What to Know About the Ketogenic Diet

By , Category : Food and Nutrition

Disclaimer: Results are not guaranteed*** and may vary from person to person***.

ketogenic dietA ketogenic diet is based around the process of ketosis, the metabolic process in which your body breaks down stored fats for energy when it lacks enough glucose.

A diet based around the ketogenic effect emphasizes low-carb, high-fat meals. If this sounds similar to the Atkins diet, that’s because Atkins is based on the same principle and can be considered a type of ketogenic diet.

While a ketogenic diet results in weight loss if done properly, there are a few bits of misunderstanding floating around about its other health effects.

This is because the original ketogenic diet was devised as an epilepsy treatment and currently exists as a form of medical nutrition therapy.

Although on the surface, the ketogenic diet used for epilepsy and the ketogenic diet used for weight loss use the same principles (low carb/high fat), the two are not comparable.
The ketogenic diet for epilepsy is designed to trigger metabolic responses capable of managing seizures, specifically does not serve as a weight loss method, and requires clinical support.

For the purposes of this article, the phrase ketogenic diet is going to refer to the version intended for weight loss.

Ketogenic diet meal plan

The Meal Plan for the Ketogenic Diet

The standard meal plan for a ketogenic diet is based on extremely low levels of carbohydrates, modest protein, and a great deal of fat. Specifically, 75% of the day’s calories come from fat, 20% come from protein, and five percent come from carbs.

One thing to keep in mind, however, is that the five percent from carbs does not kick in initially. Most ketogenic diet meal plans have you start out with only fat and protein and no carbs whatsoever for a month or two. Foods the ketogenic diet has you eliminate during this period include things such as grains, rice, beans, potatoes, milk, cereals, fruits, and certain high-carb vegetables.

On the other hand, a list of foods the ketogenic diet wants you to focus on would include morsels such as meat, fish, eggs, nuts, avocado, low-carb vegetables, butter, and healthy oils.

Now, the ketogenic diet is good for triggering the ketosis process, but it takes a proper caloric balance in order to translate this effect into weight loss. No matter what method you are using, weight loss is only accomplished if the amount of calories taken in is less than the amount of calories you burn. The general FDA recommendation is 2,000 calories per day for maintaining weight, so you would most likely want to aim for something around 1,500 when trying to promote weight loss.

Sample Ketogenic Diet Menu


One of the following meals:

  • Bacon with a side of eggs and tomatoes
  • A ketogenic milk shake (see the recipe below for an example)
  • Omelet with avocado, salsa, goat cheese, and basil


One of the following meals:

  • Ham and cheese slices with nuts
  • Beef or chicken stir fry
  • Shrimp or chicken salad


One of the following meals:

  • Steak with sautéed mushrooms and onions and a side salad
  • Chicken stuffed with pesto and cream cheese
  • Pork chops with Parmesan cheese and side salad
delicious meal option on the ketogenic diet

Bacon with a side of eggs and tomatoes is just one
delicious meal option you can have while on the ketogenic diet.

Other Health Effects of the Ketogenic Diet

Determining what other health benefits the ketogenic diet can provide is somewhat tricky. Most research is concerned with the ketogenic epilepsy diet, which as mentioned earlier is not the same as the weight loss diet.

As a result, any findings about the epilepsy diet cannot be reliably assumed to also apply to the ketogenic diet described here. There is also conflation where people look at studies focusing on low-carb diets and try to claim those results for the ketogenic diet.

This is a mistake. The ketogenic diet is ultra-low in carbs, modest in protein, and high in fat. Distinctions like this matter when dealing with both scientific research and the body’s metabolism in general. Having said that, there are some indicators that a ketogenic diet could have benefits beyond weight loss.

Insulin Control

Since the ketogenic diet is low in carbs (and therefore, glucose), it is thought to be able to help manage insulin levels in people with type 2 diabetes. A 2008 study found some potential for a ketogenic diet to enable diabetics to reduce or eliminate their use of medication, for instance.

However, a single study, especially one with such a small sample size, can’t be used to make any firm declarations one way or another. At the very least, though, it’s not too much of a stretch to think that the ketogenic diet could produce insulin resistance-reduction similar to those seen in other low-carb diets, barring possible confounding factors from the high fat level.

Polycystic Ovary Syndrome

There is a small pilot study that suggests women with polycystic ovary syndrome (PCOS) can reduce fasting insulin levels, free testosterone, and weight by using a ketogenic diet.

The study only had 11 participants, however, and pilot studies are essentially “proof of concept” trials meant to see if there are grounds for more thorough investigation. Due to this, it can only be said that a ketogenic diet may have an effect on PCOS, though what kind and how strong is up in the air.

Alzheimer’s, Parkinson’s, and Brain Injuries

There is ongoing animal research about whether the ketogenic epilepsy diet can improve various neurological conditions. This research is still ongoing, animal models do not always translate into human effects (especially when metabolism is concerned), and only the epilepsy diet is being considered. These findings, even if they were conclusive (which they are not), would not be translatable to the ketogenic weight loss diet.


The idea of the ketogenic diet as a cancer treatment or cure is something you may come across, particularly in relation to brain cancer. The underlying theory is that brain tumor cells are almost entirely reliant on glucose for energy while healthy brain cells can handle glucose or ketones (the thing ketosis produces).

Therefore, a diet that promotes ketosis can help feed the brain while starving a tumor. This is an ongoing area of research and there are animal trials occurring, but this is focused on possible benefits from the epilepsy-style ketogenic diet. In other words, there is no human evidence that the epilepsy ketogenic diet affects tumors (brain or otherwise) and even less that the ketogenic weight loss diet can have an effect.

This does not mean an effect can’t be discovered, just that it is spectacularly premature to base any dietary decisions on the idea.

Side Effects of the Ketogenic Diet

The ketogenic diet is designed to manipulate your body’s metabolism in a way that it is not used to for prolonged stretches of time. This is going to result in certain side effects that you should prepare for when starting out.

  • The low amount of carbs will make it harder to build muscle while on the diet, but the moderate level of protein should at least reduce any potential muscle loss.
  • Ketosis produces a substance called acetone, which will make your breath and urine smell.
  • Acetone is also an indicator of ketoacidosis, a toxic and uncontrolled form of ketosis that can affect diabetics. Since you can’t tell by smell whether acetone is from the ketogenic diet or ketoacidosis, diabetics will need to be extra vigilant.
  • You may experience constipation, diarrhea, or other digestive issues for the first month or so.
  • You may also experience a reduction of energy, mental slowness, sleep issues, or nausea during the initial transition period.

A Fun Ketogenic Diet Recipe

Now that I’ve finished being a killjoy, let’s talk milkshakes! Specifically, a peanut butter milkshake that’s compatible with the ketogenic diet once you’re able to have that 5% of carbs per day. Almond or cashew butter can be an appropriate substitute in case of allergies as well.


  • 2 tbsp nut butter of your choice
  • 1/2 cup coconut cream or full-fat coconut milk
  • 1 cup milk (any kind, feel free to be creative)
  • 1 tsp pure vanilla extract
  • 1 cup ice
  • Stevia to taste


1. Simply put the ingredients in a blender, blend, and enjoy.

Bottom Line

The ketogenic diet is a high-fat, ultra-low-carb plan that makes use of the ketosis process to promote weight loss. The transition period can be a bit bumpy but after that it gets a lot easier to maintain, which is important since a key factor in any diet is how well you stick to it.

There may be other health benefits to the ketogenic diet but the research isn’t quite there yet to make any definitive conclusions, so for the time being it’s best to just consider the diet as yet another weapon in your weight-loss arsenal. Enjoy!

Sources for Today’s Article:
Mawer, R., “The Ketogenic Diet 101: A Detailed Beginner’s Guide,” Authority Nutrition web site, March, 2016; https://authoritynutrition.com/ketogenic-diet-101/, last accessed April 26, 2016.
Mavropoulos, J., et. al., “The Effect of a Low-Carbohydrate, Ketogenic Diet on the Polycystic Ovary Syndrome: a Pilot Study,” Nutrition & Metabolism, 2005; doi:10.1186/1743-7075-2-35.
Westman, E., et. al., “The Effect of a Low-Carbohydrate, Ketogenic Diet versus a Low-Glycemic Index Diet on Glycemic Control in Type 2 Diabetes Mellitus,” Nutrition & Metabolism, 2008; doi:10.1186/1743-7075-5-36.

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Dr. Jeffrey Shapiro, MD

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After receiving athletic and academic awards at Yale and Stanford, Jeff has coached those seeking peak wellness, appeared on ABC News 20/20 and served as a consultant for CBS News 60 Minutes and The Late Show with David Letterman. As the author of many research studies and practicing anesthesiology/critical care medicine for more than 20 years, Jeff can be your guide to common sense decision making regarding drugs, supplements and vitamins. With no corporate sponsors and no vitamins or supplements... Read Full Bio »