Because people with type 2 diabetes are at an increased risk for cardiovascular disease, there’s a specific 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, to manage diabetes. Those with epilepsy should also consult their doctor before using this as part of their treatment plan.
The classic ketogenic diet is not a balanced diet and only contains tiny portions of fresh fruit and vegetables, fortified cereals, and calcium-rich foods. In particular, the B vitamins, calcium, and vitamin D must be artificially supplemented. This is achieved by taking two sugar-free supplements designed for the patient's age: a multivitamin with minerals and calcium with vitamin D.[18] A typical day of food for a child on a 4:1 ratio, 1,500 kcal (6,300 kJ) ketogenic diet comprises three small meals and three small snacks:[28]

Forget the heavy casserole recipes and try this low-carb pot pie tonight! Nothing says comfort food like a chicken pot pie. This low-carb pot pie recipe skips the traditional gluten-filled dough of chicken pot pies and replaces it with cauliflower for a more low-carb option. I simply suggest switching out the cornstarch with arrowroot or tapioca starch.


Missing Nutrients. One of the biggest concerns for dietitians is the keto diet’s lack of key foods. Many question the eating plan’s impact on the development of certain chronic diseases. Without milk, for example, getting enough calcium and vitamin D for sturdy bones becomes a challenge. Take away whole grains, fruit, beans, and potatoes, and it’s nearly impossible to consume enough potassium for healthy blood pressure or enough fiber to stay regular. And unless you’re eating lots of low-carb, leafy green vegetables, you miss out on vitamins A, C, K, and folate, too. 

^ Freeman JM, Vining EP, Pillas DJ, Pyzik PL, Casey JC, Kelly LM. The efficacy of the ketogenic diet—1998: a prospective evaluation of intervention in 150 children. Pediatrics. 1998 Dec;102(6):1358–63. doi:10.1542/peds.102.6.1358. PMID 9832569. https://web.archive.org/web/20040629224858/http://www.hopkinsmedicine.org/press/1998/DECEMBER/981207.HTM Lay summary]—JHMI Office of Communications and Public Affairs. Updated 7 December 1998. Cited 6 March 2008.
For many people, one of the more surprising side effects of starting a ketogenic diet is a bout with the “keto flu.” How so? “When you go on this diet, your kidneys don’t retain as much salt or water, which can lead to flu-like symptoms, such as fatigue and headache, or constipation,” says Laura Saslow, PhD, an assistant professor at the University of Michigan School of Nursing. “But these are typically short-lived symptoms that can be prevented or treated by increasing your salt and water intake.” However, if you have high blood pressure, speak with your doctor before adding more sodium to your diet. And know that the keto flu only lasts a week or two; symptoms typically subside once the body adjusts to the diet.
A ketogenic diet also has been shown to improve blood sugar control for patients with type 2 diabetes, at least in the short term. There is even more controversy when we consider the effect on cholesterol levels. A few studies show some patients have increase in cholesterol levels in the beginning, only to see cholesterol fall a few months later. However, there is no long-term research analyzing its effects over time on diabetes and high cholesterol.
The keto diet isn’t new, and it’s been around for nearly a century. It was originally developed to treat people with epilepsy. In the 1920s, researchers found that raised levels of ketones in the blood led to fewer epileptic seizures in patients. The keto diet is still used today to treat children with epilepsy who don’t respond well to anti-epileptic drugs.[2]
In 1921, Rollin Turner 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.[10] Dr. Russell Morse 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]

I have been on a low carb keto diet for more than a year. As T2DM my A1C dropped from 9% to 5.4% & I discontinued meds. All my lipids improved even with ample healthy saturated fat. More than a year now so I wonder why this would be a short term improvement when its obvious that I will not go back to a high A1C and taking 3 diabetes medications including sulphonylureas. It is clear from this article that you lack the necessary experience that would be gained from wholeheartedly trying the diet or monitoring patients doing it properly like me. I would be probably be facing my first amputation if I believed the negativity in your article. So for people with diabetes who may be dissuaded by your article. Ignore it and take back your health by restricting carbs (<25 g a day) or as low as you reasonably can below 130g while being satisfied that you are getting adequate nutrition.


Thanks for this post, I am always on the look out for new blogs I haven’t discovered yet and you have provided a couple. I am also on the look out for new dinner recipes ( this is not to say I don’t appreciate your dessert recipes cause boy do I ) but my husband cannot eat red meat of any kind so this makes it even harder to make a low carb dinner for us. I have gotten used to subbing ground turkey for beef and have discovered that using broth from dried porcinis gives it a very beefy flavor. Now I have a few more recipes to try, Thanks for that.
Bread probably isn’t the first thing that comes to mind when you think about the ketogenic diet because it’s generally full of carbs. But, if you replace your store-bought bread with a homemade keto bread recipe, it can fit seamlessly into your keto low-carb, high-fat diet. How does bread even become keto-friendly? With almond flour, a lot of eggs, cream of tartar, butter, baking soda and apple cider vinegar.

The Johns Hopkins Hospital protocol for initiating the ketogenic diet has been widely adopted.[43] It involves a consultation with the patient and their caregivers and, later, a short hospital admission.[19] Because of the risk of complications during ketogenic diet initiation, most centres begin the diet under close medical supervision in the hospital.[9]
Note: Are you a vegetarian or vegan and want to go on a ketogenic diet? It’s still possible! Just keep in mind that the dietary restrictions can sometimes be a little bit intense. Make sure to plan ahead and prepare to aid your success. To help out, we’ve published articles (with 7 day meal plans included) for both the vegetarian ketogenic diet and the vegan ketogenic diet.

Hi, I'm Amanda. I’ve been cooking primal keto and lactopaleo recipes for over a decade, and have developed recipes for top nutrition coaches and ketogenic meal subscription boxes. I'm the author of Keto Life (a guide) and the best-selling Wicked Good Ketogenic Diet Cookbook (a cookbook). Ever heard the phrase,"never trust a skinny chef"? Well, consider me super trustworthy. I will probably never be "skinny," and that’s OK because I’m not here to teach you how to lose weight, my goal is to provide you with awesome recipes. I absolutely adore the ketogenic lifestyle, and it has helped me overcome a number of health issues. I hope my recipes help you do the same, while eatin’ good!
This may require a lifestyle change for many families, so we advise families who are interested in the diet to learn more by reading some of our excellent printed resources and to talk to each person who regularly cares for the child to make sure there is agreement to try the diet. We usually encourage an appointment with one of our epileptologists to confirm that the diet is right for your child, and then an appointment with our ketogenic diet team to go over more of the details.
^ Freeman JM, Vining EP, Pillas DJ, Pyzik PL, Casey JC, Kelly LM. The efficacy of the ketogenic diet—1998: a prospective evaluation of intervention in 150 children. Pediatrics. 1998 Dec;102(6):1358–63. doi:10.1542/peds.102.6.1358. PMID 9832569. https://web.archive.org/web/20040629224858/http://www.hopkinsmedicine.org/press/1998/DECEMBER/981207.HTM Lay summary]—JHMI Office of Communications and Public Affairs. Updated 7 December 1998. Cited 6 March 2008.

Despite the fact that your child will be mostly eating fats, they won’t gain weight. The portions for every item at every meal are extremely precise; one of our dietitians will plan meals for your child with set ratios that should be followed as closely as you would a dosage of medication. Daily meals are also balanced with physical exercise when medically possible.
I have been on a low carb keto diet for more than a year. As T2DM my A1C dropped from 9% to 5.4% & I discontinued meds. All my lipids improved even with ample healthy saturated fat. More than a year now so I wonder why this would be a short term improvement when its obvious that I will not go back to a high A1C and taking 3 diabetes medications including sulphonylureas. It is clear from this article that you lack the necessary experience that would be gained from wholeheartedly trying the diet or monitoring patients doing it properly like me. I would be probably be facing my first amputation if I believed the negativity in your article. So for people with diabetes who may be dissuaded by your article. Ignore it and take back your health by restricting carbs (<25 g a day) or as low as you reasonably can below 130g while being satisfied that you are getting adequate nutrition.
What about fruits and vegetables? All fruits are rich in carbs, but you can have certain fruits (usually berries) in small portions. Vegetables (also rich in carbs) are restricted to leafy greens (such as kale, Swiss chard, spinach), cauliflower, broccoli, Brussels sprouts, asparagus, bell peppers, onions, garlic, mushrooms, cucumber, celery, and summer squashes. A cup of chopped broccoli has about six carbs.
No animal on earth lives permanently in ketosis. Omnivorous animals such as bears and dogs, and obligate carnivores such as cats – the ultimate low-carbers – use gluconeogenesis to transform amino acids from protein into glucose[1]. This allows them to maintain optimal blood glucose levels to fulfill their bodies’ needs for this vital nutrient. Only in prolonged starvation or a diabetic state will these animals enter ketosis.
Tea and coffee, including Bulletproof Coffee, are completely ketogenic, with bonus points for jump-starting weight loss and focusing your mental clarity. Watch out for sweeteners, fillers, or artificial flavors. While you can drink unsweetened, plant-based milk alternatives in moderation without going out of ketosis, they are not Bulletproof, and are usually loaded with toxic molds — the exception being full-fat coconut milk.[4] If you plan to include them in your diet, beware of carrageenan and BPA-lined containers.

Some keto cookies or a keto brownie can certainly be delicious, but if you’re looking for a dessert that’s a little more interesting, then you have to try this chocolate chia pudding! I love chia seeds for a number of reasons. They’re high in antioxidants, vitamins such as calcium, potassium and magnesium, Omega-3 ALA, dietary fiber and even protein. So, while this dish feels like a dessert, you’re receiving plenty of necessary nutrients. Enjoy guilty-free!
To minimize the risk of hypoglycemia, Yancy and his team decrease medication as soon as a patient starts the diet. While drugs like metformin and liraglutide (Victoza) are less of a concern, there are others that pose a substantial hypoglycemia threat. In addition to insulin, the sulfonylurea drugs glipizide and glyburide require a watchful eye, as they work by stimulating the pancreas to make more insulin, increasing the risk of dangerous lows in the face of insufficient carbohydrate intake. “People on this diet need to be prepared to check their blood glucose any time they feel like it could be getting too low,” says Urbanski. “I would say a minimum of twice a day, but ideally three to four times a day, at least in the beginning in order to see the effect of the diet on their blood glucose readings.”
No deep fryers or air fryers needed for these wings! Forget those greasy chicken wings you’d order at a restaurant and opt-in for these homemade guiltless garlic parmesan wings. You won’t find rancid vegetable oil, gluten or a deep frier here — just avocado oil, healthy pecorino romano and free-range, organic chicken for a twist on an otherwise unhealthy classic.
In 1921, Rollin Turner 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.[10] Dr. Russell Morse 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]
A ketogenic diet helps control blood sugar levels. It is excellent for managing type 2 diabetes, sometimes even leading to complete reversal of the disease. This has been proven in studies. It makes perfect sense since keto lowers blood-sugar levels, reduces the need of medications and reduces the potentially negative impact of high insulin levels.
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