis if you aren’t diligent about finding the carbohydrate count that is just right for your body.

The best way to determine the exact net carb count that’s right for you is by figuring out your total daily calorie intake. Again, you can use the keto macro calculator for this.

Test Your Ketone Levels

What’s great about ketosis is that it’s not just a diet, it’s a measurable state of metabolism. To truly know whether you are in ketosis, simply test your ketone levels.

There are three ketone bodies: acetone, acetoacetate and beta-hydroxybutyrate (BHB). The three ways to test your ketone levels are:

  1. Urine testing: Excess ketone bodies are excreted through the urine. You can use keto test strips (or urine strips) to easily test your ketone levels at home. However, this is not the most accurate method.
  2. Blood testing: The most accurate (and the most expensive) way to test your ketone levels is with a blood meter. Similar to using a blood glucose meter, you will prick your finger, squeeze out a drop of blood, and use the blood meter to measure your blood ketone levels.
  3. Breath testing: The ketone body acetone can be detected through your breath. Using a breath meter, such as a Ketonix meter, can measure your ketone levels when you exhale. This is the least accurate method.

A Well-Rounded Approach on How to Get Into Ketosis

The keto diet is a high-fat, low-carb diet where you attempt to enter the metabolic state known as ketosis. Once you are in ketosis, you may experience a number of health benefits including weight loss, improved insulin and blood sugar levels, decreased inflammation, and increased mental clarity.

Knowing how to get into ketosis includes eating plenty of fat while keeping your carb count extremely low. When nutritional ketosis is not enough, you can try intermittent fasting, ramping up your exercise routine, or supplementing with exogenous ketones.

Be sure to routinely check your ketone levels to assess if you are effectively maintaining ketosis. If you aren’t, simply review your eating habits, make a few alterations in your diet, and then retest.

Reaching and maintaining ketosis doesn’t happen overnight, but with patience, tenacity, and solid information, you’ll be able to enjoy a healthy keto lifestyle.

Can You Stay in Ketosis Forever?


If you’ve been on the keto train for any length of time, you may wonder if you can stay in ketosis forever, because you just feel so dang good! Contrary to mainstream media, you don’t need carbs to survive. Carbs are the only macronutrient that are nonessential. Your body can make its own glucose and will do so when it needs it. This, of course, doesn’t apply to type 1 diabetics.

Yes, you can stay in ketosis forever. Ketones range from 0.5 mmol/L up to 1.0 mmol/L being light, which is still good, and 1.0 mmol/L through 3.0 mmol/L being optimal. If you want lose weight, light ketosis is a great starting point! Those who use the keto diet for therapeutic reasons, such as cancer, epilepsy, metabolic disorders, etc., may want to aim for ketones in the 3.0 mmol/L-5.0 mmol/L range. You don’t need to be higher than 5.0 mmol/L. Most people don’t need to worry about this, because it’s difficult to achieve. If you’re a type 1 diabetic or an alcoholic, you should know the risk of ketoacidosis. It’s in the 10.0 mmol/L range. As always, talk with your doctor.

Does exercise affect ketones?

It depends from person to person on how exercise will affect ketone levels. In general, anaerobic exercise, like weightlifting or interval training or those exercises that are short and usually of high intensity will raise glucose, and therefore, lower ketones temporarily. On the other hand, aerobic exercise may raise ketones. The best way to know how your body responds is to test.

I recommend everyone test their blood glucose even if they aren’t on a ketogenic diet. You need to know how certain foods affect you, so you can adjust accordingly. You don’t want to find out after years of eating the Standard American Diet that you’re suddenly a type 2 diabetic and your doctor now wants to put you on insulin.

I’ve been using and loving the Keto Mojo for blood and ketone testing, which I’ll link below. Urine strips just aren’t accurate long term for testing ketones, because when your body starts using ketones effectively, you’ll stop peeing them out.

Anyway, I really feel tracking with a Keto Mojo in the beginning can keep you on track and make you more aware of what foods will kick you out of fat burning. I’ve found this with myself. It’s made me more disciplined and is just a great tool to have.

In conclusion, remember insulin immediately shuts down ketone production. That’s why meals high in carbs will knock you out of ketosis. If you need a reset, winter is a great time to reduce your carb intake, as it aligns with our genetic hard wiring. Carbs just weren’t as plentiful in the wintertime. What do you think about the keto diet? If you have questions, message me.

My fav! (commission earned)

PS Everyone is interested in boosting their immune system in the wintertime, because most people aren’t eating well during this time. There’s just more sugar around the holidays…cookies, candies, pies, etc. And sugar depresses the immune system.

What can help? Eat more organ meats, red meat, bone broth, fermented foods, and leafy greens to get your micro nutrients and probiotics. The other thing you need is fat soluble vitamins, A, D, E, and K. You can eat grass fed butter, take cod liver oil, fish oil, and vitamin D3 with K2.

You probably aren’t going out in the sun, plus it’s just not as strong in the winter months. Depending on where you live and how healthy you are, you may need anywhere from 4,000 IU to 10,000 IU. This sounds like a lot, but in the summer, you can easily get 10,000 IU in about 30 minutes of direct sun exposure! So important, because vitamin D3 plays a huge role in staying disease free!

Vitamin D regulates cell growth and renewal and acts as a DNA proofreader gene, informing cells when something has gone wrong and instructing them to make necessary changes, as with apoptosis (the self-destruction of damaged cells before they become cancerous). In the absence of vitamin D, the proofreader gene may down-regulate or even turn off, and the risk of cancer will dramatically increase! Check out my new book, The Vitamin Cure, all about vitamin D and how to optimally get enough.

My favorite D3 with K2: (commission earned)

xo Jill

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The 3 Biggest Mistakes Women Make On The Ketogenic Diet (And How To Fix Them)

Dirty Keto Vs Clean Keto

“The human body is a miraculous self-healing machine, but those self-repair systems require a nutrient-dense diet.” — Joel Fuhrman

Most people, when they first start eating keto, use an approach I call ‘dirty’ keto.

A properly formulated ketogenic diet should have high fat, moderate amount of protein and low carbohydrate intake.

Most people “get” this intellectually, but the practical application of it oft falls short.

This is why many people will start off getting their macros on target, but after 2 or 3 weeks are absolutely starving, no matter how much fat they eat.

There are many reasons why this happens, and one of the most common reasons is that your microbiome is starving, and it will direct all your attention to lusting after pizza, or burgers, or both.

Enter the binge. The carb coma. The falling off the wagon. And the feeling of failure once again.

This is how most of the weight loss industry works.

Dirty keto is no exception.

The weight loss industry is rigged to keep you on the yo-yo routine so that you’re constantly buying more ‘stuff’ and feeling like you’re not good enough.

You might get a quick win, but the weight always comes back, because you have not been taught the skills to keep it going on your own.

Have you ever thought “I’m not good enough?”

Have you ever worried that there will never be an “after” photo?

That someone having a body you are proud of is not in cards for you?

I work from a different vantage point.

I always start with the premise that your body WANTS to be healthy, no matter what label you have been given.

Essentially, dirty keto, is what is commonly available in the market right now.

It is when people will eliminate all carbs from their diet, including vegetables, and then proceed to eat equally nutritiously devoid toxic garbage.

I may be breaking some hearts here, but you can’t just eat bacon, lard, and greasy burgers forever.

Dirty keto is a substitution of one bad habit for another.

Sure, getting rid of processed carbohydrates is awesome, but substituting it ONLY for bacon, butter and burgers is not.

Reducing your carbohydrate load has a direct impact on mortality … but are you really going to eat bacon fat fudge as a snack forever?

What are we, 6 years old with no executive brain function? How is this a reasonable long term solution, or considered healthy by any means??

Like I said…play the long game. Bacon fudge, butter, and lard all day err day is not taking into consideration longevity or vitality.

Yes macros are important, but so are micronutrients — the minerals and vitamins derived from plants and other living things.

On a cellular level, eating a properly formulated, clean ketogenic diet will support enhanced mitochondrial function, reduce ROS that cause oxidative damage, prevent cellular senescence, and increase the production of butyrate, B-hydroxybutyrate.

It amplifies autophagy, prevents cellular aging and precancerous pathways like mTOR.

Now, if you are a meat eater, I’m not saying you can never eat bacon.

Of course you can.

And I’m not AGAINST bacon and butter — I love them both.

But I am always going to look at things from both a practical perspective, and from a longevity and vitality lens.

Bacon all day every day (which is what a lot of keto “experts” will recommend) is not a long term solution for optimal health and vitality.

A properly formulated ketogenic diet is primarily plant based.

Meaning we are eating a large amount of vegetables (like green leafy ones with a high fiber content), and then layering appropriate fat and protein on top of that.

What’s nice about a “clean” ketogenic diet is that vegetarians can also be successful in becoming fat-adapted, and also profit from the benefits from a fasting-mimicking diet.

When you layer fasting along with a fasting-mimicking diet — you’ve hit the jackpot.

When we think about playing the long game with your health, we should always be asking the following questions:

What are the things I can eat that are anti — inflammatory?

What are foods I can create that will nourish and feed my cells?

What will help with regular and consistent elimination?

What will make me feel good and stabilize my mood, increase my energy, focus, and clarity?

How can I keep my brain happy and healthy?

The answer my friends, are your vegetables and your fats. Just like mom used to tell you.

I realize, as someone who spends most of her time educating people about brain health and optimization, that the brain is often forgotten.

We cannot see the brain, and changes in function are often not noticed because they are so subtle, and because the way the brain is is the way we are.

It is immensely difficult to detect changes unless they are severe.

It is hard to detect changes in your brain, because you ARE your brain.

We need to be thinking about the brain, and optimizing the brain’s performance, because your body, in all its glory, is simply a reflection of brain health and function.

One of the ways in which you can protect your brain is by the fuel you feed your brain in order to perform its best.

Everything follows the brain.

In fact, when we look at your body ,all parameters of your body — HRV, blood pressure, respiratory rate, forced vital capacity, grip strength, hormones, lab markers — will give you a good picture of the health and vitality of your brain, too.

Hormones out of whack? We need to look at the brain.

Overweight? We need to look at the brain

Low energy? We need to look at the brain

Cannot sleep through the night? We need to look at the brain.

Poor focus? We need to look at the brain.

Mood swings? We need to look at the brain.

We need to stop looking at the end organ as the primary focus, and instead look a level or two up to find why downstream changes are happening at the organ or behavioural level.

So, when we are talking about the best fuel you need to feed your brain (and therefore your body), we need to be thinking about the best possible foods for lowering inflammation, improving autophagy, removing cellular senescence, enhance energy production with whole, nutrient dense foods.

Because all these things help your brain.

We need to be thinking about a clean ketogenic diet.

Not dirty keto.

Not bacon, burgers, and butter.

Just because it fits the macros, doesn’t mean you should do it.

“The greatest risk, however, of the ketogenic diet may be the one most overlooked: the opportunity cost of not eating high-fiber, unrefined carbohydrates,” the authors wrote. “Whole grains, fruits and legumes are some of the most health-promoting foods on the planet. They are not responsible for the epidemics of Type 2 diabetes or obesity, and their avoidance may do harm.”

Dr. Shivam Joshi, a co-author of the piece, said it generated a flood of emails from people across the globe. Some expressed praise and support, while others offered condemnation, a sign of just how polarizing the diet can be, said Dr. Joshi, an attending physician at NYC Health + Hospitals/Bellevue and a clinical assistant professor at New York University medical school.

“It’s a hot-button issue, and this paper struck a chord,” he added.

While the ketogenic diet can seem like the latest in an endless stream of fad diets, it has a long history of therapeutic uses. Diabetics routinely practiced carb restriction before the discovery of insulin in the 1920s, and doctors at Johns Hopkins and other hospitals have used the diet for almost a century to reduce seizures in patients with epilepsy.

One of the benefits of carb restriction is that blood sugar levels remain stable after a meal, resulting in lower levels of insulin, a hormone that causes weight gain, said Dr. David Ludwig, an endocrinologist at Harvard Medical School and the author of a best-selling book on low-carb diets.

“Insulin is like a Miracle-Gro for fat cells,” he said. “By lowering insulin levels, fewer calories from the meal may get stored in fat cells, leaving more to fuel metabolism and feed the brain. As a result, you may feel fuller longer after eating.”

In a series of studies over the years, Dr. Ludwig has found that low carb diets cause people to burn more calories and lose more weight compared to lower fat diets. According to the carb and insulin theory of obesity, whole grains, starchy vegetables and tropical fruits are more healthful than processed carbs. But they can still cause swings in blood sugar and insulin after a meal, and that can be particularly problematic for people with diabetes, said Dr. Ludwig.

In May, the American Diabetes Association published a consensus statement on nutrition strategies for people with diabetes. It found that a variety of diets rich in unprocessed foods, like the Mediterranean and vegetarian diets, could help people prevent and manage the disease. But it also concluded that reducing overall carb intake “has demonstrated the most evidence” for improving blood sugar control.

The Keto Diet Is Gaining Popularity, But Is It Safe?

A new twist on extreme weight loss is catching on in some parts of the United States. It’s called the “keto diet.”

People promoting the diet say it uses the body’s own fat burning system to help people lose significant weight in as little as 10 days.

It has also been known to help moderate the symptoms of children with epilepsy, although experts are not quite sure why it works.

Proponents say the diet can produce quick weight loss and provide a person with more energy.

However, critics say the diet is an unhealthy way to lose weight and in some instances it can be downright dangerous.

Read More: What is the “Caveman Diet?” “

What is ketosis?

The “keto” diet is any extremely low- or no-carbohydrate diet that forces the body into a state of ketosis.

Ketosis occurs when people eat a low- or no-carb diet and molecules called ketones build up in their bloodstream.

Low carbohydrate levels cause blood sugar levels to drop and the body begins breaking down fat to use as energy.

Ketosis is actually a mild form of ketoacidosis. Ketoacidosis mostly affects people with type 1 diabetes. In fact, it is the leading cause of death of people with diabetes who are under 24 years of age.

However, many experts say ketosis itself is not necessarily harmful.

Some studies, in fact, suggest that a ketogenic diet is safe for significantly overweight or obese people.

However, other clinical reviews point out that patients on low-carbohydrate diets regain some of their lost weight within a year.

Read More: How Exercise Helps You Lose Weight “

Where it’s helpful

The keto diet was created by Dr. Gianfranco Cappello, an associate professor of surgery at the Sapienza University in Rome, Italy.

He claims great success among thousands of users. In his study, more than 19,000 dieters experienced significant, rapid weight loss, few side effects, and most kept the weight off after a year.

According to the reported results, patients lost an average of 10.2 kilograms, or about 22 pounds, after 2.5 cycles of the keto diet. Cappello concluded that the diet was a successful way for overweight and obese people to lose weight, and the few side effects, such as fatigue, are easily managed.

Bette Klein, a registered dietitian at Cleveland Clinic Children’s Hospital, has used the keto diet for years to help ease the symptoms of children with epilepsy.

She told Healthline it is particularly effective with children with refractory epilepsy who have not responded well to at least two different drug treatments.

Klein said about half of these children who go on the diet see a reduction in the number of seizures they have.

The dietitian said, however, that medical professionals are not sure why the diet works in these cases.

“There is not a clear definition of what is happening,” she said.

Rudy Mawer, a sports nutritionist, has also found some success with the keto type of diet.

He said he uses this low-carb approach with some people who have trouble losing weight. He also has high performing athletes on the plan.

Mawer told Healthline there are a number of benefits to the program.

One benefit is its quick results. People can lose some initial weight rapidly and that, in turn, helps encourage them.

“You can get motivated by this weight loss,” he said.

He added the keto diet is simple in concept. It eliminates a food group, making it easier for people to follow.

He said the diet also makes people feel full despite having fewer calories and it gives them more energy. That’s because, he said, people are giving up their sluggish diet of processed foods. He added the keto diet keeps blood sugar levels stable, which produces a more stable flow of energy.

Mawer notes there are some drawbacks.

He said the diet would not necessarily improve athletic performance, a fact that may discourage some athletes.

He added people need to adhere closely to the program or it will not work.

“It is a very strict diet,” said Mawer. “You have to do everything right.”

Every individual, he notes, is different and will react differently to such a program.

“What’s great for one person can be horrible for another person,” he said.

Read More: Experts Say Obesity is “Stamped In” “

When it’s unhealthy

Critics say the keto-type diets usually work only in the short term and can be unhealthy.

For starters, most of the lost weight is water weight, according to Lisa Cimperman, R.D.N., a clinical dietitian at University Hospitals Case Medical Center in Cleveland, Ohio, and a spokesperson for the Academy of Nutrition and Dietetics.

“Once your body enters ketosis, you also begin to lose muscle, become extremely fatigued, and eventually enter starvation mode. Then it actually becomes even harder to lose weight,” Cimperman told Healthline.

Mawer said he doesn’t believe the keto diet causes muscle loss. He did caution it’s not optimal for someone trying to gain muscle.

Other experts interviewed by Healthline had stronger words of caution.

“Keto diets should only be used under clinical supervision and only for brief periods,” Francine Blinten, R.D., a certified clinical nutritionist and public health consultant in Old Greenwich, Connecticut, told Healthline. “They have worked successfully on some cancer patients in conjunction with chemotherapy to shrink tumors and to reduce seizures among people suffering from epilepsy.”

In the general population, Blinten said a keto diet should only be considered in extreme cases.

“It can do more harm than good. It can damage the heart, which is also a muscle,” she explained.

Anyone with type 2 diabetes can benefit from weight loss and a reduced-carb diet because it will improve insulin sensitivity, Cimperman explained.

“But there are many other ways to do it besides a fad diet that won’t keep weight off long-term,” she said.

Blinten, who has used a keto diet for some cancer patients in specific circumstances, cautioned, “people will do anything to get the weight off.” However, a keto diet will do more harm than good for the majority of patients, especially if they have any underlying kidney or liver issues.

“People are using this for cosmetic reasons, but it’s so extreme that it’s dangerous,” she said.

Read More: Why Severe Anorexia is So Difficult to Treat “

The feeding tube approach

Some have taken the keto diet a step further, using a feeding tube inserted into the esophagus through the nose.

Dieters adhere to a strict 800-calorie high-protein, no-carb diet administered through the tube by a slow-drip pump mechanism. Only black coffee, tea, or water is allowed in addition to the liquid diet.

A Florida doctor, Oliver Di Pietro, has been offering this tube diet to anyone who can pay the $1,500 cost. According to a 2012 local news report, Di Pietro learned of the diet while on a trip to Italy. He insists the keto diet is safe and effective, even for those wanting to shed just a few pounds.

“This is a ridiculous approach to weight loss,” said Cimperman.

With an 800-calorie-a-day diet, “you’re essentially starving yourself,” Cimperman said. “Of course you will drop weight.”

Anything under a 1,200-calorie daily diet is considered a starvation diet and is not meant for long-term weight loss.

Tube feeding is a legitimate tool in a hospital setting, she explained.

“Someone who is on a ventilator, or can’t swallow because of a stroke or cancer, might have to eat this way. But it’s usually used as a last resort,” she said.

“In an otherwise healthy individual it can create serious complications, including infections if the tube gets contaminated, increased sodium levels, and it can cause dehydration and constipation,” Cimperman added. “What would even possess people to want to walk around with a tube up their nose?”

Melinda Hemmelgarn, a registered dietitian in Columbia, Missouri, and host of the Food Sleuth radio show, told Healthline, “It’s crazy to consider sticking a tube down your nose to lose weight. It sounds to me like somebody is making a lot of money on someone else’s vulnerabilities. Just say no to this idea.”

Read More: Doctors Finally Begin to Treat Obesity “

Don’t become weight obsessed

Hemmelgarn advised anyone thinking of going on a fad diet to “keep food in perspective. It’s a gift. It’s how we nourish ourselves and stay well.”

Marketing this diet to brides just plays into our weight-obsessed society, according to Hemmelgarn.

Instead, anyone preparing for marriage should nourish herself well, engage in plenty of physical activity like walking, jogging, or bike riding, and be good to herself by eating fresh, whole, minimally processed organic foods.

There is no magic bullet for long-term weight loss, said Blinten. For long-term weight control, a Mediterranean style diet focused on fruit, vegetables, whole grains, beans, fish, and olive oil, is one that can be healthy for life.

“We fall prey to wacko diets, but the truth is there’s no quick fix,” Blinten said. “Cutting refined carbs and replacing them with fresh fruits, vegetables, and lean protein, cutting processed foods, and avoiding too many additives will keep you healthy in the long term.”

Cimperman said the healthiest approach to weight loss is to set realistic goals and ask yourself if your diet plan is:

  • good for the long term
  • includes exercise
  • meets your long-term health goals.

If the answers are no, then that is a red flag, she cautioned.

Blinten advised dieters not to skip meals because your body goes into overdrive the next time you eat. That can actually cause you to eat more, not less. She suggested eating your largest meal at midday, then having a healthy afternoon snack.

“It keeps your metabolism and insulin levels more regular,” she explained.

Exercise, of course, is also vitally important. Every pound of muscle equals 50 calories burned, so a plan that includes a muscle enhancing regimen will help you reach your goal faster.

Hemmelgarn added, “Stay away from fashion magazines. They make us feel inadequate. If you are even considering this insane approach to weight loss, go for a walk … right now! It’ll clear your head.”

Editor’s note: This story was originally written by Liz Seegart and published on December 19, 2014. It has been updated several times since then.

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