Since the ideal protein intake is fixed based on your lean mass and activity level and your net carbs intake is specified by you, the only macronutrient that needs adjusting is the fat intake. Your fat intake is used to adjust the calorie intake. The more fat, the more calories. Typically, you adjust fat so that you reach but not exceed your target calories.
In ketogenesis, our livers start to break down fat into a usable energy source called ketone bodies, or ketones for short. “Organs like the brain that normally rely primarily on glucose for fuel can begin to use a substantial amount of ketones,” said Kevin Hall, a National Institutes of Health senior investigator who has studied the ketogenic diet. So ketones can stand in for glucose as fuel for the body when there’s a glucose shortage. “It’s an amazing physiological adaption to starvation that allows tissues like the brain to survive,” Hall added.

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A: The most common ways to track your carbs is through MyFitnessPal and their mobile app. You cannot track net carbs on the app, although you can track your total carb intake and your total fiber intake. To get your net carbs, just subtract your total fiber intake from your total carb intake. I have written an article on How to Track Carbs on MyFitnessPal.

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In one of the most recent studies on the question, which appeared this month in the journal Diabetes Therapy, 262 adults with Type 2 diabetes patients followed a ketogenic diet, coupled with intensive lifestyle counseling. After a year, among the 218 people who completed the study, their hemoglobin A1C (a measure of blood sugar) dropped on average to 6.3, just below the 6.5 percent threshold for Type 2 diabetes. The need for insulin was either reduced or eliminated in 94 percent of the participants who were using insulin when the study began. Their use of diabetes medications — other than metformin — also declined, from 57 percent to 30 percent, and metformin use decreased slightly, from 71 percent to 65 percent.

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It usually takes three to four days for your body to go into ketosis because you have to use up your body's stores of glucose, i.e., sugar first, Keatley says. Any major diet change can give you some, uh, issues, and Keatley says he often sees patients who complain of IBS-like symptoms and feeling wiped out at the beginning of the diet. (The tiredness happens because you have less access to carbs, which give you quick energy, he explains.)

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Here’s what we do know: The keto diet may be useful in treating symptoms of epilepsy, a seizure disorder. “The use of keto in treating epilepsy has the most evidence,” Angelone says. One study conducted by Johns Hopkins Medicine, for example, followed epileptic patients on the keto diet and found that 36 percent of them had a 50 percent reduction in seizures after three months on the diet, and 16 percent were seizure-free. However, experts aren't entirely sure why the keto diet has this affect, she adds.

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The ketogenic diet is not a benign, holistic, or natural treatment for epilepsy; as with any serious medical therapy, complications may result.[28] These are generally less severe and less frequent than with anticonvulsant medication or surgery.[28] Common but easily treatable short-term side effects include constipation, low-grade acidosis, and hypoglycaemia if an initial fast is undertaken. Raised levels of lipids in the blood affect up to 60% of children[38] and cholesterol levels may increase by around 30%.[28] This can be treated by changes to the fat content of the diet, such as from saturated fats towards polyunsaturated fats, and if persistent, by lowering the ketogenic ratio.[38] Supplements are necessary to counter the dietary deficiency of many micronutrients.[18]
For example, if we told you to eat 50 total carbs rather than 20-30 grams of net carbs, you could be eating anywhere between 0 and 50 grams of net carbs. At 0 grams of net carbs, most people will get into ketosis within the first week and experience deeper levels of ketosis as the weeks progress. On the other hand, while eating 50 grams of net carbs per day, many people will struggle to get into ketosis and sustain higher ketone levels.
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.
For the study, he confined 17 overweight and obese patients for two months to a hospital, where researchers measured their every movement and controlled what they were eating. (Diet researchers called this study the “gold standard” since it was an extremely well-controlled experiment, with all food provided, and it used the best technologies for measuring energy expenditure and body composition.)
Hi Sandy, I’m not a doctor so cannot give medical advice, but do have years of research and experience in this lifestyle. Kidney failure can happen due to excessive protein intake, which was more prevalent on older versions of the Atkins diet. This is a common misconception with low carb and keto diets – that they have to mean high protein – and they shouldn’t be. If you keep your protein in check, it shouldn’t be an issue. But, I would definitely consult with your doctor since you have had issues with this.

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A study with an intent-to-treat prospective design was published in 1998 by a team from the Johns Hopkins Hospital[20] and followed-up by a report published in 2001.[21] As with most studies of the ketogenic diet, no control group (patients who did not receive the treatment) was used. The study enrolled 150 children. After three months, 83% of them were still on the diet, 26% had experienced a good reduction in seizures, 31% had had an excellent reduction, and 3% were seizure-free.[Note 7] At 12 months, 55% were still on the diet, 23% had a good response, 20% had an excellent response, and 7% were seizure-free. Those who had discontinued the diet by this stage did so because it was ineffective, too restrictive, or due to illness, and most of those who remained were benefiting from it. The percentage of those still on the diet at two, three, and four years was 39%, 20%, and 12%, respectively. During this period, the most common reason for discontinuing the diet was because the children had become seizure-free or significantly better. At four years, 16% of the original 150 children had a good reduction in seizure frequency, 14% had an excellent reduction, and 13% were seizure-free, though these figures include many who were no longer on the diet. Those remaining on the diet after this duration were typically not seizure-free, but had had an excellent response.[21][22]

Thermal Effect of Activity, also known as Activity Level, determines additional energy expenditure due to moving around and exercising. According to Lyle McDonald, broadly speaking, there are 5 categories / activity levels. We readjusted the multipliers from Lyle McDonald's book to better reflect different activity levels that work for most people.


The ketogenic diet is usually initiated in combination with the patient's existing anticonvulsant regimen, though patients may be weaned off anticonvulsants if the diet is successful. Some evidence of synergistic benefits is seen when the diet is combined with the vagus nerve stimulator or with the drug zonisamide, and that the diet may be less successful in children receiving phenobarbital.[18] 

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I have been getting a lot of the same questions lately so I thought it was time to make another keto question and answer video. My channel is growing pretty fast and I've been able to inspire so many with my keto journey. It brings be so much joy and makes my weight battle victories so much sweeter knowing I'm helping you change your life. I hope this keto explained video makes sense and helps clear up your keto questions!

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Eating carbs drives up insulin production, the hypothesis suggests, stirring hunger and causing the body to hold on to fat and suppress calorie burn. But when you replace carbs with fat, you subdue hunger, boost calorie burn, and melt away fat. With fewer carbs, your body also doesn’t produce as much insulin — and that increases the rate of ketogenesis and decreases the body’s need for glucose.
Note: Because you'll be excluding some major food groups on the keto diet (grains, many fruits) you should definitely think about taking a multivitamin—especially one that contains folic acid, which helps your body make new cells and is often found in enriched breads, cereals, and other grain products, says Julie Upton, R.D., cofounder of nutrition website Appetite for Health.

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Let's find out your body fat percentage. Based on your height and weight, your body fat percentage might be around %. The most accurate measurement would be a DEXA. Skin fold measurement with a good caliper is also pretty accurate. The easiest way is to just estimate it from some comparison pictures. More: 1, 2, 3, 4. You can also try this calculator but that can be inaccurate.

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Our bodies are incredibly adaptive to what you put into it – when you overload it with fats and take away carbohydrates, it will begin to burn ketones as the primary energy source. Optimal ketone levels offer many health, weight loss, physical and mental performance benefits.1There are scientifically-backed studies that show the advantage of a low-carb, ketogenic diet over a low-fat diet. One meta-analysis of low-carbohydrate diets showed a large advantage in weight loss. The New England Journal of Medicine study resulted in almost double the weight loss in a long-term study on ketone inducing diets.

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Note: Because you'll be excluding some major food groups on the keto diet (grains, many fruits) you should definitely think about taking a multivitamin—especially one that contains folic acid, which helps your body make new cells and is often found in enriched breads, cereals, and other grain products, says Julie Upton, R.D., cofounder of nutrition website Appetite for Health.

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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]

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Another common effect of the ketogenic diet is “keto flu”: fatigue, lightheadedness, and dizziness people feel when they greatly reduce their carb intake. This effect should go away after the body adjusts to the diet, but staying on keto for a long time could lead to kidney stones, high cholesterol, constipation, slowed growth (in young people), and bone fractures. We actually don’t know whether keto is safe in the long term.

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Here’s what we do know: The keto diet may be useful in treating symptoms of epilepsy, a seizure disorder. “The use of keto in treating epilepsy has the most evidence,” Angelone says. One study conducted by Johns Hopkins Medicine, for example, followed epileptic patients on the keto diet and found that 36 percent of them had a 50 percent reduction in seizures after three months on the diet, and 16 percent were seizure-free. However, experts aren't entirely sure why the keto diet has this affect, she adds.
The ketogenic diet is usually initiated in combination with the patient's existing anticonvulsant regimen, though patients may be weaned off anticonvulsants if the diet is successful. Some evidence of synergistic benefits is seen when the diet is combined with the vagus nerve stimulator or with the drug zonisamide, and that the diet may be less successful in children receiving phenobarbital.[18]
A systematic review in 2018 looked at 16 studies on the ketogenic diet in adults. It concluded that the treatment was becoming more popular for that group of patients, that the efficacy in adults was similar to children, the side effects relatively mild. However, many patients gave up with the diet, for various reasons, and the quality of evidence was inferior to studies on children. Health issues include high levels of low-density lipoprotein, high total cholesterol, and weight loss.[24]

It usually takes three to four days for your body to go into ketosis because you have to use up your body's stores of glucose, i.e., sugar first, Keatley says. Any major diet change can give you some, uh, issues, and Keatley says he often sees patients who complain of IBS-like symptoms and feeling wiped out at the beginning of the diet. (The tiredness happens because you have less access to carbs, which give you quick energy, he explains.)

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If you stick to g of carbs, g protein, and g fat, you will eat kcal and lose kg (lbs) in the first month. Keep in mind that your body weight can fluctuate by ±2kg (±4lbs) on any given day from water weight and what's in your stomach. Recalculate your macro ratio once a month! Changes in body composition have a large influence on the recommendations and weight loss.

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Hi Fran, There could be many reasons and unfortunately the comment area is not the place for 1:1 support, but highly recommend our support group here for questions like this. The color on keto sticks does not indicate the amount of fat you are burning, only the amount of excess ketones that are spilling into urine combined with how dehydrated you are (or not). The goal is to be in ketosis, not necessarily a darker color.

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When I recently asked Hall what his research tells us about weight loss with the ketogenic diet, he said simply: “The idea is that low-carb, ketogenic diets cause your body to burn way more calories, resulting in a lot of weight loss, even if you eat more than you were eating before. But our studies, as well as many others, demonstrate nothing of the sort.”

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When you approach your normal body weight, the weight loss will slow. Just remember, a “normal” body weight differs from person to person depending on our genetics and environmental exposures and may not fit what we see in the popular media. The weight loss won’t go on forever. As long as you follow the advice to eat when you are hungry, you will eventually stabilize your weight.

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A: The amount of weight you lose is entirely dependent on you. Obviously adding exercise to your regimen will speed up your weight loss. Cutting out things that are common “stall” causes is also a good thing. Artificial sweeteners, dairy, wheat products and by-products (wheat gluten, wheat flours, and anything with an identifiable wheat product in it).

A macronutrient (macro) is one of three main sources of daily energy supply: carbohydrates, proteins and fats. All of them are essential in maintaining a healthy life and good exercise condition, but different diets and different occasions call for different balance between them and our keto calculator is here to help you estimate how much of each you need to consume to follow a keto dietary plan.

You didn’t convert grams to calories. You must convert the grams of fat and protein to calories and then calculate your macronutrient percentages. Calorie percentages, not gram percentages, are what the recommended keto percentages are based on. Usually, once you account for the fact that one gram of fat has five more calories than one gram of protein the calorie percentages will end up being what you expect from a typical keto diet.

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Anticonvulsants suppress epileptic seizures, but they neither cure nor prevent the development of seizure susceptibility. The development of epilepsy (epileptogenesis) is a process that is poorly understood. A few anticonvulsants (valproate, levetiracetam and benzodiazepines) have shown antiepileptogenic properties in animal models of epileptogenesis. However, no anticonvulsant has ever achieved this in a clinical trial in humans. The ketogenic diet has been found to have antiepileptogenic properties in rats.[56]

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But what’s lost in the many trend articles and books about “going keto” for weight loss today is that this diet is the same one the now-late Dr. Robert Atkins and other low-carb evangelists have been selling since the 1960s. (Diet peddlers have an incredible knack for rebranding old ideas over and over, and in our eternal confusion about what to eat, we keep falling for it all.)

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A computer program such as KetoCalculator may be used to help generate recipes.[47] The meals often have four components: heavy whipping cream, a protein-rich food (typically meat), a fruit or vegetable and a fat such as butter, vegetable oil, or mayonnaise. Only low-carbohydrate fruits and vegetables are allowed, which excludes bananas, potatoes, peas, and corn. Suitable fruits are divided into two groups based on the amount of carbohydrate they contain, and vegetables are similarly divided into two groups. Foods within each of these four groups may be freely substituted to allow for variation without needing to recalculate portion sizes. For example, cooked broccoli, Brussels sprouts, cauliflower, and green beans are all equivalent. Fresh, canned, or frozen foods are equivalent, but raw and cooked vegetables differ, and processed foods are an additional complication. Parents are required to be precise when measuring food quantities on an electronic scale accurate to 1 g. The child must eat the whole meal and cannot have extra portions; any snacks must be incorporated into the meal plan. A small amount of MCT oil may be used to help with constipation or to increase ketosis.[37]

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This seminal randomized trial, published in JAMA in 2007, involved 300 women and measured their weight loss on the Atkins diet compared to the Zone, Learn, and Ornish diets. The researchers found that while women on Atkins shed a few more pounds, the weight loss on low-carb diets was “likely to be at least as large as for any other dietary pattern” and “the magnitude of weight loss [on Atkins] was modest, with a mean 12-month weight loss of only 4.7 kg.” In other words, long-term weight loss on Atkins wasn’t meaningfully different from the other diets.

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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]
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.

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The nerve impulse is characterised by a great influx of sodium ions through channels in the neuron's cell membrane followed by an efflux of potassium ions through other channels. The neuron is unable to fire again for a short time (known as the refractory period), which is mediated by another potassium channel. The flow through these ion channels is governed by a "gate" which is opened by either a voltage change or a chemical messenger known as a ligand (such as a neurotransmitter). These channels are another target for anticonvulsant drugs.[7]

After increasing water intake and replacing electrolytes, it should relieve most all symptoms of Keto Flu. For an average person that is starting a ketogenic diet, eating 20-30g of net carbs a day, the entire adaptation process will take about 4-5 days. My advice is to cut your carbs to fewer than 15g to ensure that you are well on your way into ketosis within one week. If you are experiencing any more keto flu symptoms, double check your electrolyte intake and adjust. 

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You didn’t convert grams to calories. You must convert the grams of fat and protein to calories and then calculate your macronutrient percentages. Calorie percentages, not gram percentages, are what the recommended keto percentages are based on. Usually, once you account for the fact that one gram of fat has five more calories than one gram of protein the calorie percentages will end up being what you expect from a typical keto diet.

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The ketogenic diet is a high-fat, adequate-protein, low-carbohydrate diet that in medicine is used primarily to treat difficult-to-control (refractory) epilepsy in children. The diet forces the body to burn fats rather than carbohydrates. Normally, the carbohydrates contained in food are converted into glucose, which is then transported around the body and is particularly important in fueling brain function. However, if little carbohydrate remains in the diet, the liver converts fat into fatty acids and ketone bodies. The ketone bodies pass into the brain and replace glucose as an energy source. An elevated level of ketone bodies in the blood, a state known as ketosis, leads to a reduction in the frequency of epileptic seizures.[1] Around half of children and young people with epilepsy who have tried some form of this diet saw the number of seizures drop by at least half, and the effect persists even after discontinuing the diet.[2] Some evidence indicates that adults with epilepsy may benefit from the diet, and that a less strict regimen, such as a modified Atkins diet, is similarly effective.[1] Potential side effects may include constipation, high cholesterol, growth slowing, acidosis, and kidney stones.[3]

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