It’s also common for people starting the diet to experience flu-like symptoms, such as headaches and fatigue. This side effect is so common that there’s a name for it: the keto flu. “You shed a ton of water weight at first, which can lead to dehydration,” Nisevich Bede explains. This can worsen the symptoms of the keto flu. To counter it, she recommends staying hydrated and loading up on electrolytes through electrolyte tablets.

There is a reason why we store hundreds of thousands of calories in the form of fat in our body and only about 2000 calories in the form of glucose (with only a small amount of this useable by the brain). The reason is simple - The body prefers fat as its fuel source. Mark Sisson explains this in his article ‘A metabolic Paradigm Shift, or Why Fat is the Preferred Fuel for Human Consumption’.

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But people who started following the keto diet noticed weight loss for a few reasons: When you eat carbs, your body retains fluid in order to store carbs for energy (you know, in case it needs it). But when you’re not having much in the carb department, you lose this water weight, says Warren. Also, it's easy to go overboard on carbohydrates—but if you're loading up on fat, it may help curb cravings since it keeps you satisfied.
The remaining calories in the keto diet come from protein — about 1 gram (g) per kilogram of body weight, so a 140-pound woman would need about 64 g of protein total. As for carbs: “Every body is different, but most people maintain ketosis with between 20 and 50 g of net carbs per day,” says Mattinson. Total carbohydrates minus fiber equals net carbs, she explains.

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There are three instances where there’s research to back up a ketogenic diet, including to help control type 2 diabetes, as part of epilepsy treatment, or for weight loss, says Mattinson. “In terms of diabetes, there is some promising research showing that the ketogenic diet may improve glycemic control. It may cause a reduction in A1C — a key test for diabetes that measures a person’s average blood sugar control over two to three months — something that may help you reduce medication use,” she says.

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Polycystic Ovary Syndrome (PCOS) Because women with the infertility condition PCOS are at a greater risk for diabetes and obesity, some clinicians recommend the keto diet, says Taylor Moree, RD, LD, of Balance Fitness and Nutrition in Atlanta. But PCOS is no different from most health conditions mentioned here: Long-term research on the safety is needed. 

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Early studies reported high success rates; in one study in 1925, 60% of patients became seizure-free, and another 35% of patients had a 50% reduction in seizure frequency. These studies generally examined a cohort of patients recently treated by the physician (a retrospective study) and selected patients who had successfully maintained the dietary restrictions. However, these studies are difficult to compare to modern trials. One reason is that these older trials suffered from selection bias, as they excluded patients who were unable to start or maintain the diet and thereby selected from patients who would generate better results. In an attempt to control for this bias, modern study design prefers a prospective cohort (the patients in the study are chosen before therapy begins) in which the results are presented for all patients regardless of whether they started or completed the treatment (known as intent-to-treat analysis).[19]
“the mitochondria – work much better on a ketogenic diet as they are able to increase energy levels in a stable, long-burning, efficient, and steady way. Not only that, a ketogenic diet induces epigenetic changes[6] which increases the energetic output of our mitochondria, reduces the production of damaging free radicals, and favours the production of GABA”

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As mentioned, 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.
Otherwise in a nutshell ketosis can be defined as a “metabolic state that happens when you consume a very low carb, moderate protein, high fat diet (or fast for extended periods) that causes your body to switch from using glucose as it’s primary source of fuel, to running off ketones. Ketones themselves are produced when the body burns fat, and they’re primarily used as an alternative fuel source when glucose isn’t available.” (Keto Clarity)
As per heartburn, studies done have shown that a ketogenic diet can have beneficial effects for those who have Non Alcoholic Fatty Liver Disease. A 2006 paper published in the Journal of Digestive Diseases and Sciences found that ‘Six months of a low-carbohydrate, ketogenic diet led to significant weight loss and histologic improvement of fatty liver disease’

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The first modern study of fasting as a treatment for epilepsy was in France in 1911.[12] Twenty epilepsy patients of all ages were "detoxified" by consuming a low-calorie vegetarian diet, combined with periods of fasting and purging. Two benefited enormously, but most failed to maintain compliance with the imposed restrictions. The diet improved the patients' mental capabilities, in contrast to their medication, potassium bromide, which dulled the mind.[13]

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Run by the Charlie Foundation, this calculator can be helpful when you’re using keto as a therapy to help manage a medical condition. The calculator helps estimate calorie needs based on weight, assists in determining a macro ratio and macros needed per meal, and can calculate macro numbers on the basis of meals and snacks you enter into the system. Also takes into account fluids, supplements, and medications.
But beyond that, experts aren't convinced that the keto diet has any other scientifically proven health benefits. In fact, it may have some distinct downsides. If you follow the keto diet incorrectly, for example (like by eating lots of saturated fats, versus healthy unsaturated fats), you're at risk of raising your cholesterol levels. “The best strategy to keep your heart healthy is to get as much fat as possible from unsaturated sources such as olive, avocado and canola oils, nuts, seeds, avocados, and olives," says Ansel.

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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]

By cutting carbs, you’ll also cut sugar and simple, refined carbohydrates, which means a steadier supply of energy. (No more sugar highs and crashes!) Once their bodies are used to the diet, “The first thing people report is, ‘Oh my gosh, I have this steady energy and I don’t have the need to snack at 3 p.m. because my energy is waning,’” Nisevich Bede says. Research published in January 2015 in the journal Obesity Review showed that the keto diet may lead to fewer hunger pangs and a lower desire to eat. (3)

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The keto diet may also be beneficial for adults with epilepsy, though the Epilepsy Foundation notes that it’s less frequently recommended for this group because it is so restrictive and difficult to stick with. (1) One study, published in May 2016 in the journal Epilepsy & Behavior, found the diet reduced the frequency of seizures for many study participants, 7 percent of whom were seizure-free at the four-year mark. (2) And though it wasn’t the goal for this study, nearly 20 percent of the participants lost weight while following the diet.
Carbohydrates have been linked to this skin condition, so cutting down on them may help. And the drop in insulin that a ketogenic diet can trigger may also help stop acne breakouts. (Insulin can cause your body to make other hormones that bring on outbreaks.) Still, more research is needed to determine exactly how much effect, if any, the diet actually has on acne.  

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The ketogenic diet is calculated by a dietitian for each child. Age, weight, activity levels, culture, and food preferences all affect the meal plan. First, the energy requirements are set at 80–90% of the recommended daily amounts (RDA) for the child's age (the high-fat diet requires less energy to process than a typical high-carbohydrate diet). Highly active children or those with muscle spasticity require more food energy than this; immobile children require less. The ketogenic ratio of the diet compares the weight of fat to the combined weight of carbohydrate and protein. This is typically 4:1, but children who are younger than 18 months, older than 12 years, or who are obese may be started on a 3:1 ratio. Fat is energy-rich, with 9 kcal/g (38 kJ/g) compared to 4 kcal/g (17 kJ/g) for carbohydrate or protein, so portions on the ketogenic diet are smaller than normal. The quantity of fat in the diet can be calculated from the overall energy requirements and the chosen ketogenic ratio. Next, the protein levels are set to allow for growth and body maintenance, and are around 1 g protein for each kg of body weight. Lastly, the amount of carbohydrate is set according to what allowance is left while maintaining the chosen ratio. Any carbohydrate in medications or supplements must be subtracted from this allowance. The total daily amount of fat, protein, and carbohydrate is then evenly divided across the meals.[37]

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There are many ways in which epilepsy occurs. Examples of pathological physiology include: unusual excitatory connections within the neuronal network of the brain; abnormal neuron structure leading to altered current flow; decreased inhibitory neurotransmitter synthesis; ineffective receptors for inhibitory neurotransmitters; insufficient breakdown of excitatory neurotransmitters leading to excess; immature synapse development; and impaired function of ionic channels.[7]

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Wondering what fits into a keto diet — and what doesn’t? “It’s so important to know what foods you’ll be eating before you start, and how to incorporate more fats into your diet,” says Kristen Mancinelli, RD, author of The Ketogenic Diet: A Scientifically Proven Approach to Fast, Healthy Weight Loss, who is based in New York City. We asked her for some guidelines.
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.[18] Few adverse effects have been reported, though cholesterol is increased and the diet has not been studied long term.[48] Although based on a smaller data set (126 adults and children from 11 studies over five centres), these results from 2009 compare favorably with the traditional ketogenic diet.[18]

Here’s what we do know: The keto diet may be useful in treating symptoms of epilepsy, a seizure disorder. “The use of keto in treating epilepsy has the most evidence,” Angelone says. One study conducted by Johns Hopkins Medicine, for example, followed epileptic patients on the keto diet and found that 36 percent of them had a 50 percent reduction in seizures after three months on the diet, and 16 percent were seizure-free. However, experts aren't entirely sure why the keto diet has this affect, she adds.
Polycystic Ovary Syndrome (PCOS) Because women with the infertility condition PCOS are at a greater risk for diabetes and obesity, some clinicians recommend the keto diet, says Taylor Moree, RD, LD, of Balance Fitness and Nutrition in Atlanta. But PCOS is no different from most health conditions mentioned here: Long-term research on the safety is needed.
In the mid-1990s, Hollywood producer Jim Abrahams, whose son's severe epilepsy was effectively controlled by the diet, created the Charlie Foundation to promote it. Publicity included an appearance on NBC's Dateline programme and ...First Do No Harm (1997), a made-for-television film starring Meryl Streep. The foundation sponsored a multicentre research study, the results of which—announced in 1996—marked the beginning of renewed scientific interest in the diet.[1] 

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The possible benefits of the diet are impressive, but there are a few potential downsides to note. One is it’s tough to stick to. In fact, in a review of 11 studies involving adults on the keto diet, which was published in January 2015 in the Journal of Clinical Neurology, researchers calculated a 45 percent compliance rate among participants following the approach with the aim of controlling epilepsy. (13) “The diet is pretty hard to follow because it’s a complete shift from what you’re used to,” Nisevich Bede says. Slashing your intake of carbs can also make you feel hungrier than usual — a feeling that can last until you’re three weeks in.

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