Achieving ketosis is a pretty straightforward, but it can seem complicated and confusing with all of the information out there. Here’s the bottom line on what you need to do, ordered in levels of importance:
Y. Wady Aude, MD; Arthur S. Agatston, MD; Francisco Lopez-Jimenez, MD, MSc; Eric H. Lieberman, MD; Marie Almon, MS, RD; Melinda Hansen, ARNP; Gerardo Rojas, MD; Gervasio A. Lamas, MD; Charles H. Hennekens, MD, DrPH, “The National Cholesterol Education Program Diet vs a Diet Lower in Carbohydrates and Higher in Protein and Monounsaturated Fat,” Arch Intern Med. 2004;164(19):2141-2146. http://archinte.jamanetwork.com/article.aspx?articleid=217514.
More Energy. Studies have shown that the rapid rate of oxidation in MCFAs (Medium Chain Fatty Acids) leads to an increase in energy expenditure. Primarily, MCFAs are converted into ketones (our best friends), are absorbed differently in the body compared to regular oils, and give us more overall energy.
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.
Disclaimer: Bulletproof products have been provided to me for the purpose of this review by Bulletproof as free samples. This has not influenced my review and the opinions expressed in this post are my own. Bulletproof is one of the sponsors in our KetoDiet Challenges contributing a package of Ground Coffee, Brain Octane Oil, protein powder, mug and t-shirt to all 5 winners.
Another difference between older and newer studies is that the type of patients treated with the ketogenic diet has changed over time. When first developed and used, the ketogenic diet was not a treatment of last resort; in contrast, the children in modern studies have already tried and failed a number of anticonvulsant drugs, so may be assumed to have more difficult-to-treat epilepsy. Early and modern studies also differ because the treatment protocol has changed. In older protocols, the diet was initiated with a prolonged fast, designed to lose 5–10% body weight, and heavily restricted the calorie intake. Concerns over child health and growth led to a relaxation of the diet’s restrictions.[18] Fluid restriction was once a feature of the diet, but this led to increased risk of constipation and kidney stones, and is no longer considered beneficial.[3]
Like I said already, during the initial adaptation phase of a ketogenic diet, there is potential for the HPA axis to become dysregulated. During this time, it would be advantageous to take precautions to support the HPA axis as best as you can.
When implementing any new diet — not just keto — it’s important to do so safely, and in a way that supports your unique lifestyle. With this in mind, here are two potential side effects you should know about:
Most people on the keto diet need to bump up their daily salt intake by an extra gram or two to avoid side effects like headaches, dizziness and even fainting, says Volek. To eliminate the symptoms caused by salt depletion, Volek suggests drinking broth made with a bouillon cube (which has slightly less than 1 gram of sodium), once or twice a day.
In 1921, Rollin Woodyatt reviewed the research on diet and diabetes. He reported that three water-soluble compounds, β-hydroxybutyrate, acetoacetate and acetone (known collectively as ketone bodies), were produced by the liver in otherwise healthy people when they were starved or if they consumed a very low-carbohydrate, high-fat diet. Russel Wilder, at the Mayo Clinic, built on this research and coined the term ketogenic diet to describe a diet that produced a high level of ketone bodies in the blood (ketonemia) through an excess of fat and lack of carbohydrate. Wilder hoped to obtain the benefits of fasting in a dietary therapy that could be maintained indefinitely. His trial on a few epilepsy patients in 1921 was the first use of the ketogenic diet as a treatment for epilepsy.[10]
One major downside to the ketogenic diet regarding diabetes is that you’re eating a lot of fat, and that fat may be saturated, which is unhealthy. Because people with type 2 diabetes are at an increased risk for cardiovascular disease, there’s concern that the saturated fat in the diet may drive up LDL, or “bad,” cholesterol levels, and further increase the odds of heart problems. If you have type 2 diabetes, talk to your doctor before attempting a ketogenic diet. They may recommend a different weight-loss diet for you, like a reduced-calorie diet. Those with epilepsy should also consult their doctor before using this as part of their treatment plan.
When I first tried MCT oil a while ago, I didn’t know about the potential side effects and digestive discomfort. If you are new to MCTs, make sure you start with a small amount (such as a teaspoon) and gradually add more to avoid stomachache and/ or diarrhoea.
Diabetic ketoacidosis (DKA) is a dangerous metabolic state that is most commonly seen in people with Type 1 diabetes and sometimes Type 2 diabetics if they aren’t properly managing their insulin and diet.
There are a lot of misconceptions about low carb dieting which has caused an infamous outlook on keto. There have been tons of studies published over the last 30 years that show how high amounts of fat and few carbs are beneficial.
Keto is a diuretic. Everytime you urinate you’re losing electrolytes and water. To combat this you can make a nice drink from a bouillion cube (makes a great broth) or by using MiO with Electrolytes and increasing your water intake. The goal is to replace the electrolytes that you’re using.
Make things yourself. While it’s extremely convenient to buy most things pre-made or pre-cooked, it always adds to the price per pound on items. Try prepping veggies ahead of time instead of buying pre-cut ones. Try making your stew meat from a chuck roast. Or, simply try to make your mayo and salad dressings at home. The simplest of things can work to cut down on your overall grocery shopping.
Stephen B. Sondike, MD, Nancy Copperman, MS, RD, Marc S. Jacobson, MD, “Effects Of A Low-Carbohydrate Diet On Weight Loss And Cardiovascular Risk Factor In Overweight Adolescents,” The Journal of Pediatrics: Vol 142, Issue 3: 253-258; March 2003. http://www.sciencedirect.com/science/article/pii/S0022347602402065.
Studies show that aerobic endurance is not decreased with a ketogenic diet[*]. However, athletes who switch to keto might experience limitations in performance at the beginning. This is simply the body adjusting to using fat as its preferred energy source.
“In the beginning, I was terribly worried that I would lose muscle mass because of the low protein intake,” he says. “But, I lost absolutely no muscle and was able to add lean mass to my physique. How is this possible? It’s because ketones have a ‘protein sparing’ effect. So tons of protein is not necessary.”
If this is your first time drinking ketoproof coffee, I suggest taking 1-2 hours or so to drink it down. Normally when people have a large exposure to coconut oil and they’re not used to it, it can make them go to the bathroom quite often. Make sure you build a tolerance to coconut oil before drinking it within a 20 minute time frame.
The common keto side effects that people experience come down to three primary culprits: Hypoglycemia, HPA axis dysfunction, and poor hydration/mineral balance. The following strategies will help prevent these underlying issues and their respective side effects:

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Jump up ^ Wang D, Pascual JM, De Vivo D. Glucose Transporter Type 1 Deficiency Syndrome. In: Adam MP, Ardinger HH, Pagon RA, Wallace SE, Bean LJH, Stephens K, Amemiya A, editors. GeneReviews. Seattle (WA): University of Washington, Seattle; 1993-2018. 2002 Jul 30 [updated 2018 Mar 1]. PMID 20301603.
A lot of people take their macros as a “set in stone” type of thing. You shouldn’t worry about hitting the mark every single day to the dot. If you’re a few calories over some days, a few calories under on others – it’s fine. Everything will even itself out in the end. It’s all about a long term plan that can work for you, and not the other way around.
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