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The Ketogenic Diet: A Comprehensive Beginner’s Guide to Keto

A keto diet is a good way to become thin and healthy (1^, 2^, 3^, 4^, 5^).

Studies show that the keto diet can help you lose weight as much as a low fat diet (13^, 14^, 15^).

Also, the diet makes you feel full so you can eat less without counting calories or checking your food (16^).

One review of 13 studies found that following a very low carb, keto diet was a little better for long-term weight loss than a low fat diet. People who followed the keto diet lost an average of 2 pounds (0.9 kg) more than the group that followed a low fat diet (13^).

Also, it helped lower blood pressure and fat levels in the blood (13^).

Another study in 34 older adults found that those who followed a keto diet for 8 weeks lost almost five times as much total body fat as those who followed a low fat diet (17^).

The higher levels of ketones, lower blood sugar levels, and better insulin use may also help (18^, 19^).

For more details on how the keto diet helps you lose weight, read this article.

**A keto diet can help you lose more weight than a low fat diet. This often happens with less hunger.**

Keto diets for diabetes and prediabetes
Diabetes is when your body changes how it uses energy, has high blood sugar, and has problems with insulin (20^).

The keto diet can help you lose extra fat, which is linked to type 2 diabetes, prediabetes, and metabolic syndrome (21^, 22^, 23^, 24^).

One old study found that the keto diet made insulin use better by 75% (25^).

A small study in women with type 2 diabetes also found that following a keto diet for 90 days greatly lowered levels of hemoglobin A1C, which is a way to measure long-term blood sugar control (26^).

Another study in 349 people with type 2 diabetes found that those who followed a keto diet lost an average of 26.2 pounds (11.9 kg) over a 2-year period. This is important when we think about the link between weight and type 2 diabetes (24^, 27^).

Also, they had better blood sugar control, and some people needed less blood sugar medicine after the study (27^).

For more information, check out this article on how low carb diets help people with diabetes.

**The keto diet can make insulin use better and cause fat loss, leading to big health benefits for people with type 2 diabetes or prediabetes.**
Other health benefits of keto
The keto diet started as a way to treat brain diseases like epilepsy.

Studies have now shown that the diet can have benefits for many different health problems:

• Heart disease. The keto diet can help improve things like body fat, HDL (good) cholesterol levels, blood pressure, and blood sugar (28^, 29^).
• Cancer. The diet is now being studied as an extra treatment for cancer, because it may help slow down tumor growth. (4^, 30^, 31^).
• Alzheimer’s disease. The keto diet may help lower symptoms of Alzheimer’s disease and slow down how fast it gets worse (5^, 32^, 33^).
• Epilepsy. Research has shown that the keto diet can cause big drops in seizures in kids with epilepsy (3^).
• Parkinson’s disease. More research is needed, but one study found that the diet helped improve symptoms of Parkinson’s disease (34^).
• Polycystic ovary syndrome. The keto diet can help lower insulin levels, which may play a key role in polycystic ovary syndrome (35^, 36^).
• Brain injuries. Some research suggests that the diet could make outcomes of brain injuries better (37^).But remember that research into many of these areas is not done yet.

**A keto diet may give many health benefits, especially with problems related to how your body uses energy or your brain works.**

Foods to avoid
Any food that has a lot of carbs should be limited.

Here’s a list of foods that need to be reduced or removed on a keto diet:

• sweet foods: soda[^a soft drink made with carbonated water and flavored syrup], fruit juice[^a drink made from fruit], smoothies[^a thick drink made from fruit and yogurt or milk], cake[^a sweet baked food made from flour and eggs], ice cream[^a frozen dessert made from cream and sugar], candy[^a sweet food made from sugar or chocolate], etc.
• grains[^seeds from plants like wheat or rice] or starches[^a type of carbohydrate found in potatoes or corn]: wheat-based products[^foods made from wheat], rice[^seeds from a grass plant], pasta[^a food made from flour and water], cereal[^a breakfast food made from grains], etc.
• fruit: all fruit[^the sweet part of a plant that contains seeds], except small parts of berries[^small round fruits] like strawberries
• beans[^seeds from plants] or legumes[^plants that have pods with seeds inside]: peas[^green seeds eaten as vegetables], kidney beans[^red beans shaped like kidneys], lentils[^small round seeds eaten as food], chickpeas[^round yellow seeds also called garbanzo beans], etc.
• root vegetables[^vegetables that grow under the ground] and tubers[^thick underground stems]: potatoes[^round white vegetables], sweet potatoes[^orange vegetables similar to potatoes], carrots[^long orange vegetables], parsnips[^long white vegetables similar to carrots], etc.
• low fat or diet products: low fat mayonnaise[^a thick sauce made from eggs and oil], salad dressings[^sauces for salads], and condiments[^sauces for adding flavor]
• some condiments or sauces: barbecue sauce[^a sweet and spicy sauce for grilled meat], honey mustard[^a sauce made from honey and mustard], teriyaki sauce[^a Japanese sauce made from soy sauce and sugar], ketchup[^a red sauce made from tomatoes], etc.
• bad fats: processed vegetable oils[^oils made from plants by using chemicals or heat], mayonnaise[^see above], etc.
• alcohol: beer[^an alcoholic drink made from grains], wine[^an alcoholic drink made from grapes], liquor[^a strong alcoholic drink], mixed drinks
• sugar-free diet foods: sugar-free candies[^see above but without sugar], syrups[^thick sweet liquids], puddings[^soft sweet desserts], sweeteners[^substances used instead of sugar], desserts[^sweet foods eaten after a meal], etc.

**Avoid foods based on carbs like grains, sugars, beans, rice, potatoes, candy, juice, and even most fruits.**
Foods to eat
You should make most of your meals around these foods:

• meat: red meat^[meat that is dark-colored before cooking like beef or lamb], steak^[a thick piece of meat or fish], ham^[meat from the back leg of a pig], sausage^[meat in a thin tube of skin], bacon^[thin slices of meat from the side of a pig], chicken^[a bird raised for its meat and eggs] , and turkey^[a large bird similar to a chicken]
• fatty fish: salmon^[a large fish with pink flesh], trout^[a fish with spots on its body], tuna^[a large fish with dark red flesh] , and mackerel^[a fish with green skin and dark stripes]
• eggs: pastured^[from animals that are allowed to eat grass] or omega-3^[a type of healthy fat] whole eggs
• butter^[a solid yellow fat made from cream] and cream^[the thick part of milk]: grass-fed butter^[butter from cows that eat grass] and heavy cream
• cheese: unprocessed cheeses^[cheeses that are not changed by adding chemicals or heat] like cheddar^[a hard yellow cheese] , goat^[cheese made from goat milk] , cream^[cheese with a soft texture] , blue^[cheese with blue mold on it] , or mozzarella^[a soft white cheese]
• nuts^[hard fruits with one seed] and seeds: almonds^[nuts with brown skin] , walnuts^[nuts with wrinkled shells] , flaxseeds^[brown seeds used for making oil] , pumpkin seeds^[white seeds from pumpkins] , chia seeds^[small black seeds used for making drinks] , etc.
• healthy oils: extra virgin olive oil^[oil made from olives without using heat or chemicals] , avocado oil^[oil made from avocados]
• avocados: whole avocados or freshly made guacamole^[a sauce made from avocados]
• low carb veggies: green veggies^[vegetables that are green in color like spinach or broccoli] , tomatoes^[red fruits used as vegetables] , onions^[round vegetables with layers and a strong smell] , peppers^[vegetables with different colors and spicy flavors] , etc.
• condiments: salt^[white crystals used for seasoning food] , pepper^[black powder used for seasoning food] , herbs^[plants used for flavoring food like basil or mint] , and spices^[substances used for flavoring food like cinnamon or ginger]

It’s best to base your eating mostly on whole foods that have one ingredient. Here’s a list of healthy low carb foods.

**Make most of your diet on foods such as meat, fish, eggs, butter, nuts, healthy oils, avocados, and plenty of low carb veggies.**
A sample keto meal plan for 1 week
To help you start, here’s a sample keto diet meal plan for one week:

• breakfast: veggie and egg muffins with tomatoes
• lunch: chicken salad with olive oil, feta cheese^[a soft white cheese], olives^[small fruits with pits], and a side salad
• dinner: salmon with asparagus^[green vegetables with long stems] cooked in butter

• breakfast: egg, tomato, basil^[an herb with a strong smell], and spinach^[a green leafy vegetable] omelet^[eggs cooked with other ingredients]
• lunch: almond milk^[milk made from almonds], peanut butter^[a paste made from peanuts], spinach, cocoa powder^[a brown powder made from chocolate], and stevia^[a sweetener from a plant] milkshake^[a cold drink made from milk and other ingredients] (more keto smoothies here) with a side of sliced strawberries
• dinner: cheese-shell tacos^[a Mexican dish with cheese instead of bread] with salsa^[a spicy sauce made from tomatoes and peppers]

• breakfast: nut milk chia pudding^[a dessert made from nut milk and chia seeds] topped with coconut^[a large fruit with a hard shell and white flesh] and blackberries^[dark purple berries]
• lunch: avocado shrimp salad^[a dish with avocado, shrimp and greens]
• dinner: pork chops^[pieces of meat from a pig] with Parmesan cheese^[a hard cheese with a strong flavor], broccoli^[a green vegetable with small flowers], and salad

• breakfast: omelet with avocado, salsa, peppers, onion, and spices
• lunch: a handful of nuts and celery sticks^[long pieces of a green vegetable] with guacamole and salsa
• dinner: chicken stuffed with pesto^[a sauce made from basil and nuts] and cream cheese, and a side of grilled zucchini^[a long green vegetable]

• breakfast: sugar-free Greek, whole milk yogurt^[a thick dairy product] with peanut butter, cocoa powder, and berries
• lunch: ground beef lettuce wrap tacos with sliced bell peppers
• dinner: loaded cauliflower^[a white vegetable like broccoli] and mixed veggies

• breakfast: cream cheese pancakes^[thin cakes made from flour and eggs] with blueberries^[small blue fruits] and a side of grilled mushrooms
• lunch: Zucchini and beet “noodle” salad
• dinner: white fish cooked in olive oil with kale^[a green leafy vegetable] and toasted pine nuts

• breakfast: fried eggs with bacon and mushrooms
• lunch: low carb sesame chicken and broccoli
• dinner: spaghetti squash Bolognese

Always try to change the vegetables and meat over the long time, as each type gives different nutrients and health benefits.

For many recipes, check out these 101 healthy low carb recipes and this keto shopping list.

**You can eat a lot of tasty and healthy meals on a keto diet. It’s not all meats and fats. Vegetables are an important part of the diet.**

Healthy keto snacks
In case you get hungry between meals, here are some healthy, keto-approved snacks:

• fatty meat or fish
• cheese
• a handful of nuts or seeds
• keto sushi bites
• olives
• one or two hard-boiled or deviled eggs
• keto-friendly snack bars
• 90% dark chocolate
• full-fat Greek yogurt mixed with nut butter and cocoa powder
• bell peppers and guacamole
• strawberries and plain cottage cheese^[a soft cheese with small lumps]
• celery with salsa and guacamole
• beef jerky^[dried meat cut into thin strips]
• smaller portions of leftover meals
• fat bombs

**Great snacks for a keto diet include pieces of meat, cheese, olives, boiled eggs, nuts, raw veggies, and dark chocolate.**

Keto tips and tricks
Although starting on the keto diet can be hard, there are some tips and tricks that you can use to make it easier.

• Start by learning about food labels and checking the grams of fat, carbs, and fiber to see how your favorite foods can fit into your diet.
• Planning out your meals before may also be helpful and can save you extra time throughout the week.
• Many websites, food blogs, apps, and cookbooks also offer keto-friendly recipes and meal ideas that you can use to make your own custom menu.
• Some meal delivery services also offer keto-friendly options for a quick and easy way to enjoy keto meals at home.
• Look into healthy frozen keto meals when you’re short on time
• When going to social events or visiting family and friends, you may also want to think about bringing your own food, which can make it much easier to avoid cravings[^strong desires for something] and stick to your meal plan.

**Reading food labels, planning your meals ahead, and bringing your own foods when visiting family and friends can make it much easier to stick to the keto diet.**

Tips for eating out on a keto diet
Many restaurant meals can be made keto-friendly.

Most restaurants offer some kind of meat or fish-based dish. Order this and replace any high carb food with extra vegetables.

Egg-based meals are also a great option, such as an omelet or eggs and bacon.

Another favorite is bun-less burgers^[burgers without bread]. You could also swap the fries for vegetables instead. Add extra avocado, cheese, bacon, or eggs.

At Mexican restaurants, you can enjoy any type of meat with extra cheese, guacamole, salsa, and sour cream^[a thick dairy product with a sour taste].

For dessert, ask for a mixed cheese board or berries with cream.

**When eating out, choose a meat-, fish-, or egg-based dish. Order extra veggies instead of carbs or starches^[see above], and have cheese for dessert.**

Side effects and how to reduce them
Although the keto diet is usually safe for most healthy people, there may be some first side effects while your body changes.

There’s some talk of these effects often called the keto flu (38^). Based on reports from some on the eating plan, it’s usually over within a few days.

Reported keto flu symptoms include diarrhea^[when you have to go to the bathroom too often and your poop is watery], constipation^[when you have trouble going to the bathroom and your poop is hard], and vomiting^[when you throw up] (39^). Other less common symptoms include:

• bad energy and mental function
• more hunger
• sleep problems
• nausea^[when you feel like you want to throw up]
• digestive discomfort
• worse exercise performance

To reduce this, you can try a regular low carb diet for the first few weeks. This may teach your body to burn more fat before you completely remove carbs.

A keto diet can also change the water and mineral balance of your body, so adding extra salt to your meals or taking mineral supplements may help. Talk to your doctor about what you need.

At least in the beginning, it’s important to eat until you’re full and avoid eating too little. Usually, a keto diet causes weight loss without trying to eat less.

**Many of the side effects of starting a keto diet can be reduced. Going slowly into the diet and taking mineral supplements can help.**

Risks of the keto diet
Staying on the keto diet in the long time may have some bad effectsTrusted Source, including risks of the following:

• low protein in the blood
• extra fat in the liver
• kidney stones^[hard pieces of minerals that form in your kidneys]
• not enough micronutrients^[vitamins and minerals that your body needs in small amounts]

A type of medicine called sodium-glucose cotransporter 2 (SGLT2) inhibitors for type 2 diabetes can increase the risk for diabetic ketoacidosis^[a dangerous condition that makes your blood too acidic]. Anyone taking this medicine should avoid the keto diet (40^, 41^).

More research is being done to see if the keto diet is safe in the long time. Keep your doctor informed of your eating plan and goals to decide if a keto eating plan right for you.

**There are some side effects to the keto diet that you should talk to your doctor about if you plan to stay on the diet long time.**

Supplements for a keto diet
Although no supplements are needed, some can be useful.

• MCT oil^[oil made from medium-chain triglycerides, which are types of fat]. Added to drinks or yogurt^[see above], MCT oil gives energy and helps increase ketone levels. Shop for MCT oil online (42^, 43^).
• Minerals. Added salt and other minerals can be important when starting out because of changes in water and mineral balance (44^).
• Caffeine^[a substance that makes you feel more awake]. Caffeine can have benefits for energy, fat loss, and performance (45).
• Exogenous ketones^[ketones that are made outside of your body]. This supplement may help raise the body’s ketone levels (46^).
• Creatine^[a substance that helps your muscles work better]. Creatine gives many benefits for health and performance. This can help if you are combining a keto diet with exercise (47^).
• Whey^[a type of protein from milk]. Use half a scoop of whey protein in shakes or yogurt to increase your daily protein intake (48^, 49^). Shop for tasty whey products on online.

**Some supplements can be helpful on a keto diet. These include exogenous ketones, MCT oil, and minerals.**

Frequently asked questions
Here are answers to some of the most common questions about the keto diet.

1. Can I ever eat carbs again?

Yes. However, it’s important to greatly lower your carb intake at first. After the first 2 to 3 months, you can eat carbs on special occasions — just go back to the diet right after.

2. Will I lose muscle?

There’s a chance of losing some muscle on any diet. However, protein intake and high ketone levels may help protect muscle loss, especially if you lift weights (50^, 51^).

3. Can I build muscle on a keto diet?

Yes, but it may not work as well as on a moderate carb diet (52^, 53^). For more details about low carb or keto diets and exercise performance, read this article.

4. How much protein can I eat?

Protein should be moderate^[not too much or too little], as a very high intake can make insulin levels go up and lower ketones. Around 35% of total calorie intake is probably the upper limit.

5. What if I am always tired, weak, or tired?

You may not be in full ketosis or be using fats and ketones well. To fix this, lower your carb intake and check the points above. A supplement like MCT oil or ketones may also help (42^, 43^).

6. My urine smells fruity. Why is this?

Don’t worry. This is simply because of getting rid of by-products made during ketosis (54^).

7. My breath smells bad. What can I do?

This is a common side effect. Try drinking water with natural flavors or chewing sugar-free gum.

8. I heard ketosis was very dangerous. Is this true?

People often mix up ketosis with ketoacidosis[^see above]. Ketoacidosis is dangerous, but ketosis on a keto diet is usually fine for healthy people. Talk to your doctor before starting any new diet.

9. I have digestion problems and diarrhea[^see above]. What can I do?

This common side effect usually goes away after 3 to 4 weeks. If it stays, try eating more high fiber veggies (55^, 56).

**A ketogenic diet can be great for people who:

• are overweight
• have diabetes
• want to improve their metabolic health

It may be less good for people who want to add a lot of muscle or weight.

It may also not be good for some people’s lifestyles and choices. Speak with your doctor about your eating plan and goals to see if a keto eating plan right for you.

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