When your body burns its stores of fat, it can be hard on your kidneys. And starting a ketogenic diet -- or going back to a normal diet afterward -- can be tricky if you’re obese because of other health issues you’re likely to have, like diabetes, a heart condition, or high blood pressure. If you have any of these conditions, make diet changes slowly and only with the guidance of your doctor.
This is a typical lipid response to a low carb high fat diet. TG going town and HDL going up is clearly positive. Normally a slight elevation of LDL-C is not a cause for concern. I would suggest you check your lipids on 3-6 months. If there is further elevation of LDL-C you might try to reduce the relative contribution of saturated fat in your diet and use other fats instead, olive oil instead of butter etc.
I have been dealing with a chronic digestive condition for 15 years, interacting with specialists in three different states. In that time, not one single medical professional had ever asked me about my eating habits!!! It’s as though what you put in your mouth is completely unrelated to what happens to your health. If it doesn’t entail a prescription pad or a scalpel, it’s not of interest. Farmers don’t pay kickbacks the way Big Pharma does. When it comes to nutrition, we are on our own.

Blood levels of triglycerides have emerged as a very important risk factor for cardiovascular disease.  High serum triglyceride level is associated with abnormal lipoprotein metabolism, as well as with other risk factors including obesity, insulin resistance, diabetes mellitus, and lowered levels of HDL cholesterol. It has been shown in a number of studies that carbohydrate restriction lowers triglyceride levels significantly.
Great Q. While the answer isn't totally black and white, Zeitlin says that for most healthy people, if you're trying to lose weight, a low-carb diet would be the better fit because it doesn't aim to put your body into an unnatural state (ahem, ketosis). Instead, by cutting back on foods that are high in sugar and starches, you're able to drop weight and still maintain a healthy form of energy for your brain and body to run on.
Thank you for writing this post, it’s very helpful! I started low carbing a while back (probably more than a year ago) and ended up backsliding, as can often happen when trying to drastically change your eating habits. On Friday I had my annual physical and my doctor ordered blood work for glucose and insulin because previous results indicate I’m insulin resistant. The results from Friday indicate I still am, so now I’m a little worried and going back to low carb. One phone app (and website) I’ve found to be really helpful is Fat Secret. You can choose exactly which macro nutrients you want to see and it also shows percent of fat, carbs, and protein in a pie chart that I find helps me wrap my head around what I’ve consumed. It also helps that the app and website don’t seem to promote one eating plan over another.
Jill – Low carb has a much looser definition. It’s pretty open to whatever you want to do. You may want to eat a bit more for satiety if nothing else. But no, you don’t HAVE to go as high in fat. Since there is no real outline for low carb eating, you can pretty much adjust it to anything you want. Experiment and see what your body reacts best to. I’ve brought down my fat intake a bit more as well because I found that I was stalling with 80% fat, 15% protein. I do more like 70% fat and 25% protein now. Got my weight loss moving again. So it’s just about what works best for you and your body.
At the end of the day, “you want to create a diet for yourself that feels comfortable for you to commit to for the long-term, so you don't gain and lose, gain and lose—called weight cycling—and feel like you are constantly dieting.” The first can invite health problems (like insulin resistance); the latter is, well, not fun (or all that healthy, mentally speaking).
It is important to remember that people have different needs, and that no single weight-loss diet suits everyone. A ketogenic diet may be an option for some people who have had difficulty losing weight with other methods, but if you choose to go on a ketogenic diet, it’s best to be under the supervision of a doctor and an accredited practising dietitian.

When you’re following a traditional ketogenic diet, you consume around 75 percent of your daily calories from healthy fats, 5 percent from carbohydrates and approximately 20 percent from protein. In general, ketogenic diets typically limit daily net carb intake to just 20–30 grams, which is calculated by subtracting the number of grams of fiber from the total number of carbs.
I was on keto for 4 months and felt like CRAP. I ate 1500 cals a day, ate plenty of fat – kept it “clean keto” and could not for the life of me maintain enough energy to workout by the end of the day. It sucked. Yeah, I lost close to 70 lbs, but I felt lousy all the time (and yes, my electrolytes were fine; I took mag and potassium supplements, drank salted bone broth daily – I did it all).
Hi Sandy, I’m not a doctor so cannot give medical advice, but do have years of research and experience in this lifestyle. Kidney failure can happen due to excessive protein intake, which was more prevalent on older versions of the Atkins diet. This is a common misconception with low carb and keto diets – that they have to mean high protein – and they shouldn’t be. If you keep your protein in check, it shouldn’t be an issue. But, I would definitely consult with your doctor since you have had issues with this.
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