This answer made me sad. Having lived in New York all of my life, I from a young age saw loved ones fall victim to spontaneous gluten intolerance and restaurants run to their rescue with accommodating menus.  This is why I get annoyed. What’s a dietary prescription for someone who wants to go to a dinner party and be able to eat a meal that was prepared for them? Keto is cultish not for its members’ radical commitment to a dietary restriction but for their lack of full participation in the outside world.
More good news: Snacks are totally allowed (and I'm not just talking about carrot sticks). There are plenty of packaged options out there designed for keto fans. FATBAR is one of them. These snack bars have 200 calories, 16 grams of fat, and four grams of net carbs. They're also plant-based and are made with almond or cashew butter, cocoa butter, coconut, pea protein, sunflower seeds, and chia seeds.
There are a few ways of pushing your body into ketosis, including sustained periods of fasting and following a ketogenic diet (as the name so obviously suggests).  Dr. D’Agostino also suggests spending some time in the sun and heat.  Getting out in the sun lowers glucose and raises ketones, and can push you into ketosis, especially if you’ve been fasting.

People claiming huge benefits of these supplements – despite the lack of solid scientific support – may sometimes have a financial reason to believe in the supplements. Some of these products are sold under a multi-level marketing arrangement, where sales people are paid based on commission. For example, the company Prüvit sells drinkable ketones, called KETO//OS with a multi-level marketing structure.


A high-fat diet also trains your body to burn even more fat during exercise, even at high intensities. Fat is released faster and in greater amounts from your storage adipose tissue and transported more quickly into your muscles and mitochondria. Your muscles also store more energy as fat and use this fat-based fuel more efficiently and quickly. Even more interestingly, a high-fat diet can cause a shift in the gene expression that codes for specific proteins that increase fat metabolism – and create very similar adaptations to exercise itself. So the mere act of shifting primary fuel intake from carbohydrates to fat begins to make you more “fit”, even if you’re not exercising.
In addition, most studies that compare carbohydrate utilization with fat utilization fail to take into account the fact that full “fat adaptation” that allows you to gain all the benefits of using fat as a fuel actually takes time – often more than four weeks – and up to a couple years. But since most studies that compare fat and carbohydrate burning are short-term, you rarely see the benefits of this kind of fat adaptation actually fleshed out in research. Instead, the average research participant begins the study in a non-fat adapted state, gets either a high fat or high carb diet, then launches into exercise. But in an ideal study, that person would have followed either a high-fat or high-carb diet for many months before getting their fat burning capability investigated.
^ Fumagalli M, Moltke I, Grarup N, Racimo F, Bjerregaard P, Jørgensen ME, Korneliussen TS, Gerbault P, Skotte L, Linneberg A, Christensen C, Brandslund I, Jørgensen T, Huerta-Sánchez E, Schmidt EB, Pedersen O, Hansen T, Albrechtsen A, Nielsen R (September 2015). "Greenlandic Inuit show genetic signatures of diet and climate adaptation". Science. 349 (6254): 1343–7. Bibcode:2015Sci...349.1343F. doi:10.1126/science.aab2319. hdl:10044/1/43212. PMID 26383953.
Amazing article – gonna have to print it and read it again. To much to break down in one sitting. Thanks Ben – you’ve pulled together so much insight and references that’s given me greater confidence and conviction. I’m 50 and use to be super active and a seasoned athlete but after a few ‘mid life surgical interventions’ I had to find a better way… Ketogenics has been that for me… no more inflammation… I can’t tell you how great it’s been to be pain free! Keep leading from the front.
^ Bechtel PJ (2 December 2012). Muscle as Food. Elsevier Science. pp. 171–. ISBN 978-0-323-13953-3. Retrieved 19 May 2014. Freezing does stop the postmortem metabolism but only at about −18ºC and lower temperatures. Above −18ºC increasing temperatures of storage cause an increasing rate of ATP breakdown and glycolysis that is higher in the comminuted meat than in the intact tissue (Fisher et al., 1980b). If the ATP concentration in the frozen tissue falls below ~ 1 µmol/g no contraction or rigor can occur because they are prevented by the rigid matrix of ice.
Variations on the Johns Hopkins protocol are common. The initiation can be performed using outpatient clinics rather than requiring a stay in hospital. Often, no initial fast is used (fasting increases the risk of acidosis, 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]
^ 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.
I just discovered your site and have been thoroughly enjoying many of the articles and appreciate that you get so in depth in your explanations. I’m in my late 40’s and, while not an extreme endurance athlete, I am moderately active with 18-20 mile rides 3x a week as well as some boxing and body weight resistance (push up, pull up, etc) mixed in. I’ve generally been paleo and stick to quality macros for the most part (grass fed meats/dairy, organic veg and oils) and zero supplements. I recently started following keto (after reading this article) about 10 days ago and things seem good thus far. I do, however, want to avoid any of the negative side effects you mention and also not lose any lean muscle. I’m currently about 174 lbs, 5’8″ and about 19% bodyfat – I’m taking in about 95g protein, 130g fat and <20g net carbs. I'm eating all quality – wild salmon, grass fed beef, pastured eggs, coconut oil, Brain Octane and Grass fed butter in coffee, sardines, etc. With a smattering of organic veg, but it seems real easy to bust through the carb barrier. *I'M ALSO TAKING KETOCANA PRE-WORKOUT* and I notice this is keeping me going throughout a ride or the gym.
Thanks for all of the great info!! I have Hashimoto’s and would really like to try a high fat/low carb diet. You mentioned that this might not be a good option for people with thyroid issues. How do you recommend I modify my diet to lose weight taking into consideration the Hashimoto’s. I take Westhroid, a non-synthetic thyroid supplement to help with my sluggish thyroid. Thanks so much for any advice you can give me. :)
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.

Next, you need to ease yourself into this stuff. As I mentioned earlier, KETO//OS is blended with MCT’s, which can cause digestive distress if you’re not used to consuming them. This is due to the fact that your body has not yet adapted to the increased fats in your diet, and is less efficient at utilizing ketones as its fuel source. Once your body has adapted to MCT in the diet, the digestive distress will resolve.  But I recommend you start slowly with just about a half a serving a day, and over two weeks, build up to a full serving twice a day.
About 20% of children on the ketogenic diet achieve freedom from seizures, and many are able to reduce the use of anticonvulsant drugs or eliminate them altogether.[18] Commonly, at around two years on the diet, or after six months of being seizure-free, the diet may be gradually discontinued over two or three months. This is done by lowering the ketogenic ratio until urinary ketosis is no longer detected, and then lifting all calorie restrictions.[46] This timing and method of discontinuation mimics that of anticonvulsant drug therapy in children, where the child has become seizure-free. When the diet is required to treat certain metabolic diseases, the duration will be longer. The total diet duration is up to the treating ketogenic diet team and parents; durations up to 12 years have been studied and found beneficial.[9]

1. If a set number ketones in the blood is an indicator that my body has transitioned to ketosis and not necessarily the cause (the cause being limited access to glycogen because of limited carb intake) then how does using exogenous ketones put me in ketosis as opposed to mimic being in ketosis (because when measuring blood ketones suddenly there are more because I put them there, I didn’t create them)?


The Dr. Formulated Keto line of products is fully transparent, compliant to the keto guidelines and designed to be convenient—we’ve done the math for you—just mix. Crafted for those seeking to enter into ketosis or stick to a low-carbohydrate diet for weight loss and health purposes, all Dr. Formulated products are Keto Certified, Paleo Friendly and clean: Non-GMO Project Verified and Truly Grass Fed.
The Inuit are often cited as an example of a culture that has lived for hundreds of years on a low-carbohydrate diet.[42] However, in multiple studies the traditional Inuit diet has not been shown to be a ketogenic diet.[43][44][45][46] Not only have multiple researchers been unable to detect any evidence of ketosis resulting from the traditional Inuit diet, but the ratios of fatty-acid to glucose were observed at well below the generally accepted level of ketogenesis.[44][47][45][46] Furthermore, studies investigating the fat yields from fully dressed wild ungulates, and the dietary habits of the cultures who rely on them, suggest that they are too lean to support a ketogenic diet.[48][49] With limited access to fat and carbohydrates, cultures such as the Nunamiut Eskimos—who relied heavily on caribou for subsistence—annually traded for fat and seaweed with coastal-dwelling Taremiut.[48]
Yes, the carb backloading approach can definitely help. Honestly I have SO MANY ARTICLES here on the site about sleep. Just go ahead and use the search bar for sleep and you'll find a plethora of info. For targeted sleep advice, I'd be happy to help you via a personal one-on-one consult. Just go to https://bengreenfieldfitness.com/coaching. and then choose a 20 or 60 minute consult, whichever you'd prefer. I can schedule ASAP after you get that.

Would be curious to receive feedback on any of the above! And if anyone is interested in more info on my future Ketone product which will taste great, have 11.7g of BHB, 30 servings and priced lower than all the competitors, then message me on FB under Rhys Kabra, or email [email protected] for status updates on the upcoming new Brand of Ketone products! :)


Before you consume a BHB salt, these individual components are held together by ionic bonds. However, when you consume a supplement containing a BHB salt, it is absorbed into the blood where it dissociates into free sodium (Na+), potassium (K+), and finally, the actual ketone. This means that consuming a product containing a BHB directly and immediately puts ketones into your blood, without the need for you to eat tons of fats or engage in carbohydrate restriction or fasting to generate the ketones.

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.

I am not a doctor and this is not to be taken, interpreted or construed as medical advice. Please talk with a licensed medical professional about this. These are just my own personal thoughts and not a prescription or a diagnosis or any form of health care whatsoever. Your mother can avoid the "keto flu" by adding sufficient sodium to her diet and staying well hydrated, especially in the first few days of starting to reduce carbohydrates. The keto flu could also be called “carbohydrate withdrawal symptoms” because of the effects on hormonal and electrolyte balance. If you're not already using a device to measure ketones in your body, I recommend this one: https://bengreenfieldfitness.com/ketonix As far as how much to take, it all depends….you can actually do more than two servings per day if you want, and you can experiment to see how many servings your body should handle. You should know that it would be very difficult to overdose on ketones. They are water soluble, so any excess ketones will be eliminated mainly via the urine. Hope this helps!
Probably, and there are a few reasons why the keto diet usually equals weight-loss gold, says Keatley. For starters, people usually reduce their daily caloric intake to about 1,500 calories a day because healthy fats and lean proteins make you feel fuller sooner—and for a longer period of time. And then there’s the fact that it takes more energy to process and burn fat and protein than carbs, so you're burning slightly more calories than you did before. Over time, this can lead to weight loss.
In Asia, the normal diet includes rice and noodles as the main energy source, making their elimination difficult. Therefore, the MCT-oil form of the diet, which allows more carbohydrate, has proved useful. In India, religious beliefs commonly affect the diet: some patients are vegetarians, will not eat root vegetables or avoid beef. The Indian ketogenic diet is started without a fast due to cultural opposition towards fasting in children. The low-fat, high-carbohydrate nature of the normal Indian and Asian diet means that their ketogenic diets typically have a lower ketogenic ratio (1:1) than in America and Europe. However, they appear to be just as effective.[54]

Keep up electrolytes. The major electrolytes in our bodies are sodium, potassium and magnesium. Because a low carb diet (especially a keto diet!) reduces the amount of water you store, this can flush out electrolytes and make you feel sick (called “keto flu”). This is temporary, but you can avoid or eliminate it by salting your food liberally, drinking broth (especially bone broth), and eating pickled vegetables. Some people also choose to take supplements for electrolytes, but it’s best to first consult a doctor that understands and supports keto/low carb lifestyles.
Some people on a keto or low carb diet choose to count total carbs instead of net carbs. This makes it more difficult to fit in more leafy greens and low carb vegetables (which are filled with fiber), so you should only try that if you don’t get results with a net carb method. And, start with reducing sugar alcohols and low carb treats before deciding to do a “total carbs” method.

Drink lots of water. This is especially crucial on a low carb or keto diet. Why? When you eat carbohydrates, your body stores the extra as glycogen in the liver, where they are bound to water molecules. Eating low carb depletes this glycogen, which allows you to burn fat – but it also means you are storing less water, making it easier to get dehydrated. Instead of the traditional recommendation of 8 cups of water per day, aim for 16 cups when following a low carb lifestyle.

Because the ketogenic diet alters the body's metabolism, it is a first-line therapy in children with certain congenital metabolic diseases such as pyruvate dehydrogenase (E1) deficiency and glucose transporter 1 deficiency syndrome,[35] which prevent the body from using carbohydrates as fuel, leading to a dependency on ketone bodies. The ketogenic diet is beneficial in treating the seizures and some other symptoms in these diseases and is an absolute indication.[36] However, it is absolutely contraindicated in the treatment of other diseases such as pyruvate carboxylase deficiency, porphyria, and other rare genetic disorders of fat metabolism.[9] Persons with a disorder of fatty acid oxidation are unable to metabolise fatty acids, which replace carbohydrates as the major energy source on the diet. On the ketogenic diet, their bodies would consume their own protein stores for fuel, leading to ketoacidosis, and eventually coma and death.[37]

The diet is extremely regimented and very difficult to stick to, as just one baked potato and one slice of bread could hold an entire day’s worth of carbohydrates. While this is a deterrent for many, Christy Brissette, RD, a private-practice dietitian in Chicago, notes that many of her patients like the diet because of its strictness. “Some of my clients feel that the keto diet works for them because it doesn't involve any calorie counting and the rules are simple to understand,” she says. “They feel they have strict parameters that can take the guesswork out of dieting.”
The ketogenic diet is a medical nutrition therapy that involves participants from various disciplines. Team members include a registered paediatric dietitian who coordinates the diet programme; a paediatric neurologist who is experienced in offering the ketogenic diet; and a registered nurse who is familiar with childhood epilepsy. Additional help may come from a medical social worker who works with the family and a pharmacist who can advise on the carbohydrate content of medicines. Lastly, the parents and other caregivers must be educated in many aspects of the diet for it to be safely implemented.[5]
3) Cholesterol levels usually go up with inflammation, because inflammation causes damage to the tissues, and cholesterol is manufactured and released in circulation to patch things up. So, again, eating high fat is the best way to drop inflammation; not increase it. My hsCRP are always below 0.1, and most of the time, below detection level. Oxidation of cholesterol causes inflammation; not the other way around. So, your point about inflammation is a non-issue.
I was thinking of buying exogenous ketones for my mother. She plays golf daily but gained some weight as of late. My mother does not want to do the diet but I was thinking this might help her with energy and losing weight. Another person told me it would help her. But then I got to thinking, if she went into Ketosis, then wouldn’t she get the keto flu rather than get energy and mental clarity? Would I need to tell her to take it everyday?
Watermelon is a staple summer fruit and another low-carb way to help satisfy your sweet tooth on keto. Each ½ cup of diced watermelon has 5.4 g of net carbs. It’s also an acceptable choice when dieting because of its high water content. The ½ cup serving size of watermelon has about 23 calories and 4.7 g of sugar. This juicy fruit also offers 432 IU of vitamin A, which is 8.6 percent of the DV.
Hi Ben, I have a question about being in ketosis. So from what I understand, a serving of Keto os will keep you in ketosis for about 4-6 hours or so……my question is doesn’t your body have to be in constant ketosis in order to really experience the benefits of using the fat as fuel? Also, if someone is not following the Keto diet, what happens to the glucose they are still consuming if they are supposedly using ketones for energy? Also, do you see any benefit from using Keto os vs. Brain Octane? I ask because there is a significant difference in price. Thank you so much!!
In addition, most studies that compare carbohydrate utilization with fat utilization fail to take into account the fact that full “fat adaptation” that allows you to gain all the benefits of using fat as a fuel actually takes time – often more than four weeks – and up to a couple years. But since most studies that compare fat and carbohydrate burning are short-term, you rarely see the benefits of this kind of fat adaptation actually fleshed out in research. Instead, the average research participant begins the study in a non-fat adapted state, gets either a high fat or high carb diet, then launches into exercise. But in an ideal study, that person would have followed either a high-fat or high-carb diet for many months before getting their fat burning capability investigated.

Ketone bodies are acidic, but acid-base homeostasis in the blood is normally maintained through bicarbonate buffering, respiratory compensation to vary the amount of CO2 in the bloodstream, hydrogen ion absorption by tissue proteins and bone, and renal compensation through increased excretion of dihydrogen phosphate and ammonium ions.[9] Prolonged excess of ketone bodies can overwhelm normal compensatory mechanisms, defined as acidosis if blood pH falls below 7.35.
Hi Kelly, All packaged foods will have a nutrition label that list the macros per serving, including fat, protein and cabrohydrates. Net carbs, which is what most people look at for low carb and keto, are total carbs (the amount on the label) minus fiber and sugar alcohols, as explained in the article above. I have a low carb food list here that gives you a full list of all the foods you can eat, and the net carbs in each. You can also sign up above to be notified about the meal plans, which are a great way to get started.
Because the ketogenic diet alters the body's metabolism, it is a first-line therapy in children with certain congenital metabolic diseases such as pyruvate dehydrogenase (E1) deficiency and glucose transporter 1 deficiency syndrome,[35] which prevent the body from using carbohydrates as fuel, leading to a dependency on ketone bodies. The ketogenic diet is beneficial in treating the seizures and some other symptoms in these diseases and is an absolute indication.[36] However, it is absolutely contraindicated in the treatment of other diseases such as pyruvate carboxylase deficiency, porphyria, and other rare genetic disorders of fat metabolism.[9] Persons with a disorder of fatty acid oxidation are unable to metabolise fatty acids, which replace carbohydrates as the major energy source on the diet. On the ketogenic diet, their bodies would consume their own protein stores for fuel, leading to ketoacidosis, and eventually coma and death.[37]
It also means that if you’re a very active athlete or exercise enthusiast and you’re following “trickle-down” advice from the sedentary or less active ketosis experts to eat less than 40g of carbs per day, you’re making a big mistake when it comes to your hormonal balance, and you need to up your carbohydrate intake to 100-200g of carbs per day. You’d be surprised at how easy it is (if you’re a very active person) to stay in ketosis on this level of carbohydrate intake. Go ahead. Do Ketonix breath testing to prove me wrong. You can eat boatloads of carbohydrates at night and be back in ketosis within just two to three hours. When you combine that with the cutting-edge tricks you’re about to learn, you’ll find that you can toss hormonal issues out the window, get into ketosis, have your cake, and eat it too. Literally.
Hi Ben…first, I have learned so much from you, thank you! I’m interested in using exogenous ketone supplements and I have a question for you. I just read the transcript of an interview Dave Asprey did with Dr. Richard Veech (episode 299). He advises against them, and says they can even be harmful. I was disappointed to read this, and wanted to ask you about it, since I respect your opinion greatly….thank you.
I think there is a lot more to the story than ketosis or very low carb for everyone. In my own experience, high carb works much better. I tried very low carb for a long without really feeling amazing, I then switched back to high carb and quickly lost weight and leaned out. I still eat high carb and my strength is better and I'm even leaner now. I find it very difficult to overeat (I obviously eat very 'clean diet').
A study in the Journal of Applied Physiology showed that people who do twice-a-day workouts, but defy standard nutrition recommendations by not eating for two hours after the first session (thus depleting carbohydrate stores with the first session) experienced a better ability to burn fat (with no loss in performance) compared with a group that trained only once a day and ate carbohydrates afterward.
Intermittent fasting is another way to achieve ketosis. This doesn’t suggest going days without food, but rather intermittent fasting. You can eat for eight hours and then fast for 16 hours, or eat a low-calorie diet for a few days (about 1,200 daily calories if you’re a woman and 1,500 daily calories if you’re a man). As you take in less food, your body uses more of its fat stores for fuel.
Carbohydrates have been linked to this skin condition, so cutting down on them may help. And the drop in insulin that a ketogenic diet can trigger may also help stop acne breakouts. (Insulin can cause your body to make other hormones that bring on outbreaks.) Still, more research is needed to determine exactly how much effect, if any, the diet actually has on acne. 
When you eat less than 50 grams of carbs a day, your body eventually runs out of fuel (blood sugar) it can use quickly. This typically takes 3 to 4 days. Then you’ll start to break down protein and fat for energy, which can make you lose weight. This is called ketosis. It's important to note that the ketogenic diet is a short term diet that's focussed on weight loss rather than the pursuit of health benefits. 

Exogenous ketosis comes from an external source. Consuming exogenous ketones, like a ketone drink containing a ketone ester or a ketone salt, raises blood ketone levels. The body isn't producing ketones in this state, but still remains in ketosis from having ketones introduced from an outside source. However, the body isn't ketogenic–that specifically means the body is producing its own ketones.


But people who started following the keto diet noticed weight loss for a few reasons: When you eat carbs, your body retains fluid in order to store carbs for energy (you know, in case it needs it). But when you’re not having much in the carb department, you lose this water weight, says Warren. Also, it's easy to go overboard on carbohydrates—but if you're loading up on fat, it may help curb cravings since it keeps you satisfied.
Keto breath, on the other hand, is less of a side-effect and more of a harmless inconvenience (your breath literally smells like nail polish remover). Basically, when your body breaks down all that extra fat on the keto diet, it produces ketones—one of which is the chemical acetone, Keatley previously told WomensHealthMag.com. (Yes, the same stuff that's in nail polish remover.)
My Husband and I started doing Keto July 2018. We got over weight after we got out of the Marine Corps. It has been hard to workout because I became disabled, but my diet was not good. After our friend Amber recommended your site and support group, we found a lot of helpful information to get us started on a successful journey. So far it’s been one month and we have lost 18 pounds each!
For someone more interested in health/muscle gain rather than weight loss, should I up the protein and good carb levels a bit? I’m around 10% BF and weigh 220, so I require a higher calorie intake the average. In just a few days striving for a Keto-diet, I’m averaging between 50-60g gross carbs (30g net), 160g protein and 220 fat (8%-22%-70%) DO you think that is a good target or should I try and adjust?

I asked James Fell if he had some practical advice on sustainable dieting. “When it comes to weight loss,” he said, “the only thing that matters is caloric deficit. However, quality of diet affects quantity. A higher quality diet is more likely to be one that allows you to eat a lower quantity of calories and still be satisfied. That being said, there are many different ways to find a high-quality diet.”
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