How to get off keto without gaining weight?

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How to Transition Off Keto (Without Regaining the Weight)

Dr. Axe August 9, 2019 Nutrition Advice Email Print Twitter Pinterest Facebook

This post was most recently updated on August 12th, 2019

Whether you’re looking to lower your blood sugar levels, curb cravings or shed excess body weight, the ketogenic diet is a popular eating plan that’s loaded with health benefits. By cutting back on carbs and bumping up your fat intake, you can switch your body into a state of ketosis to reap all of the rewards associated with going keto.

However, it’s not meant to be a long-term solution for better health. In fact, it’s generally recommended to follow the ketogenic diet for no longer than two to six months, unless under the supervision of a doctor.

Transitioning off of keto correctly is incredibly important. Jumping right back into a normal diet can cause increased hunger, bloating and weight gain. It can also wreak havoc on regularity, alter your mood and even tank energy levels. Loading up on the carbs can also impact blood sugar levels, which can cause issues like cravings, irritability, anxiety and dizziness.

So how can you ensure a seamless switch back into your normal way of eating, without the weight gain and negative side effects? Here are a few tips to help you transition off of keto and resume a regular diet.

1. Slowly increase carb consumption

Rather than ramping up carb consumption right off the bat, it’s best to increase your intake gradually. This can help minimize any potential side effects while also keeping your waistline in check to avoid regaining extra pounds.

Ideally, try increasing your carb consumption by around 10 grams per day until you reach your goal, which should be around 40 percent of your total daily calories. Additionally, be sure to keep track of any changes in the way that you feel and adjust your daily carb count as needed.

You can also try the technique of carb cycling, where you essentially eat healthy, higher carb four days of the week and keto the other three days. My wife Chelsea swears by the carb cycling diet for keeping her at her ideal weight.

2. Focus on fiber

Filling up on fiber is a great way to maintain weight loss and regularity when transitioning off the keto diet. Fiber moves through the digestive tract slowly to help keep you feeling fuller for longer while also optimizing digestive health. Picking healthy, fiber-rich foods can also slow the absorption of sugar in the bloodstream, preventing spikes and crashes in blood sugar levels as you slowly reintroduce carbs into your diet.

Fruits, vegetables, nuts, seeds and legumes are all great sources of fiber, along with a range of other vitamins and minerals that your body needs. Whole grains such as oats, buckwheat, barley and quinoa can also be enjoyed in moderation as part of a nutritious, well-rounded diet.

Limiting your sugar intake is one thing you should definitely take from the keto diet back into your regular eating routine. Added sugar is associated with a number of negative effects on health, including heart disease, diabetes, liver problems and even cancer. It also contributes little to your diet other than extra calories, which can increase the risk of weight gain over time.

Sweets, baked goods, fruit juice, dairy desserts and soft drinks are all concentrated sources of added sugar that should be limited in a healthy diet. However, there are plenty of nutritious alternatives that can help satisfy your sweet tooth, such as fruit or dark chocolate. Try making your own homemade trail mix, blending up a low-sugar smoothie or sprinkling fresh berries over yogurt or oatmeal for a wholesome snack.

4. Stay hydrated

Drinking enough water is essential for maintaining overall health, and staying well-hydrated plays a key role in regulating your body’s temperature, transporting nutrients and supporting brain function. However, it becomes especially important when transitioning off the ketogenic diet, as it can help prevent digestive issues, fight fatigue and keep you feeling your best.

As a general rule of thumb, aim for 25-50 percent your body weight in ounces of water daily. If you weigh 150 pounds, for example, you should try to squeeze in at least 38-75 ounces of water per day. Setting a timer, using an app to track your intake, or infusing your pitcher with your favorite flavors are a few strategies that can make it easier to help meet your daily needs.

5. Practice other healthy habits

Just because you’re switching up your diet doesn’t mean it’s time to throw out all the other healthy habits that you’ve picked up along the way. In fact, there are a multitude of different factors involved in weight control, and what you put on your plate is just one piece of the puzzle.

Besides enjoying a healthy diet rich in healthy whole foods, be sure to get plenty of sleep and incorporate a mix of aerobic and resistance training into your routine. Stress can also impact what you see on the scale, so be sure to practice a few stress-relieving techniques like yoga, meditation and deep breathing to keep stress levels to a minimum.

Dr. Axe

Dr. Josh Axe, DC, DNM, CNS, is a doctor of chiropractic, doctor of natural medicine, clinical nutritionist and author with a passion to help people get well using food as medicine. He operates the No. 1 natural health website in the world at DrAxe.com, with over 15 million unique visitors every month, and is co-founder of Ancient Nutrition, a health company that provides history’s healthiest whole food nutrients to the modern world. He’s author of the books “Eat Dirt,” “Essential Oils: Ancient Medicine” and the just released “Keto Diet: Your 30-Day Plan to Lose Weight, Balance Hormones and Reserve Disease.”

Dr. Josh Axe, DC, DNM, CNS, is a doctor of chiropractic, doctor of natural medicine, clinical nutritionist and author with a passion to help people get well using food as medicine. He operates the No. 1 natural health website in the world at DrAxe.com, with over 15 million unique visitors every month, and is co-founder of Ancient Nutrition, a health company that provides history’s healthiest whole food nutrients to the modern world. He’s author of the books “Eat Dirt,” “Essential Oils: Ancient Medicine” and the just released “Keto Diet: Your 30-Day Plan to Lose Weight, Balance Hormones and Reserve Disease.”

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So you’ve followed the ketogenic diet for a few months now. You’ve achieved ketosis, lost some weight and (hopefully) experienced the intense mental clarity that keto-fanatics rave about.

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But after months of eating high fat, high protein and very little carbs, how do you reset your body to eat normally again?

“It probably took you a few days to get into ketosis when starting off on the keto diet,” says registered dietitian Kristin Kirkpatrick. “So a sudden influx of carbs and sugar could wreak havoc on your body if you go wild with your diet.”

If you don’t transition properly off the ketogenic diet, you could be setting yourself up for some not-so-pretty symptoms:

  • Weight gain.
  • Bloating and other bathroom issues.
  • Blood sugar spikes, which could cause fatigue and irritability.
  • Increased hunger and sugar addiction.

Instead, follow these three tips on how to effectively come off the keto diet.

1. Focus on hard to digest carbs

When looking to incorporate carbs back into your diet after severe restriction, Kirkpatrick recommends focusing on eating carbs that are high in protein and fiber.
“Bean based pasta, crackers with seeds or sprouted breads are all great options when looking to bring carbs back into your diet,” she says. “Even starting to add in cashews or more avocados are great additions.”
There’s a reason carbs stand for CarboHYDRATES. You’re naturally going to gain a few pounds when you reintroduce them back into your diet because they contain water. The key is to pick healthy, whole carbs that won’t cause gigantic spikes in your blood sugar. The worst thing you can do is go hog wild and start eating donuts and cookies. Instead, focus on the quality of the carbs and pick kinds that take more time to digest.
Transitioning off the keto diet should take a few weeks. About 14 days is pretty reasonable for your body to adjust to the change. Some people find it helpful to increase their carb intake each day by about 10 percent, while others use an app to help keep track. Kirkpatrick suggests that the easiest way is to look at serving size and aim for two extra servings of carbs per day.

2. Be aware of the sugar pitfall

Don’t trade keto fat bombs for sugar bombs! One of the benefits of the ketogenic diet is the low sugar intake and eliminating added sugar in your diet.
“If you followed keto for a couple months, you probably noticed decreased sugar cravings,” says Kirkpatrick. “There’s research proving that sugar is addicting – so why would you want to go back to that?”
A good rule of thumb is to avoid anything with more than 4 grams of added sugar. Also be aware of too much naturally occurring sugar, which can hide in things like honey and certain fruits.
“If you have a bar that has 22 grams of sugar but it’s all from dates, that’s still not good and you’re going to spike your blood sugar,” she says.

3. Good habits help

When you first started keto, it probably took some time to educate yourself and learn about the diet. So coming off keto should be a similar and slow process.
“Weight loss isn’t just about the food – your environment, support system and lifestyle all play a factor in it,” explains Kirkpatrick. “So when keto is over and those things aren’t aligned correctly, it’s going to be easy to fall back into old habits and regain the weight.”
Staying hydrated is another important factor when working on healthy habits post keto. Being dehydrated causes irritability and can make you feel hungry when you’re actually just thirsty.
It all goes back to choosing healthy, balanced meals and snacks. Regaining the weight can be scary, but eating healthy fats, lean protein and quality carbs can still lead to weight loss.

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Most people automatically assume that I hate the keto diet. That’s not exactly true, but first, in case you’ve been living under a bridge, here is what you need to know about the keto diet.

What is the Keto diet?

The ketogenic (keto for short) diet was initially developed for kids with epilepsy. The ketogenic diet was effective and reducing the frequency of seizures, and recently it has become popular as a weight-loss strategy.

Done correctly, the keto diet is composed of 70% fat, 15% protein, and 5% carbs. It requires continuous monitoring of ketone levels (in blood or urine) and diligent planning. Like any diet, it can be done healthy (avocado, leafy greens, etc.) or terribly (bacon and bulletproof coffee.)

It isn’t my first (or even in my top 10) recommendation for improving your health or weight loss but, I don’t hate it.

I dabbled in keto long before it became famous when I thought I had PCOS because a doctor made an off-handed comment that he “wasn’t totally convinced I didn’t have PCOS.” I didn’t have PCOS, you can read about how I got my period back after five years of nothing here.

So, I don’t hate the keto diet. I’m happy for those people who got results on it, I’m in support of any improvement to your health. I’m all for any improvement to your health. Recently, though, I’ve been getting a lot of questions from those who had some success on the keto diet but are looking to transition off the keto diet without gaining weight.

There are several reasons someone may want to transition off, let’s visit those, and then we will get to the how-to piece.

When You Should Quit The Keto Diet

Your Digestion Worsens

Lack of fiber can cause slow motility (read constipation) and deprive the good bacteria in the colon of food (read gas, bloating, etc.) Although some short-chain fatty acids such as butyrate found in butter can provide some food for your helpful microbes, it probably isn’t their preferred fuel. If you are starting to experience GI issues, like heartburn or constipation, it’s probably time to come off.

Your Not Enjoying Your Food

If you started to hate your meals, it’s better to come up with a game plan to get off keto without killing your progress, then snap one day and throw away everything.

You Lose Your Menstrual Cycle

Some women, with pre-existing insulin resistance such as in PCOS, may experience improvement in their cycle when on Keto. However, many women may see their cycles become erratic or non-existent when on Keto. This is a sign your body is not adjusting well, and you want to get off.

Your Weight Loss Has Stalled

If you’ve hit a plateau, then the diet has run its course. I use the word diet here because that’s what it is; it isn’t a lifestyle change; it’s a diet. It’s time to move to a different strategy, which I have outlined below because I find this is 99% the reason why people quit keto.

You’ve Been On It A Long Time

The thing is, we each have a set of genetics which makes us predisposed to certain chronic illnesses. And we have no idea how the keto diet in the long term influences your risk for things like heart disease and cancer. What we do know is that heart disease and cancer risk go down with a diet high in fiber and antioxidants, two things lacking on the keto diet. If you’ve been on it over a year, my recommendation is to come off of it or be okay with being a human experiment since we have ZERO long term research.

How To Transition Off The Keto Diet

A quick note here – most people know this, but you will regain some water weight. Up to 5 pounds, but 2-3 pounds is normal. If you can, it’s best to monitor your body fat percentage over pounds.

If you aren’t counting macros and testing your urine for ketones, you haven’t been doing the keto diet. You’ve been doing some modified low carb diet. If this is you, you can jump straight to carb cycling.

If you are counting macros and testing your urine for ketones, then you have been doing the keto diet correctly. Here is how to get off with minimal weight gain.

Step 1: Increase Variety of Vegetables

Introduce non-starchy vegetables you were previously avoiding like tomatoes, bell peppers, and eggplant. Drop your macros accordingly.

Week 1-2: 60% Fat, 20% protein, 10% carbs

Week 3-4: 55% Fat, 25% protein, 15% carbs

Step 2: Introduce Complex Carbs

Introduce high fiber complex carbs in one serving (no more than 30 grams at a time) per day AFTER your workout. Examples: sweet potatoes, beans, oats, brown rice, or quinoa. No fruit or other sugar yet.

Week 5-6: 50% Fat, 30% protein, 20% carbs

Week 7-8: 45% Fat, 30% protein, 25% carbs

Step 3: Introduce Higher Glycemic Index Carbs & Begin Carb Cycling

Move your complex carbs to another meal of the day and introduce fast-acting carbs after your workout. Usually, fruit is a great option here. My favorite post-workout snack is a banana (think they have too much sugar? See are bananas bad for you?) You’ll now adjust your carbohydrates to increase percentage-wise on the days you workout and decrease on the days you don’t.

This allows you to maintain the benefits of the metabolic flexibility you developed and continue to have low carb days, just not a low carb life. I wrote more about carb cycling and how to do it in this post.

This is where it gets essential to work with a coach to determine your macros (if you desire to count macros) because they should be individualized to You do not have to count macros to maintain your weight loss. Read that again.

Counting Macros

If you want to continue to count macros because you like it and it doesn’t stress you out. Great! Get a custom macro calculation for your workouts and rest days (two separate calculations.) Most people do well on a 40/30/30 plan with some variation for workouts. If you need healthy recipes and meal ideas for this type of eating, I can help with that too! I have monthly meal plans that come with meal prep guides, and each day follows a 40/30/30 plan.

Intuitive Eating

If you do not want to continue to count macros, I recommend you checking out my mini-series on intuitive eating and consider signing up for my 52 weeks to 52 healthy habits program.

Customization

Each step in the plan can vary in length of time needed for their transition off of the keto diet. When I have nutrition coaching clients who are coming off keto, I give them custom macro calculations every week as we monitor their progress and make adjustments.

Some can go just one week with every step seeing little to no weight gain or even weight loss. Some will see the scale rise one week and fall the next as they adjust to more carbs in their diet; they need a little bit more time between adjustments.

While working through this plan, remember it’s important to tackle:

  • hormone imbalances (pre-existing or created by keto)
  • metabolism issues (pre-existing or created by eating too few calories while on keto)
  • other health concerns (you may need to go faster or slower in your transition depending on health concerns)

Question of the day:

Have you tried the keto diet?

How to Safely and Effectively Come Off the Keto Diet

So you tried the ketogenic diet, the über-popular low-carb, high-fat eating style. By focusing on high-fat foods (all the avocados!), this type of diet puts your body into a state of ketosis, using fat for energy instead of carbs. For many people, this switch results in weight loss, but most don’t (or shouldn’t) stick with the keto diet long-term unless they’re on it for a medical reason. Here’s why, plus how to get off keto safely if you’re considering doing it.

Why Do People Go Off Keto?

“Life usually ends up getting in the way,” says Shoshana Pritzker, R.D., C.D.N., C.S.S.D., a sports nutritionist and registered dietitian. For most people, how long you can stay on keto is however long you can say “no” to typical social munchies and drinks, she adds. Sometimes, you just want to be able to let loose and eat some processed carbs, right?

Plus, there may be health implications to consider. “We’re really not sure what kind of health complications may arise from a long-term state of ketosis (i.e., years and years) if any,” says Pritzker. And it’s not just that. “One reason a person may want to stop keto dieting is if their lipid panel worsens,” notes Haley Hughes, R.D. “If a person who is at a high risk for heart disease is eating increased amounts of saturated fat and sources of cholesterol while consuming less fiber from whole grains, beans, fruits, and starchy vegetables, they may see increased cholesterol levels.” There are also special concerns for those with type 1 diabetes and people taking insulin, who might not be a good fit for long-term keto dieting, she says. (Related: Healthy But High-Carb Foods You Can’t Have On the Keto Diet)

Lastly, the reason for getting off keto could be as simple as having reached your goal-weight loss, performance, or otherwise-and being ready to get back to eating carbs. Regardless of why you want to stop following the keto guidelines, there are some key things you’ll need to know ahead of time.

How to Come Off Keto the Right Way

Sadly, shocking your system by downing a few slices of pizza is *not* the right way to get off of keto. Instead, you’ll need to do a little mental prep work.

Have a plan. “One of the biggest problems with dieting altogether (whether keto or another diet) is that when you stop, what do you do next?” says Pritzker. “Most people just end up going back to the way they ate previously, which wasn’t working for them before, so why would it work now?” This is especially true if you went on keto for weight-loss purposes. “Your best bet is to have a plan as to what you’re going to eat and how you’re going to start incorporating carbs back into your diet.” If you’re not sure what your goals are now or how to accomplish those goals with your diet, check in with a dietitian. (BTW, here’s why the anti-diet is the healthiest diet you could ever be on.)

Get familiar with portion sizes. “As with any strict diet, transitioning back into your normal eating style can be difficult,” says Keri Glassman, R.D., C.D.N., founder of Nutritious Life. “After restricting your carbs for so long, you’re more likely to overdo them once you allow yourself to have them again.” The first few times you eat carbs post-keto, look to see what one serving size is and stick to that.

Start with unprocessed carbs. Rather than going straight for pasta, doughnuts, and cupcakes, go for plant-based carbs when you first break up with keto. “I would reintroduce whole grains, beans, legumes, fruits, non-starchy vegetables first versus processed foods and sugar-sweetened beverages,” says Hughes.

Go slow. “Try introducing carbs slowly and gradually,” advises Pritzker. This will help you avoid any G.I. distress (think: constipation) that could come along with reintroducing carbs. “Start with adding carbs in at one meal per day. Try this for a few weeks and see how your body responds. If things are going well, add carbs into another meal or snack.” Continue adding carbs one meal or snack at a time until you’re comfortable eating them throughout the day.

Image zoom Photo: Dimitri Otis / Getty Images

What to Expect When Stopping Keto

Even if you do everything right, there are some physical effects-both positive and negative-you should watch out for when quitting a ketogenic diet.

You might have blood sugar fluctuations. “It’s hard to predict how someone will react to coming off the keto diet,” says Edwina Clark, R.D., C.S.S.D., head of nutrition and wellness at Yummly. “Some may experience minimal effects, while others may find that their blood sugar spikes then crashes after their first carb-moderate meal.” Roller-coaster blood sugar levels can cause jitteriness, mood changes, hyperactivity, and fatigue, so check with your doctor if you experience any of these symptoms.

You might gain weight. (But don’t freak out.) You also might not! “Weight fluctuation is always a possibility, but weight gain will depend on many factors, including how your body metabolizes carbs, the rest of your diet, exercise, and more, says Glassman.

It also depends on how long you’ve been on keto. “Much of the weight lost when cutting carbs is water weight initially,” says Pritzker. “When you reintroduce carbs you also introduce additional water; with every gram of carb, you get 4 grams of water. This can make you feel like you’ve gained a ton of weight rapidly, though much of it is probably water retention.” This type of water weight gain applies to everyone coming off keto, but those who have been on it for a shorter period of time and lost just a small amount of weight on the diet may notice it more. (Related: 6 Unexpected Causes of Winter Weight Gain)

Bloating could happen. But it’s temporary. “The most common issue that people deal with is bloating and intestinal issues because of the re-introduction of fibrous foods,” says Taylor Engelke, R.D.N. Even though foods like beans and sprouted bread are good for you, your body may need to get used to digesting them again. You can expect this to subside in a few days to a few weeks.

You may have more energy. “People may have increased energy after adding carbohydrate back into their diet since glucose (which is found in carbs) is your body’s main fuel source,” says Hughes. You may also notice better performance in HIIT workouts and endurance training. Plus, you could feel better mentally, since the brain also uses glucose to function. “Many people report having a much better memory and feel less ‘foggy’ with concentration or functioning at work,” says Engelke. (Related: 8 Things You Need to Know About Exercising On the Keto Diet)

You might feel hungrier. “The high-fat and moderate-protein combo of a keto diet make it super satiating,” says Glassman. That’s why a lot of people experience a suppressed appetite while trying keto. “It is possible that you might feel hungrier after each meal as they start to contain less fat and more carbs, which tend to be faster-digesting,” she adds. To combat this and smooth your transition, Clark suggests pairing carbs with both protein and fat. “This can help slow down digestion, boost fullness, and limit blood sugar spikes and crashes as you reintroduce carbohydrates.”

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Are you thinking about quitting keto diet?

If you google quitting keto you’ll find lots of personal stories from people who only lasted a few days, weeks or maybe even a couple of months before giving up. This isn’t one of those stories.

I did keto for 9 months, and it didn’t make me miserable.

The keto diet reset the way I eat. Even once I started transitioning off the keto diet, I knew I wasn’t going to go back to eating the high carb diet I had before. Not only because I didn’t want to gain all the weight back, but also because I felt good about my new healthier way of eating.

Coming off keto while maintaining your weight loss is possible.

And yes, eating carbs after keto is also possible too.

Just as long as you don’t go overboard with them or fall back into your old eating habits.

My Keto Results

3 months ago, I did a post about my 6-month keto results. I had lost 30 pounds, and while my weight loss had stalled by then, I was still enjoying all the other benefits of the keto diet.

That was why I kept doing keto. I enjoyed having so much energy all day and the positive effect it had on my mood and concentration. Plus, my skin looked better, I no longer suffered from intense menstrual crampsand my ability to handle stress had dramatically improved.

There are lots of benefits to keto beyond weight loss.

Why I Quit Keto

Keto Benefits Wearing Off

While I had been enjoying all those keto benefits for the first 8 months, things started to change once I hit month 9.

That awesome increase in energy I had enjoyed started to fade. By mid-afternoon I found myself feeling extremely tired. By the end of the 9th month, I was basically exhausted every night. Even when I started going to be earlier, that mid-day energy crash kept hitting me.

Maybe it was just because of the lack of energy but my focus and concentration were being affected too. I found myself struggling to get any writing done in a decent amount of time and my mind wandered frequently. It got so bad I started taking lions mane mushroom supplements to help me stay focused while I was writing.

Negative Effects on My Body

Then I started noticing some other weird things happening to my body.

My hair had become thin. While I had noticed this earlier and wasn’t too worried about it, the research I had done on hypothyroidism had me wondering if the hair loss had just been from losing weight or if it may have been a sign of something more serious.

Then I noticed my nails had become brittle. While my nails are never super long, I found myself constantly breaking them just by banging a finger on something.

Then there were the rashes.

It started out with some eczema on my fingers. I had wondered if it was just from the cold weather, but even when it started warming up the eczema didn’t go away.

There was also a rash on the back of my leg, which had started out as a small bug bite, that would flare up and turn into a small itchy rash once in a while. When the itchy bumps lasted a few months, I started to wonder what was going on.

Then I had the same problem with a blister. It had started out as a blister on my heal, but then it became itchy. Just like my leg the blister spot would get a small rash and itch on and off.

Then another rash developed on my lower back, followed by a really sore one on my armpit.

Sick of Counting Carbs

The final straw for me was all the measuring and tracking of my food.

Before starting keto I had been counting calories using My Fitness Pal. After I switched to keto I kept using My Fitness Pal to track my carbs. Other than a couple of weeks in the summer between diets, I had been recording everything I ate for a year.

I hated it. I was tired of it.

I hated that my kids saw me measuring out everything I ate. Really, what was I teaching them about healthy eating habits when I had to grab a tablespoon just to snack on some almonds or limit myself to only having 10 blueberries.

Deciding I Was Done

With the rashes getting worse and the worry that my eating habits may be affecting my hormones, I decided that it was time for me to be done with keto.

Now I’m not bashing the keto diet. If you follow keto and continue seeing benefits from it and feel good, stick with it. If something works for you there is no reason to change it.

But it was clear that it wasn’t working for me anymore.

I’m sure that some keto experts could tell me how to make some changes to remedy all the issues I was having, and maybe it would have worked, but I decided it was time to move on and focus on just eating healthy.

Transitioning Off Keto Diet

My transition off keto started on Easter.

At that point, I hadn’t even really decided to quit. I was just going off keto for a day, so I could enjoy a family dinner with taco salad, mashed potatoes, stuffing, and my mom’s homemade dinner rolls.

Even after that one-day keto cheat, I hadn’t decided I would quit. I thought maybe I just needed to take a week off keto. So, for the first week after Easter, I ate the same way I had been, but allowed myself some extra fruits and vegetables, and stopped tracking my carbs.

After that week I continued eating how I had been and spent a couple of days entering my food into my fitness pal at the end of the day to see how I had done without tracking the carbs I was eating. Even when I was trying to eat keto I was still getting 70-80 grams of carbs a day.

But my energy had increased.

After that, I stopped tracking my carbs and instead I focused on eating to replenish my gut bacteria to address the eczema.

Within a week all my rashes were gone.

That was when I decided that I wasn’t just taking a break from keto, I was done with it.

Do You Gain the Weight Back After Keto

I didn’t step on a scale for the first few weeks.

I knew I had gained back a little bit of weight. When I finally checked to see how much, I was happy to see that I had only gained about 5 pounds back. Over the last 3 months, my weight has fluctuated a bit. I have lost those 5 pounds and then gained them back when I loosened up a bit too much and indulged in too many treats.

But still, I have not gained back any more than that initial 5 pounds, and I’m ok with that.

My focus right now is on getting into a new workout routine and increasing the length of my strength training sessions. And, of course, continuing to eat what I consider to be a healthy diet.

Coming Off Keto Symptoms

While I personally didn’t experience any symptoms from coming off keto some people report that in addition to gaining back some weight or getting a bit bloated, they experience a bit of fatigue, mood swings, and increased hunger from blood sugar spikes.

This is why it’s important to transition off keto slowly and not go overboard in the high carb sugary treats.

What Can I Eat When Coming Off Keto?

If you’re concerned about gaining the weight back then you will need to continue to be careful about what you eat after keto.

While there is no specific keto maintenance diet, many people find that continuing to follow a low carb diet will help them maintain their keto weight loss. How many carbs a day to maintain weight will be different for everyone.

Other people may find that the transition to a paleo or primal diet is easier for them to follow. Since these diets restrict foods like grains and sugar, they are naturally lower carb.

Or you may just find that eating keto for a long period of time has changed your relationship with food and you are now able to maintain healthy eating habits without following a specific diet and continue to use the keto recipes you have gotten used to.

If you’re worried that you might end up going back to your old eating habits consider finding some new low-carb recipes or paleo recipes to help you stay on track.

Keto Reset My Eating Habits (How I Eat Now)

Unlike counting calories, eating keto changed my eating habits. Because I became so used to making healthy food choices for 9 months, I find it easy to continue to do so.

While I no longer follow the keto diet strictly, I still do eat a lot of keto foods and keto meals at home.

I still don’t buy any grains. We continue to use lettuce for burgers and tacos and other vegetables in place of pasta and rice. Not only does this keep my carbs (and calories) lower, but it makes it easier to make sure I am eating a wide variety of vegetables every day.

I also don’t buy sugar, or sugar-filled processed crap (with the exception of the occasional piece of dark chocolate). I have continued to use stevia, or sometimes honey, in my baked goods.

I do allow myself more fruit than I did before, but I still don’t overdo it (though it is so nice to be able to eat a full banana again).

For the most part, I would say I am eating close to a paleo diet, or probably more of a primal diet since I still eat dairy, peanuts, and beans when I am at home.

When I eat away from home, however, I am less restrictive.

I don’t worry about totally avoiding grains or sugar, but I still do my best to make healthier choices. I still love my salads from Pita Pit and Subway. I even opt for the salad instead of a burger most times at Wendy’s or Mc Donald’s too.

While I still enjoy my lettuce-wrapped burger from A & W, I now allow myself a small indulgence with some sweet potato fries with Chipotle dip on the side too.

My Tips for Coming Off Keto

  • The most important thing to remember when coming off keto is that you can’t go back to eating how you did before. If you want to maintain your keto weight loss you will still need to eat a reasonably healthy diet.
  • When transitioning off keto you need to take it slow. Don’t go out and eat a burger and fries right away.
  • Starting out by continuing to eat keto meals and snacks, but without tracking your carbs, can make the transition easier. By now you’ve likely found some favorite keto recipes so there is no need to give them up just because you’re not strictly keto anymore.
  • Increase your carbs slowly. Start by just increasing your vegetables and adding more fruit. Let yourself indulge in some nuts, but don’t go crazy and eat the whole bag.
  • If you are worried that you may gain all the weight back consider following a low carb diet instead. You can find your carb limit for weight maintenance by increasing your carbs by 10-20 grams per week.
  • Consider the paleo or primal diet. If you’re sick of tracking how much you eat but still want to stick with a healthy diet the paleo diet, or less restrictive primal diet, may be a better option for you.
  • Don’t forget to keep being mindful of portion sizes. While measuring out your food isn’t necessary, it can still be helpful to stick to only eating a serving size amount of food that is higher in carbs and calories. Even if you decide to indulge and have something like potato chips, measure out a serving in a bowl instead of eating it right out of the bag.
  • Consider continuing to avoid sugar. While the occasional treat may not hurt, it’s pretty easy to let that sugar sneak back into your diet. It may be helpful to continue to eat keto treats at home and only indulge in the sugar-filled ones occasionally when you are out.
  • Consider continuing to avoid grains. If you have been following keto for a while, you’ve obviously learned how to eat without bread and pasta so consider sticking with it.
  • Keep loading up on the vegetables. Even if you choose to go back to eating some grains, try to continue to add all the vegetables you had been using in place of grains to your meals.
  • Avoid processed crap. By now you should be used to living without the convenience of packaged meals. Regardless of what you are eating, homemade meals from scratch will always be healthier than something that sits in a freezer for months until it’s microwaved.
  • Expect some bloating. If you look in the mirror and realize that your belly is bigger already, don’t freak out. When you start reintroducing all those foods you have been avoiding it will take your body a while to readjust to digesting them. Some bloating for the first week or two is normal.
  • You might gain some weight back. Again, don’t freak out. In fact, don’t step on the scale right away. A lot of what you gain right away will just be from water retention, as long as you aren’t overdoing it. Your weight will fluctuate as you adjust.
  • Treat yourself.

Once you have eased yourself off of keto and adjusted to eating more carbs, go get whatever it was that you have been missing most.

Just don’t be surprised if it’s not as good as you remember.

I couldn’t wait to go buy some popcorn chicken from KFC when I stopped keto and was so disappointed by the rubbery texture of it when I did. It’s hard to go back to eating food-like substances once you have adjusted to eating real food.

It has now been almost 3 months since I started coming off keto. And I feel great.

I have continued to eat healthy food without the stress of feeling like I can’t have a treat at a social gathering.

While the keto diet wasn’t something I ended up sticking to long term, I still feel that it is a great diet to help you reset your way of eating.

Do you have any tips for coming off keto? Did you slowing adjust to eating carbs after keto or jump right in and indulge in a treat? Where you able to maintain your weight loss after quitting keto?

Follow me on Facebook to see how I make out in my journey to better health without keto and let me know how you transitioned off the keto diet on this post.

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If I Stop Keto, Will I Gain the Weight I Lost?

One concern people have with attempting a keto diet is whether they will regain the lost weight if and when they stop maintaining the ketogenic lifestyle. It’s a reasonable concern. A very low-carb diet eliminates bloating and the consumption of inflammatory foods and also programs your body to burn fat for energy. Thus, it’s fair to wonder whether your weight loss will go in reverse if you reintroduce carbs (and consequently inflammatory foods) and step out of ketosis for extended amounts of time or permanently. Fortunately, the answer is no. You will not necessarily regain the weight, provided you are thoughtful during and after the transition.

There are many reasons people choose to stop maintaining a state of ketosis. Two examples include traveling or big life transitions that make it difficult to stick to a certain way of eating (such as having a new baby at home and friends dropping off meals). Meanwhile, some people feel best when they cycle in and out of ketosis for periods of time, while others met their keto goals and simply want to reintroduce more carbs into their diet.

While you can simply quit the keto diet at any time, below are a few tips to follow should you decide to transition out of a ketogenic lifestyle, which can help ensure you don’t gain back all the weight you lost on the keto diet.

Make a Slow Transition Off Keto

First and foremost think slow and steady. Any major diet change can impact your digestive health and weight, so you want to be sure not to swiftly go from keto to a standard American diet, which is extremely high in carbohydrates and low in nutrients. If you go full force into carbage, you may regain weight quickly and struggle with digestive distress from the carb overload. Your best bet is to slowly reintroduce carbs into the diet. Start by adding in starchy vegetables or fruit, one serving per day, and slowly work your way up. See how adding one serving back into your diet feels for a couple of days, and then slowly increase, if desired.

Remember, even off keto, there’s no need for copious amounts of processed carbs or any carbs at all. Keep in mind: low and slow.

Stick to Real, Whole, Unprocessed Foods

When transitioning out of ketosis, continue to stick with a “clean” diet, avoiding processed foods to avoid excessive weight gain.

Obesity probably resulted from changes in the caloric quantity and quality of the food supply in concert with an industrialized food system that produced and marketed convenient, highly processed foods from cheap agricultural inputs. Such foods often contain high amounts of salt, sugar, fat, and flavor additives and are engineered to have super-normal appetitive properties that increase desire and consumption.

— Obesity journal, Did the Food Environment Cause the Obesity Epidemic?

In other words, processed foods are calorie-heavy, make you want to eat more, and they don’t provide optimal nutrition. Plus, highly processed grains and sugar contribute to weight gain and inflammation, the latter of which is the root of many disease processes in the body, including cardiovascular disease, metabolic syndrome, type 2 diabetes, and autoimmunity.

Consuming high amounts of carbs can also put you back on the “blood sugar roller coaster.” The human brain runs much more efficiently on ketones than on glucose. Your brain cannot synthesize or store glucose, so when glucose runs low, you may get irritable and feel shaky until you consume more. The more processed and sugary foods you consume (such as bagels, cereal, bread, chips, pasta, and candy), the more you may struggle with blood-sugar regulation.

You’ve worked hard to lose weight and get healthy on keto. Your best option to not gain weight and continue to feel good if you stop following a keto diet is to make clean food choices, such as vegetable sources of carbs, wild-caught fish, and grass-fed pasture-raised meats; continue to nurture yourself with real whole foods. Keep healthy fats in your diet, and consume fat with your carbs, to help slow the absorption of sugar into your bloodstream.

If you decide to reintroduce grains and grain products, such as bread and pasta, into your diet, stick with organic versions of ancient varieties, such as amaranth, millet, and quinoa, which have not been through selective breeding like modern wheat and corn products. Also, consume these grains in small amounts, as the carbs will still invoke an insulin response in the body.

Incorporate Movement Into Your Routine

While transitioning out of ketosis, remember to keep moving your body throughout the day. Research shows that regular movement throughout the day has a much greater impact on your overall health than one heavy exercise session. Ongoing movement can help with keeping the weight off and increase your overall feelings of well-being. We’re not talking multiple jogging sessions, either. It can be as simple as taking a few breaks from work to go for a walk, standing up and stretching, or doing a few yoga poses throughout the day.

The Final Word

Whether you’re considering a keto diet and want to know what happens “afterward,” or are on a keto diet and considering transitioning out of it, remember these simple tips if you want to avoid gaining weight as you evolve your diet. The best way to keep off the weight when transitioning out of ketosis is to go low and slow, eat carbs from vegetable and fruit (real food) sources, continue to nurture your body with real food, avoid highly processed foods, and move your body throughout the day.

The keto diet is popular among people looking to shed pounds. But the question remains: Is keto diet safe in the long-term? Here, what researchers and doctors want you to know.

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What is the keto diet?

The ketogenic (keto) diet is a high-fat, low-calorie diet. People following the keto diet aim to eat 75 percent of their calories from fat, 20 percent from protein, and 5 percent from carbohydrates. If you’re curious about the plan, check out these before-and-after keto diet pictures. The keto diet has been used for decades to help children with certain types of epilepsy avoid seizures—and research backs up the continuous use in these people.

What about everyone else: Is keto diet safe in the long term?

How long the keto diet is safe for weight loss is still under study. Early research found that overweight individuals who followed it for 24 weeks had positive results. Another study recommends people follow the diet for no more than 12 months. Even during that time, say the authors, “close monitoring of functions while on a ketogenic diet is imperative.” In other words, let your doctor know what you’re up to, and keep an eye on your kidney health. Beyond a year, no one’s really sure how safe the diet is.

“My professional recommended period of following the keto diet is about six months maximum, and that will also depend on how much the person weighed prior to starting the diet and the state of his or her overall health within those six months,” says Nikola Djordjevic, MD, of MedAlertHelp.org. He adds, “That said, I highly advise that anyone on the keto diet get checked by a professional nutritionist or a medical doctor regularly to make sure he or she hasn’t developed any complications like hypertension.”

Precautions to take with long-term keto dieting

Despite all the keto success stories, most doctors still warn against the plan—in part because U.S. News & World Report ranked it as one of the worst diets. Doctors who do support keto say there are rules and guidelines that are more likely to keep the diet effective and healthy, starting with:

Focus on quality fats

“Since the largest component of a keto diet is fat, my biggest concern with keto is that the fats consumed may not be healthy ones,” says Alvin Berger, MS, PhD, adjunct professor of nutrition at the University of Minnesota and CEO of SciaEssentials. “Examples of undesirable fats include excessive amounts of coconut oil, deep-fried fats, lard, and oxidized/rancid fats.” Dr. Berger suggests you work with a certified nutritionist, particularly one with an expertise in fats, to hone your keto diet for the long term.

Don’t waste your carbs

Keto eaters find a lot of “low-carb” hacks for their favorite non-keto foods, from chocolate chip cookies to baked bread, but Dr. Berger says you should use the carbs you can consume on healthier options, like vegetables.

Pay attention to micronutrients

Keto dieters can miss out on some key nutrients like electrolytes such as sodium and potassium, says Jennifer Mason, MS RD, a dietitian who specializes in low-carb and keto diets. Without adequate sources of these two nutrients, you may experience nausea, weakness, muscle cramps, and constipation—or the keto flu. You can try supplements, or focus on nutrient-rich foods that will provide you what you need.

Eat real food

Your pharmacy shelves are groaning under the weight of keto supplements, but Adam Nally, DO, author of The Keto Cure, advises steering clear. “I recommend using real food instead of protein powders and MCT oil,” he says. “Adequate nutrients in a ketogenic diet come from eating real animal protein and real animal fat over the long term.” If you are considering keto supplements, review this list of the keto supplements that might be worth your money.

Related video: Keto Diet Pros, Cons And Tips For Making It Work (Provided by CBS New York)

How to Switch from a Keto Diet to an Authentic Mediterranean Diet

I have had several readers contact me about switching from a Keto diet to the Mediterranean diet. Let me start by saying that any diet for weight loss will have results if you follow it. Studies have shown that optimizing adherence is the most important factor for weight loss success. Having said that, when choosing a diet, an eating plan, a way of life- you really need to think about how realistic it is. Can you eat this way forever and be content? If the answer is no, then most likely that diet will be a failure.

Benefits of Switching from Keto Diet to a Mediterranean Diet

1. Easier to follow. The Mediterranean diet does not eliminate any food group.

2. Healthier and Evidence Based. I will not go into all the details here, but over 6000 studies support the Mediterranean Diet, the Keto Diet on the other hand has much less evidence. Actually, there is no comparison, the Mediterranean Diet has by far the most evidence than any other diet.

3. Long-term results. For the most part we know that a low carbohydrate diet may accelerate weight loss IN THE SHORT TERM, long term though there is no difference with a Mediterranean diet.

The real/authentic Mediterranean diet is not a high carbohydrate diet. It is not about pasta and bread but about a lot of vegetables and a lot of olive oil.

4. It’s a Real Diet. The Mediterranean diet is a real way of eating that appeared in certain areas of the world, not a man-made diet.

5. What about diabetes? Repeatedly, overviews and meta-analysis of studies show that the Mediterranean diet not only can prevent the appearance of diabetes, but for those who have it, the diet can provide a good control of blood sugar. It is important to note that some of this protection can be attributed to the polyphenols (compounds with antioxidant activity found in plants) present in the diet.

The Authentic Mediterranean Diet is NOT a High Carbohydrate Diet

Before we start I need to clarify one issue or rather a misconception about the Mediterranean Diet that may be important to Keto followers. Contrary to what you may have heard, the real/authentic Mediterranean diet is not a high carbohydrate diet. It is not about pasta and bread, but about a lot of vegetables and a lot of olive oil. A typical menu on the Greek Diet which is considered the prototype of the Mediterranean diet, comes to about 40% fat, 40% carbohydrates and 20% protein. These are the findings from an analysis of macro- and micronutrients in a traditional Greek menu gathered by top Mediterranean Diet researcher Dr. Antonia Trichopoulou. The Greek diet is extremely rich in plant foods with small amounts of meat and the fat mainly comes from the generous use of extra virgin olive oil, resulting in moderate carbohydrate, moderate fat (not low fat) diet making it highly palatable.

So now that we have that out of the way, let’s look at how you can transition to a Mediterranean Diet smoothly:

5 Ways To Transition From a Keto Diet to the Mediterranean Diet

1. Start with Keto Friendly Mediterranean Meals. If you look specifically at the Greek-Mediterranean diet you will find numerous foods that are quite keto friendly, this will get you used to consuming more vegetables and good fats. Some to try:

  • Greek Green Beans
  • Shrimp with Tomatoes and Feta
  • Stuffed Eggplant with Tomato and Onion
  • One Pot Greek Style Mushrooms and Leeks
  • Mediterranean Garlic and Herb Crusted Roasted Sardines
  • Roasted Zucchini and Tomatoes
  • Traditional Greek Asparagus Omelet

2. Introduce Carbohydrates with Beans. Since you will be introducing carbohydrates in your diet again, the best way is to start eating beans. Bean or legumes combine, carbohydrates, protein, fiber and antioxidants and provide good blood sugar control. Start out with this lentil stew and these one pot black-eyed beans as they are better tolerated.

3. Always Pair Carbohydrates with Good fats and Protein. Don’t start eating carbohydrates on their own as this may lead to blood sugar fluctuations as well as increased hunger, always pair them with some good extra virgin olive oil and plenty of vegetables as well as some protein such as tahini, peanut butter, cheese etc,

4. Reduce Meat Gradually. We know from the research that processed meats specifically, and red meat are associated with reduced longevity. In the Mediterranean diet red meat is consumed in small amounts about once a week. Try by reducing meat gradually: instead of 5-6 ounces reduce to 2 ounces. For more tips checkout this post for eating less meat in 5 steps.

5. Have Vegetable Based Meals. The Mediterranean diet has hundreds of recipes that consist of vegetables. These vegetable main course recipes are filling, healthy and often consist of mostly vegetables. They may be accompanied with a bit of cheese and if you wish a small piece of whole grain bread or barley rusks.

A Final Word

It can be scary to change your diet, especially if you feel it may cause you to gain weight. Take it slowly and adjust as needed. The most important part of this switch is not so much increasing your carbs, but reducing meat intake and saturated fats.

Good Luck!

Next Steps: Following A Complete Mediterranean Diet Plan

Once you are ready, head over to my Complete Guide to the Authentic Mediterranean Diet for more guidance including menu plans, tips, lists and more.

Selected References

  • Systematic Review of the Mediterranean Diet for Long-Term Weight Loss. The American Journal of Medicine
  • Is There an Optimal Diet for Weight Management and Metabolic Health? Gastroenterology
  • Dietary Polyphenols, Mediterranean Diet, Prediabetes, and Type 2 Diabetes: A Narrative Review of the Evidence. Oxidative Medicine and Cellular Longevity
  • Mediterranean diet and type 2 diabetes. Diabetes Metabolism Research and Review
  • A journey into a Mediterranean diet and type 2 diabetes: a systematic review with meta-analyses. British Medical Journal Open
  • Macro- and micronutrients in a traditional Greek menu. Forum of Nutrition

The biggest differences between the keto diet and the Mediterranean diet

  • The Mediterranean diet is not an actual “diet,” but the keto diet is, according to Rachael Hartley, a registered and licensed dietitian.
  • The keto diet involves counting and numbers, but the Mediterranean diet is more of a general guideline for eating.
  • Both diets include fats, but the types of fats are not the same.
  • Visit Insider’s homepage for more stories.

Although they’re both popular, the Mediterranean diet and keto diet are incredibly different.

But in reality, they’re both very different — and the Mediterranean diet was just voted the best of the year while keto was voted one of the worst.

The ketogenic diet involves eating high-fat foods with moderate amounts of proteins and a low amount of carbohydrates. This diet tricks the body into burning fats and ketones over carbohydrates.

The Mediterranean diet focuses on plant-based foods, fresh fruits and vegetables, and eating lean proteins. This diet shifts the emphasis away from processed foods and is considered more of a way of eating than a traditional diet.

Here are some of the key differences between the trendy diets.

Keto is a true diet, but the Mediterranean diet is actually an eating pattern

By definition, a diet includes the kinds of food that a person eats — or doesn’t eat — on a very regular basis. A diet limits your food options and may be used for weight loss, medical purposes, or personal reasons.

This is one of the main ways where the keto diet and the Mediterranean diet differ.

“The keto diet is based on more rigid rules about what you can and can’t eat and it uses grams as a measurement tool,” Rachael Hartley, a registered and licensed dietitian, told Insider.

“While people can use the Mediterranean diet pattern and turn it into a diet, research-wise it is based on a dietary pattern of eating and has much less like riding rules about what you can and can’t eat like the keto diet. The Mediterranean diet pattern is a pretty big-picture model,” she added.

Keto is a lot more restrictive than the Mediterranean diet

The keto diet doesn’t allow you to consume carb-heavy foods, like bread. Peter Kramer/Getty Images

Unlike the Mediterranean diet, the keto diet focuses on restrictions by naming a number of foods you should not consume.

“Really no foods are off-limits on the Mediterranean diet plan. With keto, that are very specific foods that you aren’t allowed to eat or don’t have room to eat because your carb grams are so limited. The Mediterranean diet allows you to work in any food that you like,” Hartley explained.

“The Mediterranean is focused on inclusion and emphasizes olive oil and other healthy fats, whole grains, legumes, leafy greens,” said Hartley. “The keto diet follows a very high-fat, moderate protein, very low-carbohydrate way of eating.”

She continued, “Unlike the keto diet, there are not rigid rules attached to the Mediterranean diet pattern. That’s why we call it a dietary pattern and not a diet.”

Both diets encourage foods with fat, but not the same types of fats

Those embarking on the keto diet may find themselves eating foods such as cheese, bacon, and butter. These foods, which are high in fat, are encouraged on the keto diet.

And although the Mediterranean diet also encourages followers to eat foods containing fat, the two recommendations are not the same.

“From a nutritional standpoint, the keto diet is much higher in fat, although, both diets emphasize fat,” said Hartley. “The Mediterranean diet plan used to be called high fat. But, compared to keto, it’s definitely nowhere close. Most diets emphasize fat, but the keto diet is significantly higher in fat where fats make up the vast components of energy that you’re getting from the diet.”

The Mediterranean diet plan encourages followers to consume healthy fats like avocados and olive oil.

Hartley added, “The keto diet also emphasizes fats to the point that it can be challenging to get adequate amounts of other macronutrients.”

The Mediterranean diet calls for nutrient-rich food groups, but keto does not

The Mediterranean diet emphasizes eating nutrient-rich foods.

The two styles of eating are built on a foundation of different food groups.

“Another nutritional difference between the Mediterranean diet pattern and the keto diet is that the Mediterranean emphasizes whole grains, legumes, and other fiber-rich carbohydrate foods,” said Harley. “The keto diet does not emphasize these nutrient-rich food groups.”

The keto diet requires you to track your food, but the Mediterranean diet does not

The Mediterranean diet takes less planning than the keto diet.

Followers of the Mediterranean diet plan do not need to count calories or carbs, but participants of the keto diet need to keep a close eye on what they are eating in an effort to be be in ketosis.

“With the keto diet, there’s a lot of numbers and counting involved. In order to supposedly maintain ketosis, you have to count grams of carbs, grams of protein, grams of fat, and be a human calculator when it comes to food,” said Hartley. “With the Mediterranean diet pattern, the emphasis is really on foods rather than on numbers.”

The sustainability rate for each diet is very different

Operating on a high-fat, low-carb diet, such as the keto diet, is hard to maintain. Rick Wilking/Reuters

Lisa De Fazio, a registered dietitian nutritionist, told Insider that she sees patients who have followed the keto diet and now have high cholesterol as a result.

“You cannot eat large amounts of meat, cheese, and fat without consequences. You can’t eat this way until you die,” said De Fazio. “When you stop keto eating and eat carbs you gain the weight back and more because you have screwed up your body’s metabolism.”

Hartley agreed, and said, “I don’t think it’s super viable for most people to adhere to the keto diet long-term.”

The keto diet may have more health risks than the Mediterranean diet plan

The ketogenic diet can cause high cholesterol, low blood pressure, and hypoglycemia from not eating carbohydrates.

“There are significantly more health risks associated with keto than the Mediterranean. It is possible for someone to take any nutritional advice too far — including with the Mediterranean diet pattern — but with the ketogenic diet, there is much more risk for health concerns,” said Hartley. “Also constipation from not getting enough fiber, because those fiber-rich carbs are restricted.”

Aside from what foods are and aren’t included, Hartley told Insider that the setup of the ketogenic diet may be triggering for someone at risk of developing an eating disorder.

“I think many people who are at risk of eating disorders and attempt a diet pattern that’s very rigid and numbers-focused can be very triggering for them,” said Hartley. “Even for people who don’t have an eating disorder, adhering to a rigid diet can often trigger eating disorder behaviors.”

Both diets moderate your sugar intake but in a different way

Added sugars are not recommended for either diet, but the rule is stricter for the keto diet. Koichi Kamoshida/Getty

The Mediterranean diet does not necessarily restrict your sugar consumption, but rather it emphasizes other fresh foods, per Hartley. This isn’t really the case when it comes to the keto diet, though, she said.

“The principle is more crowding out the sugar. The Mediterranean diet pattern highlights lots of other fresh foods like fruits, and veggies. So, there is a lower intake in sugar but there aren’t rules like ‘you can’t have this or that’ on the Mediterranean diet,” said Hartley. “With the keto diet, I’d imagine a very small amount of sweets that would chip into your total daily allowance pretty quickly. I can’t imagine you could realistically work in something that has actual sugar in it.”

  • I lost more than 120 pounds on the keto diet. Here’s why I’m quitting it.
  • What a day of healthy eating looks like on the keto diet, according to nutritionists
  • 10 of the biggest downsides of the keto diet

The Mediterranean diet is really the poster child for mainstream healthy eating right now, and even though it’s not exactly Paleo, the research on it is pretty interesting.

The diet of actual people living around the Mediterranean sea obviously varies, but the “Mediterranean diet” in most studies focuses on whole grains, legumes, low-fat dairy, nuts, fish, fruits, vegetables, and olive oil, and discourages red meat, refined flour, refined sugar, animal fat, and processed foods.

It’s pretty well-proven that the diet improves most people’s overall health, and from a Paleo perspective, that’s not surprising. Parts of it are very healthy (the fish and the vegetables), and even the parts that aren’t ideal (like the grains) are better than the typical American diet.

But the research on the Mediterranean diet is more interesting than just “lentil soup is better than Twinkies, no kidding, news at 11.” Here are 5 things Paleo eaters should know about the Mediterranean diet – how it strikes another blow against low-fat dogma, how it can work as a low-carb, high-fat diet, and how it might be a step towards more Paleo-friendly advice even in the Dietary Guidelines.

1. The Mediterranean Diet Consistently Beats Low-Fat Diets

The Mediterranean diet is low in fat by Paleo standards (around 35% fat, depending a little on who’s running the study, and obviously the ketogenic versions are higher). But that’s at the high end of the typical government nutrition guidelines, and more importantly, the Mediterranean diet is focused much more on getting high-quality fat than on reducing fat as much as possible. The focus is much more on quality than quantity.

And the Mediterranean approach seems to work. In the real world, advice to eat a Mediterranean diet consistently produces better results than advice to eat a low-fat diet. Whether it’s risk of death from heart disease, risk of diabetes, or weight loss, the Mediterranean diet pattern wins.

This is a huge argument for diet quality over diet quantity – and also for a diet with a recognizably delicious cuisine, a diet that doesn’t conjure up images of bland and gross food, and a diet focused on fresh meals rather than processed food.

2. The Mediterranean Diet Rivals Low-Carb for Weight Loss.

The Mediterranean diet is constantly praised as a sustainable or healthy way to lose weight. But guess what other diet does just as well?

This review looked at studies comparing the Mediterranean diet to other dietary patterns for weight loss in people with obesity. The Mediterranean diet smashed low-fat diets (no surprise there) but Mediterranean and low-carb did about equally well.

That’s obviously a victory for the low-carb crowd: their diet works as well as the current “golden child” of dietary advice. But you could also take it the other way: a moderate-carb diet works just as well as a low-carb diet, as long as that moderate-carb diet is focused on quality of food and not just calorie-counting.

But wait…why not combine the two for a double whammy of weight-loss success? Well, actually, that’s been done!

3. There’s a Very Low-Carb/Ketogenic Mediterranean Diet (and it’s Really Impressive)

A ketogenic diet is a very low-carb, very high-fat diet (usually less than 5% calories from carbs, with around 80% from fat). Paleo doesn’t have to be a ketogenic diet, but it can be, and a lot of people find that a ketogenic Paleo diet is a very impressive tool for weight loss and general health.

Ketogenic Mediterranean diets take out all the bread and legumes, and replace them with more olive oil, low-carb vegetables, fatty fish, and nuts. The benefits include…

  • Improvements in metabolic syndrome and nonalcoholic fatty liver disease (NAFLD)
  • Improvements in cardiovascular health
  • Weight loss and improvements in inflammatory markers

This research suggests that those “heart-healthy whole grains” aren’t actually necessary for the health benefits of the Mediterranean diet; most of these diets were basically Paleo with some low-fat dairy thrown in. For Paleo eaters who find the Mediterranean diet concept interesting but don’t want to venture into the land of whole wheat and chickpeas, this might be a good place to start. (And if you’re not huge on the full ketogenic thing, you could add carbs with potatoes and/or sweet potatoes as you like.)

Take those first three points all together, and it looks like the Mediterranean diet is making a pretty strong case against low-fat diets or the need for “healthy whole grains.” Mediterranean-style emphasis on healthy fats outperforms low-fat diets, and you can get Mediterranean diet benefits with almost no carbs or grains at all.

4. The Diet Alone Isn’t Magic

The original promoter of the Mediterranean Diet was Ancel Keys (yes, the same Ancel Keys better-known for unjustifiably demonizing saturated fat and cholesterol as the “causes” of heart disease). Keys traveled to the island of Crete, off the coast of Greece, and observed that traditional Cretan dietary patterns were associated with low rates of heart disease. And the “Mediterranean diet” was born.

But even people eating the Mediterranean diet in studies don’t end up as healthy as the Cretans, and this review points out one possible reason why. The people living in Crete and southern Italy at the time also enjoyed “a relaxing psychosocial environment, mild climate, preservation of the extended family structure, and even a siesta, as well as regular activity, mainly through walking.” Think about the lessons of Roseto, PA: strong social connections can dramatically reduce rates of heart disease even when the people are eating huge piles of refined flour and everyone smokes. Or think about the importance of sleep and stress, or the benefits of walking.

The history of the Mediterranean diet is one more point in favor of considering all these things as part your health environment: it’s not just the food you put in your mouth.

5. It Might be Changing the Dietary Guidelines in a Paleo-Friendly Direction.

Maybe the most exciting thing about the Mediterranean Diet is the politics.

The Mediterranean Diet is the fat-is-not-evil wedge that’s slowly filtering into mainstream dietary advice. It’s the poster child for “good fat,” for unprocessed foods, and for focusing on overall diet patterns instead of picking on just one nutrient. And as it filters into the public consciousness that olive oil is actually good for you, we might be getting a welcome dose of fat-friendly, whole-foods nutrition coming along for the ride.

The latest version of the Dietary Guidelines for Americans even touts the Mediterranean diet as a suggested dietary pattern. Who knows: maybe next they’ll actually get tough on sugar!

Do you have a favorite Mediterranean-inspired recipe? Share on Facebook or Twitter!

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