The Ketogenic Diet: A Detailed Beginner's Guide to Keto

The ketogenic diet (keto) is a low-carb, high-fat diet that causes weight loss and provides numerous health benefits. This is a detailed beginner's guide. HealthlineHealthConditionsDiscoverPlanConnectSubscribeNutritionHealthyEatingMealPrepLifestyleDietsWeightManagementVitamins&SupplementsConditionsProductsNutritionEvidenceBasedTheKetogenicDiet:ADetailedBeginner’sGuidetoKetoWrittenbyRudyMawer,MSc,CISSN—MedicallyreviewedbyAmyRichter,RD,Nutrition—UpdatedonOctober22,2020WhatItIsDiettypesKetosisWeightlossDiabetesOtherbenefitsFoodstoavoidFoodstoeatSampleplanSnacksTipsDiningoutSideeffectsRisksSupplementsFAQsBottomlineWeincludeproductswethinkareusefulforourreaders.Ifyoubuythroughlinksonthispage,wemayearnasmallcommission.Here’sourprocess.Theketogenicdiet(orketodiet,forshort)isalowcarb,highfatdietthatoffersmanyhealthbenefits.Infact,manystudiesshowthatthistypeofdietcanhelpyouloseweightandimproveyourhealth(1).Ketogenicdietsmayevenhavebenefitsagainstdiabetes,cancer,epilepsy,andAlzheimer’sdisease(2,3,4,5).Hereisadetailedbeginner’sguidetotheketodiet.Whatisaketogenicdiet?KetobasicsTheketogenicdietisaverylowcarb,highfatdietthatsharesmanysimilaritieswiththeAtkinsandlowcarbdiets.Itinvolvesdrasticallyreducingcarbohydrateintakeandreplacingitwithfat.Thisreductionincarbsputsyourbodyintoametabolicstatecalledketosis.Whenthishappens,yourbodybecomesincrediblyefficientatburningfatforenergy.Italsoturnsfatintoketonesintheliver,whichcansupplyenergyforthebrain(6).Ketogenicdietscancausesignificantreductionsinbloodsugarandinsulinlevels.This,alongwiththeincreasedketones,hassomehealthbenefits(6,7,8).SUMMARYTheketodietisalowcarb,highfatdiet.Itlowersbloodsugarandinsulinlevelsandshiftsthebody’smetabolismawayfromcarbsandtowardfatandketones.DifferenttypesofketogenicdietsThereareseveralversionsoftheketogenicdiet,including:Standardketogenicdiet(SKD):Thisisaverylowcarb,moderateproteinandhighfatdiet.Ittypicallycontains70%fat,20%protein,andonly10%carbs(9).Cyclicalketogenicdiet(CKD):Thisdietinvolvesperiodsofhighercarbrefeeds,suchas5ketogenicdaysfollowedby2highcarbdays.Targetedketogenicdiet(TKD):Thisdietallowsyoutoaddcarbsaroundworkouts.Highproteinketogenicdiet:Thisissimilartoastandardketogenicdiet,butincludesmoreprotein.Theratioisoften60%fat,35%protein,and5%carbs.However,onlythestandardandhighproteinketogenicdietshavebeenstudiedextensively.Cyclicalortargetedketogenicdietsaremoreadvancedmethodsandprimarilyusedbybodybuildersorathletes.Theinformationinthisarticlemostlyappliestothestandardketogenicdiet(SKD),althoughmanyofthesameprinciplesalsoapplytotheotherversions.SUMMARYThereareseveralversionsoftheketodiet.Thestandard(SKD)versionisthemostresearchedandmostrecommended.Whatisketosis?Ketosisisametabolicstateinwhichyourbodyusesfatforfuelinsteadofcarbs.Itoccurswhenyousignificantlyreduceyourconsumptionofcarbohydrates,limitingyourbody’ssupplyofglucose(sugar),whichisthemainsourceofenergyforthecells.Followingaketogenicdietisthemosteffectivewaytoenterketosis.Generally,thisinvolveslimitingcarbconsumptiontoaround20to50gramsperdayandfillinguponfats,suchasmeat,fish,eggs,nuts,andhealthyoils(6).It’salsoimportanttomoderateyourproteinconsumption.Thisisbecauseproteincanbeconvertedintoglucoseifconsumedinhighamounts,whichmayslowyourtransitionintoketosis(10).Practicingintermittentfastingcouldalsohelpyouenterketosisfaster.Therearemanydifferentformsofintermittentfasting,butthemostcommonmethodinvolveslimitingfoodintaketoaround8hoursperdayandfastingfortheremaining16hours(11).Blood,urine,andbreathtestsareavailable,whichcanhelpdeterminewhetheryou’veenteredketosisbymeasuringtheamountofketonesproducedbyyourbody.Certainsymptomsmayalsoindicatethatyou’veenteredketosis,includingincreasedthirst,drymouth,frequenturination,anddecreasedhungerorappetite(12).SUMMARYKetosisisametabolicstateinwhichyourbodyusesfatforfuelinsteadofcarbs.Modifyingyourdietandpracticingintermittentfastingcanhelpyouenterketosisfaster.Certaintestsandsymptomscanalsohelpdeterminewhetheryou’veenteredketosis.KetogenicdietscanhelpyouloseweightAketogenicdietisaneffectivewaytoloseweightandlowerriskfactorsfordisease(1,2,3,4,5).Infact,researchshowsthattheketogenicdietmaybeaseffectiveforweightlossasalowfatdiet(13,14,15).What’smore,thedietissofillingthatyoucanloseweightwithoutcountingcaloriesortrackingyourfoodintake(16).Onereviewof13studiesfoundthatfollowingaverylowcarb,ketogenicdietwasslightlymoreeffectiveforlong-termweightlossthanalowfatdiet.Peoplewhofollowedtheketodietlostanaverageof2pounds(0.9kg)morethanthegroupthatfollowedalowfatdiet(13).What’smore,italsoledtoreductionsindiastolicbloodpressureandtriglyceridelevels(13).Anotherstudyin34olderadultsfoundthatthosewhofollowedaketogenicdietfor8weekslostnearlyfivetimesasmuchtotalbodyfatasthosewhofollowedalowfatdiet(17).Theincreasedketones,lowerbloodsugarlevels,andimprovedinsulinsensitivitymayalsoplayakeyrole(18,19).Formoredetailsontheweightlosseffectsofaketogenicdiet,readthisarticle.SUMMARYAketogenicdietcanhelpyouloseslightlymoreweightthanalowfatdiet.Thisoftenhappenswithlesshunger.KetogenicdietsfordiabetesandprediabetesDiabetesischaracterizedbychangesinmetabolism,highbloodsugar,andimpairedinsulinfunction(20).Theketogenicdietcanhelpyouloseexcessfat,whichiscloselylinkedtotype2diabetes,prediabetes,andmetabolicsyndrome(21,22,23,24).Oneolderstudyfoundthattheketogenicdietimprovedinsulinsensitivitybyawhopping75%(25).Asmallstudyinwomenwithtype2diabetesalsofoundthatfollowingaketogenicdietfor90dayssignificantlyreducedlevelsofhemoglobinA1C,whichisameasureoflong-termbloodsugarmanagement(26).Anotherstudyin349peoplewithtype2diabetesfoundthatthosewhofollowedaketogenicdietlostanaverageof26.2pounds(11.9kg)overa2-yearperiod.Thisisanimportantbenefitwhenconsideringthelinkbetweenweightandtype2diabetes(24,27).What’smore,theyalsoexperiencedimprovedbloodsugarmanagement,andtheuseofcertainbloodsugarmedicationsdecreasedamongparticipantsthroughoutthecourseofthestudy(27).Formoreinformation,checkoutthisarticleonthebenefitsoflowcarbdietsforpeoplewithdiabetes.SUMMARYTheketogenicdietcanboostinsulinsensitivityandcausefatloss,leadingtosignificanthealthbenefitsforpeoplewithtype2diabetesorprediabetes.OtherhealthbenefitsofketoTheketogenicdietactuallyoriginatedasatoolfortreatingneurologicaldiseasessuchasepilepsy.Studieshavenowshownthatthedietcanhavebenefitsforawidevarietyofdifferenthealthconditions:Heartdisease.Theketogenicdietcanhelpimproveriskfactorslikebodyfat,HDL(good)cholesterollevels,bloodpressure,andbloodsugar(28,29).Cancer.Thedietiscurrentlybeingexploredasanadditionaltreatmentforcancer,becauseitmayhelpslowtumorgrowth.(4,30,31).Alzheimer’sdisease.TheketodietmayhelpreducesymptomsofAlzheimer’sdiseaseandslowitsprogression(5,32,33).Epilepsy.Researchhasshownthattheketogenicdietcancausesignificantreductionsinseizuresinepilepticchildren(3).Parkinson’sdisease.Althoughmoreresearchisneeded,onestudyfoundthatthediethelpedimprovesymptomsofParkinson’sdisease(34).Polycysticovarysyndrome.Theketogenicdietcanhelpreduceinsulinlevels,whichmayplayakeyroleinpolycysticovarysyndrome(35,36).Braininjuries.Someresearchsuggeststhatthedietcouldimproveoutcomesoftraumaticbraininjuries(37).However,keepinmindthatresearchintomanyoftheseareasisfarfromconclusive.SUMMARYAketogenicdietmayprovidemanyhealthbenefits,especiallywithmetabolic,neurological,orinsulin-relateddiseases.FoodstoavoidAnyfoodthat’shighincarbsshouldbelimited.Here’salistoffoodsthatneedtobereducedoreliminatedonaketogenicdiet:sugaryfoods:soda,fruitjuice,smoothies,cake,icecream,candy,etc.grainsorstarches:wheat-basedproducts,rice,pasta,cereal,etc.fruit:allfruit,exceptsmallportionsofberrieslikestrawberriesbeansorlegumes:peas,kidneybeans,lentils,chickpeas,etc.rootvegetablesandtubers:potatoes,sweetpotatoes,carrots,parsnips,etc.lowfatordietproducts:lowfatmayonnaise,saladdressings,andcondimentssomecondimentsorsauces:barbecuesauce,honeymustard,teriyakisauce,ketchup,etc.unhealthyfats:processedvegetableoils,mayonnaise,etc.alcohol:beer,wine,liquor,mixeddrinkssugar-freedietfoods:sugar-freecandies,syrups,puddings,sweeteners,desserts,etc.SUMMARYAvoidcarb-basedfoodslikegrains,sugars,legumes,rice,potatoes,candy,juice,andevenmostfruits.FoodstoeatYoushouldbasethemajorityofyourmealsaroundthesefoods:meat:redmeat,steak,ham,sausage,bacon,chicken,andturkeyfattyfish:salmon,trout,tuna,andmackereleggs:pasturedoromega-3wholeeggsbutterandcream:grass-fedbutterandheavycreamcheese:unprocessedcheeseslikecheddar,goat,cream,blue,ormozzarellanutsandseeds:almonds,walnuts,flaxseeds,pumpkinseeds,chiaseeds,etc.healthyoils:extravirginoliveoil,andavocadooilavocados:wholeavocadosorfreshlymadeguacamolelowcarbveggies:greenveggies,tomatoes,onions,peppers,etc.condiments:salt,pepper,herbs,andspicesIt’sbesttobaseyourdietmostlyonwhole,single-ingredientfoods.Here’salistof44healthylowcarbfoods.SUMMARYBasethemajorityofyourdietonfoodssuchasmeat,fish,eggs,butter,nuts,healthyoils,avocados,andplentyoflowcarbveggies.Asampleketomealplanfor1weekTohelpgetyoustarted,here’sasampleketogenicdietmealplanforoneweek:Mondaybreakfast:veggieandeggmuffinswithtomatoeslunch:chickensaladwitholiveoil,fetacheese,olives,andasidesaladdinner:salmonwithasparaguscookedinbutterTuesdaybreakfast:egg,tomato,basil,andspinachomeletlunch:almondmilk,peanutbutter,spinach,cocoapowder,andsteviamilkshake(moreketosmoothieshere)withasideofslicedstrawberriesdinner:cheese-shelltacoswithsalsaWednesdaybreakfast:nutmilkchiapuddingtoppedwithcoconutandblackberrieslunch:avocadoshrimpsaladdinner:porkchopswithParmesancheese,broccoli,andsaladThursdaybreakfast:omeletwithavocado,salsa,peppers,onion,andspiceslunch:ahandfulofnutsandcelerystickswithguacamoleandsalsadinner:chickenstuffedwithpestoandcreamcheese,andasideofgrilledzucchiniFridaybreakfast:sugar-freeGreek,wholemilkyogurtwithpeanutbutter,cocoapowder,andberrieslunch:groundbeeflettucewraptacoswithslicedbellpeppersdinner:loadedcauliflowerandmixedveggiesSaturdaybreakfast:creamcheesepancakeswithblueberriesandasideofgrilledmushroomslunch:Zucchiniandbeet“noodle”saladdinner:whitefishcookedinoliveoilwithkaleandtoastedpinenutsSundaybreakfast:friedeggswithandmushroomslunch:lowcarbsesamechickenandbroccolidinner:spaghettisquashBologneseAlwaystrytorotatethevegetablesandmeatoverthelongterm,aseachtypeprovidesdifferentnutrientsandhealthbenefits.Fortonsofrecipes,checkoutthese101healthylowcarbrecipesandthisketoshoppinglist.SUMMARYYoucaneatawidevarietyoftastyandnutritiousmealsonaketogenicdiet.It’snotallmeatsandfats.Vegetablesareanimportantpartofthediet.HealthyketosnacksIncaseyougethungrybetweenmeals,herearesomehealthy,keto-approvedsnacks:fattymeatorfishcheeseahandfulofnutsorseedsketosushibitesolivesoneortwohard-boiledordeviledeggsketo-friendlysnackbars90%darkchocolatefull-fatGreekyogurtmixedwithnutbutterandcocoapowderbellpeppersandguacamolestrawberriesandplaincottagecheesecelerywithsalsaandguacamolebeefjerkysmallerportionsofleftovermealsfatbombsSUMMARYGreatsnacksforaketodietincludepiecesofmeat,cheese,olives,boiledeggs,nuts,rawveggies,anddarkchocolate.KetotipsandtricksAlthoughgettingstartedontheketogenicdietcanbechallenging,thereareseveraltipsandtricksthatyoucanusetomakeiteasier.Startbyfamiliarizingyourselfwithfoodlabelsandcheckingthegramsoffat,carbs,andfibertodeterminehowyourfavoritefoodscanfitintoyourdiet.Planningoutyourmealsinadvancemayalsobebeneficialandcanhelpyousaveextratimethroughouttheweek.Manywebsites,foodblogs,apps,andcookbooksalsoofferketo-friendlyrecipesandmealideasthatyoucanusetobuildyourowncustommenu.Alternatively,somemealdeliveryservicesevenofferketo-friendlyoptionsforaquickandconvenientwaytoenjoyketomealsathome.Lookintohealthyfrozenketomealswhenyou’reshortontimeWhengoingtosocialgatheringsorvisitingfamilyandfriends,youmayalsowanttoconsiderbringingyourownfood,whichcanmakeitmucheasiertocurbcravingsandsticktoyourmealplan.SUMMARYReadingfoodlabels,planningyourmealsahead,andbringingyourownfoodswhenvisitingfamilyandfriendscanmakeitmucheasiertosticktotheketogenicdiet.TipsforeatingoutonaketogenicdietManyrestaurantmealscanbemadeketo-friendly.Mostrestaurantsoffersomekindofmeatorfish-baseddish.Orderthisandreplaceanyhighcarbfoodwithextravegetables.Egg-basedmealsarealsoagreatoption,suchasanomeletoreggsandbacon.Anotherfavoriteisbun-lessburgers.Youcouldalsoswapthefriesforvegetablesinstead.Addextraavocado,cheese,bacon,oreggs.AtMexicanrestaurants,youcanenjoyanytypeofmeatwithextracheese,guacamole,salsa,andsourcream.Fordessert,askforamixedcheeseboardorberrieswithcream.SUMMARYWheneatingout,selectameat-,fish-,oregg-baseddish.Orderextraveggiesinsteadofcarbsorstarches,andhavecheesefordessert.SideeffectsandhowtominimizethemAlthoughtheketogenicdietisusuallysafeformosthealthypeople,theremaybesomeinitialsideeffectswhileyourbodyadapts.There’ssomeanecdotalevidenceoftheseeffectsoftenreferredtoastheketoflu(38).Basedonreportsfromsomeontheeatingplan,it’susuallyoverwithinafewdays.Reportedketoflusymptomsincludediarrhea,constipation,andvomiting(39).Otherlesscommonsymptomsinclude:poorenergyandmentalfunctionincreasedhungersleepissuesnauseadigestivediscomfortdecreasedexerciseperformanceTominimizethis,youcantryaregularlowcarbdietforthefirstfewweeks.Thismayteachyourbodytoburnmorefatbeforeyoucompletelyeliminatecarbs.Aketogenicdietcanalsochangethewaterandmineralbalanceofyourbody,soaddingextrasalttoyourmealsortakingmineralsupplementsmayhelp.Talktoyourdoctoraboutyournutritionalneeds.Atleastinthebeginning,it’simportanttoeatuntilyou’refullandavoidrestrictingcaloriestoomuch.Usually,aketogenicdietcausesweightlosswithoutintentionalcalorierestriction.SUMMARYManyofthesideeffectsofstartingaketogenicdietcanbelimited.Easingintothedietandtakingmineralsupplementscanhelp.RisksoftheketodietStayingontheketodietinthelongtermmayhavesomenegativeeffects,includingrisksofthefollowing:lowproteininthebloodextrafatintheliverkidneystonesmicronutrientdeficienciesAtypeofmedicationcalledsodium-glucosecotransporter2(SGLT2)inhibitorsfortype2diabetescanincreasetheriskfordiabeticketoacidosis,adangerousconditionthatincreasesbloodacidity.Anyonetakingthismedicationshouldavoidtheketodiet(40,41).Moreresearchisbeingdonetodeterminethesafetyoftheketodietinthelongterm.Keepyourdoctorinformedofyoureatingplantoguideyourchoices.SUMMARYTherearesomesideeffectstotheketodietaboutwhichyoushouldspeaktoyourdoctorifyouplantostayonthedietlongterm.SupplementsforaketogenicdietAlthoughnosupplementsarerequired,somecanbeuseful.MCToil.Addedtodrinksoryogurt,MCToilprovidesenergyandhelpsincreaseketonelevels.ShopforMCToilonline(42,43).Minerals.Addedsaltandothermineralscanbeimportantwhenstartingoutduetoshiftsinwaterandmineralbalance(44).Caffeine.Caffeinecanhavebenefitsforenergy,fatloss,andperformance(45).Exogenousketones.Thissupplementmayhelpraisethebody’sketonelevels(46).Creatine.Creatineprovidesnumerousbenefitsforhealthandperformance.Thiscanhelpifyouarecombiningaketogenicdietwithexercise(47).Whey.Usehalfascoopofwheyproteininshakesoryogurttoincreaseyourdailyproteinintake(48,49).Shopfortastywheyproductsononline.SUMMARYCertainsupplementscanbebeneficialonaketogenicdiet.Theseincludeexogenousketones,MCToil,andminerals.FrequentlyaskedquestionsHereareanswerstosomeofthemostcommonquestionsabouttheketogenicdiet.1.CanIevereatcarbsagain?Yes.However,it’simportanttosignificantlyreduceyourcarbintakeinitially.Afterthefirst2to3months,youcaneatcarbsonspecialoccasions—justreturntothedietimmediatelyafter.2.WillIlosemuscle?There’sariskoflosingsomemuscleonanydiet.However,proteinintakeandhighketonelevelsmayhelpminimizemuscleloss,especiallyifyouliftweights(50,51).3.CanIbuildmuscleonaketogenicdiet?Yes,butitmaynotworkaswellasonamoderatecarbdiet(52,53).Formoredetailsaboutlowcarborketodietsandexerciseperformance,readthisarticle.4.HowmuchproteincanIeat?Proteinshouldbemoderate,asaveryhighintakecanspikeinsulinlevelsandlowerketones.Around35%oftotalcalorieintakeisprobablytheupperlimit.5.WhatifIamconstantlytired,weak,orfatigued?Youmaynotbeinfullketosisorbeutilizingfatsandketonesefficiently.Tocounterthis,loweryourcarbintakeandrevisitthepointsabove.AsupplementlikeMCToilorketonesmayalsohelp(42,43).6.Myurinesmellsfruity.Whyisthis?Don’tbealarmed.Thisissimplyduetotheexcretionofby-productscreatedduringketosis(54).7.Mybreathsmells.WhatcanIdo?Thisisacommonsideeffect.Trydrinkingnaturallyflavoredwaterorchewingsugar-freegum.8.Iheardketosiswasextremelydangerous.Isthistrue?Peopleoftenconfuseketosiswithketoacidosis.Ketoacidosisisdangerous,buttheketosisonaketogenicdietisusuallyfineforhealthypeople.Speaktoyourdoctorbeforestartinganynewdiet.9.Ihavedigestionissuesanddiarrhea.WhatcanIdo?Thiscommonsideeffectusuallypassesafter3to4weeks.Ifitpersists,tryeatingmorehighfiberveggies(55,56).ThebottomlineAketogenicdietcanbegreatforpeoplewho:areoverweighthavediabetesarelookingtoimprovetheirmetabolichealthItmaybelesssuitableforeliteathletesorthosewishingtoaddlargeamountsofmuscleorweight.Itmayalsonotbesustainableforsomepeople’slifestylesandpreferences.Speakwithyourdoctoraboutyoureatingplanandgoalstodecideifaketoeatingplanrightforyou.ReadthearticleinSpanish.LastmedicallyreviewedonOctober21,2020EvidenceBasedThisarticleisbasedonscientificevidence,writtenbyexpertsandfactcheckedbyexperts.Ourteamoflicensednutritionistsanddietitiansstrivetobeobjective,unbiased,honestandtopresentbothsidesoftheargument.Thisarticlecontainsscientificreferences.Thenumbersintheparentheses(1,2,3)areclickablelinkstopeer-reviewedscientificpapers.WrittenbyRudyMawer,MSc,CISSN—MedicallyreviewedbyAmyRichter,RD,Nutrition—UpdatedonOctober22,2020Readthisnext10SignsandSymptomsThatYou'reinKetosisWrittenbyRudyMawer,MSc,CISSNKetosisisametabolicstatethatcanbecausedbyalow-carborketogenicdiet.Hereare10signsandsymptomsthatyou'reinketosis.READMORE7TipstoGetIntoKetosisMedicallyreviewedbyKathyW.Warwick,R.D.,CDEKetogenicdietshavemanypowerfulhealthbenefits,butsomepeoplehavetroublegettingintoketosis.Hereare7tipsforhowtogetintoketosis.READMORE10HealthBenefitsofLow-CarbandKetogenicDietsWrittenbyKrisGunnars,BScManystudiesshowthatlow-carbandketogenicdietscanleadtodramaticweightlossandimprovemostmajorriskfactorsforheartdiseaseand…READMORE15HealthConditionsThatMayBenefitFromaKetogenicDietWrittenbyFranziskaSpritzlerAketogenicdietisgoodformuchmorethanjustlosingweight.Learnhowitmayhelptreatepilepsy,diabetesandmanyotherconditions.READMORE10GraphsThatShowthePowerofaKetogenicDietWrittenbyRudyMawer,MSc,CISSNTheketogenicdietisaprovenwaytoloseweightandimprovehealth.These10graphsillustratethepowerfuleffectsofthediet.READMOREIsKetosisSafeandDoesItHaveSideEffects?WrittenbyHrefnaPalsdottir,MSKetosisisanaturalmetabolicstatethatoccursonaverylow-carbdiet.Itisconsideredtobesafe,butmaycausesomesideeffectsinthe…READMOREAKetogenicDiettoLoseWeightandFightMetabolicDiseaseWrittenbyRudyMawer,MSc,CISSNAketogenicdiethasbeenproventohelpyouloseweightandfightmetabolicdisease.Here’sanevidence-basedlookathowitworks.READMORELow-Carb/KetogenicDietsandExercisePerformanceWrittenbyRudyMawer,MSc,CISSNLow-carbandketogenicdietshavemanyhealthbenefits.However,theireffectsonexerciseperformancearelessclear.Thisarticlereviewsthe…READMORE20FoodstoEatontheKetoDietWrittenbySaVannaShoemaker,MS,RDN,LDandFranziskaSpritzlerTheketogenicdietisaverylowcarbdietwithnumeroushealthbenefits.Hereare20nutritiousfoodsyoucaneatonketo.READMORE