Keto Diet for Beginners: What You Need to Know (2024)

By Dr Frank Yap, MD -
There isn't a buzzier diet right now than keto diet. A keto diet is well known for being a low carb diet, where the body produces ketones in the liver to be used as energy. It’s referred to as many different names – ketogenic diet, low carb diet, low carb high fat (LCHF), etc.

In fact, many studies show that this type of diet can help you lose weight and improve your health (Source).

Ketogenic diets may even have benefits against diabetes, cancer, epilepsy, and Alzheimer’s disease (Source, Source, Source, Source).

Here is a detailed beginner’s guide to the keto diet.

What is a ketogenic diet?

Keto basics

The ketogenic diet is a very low carb, high fat diet that shares many similarities with the Atkins and low carb diets. It involves drastically reducing carbohydrate intake and replacing it with fat. This reduction in carbs puts your body into a metabolic state called ketosis. When this happens, your body becomes incredibly efficient at burning fat for energy. It also turns fat into ketones in the liver, which can supply energy for the brain (6Trusted Source).
 
Ketogenic diets can cause significant reductions in blood sugar and insulin levels. This, along with the increased ketones, has some health benefits (Trusted Source, Trusted Source, Trusted Source).

Different types of ketogenic diets

There are several versions of the ketogenic diet, including:

  • Standard ketogenic diet (SKD): This is a very low carb, moderate protein and high fat diet. It typically contains 70% fat, 20% protein, and only 10% carbs (9Trusted Source).
  • Cyclical ketogenic diet (CKD): This diet involves periods of higher carb refeeds, such as 5 ketogenic days followed by 2 high carb days.
  • Targeted ketogenic diet (TKD): This diet allows you to add carbs around workouts.
  • High protein ketogenic diet: This is similar to a standard ketogenic diet, but includes more protein. The ratio is often 60% fat, 35% protein, and 5% carbs.
However, only the standard and high protein ketogenic diets have been studied extensively. Cyclical or targeted ketogenic diets are more advanced methods and primarily used by bodybuilders or athletes. 

The information in this article mostly applies to the standard ketogenic diet (SKD), although many of the same principles also apply to the other versions.

What is ketosis?

Ketosis is a metabolic state in which your body uses fat for fuel instead of carbs.

It occurs when you significantly reduce your consumption of carbohydrates, limiting your body’s supply of glucose (sugar), which is the main source of energy for the cells.

Following a ketogenic diet is the most effective way to enter ketosis. Generally, this involves limiting carb consumption to around 20 to 50 grams per day and filling up on fats, such as meat, fish, eggs, nuts, and healthy oils (6Trusted Source).

It’s also important to moderate your protein consumption. This is because protein can be converted into glucose if consumed in high amounts, which may slow your transition into ketosis (10Trusted Source).

Practicing intermittent fasting could also help you enter ketosis faster. There are many different forms of intermittent fasting, but the most common method involves limiting food intake to around 8 hours per day and fasting for the remaining 16 hours (11Trusted Source).

Blood, urine, and breath tests are available, which can help determine whether you’ve entered ketosis by measuring the amount of ketones produced by your body.

Certain symptoms may also indicate that you’ve entered ketosis, including increased thirst, dry mouth, frequent urination, and decreased hunger or appetite (12Trusted Source).

Ketogenic diets can help you lose weight

A ketogenic diet is an effective way to lose weight and lower risk factors for disease (1Trusted Source, 2Trusted Source, 3Trusted Source, 4Trusted Source, 5Trusted Source).

In fact, research shows that the ketogenic diet may be as effective for weight loss as a low fat diet (13Trusted Source, 14Trusted Source, 15Trusted Source).

What’s more, the diet is so filling that you can lose weight without counting calories or tracking your food intake (16Trusted Source).

One review of 13 studies found that following a very low carb, ketogenic diet was slightly more effective 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 (13Trusted Source).

What’s more, it also led to reductions in diastolic blood pressure and triglyceride levels (13Trusted Source).

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

The increased ketones, lower blood sugar levels, and improved insulin sensitivity may also play a key role (18Trusted Source, 19Trusted Source).

Ketogenic diets for diabetes and prediabetes

Diabetes is characterized by changes in metabolism, high blood sugar, and impaired insulin function (20Trusted Source).

The ketogenic diet can help you lose excess fat, which is closely linked to type 2 diabetes, prediabetes, and metabolic syndrome (21Trusted Source, 22Trusted Source, 23Trusted Source, 24Trusted Source).

One older study found that the ketogenic diet improved insulin sensitivity by a whopping 75% (25Trusted Source).

A small study in women with type 2 diabetes also found that following a ketogenic diet for 90 days significantly reduced levels of hemoglobin A1C, which is a measure of long-term blood sugar management (26Trusted Source).

Another study in 349 people with type 2 diabetes found that those who followed a ketogenic diet lost an average of 26.2 pounds (11.9 kg) over a 2-year period. This is an important benefit when considering the link between weight and type 2 diabetes (Trusted Source24Trusted Source, 27Trusted Source).

What’s more, they also experienced improved blood sugar management, and the use of certain blood sugar medications decreased among participants throughout the course of the study (Trusted Source27Trusted Source).

Keto Diet and Cancer Prevention

Some mechanisms suggest that a ketogenic diet may help prevent the development of cancer in the first place.

Primarily, it may reduce several of the main risk factors for cancer.

May decrease IGF-1 levels

Insulin-like growth factor 1 (IGF-1) is a hormone that’s important for cell development. It also reduces programmed cell death.

This hormone plays a role in the development and progression of cancer (27Trusted Source).

The ketogenic diet reduces IGF-1 levels, thereby decreasing the direct effects insulin has on cell growth (28Trusted Source).

This may reduce tumor growth and cancer risk over the long term (29Trusted Source).

Can help blood sugar levels and management of diabetes

Other evidence suggests that people with elevated blood sugar levels and diabetes have an increased risk of developing cancer (30Trusted Source, 31Trusted Source).

Research shows that a ketogenic diet can be very effective at lowering blood sugar levels and managing diabetes, at least in the short term (32Trusted Source, 33).

Some people may find it challenging to adhere to the diet over a long period of time, though. More studies on the long-term safety of the diet are also needed.

May decrease obesity

Obesity is also a risk factor for cancer (34).

Since a ketogenic diet is a powerful weight loss tool, it may also help reduce the risk of cancer by fighting obesity (35).

The keto diet is also currently being explored as an additional treatment for cancer, because it may help slow tumor growth. (4Trusted Source, 30Trusted Source, 31Trusted Source).

Other health benefits of keto diet

The ketogenic diet actually originated as a tool for treating neurological diseases such as epilepsy.

Studies have now shown that the diet can have benefits for a wide variety of different health conditions:

  • Heart disease. The ketogenic diet can help improve risk factors like body fat, HDL (good) cholesterol levels, blood pressure, and blood sugar (28Trusted Source, 29Trusted Source).
  • Alzheimer’s disease. The keto diet may help reduce symptoms of Alzheimer’s disease and slow its progression (5Trusted Source, 32Trusted Source, 33Trusted Source).
  • Epilepsy. Research has shown that the ketogenic diet can cause significant reductions in seizures in epileptic children (3Trusted Source).
  • Parkinson’s disease. Although more research is needed, one study found that the diet helped improve symptoms of Parkinson’s disease (34Trusted Source).
  • Polycystic ovary syndrome. The ketogenic diet can help reduce insulin levels, which may play a key role in polycystic ovary syndrome (35Trusted Source, 36Trusted Source).
  • Brain injuries. Some research suggests that the diet could improve outcomes of traumatic brain injuries (37Trusted Source).

However, keep in mind that research into many of these areas is far from conclusive.

Keto diet foods list: Foods to avoid

Any food that’s high in carbs should be limited.

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

  • sugary foods: soda, fruit juice, smoothies, cake, ice cream, candy, etc.
  • grains or starches: wheat-based products, rice, pasta, cereal, etc.
  • fruit: all fruit, except small portions of berries like strawberries
  • beans or legumes: peas, kidney beans, lentils, chickpeas, etc.
  • root vegetables and tubers: potatoes, sweet potatoes, carrots, parsnips, etc.
  • low fat or diet products: low fat mayonnaise, salad dressings, and condiments
  • some condiments or sauces: barbecue sauce, honey mustard, teriyaki sauce, ketchup, etc.
  • unhealthy fats: processed vegetable oils, mayonnaise, etc.
  • alcohol: beer, wine, liquor, mixed drinks
  • sugar-free diet foods: sugar-free candies, syrups, puddings, sweeteners, desserts, etc.

Keto diet foods list: Foods to eat

You should base the majority of your meals around these foods:

  • meat: red meat, steak, ham, sausage, bacon, chicken, and turkey
  • fatty fish: salmon, trout, tuna, and mackerel
  • eggs: pastured or omega-3 whole eggs
  • butter and cream: grass-fed butter and heavy cream
  • cheese: unprocessed cheeses like cheddar, goat, cream, blue, or mozzarella
  • nuts and seeds: almonds, walnuts, flaxseeds, pumpkin seeds, chia seeds, etc.
  • healthy oils: extra virgin olive oil, coconut oil, and avocado oil
  • avocados: whole avocados or freshly made guacamole
  • low carb veggies: green veggies, tomatoes, onions, peppers, etc.
  • condiments: salt, pepper, herbs, and spices

Tips for eating out on a ketogenic 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. 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.

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

Side effects and how to minimize them

Although the ketogenic diet is usually safe for most healthy people, there may be some initial side effects while your body adapts.

There’s some anecdotal evidence of these effects often referred to as the keto flu (38Trusted Source). Based on reports from some on the eating plan, it’s usually over within a few days.

Reported keto flu symptoms include diarrhea, constipation, and vomiting (39Trusted Source). 

Other less common symptoms include:

  • poor energy and mental function
  • increased hunger
  • sleep issues
  • nausea
  • digestive discomfort
  • decreased exercise performance

To minimize 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 eliminate carbs.

A ketogenic 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 your nutritional needs.

At least in the beginning, it’s important to eat until you’re full and avoid restricting calories too much. Usually, a ketogenic diet causes weight loss without intentional calorie restriction.

Risks of the keto diet

Staying on the keto diet in the long term may have some negative effectsTrusted Source, including risks of the following:

  • low protein in the blood
  • extra fat in the liver
  • kidney stones
  • micronutrient deficiencies
  • constipation (HopkinsMedicine)

A type of medication called sodium-glucose cotransporter 2 (SGLT2) inhibitors for type 2 diabetes can increase the risk for diabetic ketoacidosis, a dangerous condition that increases blood acidity. Anyone taking this medication should avoid the keto diet (40Trusted Source, 41Trusted Source).

More research is being done to determine the safety of the keto diet in the long term. Keep your doctor informed of your eating plan to guide your choices.

Supplements for a ketogenic diet

Although no supplements are required, some can be useful.

Shop for tasty whey products on online.

Here are answers to some of the most common questions about the ketogenic diet.

1. Can I ever eat carbs again?

Yes. However, it’s important to significantly reduce your carb intake initially. After the first 2 to 3 months, you can eat carbs on special occasions — just return to the diet immediately after.

2. Will I lose muscle?

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

3. Can I build muscle on a ketogenic diet?

Yes, but it may not work as well as on a moderate carb diet (52Trusted Source, 53Trusted Source). 

4. How much protein can I eat?

Protein should be moderate, as a very high intake can spike insulin levels and lower ketones. Around 35% of total calorie intake is probably the upper limit.

5. What if I am constantly tired, weak, or fatigued?

You may not be in full ketosis or be utilizing fats and ketones efficiently. To counter this, lower your carb intake and revisit the points above. A supplement like MCT oil or ketones may also help (42Trusted Source, 43Trusted Source).

6. My urine smells fruity. Why is this?

Don’t be alarmed. This is simply due to the excretion of by-products created during ketosis (54Trusted Source).

7. My breath smells. What can I do?

This is a common side effect. Try drinking naturally flavored water or chewing sugar-free gum.

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

People often confuse ketosis with ketoacidosis. Ketoacidosis is dangerous, but the ketosis on a ketogenic diet is usually fine for healthy people. Speak to your doctor before starting any new diet.

9. I have digestion issues and diarrhea. What can I do?

This common side effect usually passes after 3 to 4 weeks. If it persists, try eating more high fiber veggies (55Trusted Source, 56).

A ketogenic diet can be great for people who:

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

It may be less suitable for elite athletes or those wishing to add large amounts of muscle or weight.

It may also not be sustainable for some people’s lifestyles and preferences. Speak with your doctor about your eating plan and goals to decide if a keto eating plan is right for you.

SOURCE: https://www.healthline.com/nutrition/ketogenic-diet-101

OneDayMD view: We are cautiously optimistic about low carbo and high fat diet. Check out "
Important Information About Low Carb, Cortisol and Glucose".

This article is part of the diet and anti-aging series.

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