When you start the keto diet, you are entering a new world of eating. And nowhere is that more apparent than at the supermarket. Suddenly, all of your stand-by foods like macaroni and cheese, pasta and bread are no longer on your shopping list. When you go shopping for the first few times you may feel like a fish out of water. However, with a bit of practice, you’ll feel just as comfortable as you were with your previous shopping lists.

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During the 1920s and 1930s, when the only anticonvulsant drugs were the sedative bromides (discovered 1857) and phenobarbital (1912), the ketogenic diet was widely used and studied. This changed in 1938 when H. Houston Merritt, Jr. and Tracy Putnam discovered phenytoin (Dilantin), and the focus of research shifted to discovering new drugs. With the introduction of sodium valproate in the 1970s, drugs were available to neurologists that were effective across a broad range of epileptic syndromes and seizure types. The use of the ketogenic diet, by this time restricted to difficult cases such as Lennox–Gastaut syndrome, declined further.[10]
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.

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Because some cancer cells are inefficient in processing ketone bodies for energy, the ketogenic diet has also been suggested as a treatment for cancer.[59][60] A 2018 review looked at the evidence from preclinical and clinical studies of ketogenic diets in cancer therapy. The clinical studies in humans are typically very small, with some providing weak evidence for anti-tumour effect, particularly for glioblastoma, but in other cancers and studies, no anti-tumour effect was seen. Taken together, results from preclinical studies, albeit sometimes contradictory, tend to support an anti-tumor effect rather than a pro-tumor effect of the KD for most solid cancers.[61]
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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When going keto, don’t forget about fish. “It’s recommended to eat at least two 3.5-ounce servings of cooked fatty fish weekly for good health—these fish contain omega-3 fatty acids that can help everything from your brain to your heart health,” says Amy Gorin, RDN, owner of Amy Gorin Nutrition in the New York City area. Lox (smoked salmon) is one option; it’s also higher in sodium, which can be helpful when you’re on keto.

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For those looking for something just a little closer to real sugar, you can use Xylitol. It cooks and tastes very similar to sugar, but it has a slight glycemic impact (13 vs. 100 for sugar). It is great, but please keep in mind that it is very toxic to animals and it will raise insulin levels slightly. These are the two most cited reasons for not using Xylitol.

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Although many hypotheses have been put forward to explain how the ketogenic diet works, it remains a mystery. Disproven hypotheses include systemic acidosis (high levels of acid in the blood), electrolyte changes and hypoglycaemia (low blood glucose).[19] Although many biochemical changes are known to occur in the brain of a patient on the ketogenic diet, it is not known which of these has an anticonvulsant effect. The lack of understanding in this area is similar to the situation with many anticonvulsant drugs.[56]

You’ll quickly find that salads are your friend when in ketosis, and for a good reason: they provide lots of food to fill you up, but they’re not going to bog you down. A bed of spinach with some red onion, bacon, a little tomato, and a hot sauce vinaigrette is quick and delicious. Add in some protein – perhaps that leftover salmon from day 1 – and you’ve got a complete, healthy lunch.

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Kristin Parker is an American temporarily living in South Korea. Her role with Team Diet Doctor is customer service. If you have a question or a comment on our social media platforms, website or our Facebook group, she will likely be the one to answer you back! Kristin cooks for a family of four, including two hungry teenage sons. Her keto meal plan yields generous servings of substantial, hearty meals that they all like. 

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This week we’re getting stricter with our fasting. We had a full week of intermittent fasting and now we’re going to skip breakfast and lunch. Water is our BEST friend here! Don’t forget that you can drink coffee, tea, flavored water, and the like to get your liquids in. Keep drinking to make sure you’re not thinking about your stomach. It MIGHT start growling, just ignore it – your body will adjust with time.

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The ketogenic diet has been studied in at least 14 rodent animal models of seizures. It is protective in many of these models and has a different protection profile than any known anticonvulsant. Conversely, fenofibrate, not used clinically as an antiepileptic, exhibits experimental anticonvulsant properties in adult rats comparable to the ketogenic diet.[58] This, together with studies showing its efficacy in patients who have failed to achieve seizure control on half a dozen drugs, suggests a unique mechanism of action.[56]
You’re transitioning. Your body is equipped to process a high intake of carbs and a lower intake of fat. Your body needs to create enzymes to be able to do this. In the transitional period, the brain may run low on energy which can lead to grogginess, nausea, and headaches. If you’re having a large problem with this, you can choose to reduce carb intake gradually.

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This week we’re introducing a slight fast. We’re going to get full on fats in the morning and fast all the way until dinner time. Not only are there a myriad of health benefits to this, it’s also easier on our eating schedule (and cooking schedule). I suggest eating (rather, drinking) your breakfast at 7am and then eating dinner at 7pm. Keeping 12 hours between your 2 meals. This will help put your body into a fasted state.

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During the 1920s and 1930s, when the only anticonvulsant drugs were the sedative bromides (discovered 1857) and phenobarbital (1912), the ketogenic diet was widely used and studied. This changed in 1938 when H. Houston Merritt, Jr. and Tracy Putnam discovered phenytoin (Dilantin), and the focus of research shifted to discovering new drugs. With the introduction of sodium valproate in the 1970s, drugs were available to neurologists that were effective across a broad range of epileptic syndromes and seizure types. The use of the ketogenic diet, by this time restricted to difficult cases such as Lennox–Gastaut syndrome, declined further.[10]
When it comes to meat, there’s not much to avoid. You should always make sure to purchase meat with fat and void lean cuts, as this will not help you lose weight. Remember, fat is your friend. Fat is needed, so your body has fat to burn and not sugar. When you are on a low carb diet, you are not fueling your body with sugar, so make sure you eat plenty of fat. If you don’t have fat to burn, your body will start burning glucose (even if you have fat stores). Your body needs to know that it never has to worry about not having enough fat.

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]


These make an ideal snack or you can make them as hors-d’oeuvres for a party. They are packed with flavor and have lots of healthy fats. They are quick and easy to make and the fresh lime juice not only adds a citrus kick. It also keeps the avocado from turning brown. If you prefer, you can use turkey or ham, but the prosciutto adds a special touch as the saltiness goes well with the avocado and the lime. Try to use avocados that are not too ripe so they will be easier to cut into slices.

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Take a 2 – 3 cups of lettuce, crumble in some bacon and dice a medium tomato. Mix that with two or three tablespoons of mayo, and toss after adding some splashes of hot sauce. Delicious, filling, full of fiber and healthy fats, and absolutely easy. I know the mayo sounds weird as a dressing, but trust us; it’s amazing! Add in some avocado chunks to boost potassium too!

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In many developing countries, the ketogenic diet is expensive because dairy fats and meat are more expensive than grain, fruit and vegetables. The modified Atkins diet has been proposed as a lower-cost alternative for those countries; the slightly more expensive food bill can be offset by a reduction in pharmaceutical costs if the diet is successful. The modified Atkins diet is less complex to explain and prepare and requires less support from a dietitian.[55]

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High-fat dairy also contains high-quality protein, vitamins, minerals, and conjugated linoleic acid (one of the few fatty acids that have been found to promote fat loss). The combination of these nutrients is essential for maintaining strength and function as we age. By adding just 7 ounces of ricotta cheese to their daily diet, for example, the older participants of a recent study were able to increase their muscle mass and muscle strength. In other words, ask for extra cheese, please.

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I have the same calories limit and macro. I easily stay within the limit but I completely stopped eating any type of bread, pasta, rice, potatoes and starchy food. I started using butter or coconut oil to cook and put mayo EVERYWHERE. It’s my new favourite topping for lettuce even XD. Then I eat plenty of eggs/meat/fatty fish and cheese. Olives are great as a snack. I cut out completely milk and use whipping cream instead. If you get into this completely counter intuitive way of thinking of food it’s super easy to get enough fat within the calorie limit.
This week we’re introducing a slight fast. We’re going to get full on fats in the morning and fast all the way until dinner time. Not only are there a myriad of health benefits to this, it’s also easier on our eating schedule (and cooking schedule). I suggest eating (rather, drinking) your breakfast at 7am and then eating dinner at 7pm. Keeping 12 hours between your 2 meals. This will help put your body into a fasted state.

This is the only way my kids will eat Brussels sprouts! It’s actually ideal for me because this dish is fast, easy and healthy, and it makes a lovely side. Quick-cooking Brussels sprout halves are available in the prepackaged salad aisle at the grocery store. They’re a timesaver if you can find them, but you can always just buy whole ones and slice them in half. —Teri Rasey, Cadillac, Michigan


Infants and patients fed via a gastrostomy tube can also be given a ketogenic diet. Parents make up a prescribed powdered formula, such as KetoCal, into a liquid feed.[19] Gastrostomy feeding avoids any issues with palatability, and bottle-fed infants readily accept the ketogenic formula.[31] Some studies have found this liquid feed to be more efficacious and associated with lower total cholesterol than a solid ketogenic diet.[18] KetoCal is a nutritionally complete food containing milk protein and is supplemented with amino acids, fat, carbohydrate, vitamins, minerals and trace elements. It is used to administer the 4:1 ratio classic ketogenic diet in children over one year. The formula is available in both 3:1 and 4:1 ratios, either unflavoured or in an artificially sweetened vanilla flavour and is suitable for tube or oral feeding.[51] Other formula products include KetoVolve[52] and Ketonia.[53] Alternatively, a liquid ketogenic diet may be produced by combining Ross Carbohydrate Free soy formula with Microlipid and Polycose.[53]
In the 1960s, medium-chain triglycerides (MCTs) were found to produce more ketone bodies per unit of energy than normal dietary fats (which are mostly long-chain triglycerides).[15] MCTs are more efficiently absorbed and are rapidly transported to the liver via the hepatic portal system rather than the lymphatic system.[16] The severe carbohydrate restrictions of the classic ketogenic diet made it difficult for parents to produce palatable meals that their children would tolerate. In 1971, Peter Huttenlocher devised a ketogenic diet where about 60% of the calories came from the MCT oil, and this allowed more protein and up to three times as much carbohydrate as the classic ketogenic diet. The oil was mixed with at least twice its volume of skimmed milk, chilled, and sipped during the meal or incorporated into food. He tested it on 12 children and adolescents with intractable seizures. Most children improved in both seizure control and alertness, results that were similar to the classic ketogenic diet. Gastrointestinal upset was a problem, which led one patient to abandon the diet, but meals were easier to prepare and better accepted by the children.[15] The MCT diet replaced the classic ketogenic diet in many hospitals, though some devised diets that were a combination of the two.[10]

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Hi 😀 yes I have a question, just starting this Keto diet, so we’re very new at this but my boyfriend had a heart attack 8 years ago so we need to be very careful to not get to high on fat with him. Can he still benefit from this diet. His Doctor said he needs to get some of his weight off he is having a hard time breathing. The Doctor said a low carb diet. But I, we would like to try the Keto diet.

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Because people with type 2 diabetes are at an increased risk for cardiovascular disease, there’s a specific concern that the saturated fat in the diet may drive up LDL, or “bad,” cholesterol levels, and further increase the odds of heart problems. If you have type 2 diabetes, talk to your doctor before attempting a ketogenic diet. They may recommend a different weight-loss diet for you, like a reduced-calorie diet, to manage diabetes. Those with epilepsy should also consult their doctor before using this as part of their treatment plan.

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The exact amount you should eat to get into ketosis will differ from person to person. Your body fat percentage, how much weight you want to lose, as well as how much exercise you do all make a difference. Our Keto Calculator will give you a good estimate of what macros you should be consuming. But remember that this is just a guide to help you on Keto…it’s not a strict guideline.
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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All grains, even whole meal (wheat, rye, oats, corn, barley, millet, bulgur, sorghum, rice, amaranth, buckwheat, sprouted grains), quinoa and white potatoes. this includes all products made from grains (pasta, bread, pizza, cookies, crackers, etc.) sugar and sweets (table sugar, HFCS, agave syrup, ice creams, cakes, sweet puddings and sugary soft-drinks).
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.
Before I went into ketosis and before I cared anything about keto meals chicken was a staple in our home. While I do love all things chicken, I have found that going the boneless skinless route can sometimes get old, boring, and you lose some of the fat. Remember that you don’t have to choose lean meats anymore. Can you still eat it? Of course, but you need to try to dress it up with fat anytime you can. This low carb poultry list isn’t exhaustive, but I think it’s enough to get you started.

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If you are looking for a healthy cooking oil, extra virgin olive oil should be your staple. A recent study found this to be the healthiest oil for baking, cooking, and deep frying at high temperatures. This is because extra virgin olive oil contains a high-quantity of stable fats and antioxidants that protect the oil from breaking down into toxic chemicals. 

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One downside to a ketogenic diet for weight loss is the difficulty maintaining it. “Studies show that weight loss results from being on a low-carb diet for more than 12 months tend to be the same as being on a normal, healthy diet,” says Mattinson. While you may be eating more satiating fats (like peanut butter, regular butter, or avocado), you’re also way more limited in what’s allowed on the diet, which can make everyday situations, like eating dinner with family or going out with friends, far more difficult. Because people often find it tough to sustain, it’s easy to rely on it as a short-term diet rather than a long-term lifestyle.

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This is the only way my kids will eat Brussels sprouts! It’s actually ideal for me because this dish is fast, easy and healthy, and it makes a lovely side. Quick-cooking Brussels sprout halves are available in the prepackaged salad aisle at the grocery store. They’re a timesaver if you can find them, but you can always just buy whole ones and slice them in half. —Teri Rasey, Cadillac, Michigan

On a ketogenic diet, your entire body switches its fuel supply to run mostly on fat, burning fat 24-7. When insulin levels become very low, fat burning can increase dramatically. It becomes easier to access your fat stores to burn them off. This is great if you’re trying to lose weight, but there are also other less obvious benefits, such as less hunger and a steady supply of energy. This may help keep you alert and focused.

How do you increase ketones in the brain


For patients who benefit, half achieve a seizure reduction within five days (if the diet starts with an initial fast of one to two days), three-quarters achieve a reduction within two weeks, and 90% achieve a reduction within 23 days. If the diet does not begin with a fast, the time for half of the patients to achieve an improvement is longer (two weeks), but the long-term seizure reduction rates are unaffected.[44] Parents are encouraged to persist with the diet for at least three months before any final consideration is made regarding efficacy.[9]

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