The modified Atkins diet reduces seizure frequency by more than 50% in 43% of patients who try it and by more than 90% in 27% of patients. Few adverse effects have been reported, though cholesterol is increased and the diet has not been studied long term. Although based on a smaller data set (126 adults and children from 11 studies over five centres), these results from 2009 compare favourably with the traditional ketogenic diet.
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.
Normal dietary fat contains mostly long-chain triglycerides (LCTs). Medium-chain triglycerides (MCTs) are more ketogenic than LCTs because they generate more ketones per unit of energy when metabolised. Their use allows for a diet with a lower proportion of fat and a greater proportion of protein and carbohydrate, leading to more food choices and larger portion sizes. The original MCT diet developed by Peter Huttenlocher in the 1970s derived 60% of its calories from MCT oil. Consuming that quantity of MCT oil caused abdominal cramps, diarrhea, and vomiting in some children. A figure of 45% is regarded as a balance between achieving good ketosis and minimising gastrointestinal complaints. The classical and modified MCT ketogenic diets are equally effective and differences in tolerability are not statistically significant. The MCT diet is less popular in the United States; MCT oil is more expensive than other dietary fats and is not covered by insurance companies.
“Rapid, significant weight loss is a common side effect of the keto diet because of the water losses that occur as carbohydrate stores are depleted,” says Clark. In a study in the American Journal of Clinical Nutrition, obese men following a modified version of the ketogenic diet, with high protein and low carbs, lost about 14 pounds in one month, compared with the control group, which lost about 10 pounds on a high-protein, medium-carb diet.
^ 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.
In its 2016 report “Healthy Eating Guidelines & Weight Loss Advice,” the Public Health Collaboration, a U.K. nonprofit, evaluated evidence on low-carbohydrate, high-fat diets. (The Keto diet falls under the LCHF umbrella.) Among 53 randomized clinical trials comparing LCHF diets to calorie-counting, low-fat diets, a majority of studies showed greater weight loss for the Keto-type diets, along with more beneficial health outcomes. The collaboration recommends weight-loss guidelines that include a low-carbohydrate, high-fat diet of real (rather than processed) foods as an acceptable, effective and safe approach.
It is possible to combine the results of several small studies to produce evidence that is stronger than that available from each study alone—a statistical method known as meta-analysis. One of four such analyses, conducted in 2006, looked at 19 studies on a total of 1,084 patients. It concluded that a third achieved an excellent reduction in seizure frequency and half the patients achieved a good reduction.
First reported in 2003, the idea of using a form of the Atkins diet to treat epilepsy came about after parents and patients discovered that the induction phase of the Atkins diet controlled seizures. The ketogenic diet team at Johns Hopkins Hospital modified the Atkins diet by removing the aim of achieving weight loss, extending the induction phase indefinitely, and specifically encouraging fat consumption. Compared with the ketogenic diet, the modified Atkins diet (MAD) places no limit on calories or protein, and the lower overall ketogenic ratio (about 1:1) does not need to be consistently maintained by all meals of the day. The MAD does not begin with a fast or with a stay in hospital and requires less dietitian support than the ketogenic diet. Carbohydrates are initially limited to 10 g per day in children or 20 g per day in adults, and are increased to 20–30 g per day after a month or so, depending on the effect on seizure control or tolerance of the restrictions. Like the ketogenic diet, the MAD requires vitamin and mineral supplements and children are carefully and periodically monitored at outpatient clinics.
In other words, I personally found that while following “strict ketosis”, things became eerily similar to the days in college when I was a competitive bodybuilder pursuing sub-3% body fat percentages. I simply wasn’t the most fun guy to hang out with in social situations due to my extreme dietary restrictions, the intense self-control became nearly exhausting, and when I traveled, I missed out on many culinary experiences, such as homemade ravioli in Rome, freshly baked crostinis in the Basque regions of Spain, and Korean rice bowls in Seoul.
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.
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.
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. Prolonged excess of ketone bodies can overwhelm normal compensatory mechanisms, defined as acidosis if blood pH falls below 7.35.
If you want to make some enemies very quickly, just jump on to social media and say "the keto diet stinks." Because there are certainly a number of people who swear by the keto diet. Some of them will even swear at you if you say anything bad about the diet. Supporters of the diet claim that the keto diet will help lose weight relatively quickly, clear your mind, make you feel better, and even clear up your acne, because you no longer are taking in carbohydrates that "cause inflammation." People who question the diet have raised concerns about whether maintaining such a high fat diet is effective and healthy in long run. After all, high fat diets could raise the risk of various chronic medical conditions such as heart disease and cancer.
Sleep enough – for most people at least seven hours per night on average – and keep stress under control. Sleep deprivation and stress hormones raise blood sugar levels, slowing ketosis and weight loss a bit. Plus they might make it harder to stick to a keto diet, and resist temptations. So while handling sleep and stress will not get you into ketosis on it’s own, it’s still worth thinking about.
Stock up: Jet.com's new City Grocery service (available in select markets) makes it easy to ensure you always have keto-friendly veggies in the fridge. We love their delivery scheduling tool; simply fill your cart, then decide which day and timeframe you'd like your groceries delivered. One of our faves: Urban Roots Green Squash Veggie Noodles are great for whipping up low-carb "pasta" dishes.
To understand exogenous ketones, you should know that there are three types of ketones: beta-hydroxybutyrate (BHB), acetoacetate (ACA) and acetone, and all three are the normal by-products of fat breakdown by your body. In much the same way as glucose, ketones can be used by your tissues, especially your brain, diaphragm and heart and are actually a far more efficient fuel source than glucose.
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.
Koia Keto is our answer to your Keto needs! We start with a coconut milk base, blend in our Koia proprietary protein blend of pea, rice and chickpea proteins, then add ingredients you need on your Keto journey, like MCT oil, to create a 100% plant based protein beverage. Each flavor is crafted to be a deliciously indulgent treat, with choices like Chocolate Brownie and Cake Batter, so you don’t feel like you’re missing out on that midnight ice cream just because you’re staying Keto. Every bottle is packed with 14g of MCT oil, providing healthy fats for fuel, with 0g added sugar. Koia Keto is the indulgent solution for any time your sweet tooth is calling.
KETO//OS contains a specifically engineered ratio of ketone mineral salts blended with a high fiber based medium chain triglyceride (MCT) formulation, so you get a potent delivery of both exogenous ketones and medium chain triglycerides. It is simply a powder that you mix with 8-10 oz of water. Within 15-30 minutes it puts your body into a full and deep state of ketosis.
Checking your ketone level is one way to know if you’re in ketosis. This metabolic state usually kicks in after three or four days of restricting your carbohydrate intake or going through periods of intermittent fasting. You don’t have to visit a doctor to measure your level. Pick up a ketone urine test from a nearby drug store, or use a blood sugar meter that’s capable of measuring ketones.