Hi Michelle, You don’t necessarily have to “hit” macros to get into ketosis. Ketosis is achieved by restricting carbohydrates, that’s it. Fat is needed for satiety and protein is needed to prevent muscle loss. So make protein a goal and carbs a limit, then eat enough fat to stay satisfied and don’t go over your macros. You can get more individual help in our support group.

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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 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.

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]
There are numerous benefits that come with being on keto: from weight loss and increased energy levels to therapeutic medical applications. Most anyone can safely benefit from eating a low-carb, high-fat diet. Below, you’ll find a short list of the benefits you can receive from a ketogenic diet. For a more comprehensive list, you can also read our in-depth article here >

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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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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. 

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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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]

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Hi Michelle, You don’t necessarily have to “hit” macros to get into ketosis. Ketosis is achieved by restricting carbohydrates, that’s it. Fat is needed for satiety and protein is needed to prevent muscle loss. So make protein a goal and carbs a limit, then eat enough fat to stay satisfied and don’t go over your macros. You can get more individual help in our support group.

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Reduced hunger. Many people experience a marked reduction in hunger on a keto diet. This may be caused by an increased ability of the body to be fueled by its fat stores. Many people feel great when they eat just once or twice a day, and may automatically end up doing a form of intermittent fasting. This saves time and money, while also speeding up weight loss.

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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With Type 2 diabetes, the body either doesn’t produce enough insulin or becomes insulin-resistant, so it can’t move glucose from the blood into the cells for energy. Eating carbs results in an increase in blood glucose — so if you vastly cut down your carbs, your blood glucose levels won’t go up as much, and you won’t need as much insulin to manage blood sugars. It’s not surprising that researchers have been finding that people who follow a ketogenic diet can better manage their blood sugar by cutting down their carbs.
When you eat foods high in carbohydrates and fat, your body naturally produces glucose. Carbohydrates are the easiest thing for the body to process, and therefore it will use them first – resulting in the excess fats to be stored immediately. In turn, this causes weight gain and health problems that are associated with high fat, high carbohydrate diets (NOT keto).
It is now a mainstream dietary regime used wih the intent to reduce weight as it is safe for most people, but one should be especially aware of going ketogenic if one takes diabetes medicine, medication for high blood pressure or is breastfeeding. Typical foods include cheese, eggs, fish and seafood, natural fats, meet, vegetables that grow above ground. The key to maintaining the diet is low carb intake - usually with the goal of eating less than 50 grams or even less than 20 grams of carbohydrates per day. The fewer the carbs, the better, usually. Things to avoid include: fruit, potatoes, pasta, beer, bread, soda, chocolate, candy, donuts, etc.

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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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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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Thank you, Maya! That helps a lot. I’ve had a difficult time with some tracking apps, because it goes by what others put in and finding an exact match is tough. I like your idea of just tracking for the day. I thought about getting a notebook and doing it that way. I’ll ponder that. Thank you for adding the nutritional info on each recipe. That helps so much!

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A. The paleo diet mimics how our hunter-and-gatherer ancestors ate during the Paleolithic era. It avoids grains but allows high-carb foods, such as sweet potatoes and carrots, that the keto diet eschews. Another differentiator is that traditional Paleo diets don’t allow dairy whereas full-fat milk products are a part of a keto diet. However, some Paleo diets allow ghee and other dairy products.

Hi Michelle, You don’t necessarily have to “hit” macros to get into ketosis. Ketosis is achieved by restricting carbohydrates, that’s it. Fat is needed for satiety and protein is needed to prevent muscle loss. So make protein a goal and carbs a limit, then eat enough fat to stay satisfied and don’t go over your macros. You can get more individual help in our support group.

Another way to get into ketosis is by eating less than 20 grams of carbs — or a slice of bread — per day. So people on a ketogenic diet get about 5 percent of their calories from carbohydrates, 15 percent from protein, and 80 percent from fat. Note that that’s a much lower ratio of protein and a lot more fat than you’d get on other low-carb diets, but it’s this ratio that will force the body to derive much of its energy from ketones. If you eat too much protein, or too many carbs, your body will be thrown out of ketosis.
Over 8–10 mmol/l: It’s normally impossible to get to this level just by eating a keto diet. It means that something is wrong. The most common cause by far is type 1 diabetes, with severe lack of insulin. Symptoms include feeling very sick with nausea, vomiting, abdominal pain and confusion. The possible end result, ketoacidosis, may be fatal and requires immediate medical care. Learn more

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A cyclical keto diet follows the standard keto diet of 50 grams or fewer of carbs a day, with the exception of a “carb refeed” day on the seventh day of the week when you can up your carb intake to 150 grams. For some people, a standard keto diet can lead to burnout, thyroid problems, and dry eyes. Using carb cycling will help avoid these potential problems.
Implementing the diet can present difficulties for caregivers and the patient due to the time commitment involved in measuring and planning meals. Since any unplanned eating can potentially break the nutritional balance required, some people find the discipline needed to maintain the diet challenging and unpleasant. Some people terminate the diet or switch to a less demanding diet, like the modified Atkins diet or the low-glycaemic index treatment diet, because they find the difficulties too great.[42]

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The original therapeutic diet for paediatric epilepsy provides just enough protein for body growth and repair, and sufficient calories[Note 1] to maintain the correct weight for age and height. The classic therapeutic ketogenic diet was developed for treatment of paediatric epilepsy in the 1920s and was widely used into the next decade, but its popularity waned with the introduction of effective anticonvulsant medications. This classic ketogenic diet contains a 4:1 ratio by weight of fat to combined protein and carbohydrate. This is achieved by excluding high-carbohydrate foods such as starchy fruits and vegetables, bread, pasta, grains, and sugar, while increasing the consumption of foods high in fat such as nuts, cream, and butter.[1] Most dietary fat is made of molecules called long-chain triglycerides (LCTs). However, medium-chain triglycerides (MCTs)—made from fatty acids with shorter carbon chains than LCTs—are more ketogenic. A variant of the classic diet known as the MCT ketogenic diet uses a form of coconut oil, which is rich in MCTs, to provide around half the calories. As less overall fat is needed in this variant of the diet, a greater proportion of carbohydrate and protein can be consumed, allowing a greater variety of food choices.[4][5]

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