It’s no surprise that spinach is one of the most eaten leafy green vegetables on a ketogenic diet. Spinach has only 3g net carbs per cooked cup of spinach, and almost no digestible carbs raw. This veggie is a great way to bulk up lunches with salads You can make high-fat side dishes like creamed spinach to go along with any meal, too!
The ketogenic diet is indicated as an adjunctive (additional) treatment in children and young people with drug-resistant epilepsy.[25][26] It is approved by national clinical guidelines in Scotland,[26] England and Wales[25] and reimbursed by nearly all US insurance companies.[27] Children with a focal lesion (a single point of brain abnormality causing the epilepsy) who would make suitable candidates for surgery are more likely to become seizure-free with surgery than with the ketogenic diet.[9][28] About a third of epilepsy centres that offer the ketogenic diet also offer a dietary therapy to adults. Some clinicians consider the two less restrictive dietary variants—the low glycaemic index treatment and the modified Atkins diet—to be more appropriate for adolescents and adults.[9] A liquid form of the ketogenic diet is particularly easy to prepare for, and well tolerated by, infants on formula and children who are tube-fed.[5][29]
Wilder’s colleague, paediatrician Mynie Peterman, later formulated the classic diet, with a ratio of one gram of protein per kilogram of body weight in children, 10–15 g of carbohydrate per day, and the remainder of calories from fat. Peterman’s work in the 1920s established the techniques for induction and maintenance of the diet. Peterman documented positive effects (improved alertness, behaviour and sleep) and adverse effects (nausea and vomiting due to excess ketosis). The diet proved to be very successful in children: Peterman reported in 1925 that 95% of 37 young patients had improved seizure control on the diet and 60% became seizure-free. By 1930, the diet had also been studied in 100 teenagers and adults. Clifford Barborka, also from the Mayo Clinic, reported that 56% of those older patients improved on the diet and 12% became seizure-free. Although the adult results are similar to modern studies of children, they did not compare as well to contemporary studies. Barborka concluded that adults were least likely to benefit from the diet, and the use of the ketogenic diet in adults was not studied again until 1999.[10][14]
Below, you’ll learn about the grains, legumes, sugar, starchy vegetables and fruit you should avoid on the ketogenic diet. These foods contain high traces of carbohydrates and very little fat and protein.
In order to transition and remain in ketosis, aiming for about 30–50 net grams is typically the recommended amount of carbs to start with. This is considered a more moderate or flexible approach but can be less overwhelming to begin with.
If you’re new to the keto diet or just still learning the ropes, your biggest questions probably revolve around figuring out just what high-fat low-carb foods you can eat on such a low-carb, ketogenic diet. Overall, remember that the bulk of calories on the keto diet are from foods that are high in natural fats along with a moderate amount of foods with protein. Those that are severely restricted are all foods that provide lots of carbs, even kinds that are normally thought of as “healthy,” like whole grains, for example.
As you move on to Week 2 and beyond, take a look ahead. Some of the items you bought in Week 1 will need to be restocked. Whether it’s beef, chicken, or some kind of vegetables. In fact, you’ll be going through a lot of spinach on this meal plan – so make sure you keep your pantry restocked!
The original therapeutic diet for paediatric epilepsy provides just enough protein for body growth and repair, and sufficient calories[Note 1] to maintain the correct weight for age and height. The classic therapeutic ketogenic diet was developed for treatment of paediatric epilepsy in the 1920s and was widely used into the next decade, but its popularity waned with the introduction of effective anticonvulsant medications. This classic ketogenic diet contains a 4:1 ratio by weight of fat to combined protein and carbohydrate. This is achieved by excluding high-carbohydrate foods such as starchy fruits and vegetables, bread, pasta, grains and sugar, while increasing the consumption of foods high in fat such as nuts, cream, and butter.[1] Most dietary fat is made of molecules called long-chain triglycerides (LCTs). However, medium-chain triglycerides (MCTs)—made from fatty acids with shorter carbon chains than LCTs—are more ketogenic. A variant of the classic diet known as the MCT ketogenic diet uses a form of coconut oil, which is rich in MCTs, to provide around half the calories. As less overall fat is needed in this variant of the diet, a greater proportion of carbohydrate and protein can be consumed, allowing a greater variety of food choices.[4][5]
Collagen is a type of protein — one of over 10,000 in your body. Collagen is the most abundant protein in your body, accounting for 25-35% of all protein. It is the glue that holds your body together as it supports the growth of joints, organs, hair and connective tissues.
On the ketogenic diet, carbohydrates are restricted and so cannot provide for all the metabolic needs of the body. Instead, fatty acids are used as the major source of fuel. These are used through fatty-acid oxidation in the cell’s mitochondria (the energy-producing parts of the cell). Humans can convert some amino acids into glucose by a process called gluconeogenesis, but cannot do this by using fatty acids.[56] Since amino acids are needed to make proteins, which are essential for growth and repair of body tissues, these cannot be used only to produce glucose. This could pose a problem for the brain, since it is normally fuelled solely by glucose, and most fatty acids do not cross the blood–brain barrier. However, the liver can use long-chain fatty acids to synthesise the three ketone bodies β-hydroxybutyrate, acetoacetate and acetone. These ketone bodies enter the brain and partially substitute for blood glucose as a source of energy.[55]
Drink water. Try to drink a gallon of water a day. Make sure that you’re hydrating and staying consistent with the amount of water you drink. It not only helps regulate many vital bodily functions, but it also helps control hunger levels.
Exogenous ketones provide the body with extra ketones for energy. They help you get back into ketosis at any time, instead of having to wait at least a couple days. Exogenous ketones can also be taken in between meals to provide a quick punch of ketones or before a workout for additional energy.
Keto has done so much more for me then just help me lose weight. I feel like I have so much more disciplined in all aspects of my life now! So much more motivation! I feel like I can do anything. I feel great all of the time! I am up at 4:30am and intermittent fast from 8am to 2:30pm everyday. I am currently working on being able to do 100 consecutive push ups in one try. I was only able to do 5 when I started and am up to 30. The diet and life style change is giving me motivation I have never felt before. I love how I feel and truly believe this is how people were supposed to eat in life all along now just based in how amazing I feel all of the time. Thanks for all the help keto sub reddit!
And while we only store enough glucose for about 24 hours of energy, fat can be stored in the body to provide months worth of energy, which is why people can survive fasting (10). The amount of fat your body can utilize for energy will depend on your body composition and fat percentage.

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Although there are a variety of symptoms that can arise during keto adaptation, they mostly manifest from the same three underlying causes. Hypoglycemia (low blood sugar), Hypothalamic-Pituitary-Adrenal (HPA) axis dysfunction, and electrolyte/mineral deficiencies.
Normal dietary fat contains mostly long-chain triglycerides (LCT). Medium-chain triglycerides are more ketogenic than LCTs because they generate more ketones per unit of energy when metabolised. Their use allows for a diet with a lower proportion of fat and a greater proportion of protein and carbohydrate,[3] leading to more food choices and larger portion sizes.[4] The original MCT diet developed by Peter Huttenlocher in the 1970s derived 60% of its calories from MCT oil.[15] Consuming that quantity of MCT oil caused abdominal cramps, diarrhoea and vomiting in some children. A figure of 45% is regarded as a balance between achieving good ketosis and minimising gastrointestinal complaints. The classical and modified MCT ketogenic diets are equally effective and differences in tolerability are not statistically significant.[9] The MCT diet is less popular in the United States; MCT oil is more expensive than other dietary fats and is not covered by insurance companies.[3]
There are theoretically no restrictions on where the ketogenic diet might be used, and it can cost less than modern anticonvulsants. However, fasting and dietary changes are affected by religious and cultural issues. A culture where food is often prepared by grandparents or hired help means more people must be educated about the diet. When families dine together, sharing the same meal, it can be difficult to separate the child’s meal. In many countries, food labelling is not mandatory so calculating the proportions of fat, protein and carbohydrate is difficult. In some countries, it may be hard to find sugar-free forms of medicines and supplements, to purchase an accurate electronic scale, or to afford MCT oils.[53]
We also see a lot more dessert recipes with the higher carb vegetables because of their natural sweetness. Ginger and pumpkin especially come to mind. If you’re in the mood for an autumn inspired treat, consider adding vegetables to your desserts. Some examples are:
Fortunately, you can still have alcohol on a low-carb diet ― you just have to be careful. Beer is basically off limits and wine is iffy, so the rule is to stick to clear liquors. When looking for mixers, you must also look for drinks low in carbs. This recipe for a root beer float includes heavy whipping cream to mimic ice cream and get some extra fats into your system. When you’re on keto, alcohol hits you quicker, so drink in moderation! Serves 1.
Some blood pressure issues are associated with excess weight, which is a bonus since keto tends to lead to weight loss. If you have high blood pressure or other blood pressure issues, click here to learn how keto can reduce blood pressure >
Jump up ^ Musa-Veloso K, Cunnane SC. Measuring and interpreting ketosis and fatty acid profiles in patients on a high-fat ketogenic diet. In: Stafstrom CE, Rho JM, editors. Epilepsy and the ketogenic diet. Totowa: Humana Press; 2004. p. 129–41. ISBN 1-58829-295-9.
Option 2: Whole milk, unsweetened yogurt mixed with full-fat sour cream, a few raspberries, chia seeds, and walnuts. “This type of combo requires careful carb- and portion-counting since all yogurts naturally have lactose, which is a carb,” says Stefanski. “Pairing it with a carb-free protein like two eggs can help balance out the macros.”
Also Consider: For some individuals, diarrhea may be brought on by low stomach acid and/or a sluggish gallbladder. Another possibility is that you have a low-grade food sensitivity to something you are eating such as eggs, nuts, and cheese.
I walked into work today and on the main table someone had left… donuts. Donuts are my WEAKNESS, right? Well, next to the donuts someone left a note that said, “These donuts are kinda stale but still ok to eat. Just a warning!”
Finally are there any strategies you can recommend for someone like myself who deals with chronic sleep debt via jet lag and night work schedules that I can further address with supplements and/or a Keto lifestyle. I also do IF but am a little stumped as to how to proceed when I’m dealing in multiple time zones.
Holy smokes what a great article! Thank you for such a thorough read. I have been doing a “keto diet” (keeping carb’s under 40 g/day-I use a tracker) since the beginning of January and felt “fluish” at first like you state. That passed and this past week (It is now Feb 11)my weight loss has stalled so I am experimenting with even lower carb’s (15-20g/day). This change has really interrupted my sleep the past 3 nights, hence me typing this at 4:44 in the am after deciding to do some research the past hour. Will this too pass? Or is it time for a Mg supplement? And if so can I use a pill rather than a drink? Between all the water and the bone broth I am unsure how more I will want to drink ha! But if I have to then I will, just thought I would ask. Again, thank you for all you are doing and such a fantastic read!
A sales woman came over and asked if she could help me find anything, and I told her I was just looking for jeans in my size and they didn’t have them. I told her I needed a 46, and the largest they had was 42 and I thanked her and began to walk away. She stopped me and just said plainly, “You’re not a 46. You’re a 42.” I told her I wasn’t. I had been measured a couple of months back, and I was a 46 and the pants I was wearing are a 46. She continued to argue with me, and told me my pants were too big. I figured I would humour her, took a 42 into the dressing room, and holy shit. They fit.
Within just a couple days of cutting out carbs and raising fats, ketone concentrations in the blood rise and the brain will begin using them for energy preferentially. This initial keto-adaptation process usually takes about four weeks to complete, at which point you’ll reach peak fat-burning adaptations.
For ideas and inspiration on how to reach your macros, take a look at our ever-growing library of keto recipes. If you don’t want to do all of the planning yourself, consider getting detailed shopping lists and months of meal plans made for you with Our Keto Academy >
These individuals would benefit from taking a bulking and binding agent such as psyllium husk, citrus pectin, or my favorite, activated charcoal.  I have people do 2-3 grams of activated charcoal every 3 hours until the diarrhea subsides.
Your glycogen stores can still be refilled while on a ketogenic diet. A keto diet is an excellent way to build muscle, but protein intake is crucial here. It’s suggested that if you are looking to gain mass, you should be taking in about 1.0 – 1.2g protein per lean pound of body mass. Putting muscle on may be slower on a ketogenic diet, but that’s because your total body fat is not increasing as much.
At the initial consultation, patients are screened for conditions that may contraindicate the diet. A dietary history is obtained and the parameters of the diet selected: the ketogenic ratio of fat to combined protein and carbohydrate, the calorie requirements and the fluid intake.[18]
Jump up ^ Wang S, Fallah A. Optimal management of seizures associated with tuberous sclerosis complex: current and emerging options. Neuropsychiatr Dis Treat. 2014 Oct 23;10:2021-30. doi:10.2147/NDT.S51789. PMID 25364257
Calorie counting is not required on keto, nor should it be necessary. When you eat a diet high in fat, it is more satiating than a diet high in carbs (e.g., sugar). Generally, this cuts down on your chances of overeating. Instead of counting calories, pay attention to your macro levels. For further reading, learn more about micronutrients on a keto diet.
Magnesium Supplementation:  This is outlined above but I want to touch on it again here. Magnesium is powerful support for the HPA axis. Magnesium L-threonate in particular is the only form proven to be able to cross the blood-brain barrier which means it can exert its effect on the hypothalamus and pituitary glands.
I use a 3-4 cup frothing pitcher and preheat it along with my ceramic pour-over…preheat everything. Then i have a Bamix immersion blender…works so much better than ordinary immersion blenders. My coffee, butter and and MCT oil are all in the pitcher and the im-blender blends it all so beautifully with a sooth foamy top. Just delicious!
First things first.  What is your “why.” This is what will keep pushing you and driving you when your head is telling you to slack. It doesn’t have to be a magnificent “pie-in-the-sky” vision. Simply,
Variations on the Johns Hopkins protocol are common. The initiation can be performed using outpatient clinics rather than requiring a stay in hospital. Often there is no initial fast (fasting increases the risk of acidosis and hypoglycaemia and weight loss). Rather than increasing meal sizes over the three-day initiation, some institutions maintain meal size but alter the ketogenic ratio from 2:1 to 4:1.[9]
All leafy greens, including dandelion or beet greens, collards, mustard, turnip, arugula, chicory, endive, escarole, fennel, radicchio, romaine, sorrel, spinach, kale, chard, etc. — range from 0.5–5 net carbs per 1 cup
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.
Counting net carbs is more critical than counting calories on a ketogenic diet, but alcohol is the exception to the rule.  Alcohol contains 100 percent empty calories and you can easily drink a meal’s worth of calories without realizing you are over your limit.
Jump up ^ Kossoff EH, Dorward JL, Molinero MR, Holden KR. The modified Atkins diet: a potential treatment for developing countries. Epilepsia. 2008 Sep;49(9):1646–7. doi:10.1111/j.1528-1167.2008.01580_6.x PMID 18782218
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