The Ketogenic Diet

The Ultimate Low Carb Diet

For years, the Paleo diet has been one of the most popular diets.   Over the last year the ketogenic diet, also known, as the “keto” diet has become the #1 trend for people looking for rapid, dramatic weight loss.  Proponents of this ultimate low-carb diet, which is very similar to the Atkins diet, explain that it uses the body’s own fat burning mechanism, known as ketosis, to produce significant rapid weight loss.  Numerous research studies show that this low-carb, high fat diet, is not only the better option to treat obesity over low-fat, calorie restricted diets but also may help prevent chronic metabolic disease.

Origin of the keto diet

Discovered in the 1920’-30’s, as a therapy for epilepsy, the ketogenic diet was developed to provide an alternative to non-mainstream fasting, which had proven success as an epilepsy therapy.  With the introduction of new anticonvulsant therapies, the diet was eventually abandoned.  Although it emerged that most cases of epilepsy could be effectively controlled using these medications, they still failed to achieve epileptic control in around 20% to 30% of epileptics. For these individuals, and particularly children with epilepsy, the keto diet was re-introduced as a technique for managing the condition and there is solid evidence showing that a ketogenic diet reduces seizures in children, sometimes as effectively as medication.

How does the Ketogenic Diet work?

It involves dramatically reducing carbohydrate intake and replacing it with healthy fats and moderate amounts of protein.  This puts the body into a metabolic state of “ketosis” which happens when the body has the ability to burn fat as its main energy source in contrast to the “glycolic” state where blood glucose (sugar) is the body’s source of fuel.   In ketosis, the liver naturally produces fats called ketones, which burn fat more efficiently than carbs, creating a more optimal environment for maintaining a healthy weight.   When most of the body’s energy comes from ketones there is a dramatic reduction in blood sugar levels which results in more efficient fat burning, increased insulin sensitivity thus also lowering many risk factors for diseases such as diabetes, heart disease and cancer.

What do you eat on the keto diet?

At the core of the ketogenic diet is eating whole real foods (i.e. no processed, packaged, low-fat, no-fat foods with artificial sweeteners, preservatives or chemical additives) dramatically restricting all or mostly all foods with sugar and starch (carbohydrates) and consuming very high amounts of healthy anti-inflammatory fats daily at every meal.  Typical macronutrient ratios are 0%- 5% carbohydrates, 15%-35% protein and 60%-80% fat.

Carbohydrates:  Leafy Greens, Cruciferous Veggies, Herbs, Spices, Nuts, Seeds Avocado (1-2 servings daily)

Animal Protein Sources:  Grass Fed Beef, Organic Poultry, Pork, Wild Caught Fish, Shellfish, Cheese, Bacon **Vegetarian Proteins:  Eggs, Tempeh, Miso, Nuts and Seeds (see below)

Fat Sources: Olive Oil, Butter, Ghee, Avocado, Coconut Oil, Macadamia Oil, MCT Oil, Pecans, Brazil Nuts, Macadamia, Walnuts, Coconut, Hazelnuts, Pine nuts, Almonds and respective Nut Butters, Chia and Flax Seeds.

A simple guideline to get started is keeping carbohydrates to less than 20 grams of net carbs per day.

Note that in the keto diet, decreasing carbs does not mean increasing protein intake.  Protein intake is also quite moderate because a high protein diet does not promote a state of ketosis.  Calculating the appropriate amount of protein can be more involved and it’s recommended to use one of the many online keto-calculators which will compute it based on weight, lean body mass, age, activity level among other factors.  Moderate protein intake is between .6 and 1.2 grams of protein per pound of lean body mass.  Finally, how do you reach that 60%-80% fat intake? Consume whole full fat options of foods, fattier cuts of meat, use different cooking oils, dressings, sauces to sauté, top and drizzle and create different flavors, garnish with avocado, olives, nuts and seeds.

One of the benefits of the high fat percentage of the keto diet is the impact it has on naturally decreasing appetite due to the high satiety factor of fat-rich foods which places less emphasis on calorie restriction for weight control.

What Do You Eliminate 100%?

  • All refined sugars (white, brown, cane, raw etc.…) including syrups like honey, maple syrup, carob, molasses as well as any food products made with fructose, lactose, dextrose or glucose.  **Stevia, erythritol and xylitol in their pure versions (not powdered), monk fruit powder and inulin can be part of the keto diet.
  • Fruits fresh or dried are largely avoided because of their high sugar and high carb content. **Blackberries, blueberries, strawberries, raspberries are lower in carbs and are typically ok in small amounts at the end of the day before sleep
  • All Grains (including wheat, oats, rice, quinoa, cereals, couscous, corn) and All Flour products (bagels, chips, pretzels, bread, tortillas, muffins, cookies etc.)
  • White Potatoes, sweet potatoes, starchy vegetables
  • All alcohol, soda, diet sodas, sweetened teas or coffee drinks, cow’s milk

Top Health Benefits of the keto diet:

  1. Healthy Weight Loss / Weight Maintenance – An overwhelming amount of research shows that low carb-high fat- moderate protein diets are better for weight loss than calorie-restricted low-fat diets.
  2. Decreased Risk for Diabetes and Pre-Diabetes – Short term studies show that the keto diet can boost insulin sensitivity and cause fat loss, leading to a dramatic improvement for type 2 diabetes and pre-diabetes.
  3. Reduced Risk for Heart Disease – Numerous studies support that low carb diets are effective at reducing blood triglycerides, raising HDL cholesterol, improving the type and size of LDL particles, lowering blood pressure and reducing harmful abdominal fat.
  4. Neuroprotective Benefits – The keto diet has been used for decades to treat epilepsy in children who don’t respond to drug treatment.  Very low carb diets such as the keto are associated with reducing brain inflammation, improved cognitive function and are also being studied for the prevention and treatment of MS, autism, Alzheimer’s disease, Parkinson’s and even brain cancer.
  5. Relief from Chronic Pain – There is some evidence supports that the anti-inflammatory benefits of the keto diet may be beneficial for a number of types of pain, including neuropathic pain, inflammatory pain and even thermal pain.

What is the Keto Flu?

The Keto flu describes the flu-like symptoms that people starting a low-carb diet often experience. Symptoms might include fatigue, headaches, sugar cravings, irritability, stomach upset, nausea or difficulty focusing and for the vast majority of people they subside within the first week.  Consuming more fats like coconut oil, drinking enough water, adding more salts to your diet and ensuring you are taking in enough food (i.e. calories) are some of the recommended to shorten the keto flu period.

Who is the keto diet NOT for?

  1. Gut Health – Over the long term, a very low carb diet like the keto diet may lead to gut dysbiosis and a reduction in the beneficial diversity of gut bacteria because you’re also avoiding important prebiotics like soluble fiber and resistant starch.  An unhealthy gut contributes to everything from obesity and diabetes to digestive disease, autoimmunity and neurological problems.
  2. Hypothyroidism and Adrenal Fatigue (HPA Axis Dysfunction) – Eating too low carb can reduce insulin levels so low that not enough is available for healthy conversion of inactive T4 hormone to active T3 hormone.  Be aware if you start to develop hypothyroid symptoms on a low carb diet you may need to consider increasing your carb intake.  Adrenal fatigue can also result from a low carb diet by activating a stress response in the body and increasing the hormone cortisol.  In susceptible individuals a low carb diet is a potential adrenal stressor.
  3. Pregnant Women – Pregnant women need adequate carbohydrates during pregnancy to ensure healthy fetal brain development and growth.
  4. Professional or Recreational Athletes – While individual athletes will be unique in their ability to perform well on a low carb diet, some may find their weight, energy and endurance suffer so moderating carb intake according to specific health goals, training schedules and other issues are key.

Other Safety Considerations

Critics say that the keto diet and other extreme low carb diets usually only work in the short term and can do more harm than good for the majority.   Others also say that keto-like diets should be done with the guidance of a clinical health professional and only for brief periods.

What’s the Bottom Line?

A true ketogenic diet can be an effective medical treatment for certain conditions and may also accelerate weight loss.  Nonetheless, it requires very precise carb counting and macronutrient tracking and should always be prescribed and monitored by a licensed medical provider.

As a holistic health coach specializing in weight loss, I know that you can get many of the same benefits by adopting a somewhat modified keto diet, one that is not so restrictive that makes it unsustainable for the long term.  For the majority of people seeking to release excess weight and reclaim their metabolic health, the keto diet is overkill.  Like other popular diets, it may negatively impact your hormonal health and metabolism, increase stress, guilt and anxiety over food choices and worst of all it perpetuates the myth of the perfect diet. Why not embrace a nutritional plan focused on not just losing weight but gaining long-term health too.   Instead of turning to the latest popular diet in order to lose weight quickly, I recommend practicing patience and putting effort toward taking the long-term approach to consciously developing healthy sustainable eating habits.

Delicious Anytime Skillet


  • 3 tablespoons coconut oil
  • 1 medium red onion, thinly sliced
  • 2 teaspoons garlic, minced
  • 2 cups roasted butternut squash, cubed ** (can use sweet potato or carrot)
  • ½ cup dried cranberries
  • 1 head Lacinato kale, chopped into bite size pieces**
  • ½ teaspoon cinnamon
  • ¼ teaspoon nutmeg
  • 2 cups cauliflower florets, roasted **
  • Sea salt and black pepper
  • ¼ cup toasted pine nuts (optional)


  1. In a large skillet over medium heat, add coconut oil. Add onion and saute for 4-5 minutes or until softened.   
  2. Add garlic, squash and cranberries and cook for another 1-2 minutes.
  3. Add the kale and cook together for another 3-4 minutes until wilted.  Add in cinnamon and nutmeg.
  4. Toss in the cauliflower and combine well.  Season with salt and pepper.
  5. Add in the pine nuts.  Serve warm. 


  • Make Ahead:  Roast packages of pre-cut butternut squash and cauliflower florets lightly coated in coconut oil and seasoned with salt & pepper in 375 degree oven for 15-20 minutes.
  • Can substitute spinach, baby spinach, swiss chard, collard greens
  • Add in protein of choice:  ground beef / chicken / salmon / duck / bacon
Delicious Anytime Skillet Yield: 2 - 4 Servings Print
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