Note that the term “reversal” in this context simply means that the disease gets better, improving glucose control and reducing the need for medications. In the best case, it can be so much improved that blood glucose returns to normal without medication, long term. In this context, reversal means the opposite of the disease progressing or getting worse.
This article is very useful, i am happy to see a medical expert reporting on the benefits of a low carbohydrate and high protein diet. It is also very helpful to see some scientific thought being put behind the report and the analysis. I have been involved in coaching combat athletes, boxers and martial artists for almost 30 years and have also been a personal trainer working with body builders and strength athletes. I have always been an advocate for the use of Low carb/High protein for a number of reasons mostly though because this type of diet makes sense.… Read more »

Dr. Sigurdsson, Do you have any advice for dealing with a doctor who is unreceptive to the idea of a LCHF diet? I am consistently told to “cut fat” and “stop snacking” (I don’t actually snack), “eat more whole grains” and “lose weight”… and then get scolded for “being noncompliant” when my blood sugar is elevated and my weight creeps up. Frankly, it’s beyond frustrating, to the point that I actively dread going to see my doctor for anything, including totally unrelated things like sinus infections or injuries. My doctor ignores all of my research, including studies I print out… Read more »
Under normal circumstances our body uses glucose from carbohydrate foods for energy. In the absence of glucose a process called ketosis occurs. This is a state in which the body burns fats instead of carbohydrates as its main fuel source. When we don’t eat carbs, the liver breaks down fat stores to produce energy. This energy is in the form of (and also creates) molecules called ‘ketones’. 
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.
Ketogenic diets were originally developed to treat epilepsy in children as it appears to reduce the frequency of seizures. It should be noted that using the diet in this context should not be attempted without the supervision of a specialised doctor. From these medical origins, the diet was picked up by the mainstream media and marketed as a weight loss regime – it is in this context that we will be discussing the diet for the purpose of this article.

Made famous by the Atkins Diet and other similar weight-loss plans, low-carb diets are most well-known for shedding pounds fast. And despite what might initially come to mind when you think about low-carb diet plans or what you may have been told about why low-carb diets are bad for you, research suggests that a balanced low-carb diet poses few health risks if done right.

This is how most people do keto – enough wiggle room in the carb count that you can at least have a salad and some cauliflower pizza crust, but not enough wiggle room to actually go out of ketosis. Unlike the carnivore plan, the goal of garden-variety isn’t to eat only meat and avoid plant foods; the goal is to get a specific set of macros (high fat, very low carbs).
What about your lean body mass that is mentioned several times above – how do you figure out what that is? This is the weight of everything in your body that isn’t fat. The calculator will automatically figure this out based on the body fat % that you enter, which you can estimate using the chart below. You could also manually calculate it if you’re curious:

Another possible explanation is that large amounts of processed carbs may induce large swings in blood sugar. As the blood sugar goes down rapidly again (an hour or two after a meal) the body may have to release stress hormones like adrenaline to avoid low sugar. This may accentuate symptoms associated with ADHD. Avoiding processed carbs may stabilize blood sugars and thus avoid this problem.
Insulin is a hormone that lets your body use or store sugar as fuel. Ketogenic diets make you burn through this fuel quickly, so you don’t need to store it. This means your body needs -- and makes -- less insulin. Those lower levels may help protect you against some kinds of cancer or even slow the growth of cancer cells. More research is needed on this, though.
Hi. When using the calculator the choices for activity only consider what type of “job” or lifestyle you have. I am back in school, so mostly sedentary but I work out at least 5 days a week eithere circuit training cardio/weights, body pump class, or stairmaster for 45 min to an hour. Does that not count toward anything? Is that still considered sedentary? Thanks!
While a ketogenic diet can be fast and effective in the short term, it can be hard to maintain because it’s very limiting. This means a large number of people tend to drop out of the diet, contributing to unhealthy, ‘yo-yo’ dieting behaviour. The key to maintaining a healthy weight in the long-term is an eating pattern that you can sustain over time.
There’s a lot of confusing with Low carb dieting. I did strict keto for 6 weeks back in April and lost 2 inches off my waist which was my goal but found the diet too restrictive so am slowely getting into low carb but am concerned I’ll gain the wieght back. So if I eat enough carbs to not be in a ketogenic state, but not much more than that, thanwhat happens after my body’s used up all the energy from the consumed carbs? Will it then seek fuel from stored fat again – does this mean you could be in and out of keto daily?
The keto diet involves eating very small amounts of carbohydrates, medium amounts of protein and getting most of your daily kilojoules from fats. Carbohydrates are the body's preferred source of energy. When we starve the body of carbs, ketone bodies (or ketones) are produced by the liver from fat, and used as fuel for the brain and body. So on a ketogenic diet, ketones replace carbs as the body's main energy source, meaning it runs almost entirely on stored fat.
Hi Mellisa, I still recommend eating a variety of vegetables on a keto diet! You can include low carb berries as well. That being said, a multivitamin usually can’t hurt anything, so you definitely can if you feel like you are missing something. As always, I’m not a doctor and recommend consulting with your doctor for ultimate recommendations on these types of questions.
I enjoyed reading your article! I too have been following a very strict keto diet. I lost 25 lbs in two months!!! I could not believe it. The toughest part was telling myself that it was okay to consume more fats and that even the sugar in most fruits cause them to have lots of carbs. I use to be a smoothie fanatic, now occasionally I will treat myself to sliced up strawberries and heavy whipping cream whipped up.
The kilojoule-counter app MyFitnessPal helped me track how many carbohydrates I was consuming and kept my kilojoule intake in check. But the biggest challenge of this diet was the lack of variety – and the enticing allure of carbs at every turn. I was ready to throw in the towel on day four when a cafe owner refused to make me a bacon and egg roll without the roll. "What am I meant to eat?" I blubbered. In fact, studies in keto diets have found attrition rates are one of the highest challenges of the diet.
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.
I enjoyed reading your article! I too have been following a very strict keto diet. I lost 25 lbs in two months!!! I could not believe it. The toughest part was telling myself that it was okay to consume more fats and that even the sugar in most fruits cause them to have lots of carbs. I use to be a smoothie fanatic, now occasionally I will treat myself to sliced up strawberries and heavy whipping cream whipped up.

I am 56 years old. about 3 years ago My hubby and I lost quite a lot of weight on a low carb life style. Me 70 him 100. Then I had to have a hysterectomy and a year later I lost my 23 year job. Needless to say, depression and hormones took over and I gained everything back. Him too. We are back at the low carb eating. The problem, He has lost 45 pounds so far. Me, 10. It just doesn’t seem to be working for me this time. Do you think the addition of more fats will help that? I need something that will give me a boost or a completely different way. I just thought I would ask you. You seem pretty knowledgeable on the subject.


Hi Megan, Sorry about that – there was an issue with that section and you should now see it in the FAQ above, explaining how it’s determined. The weight loss per week will depend on how much weight you have to lose, as weight loss happens more rapidly the more overweight you are. But in general, between 0.5 and 2 pounds loss per week is reasonable.
You’re not losing because you’re not in ketosis, the body is burning the extra carbs you eat and because you’re not eating enough you might feel lethargic. I’m a guy, I started at 145kg am now at 139kg after two-three weeks, zero exercise, occasional lifting dumbells once a week if that, rest of the time sitting in a chair, never go out and it just keeps dropping. I had 2 days where I felt terrible too, didn’t stop me. You can deff. stay at -20 carbs unless you’re vegan then it would be much harder I think. Most of the time for me it’s fish, lean meats, all kinds of cheese although I try to eat mozarela mostly, green veggies and low carb bread. In the morning I usually have low x2 carb bread slices (3.7g each) on toast with butter and a slice of cheese, coffee with stevia and milk. For sweet I eat dark choc and whipped cream with stevia and sometimes dark choc on its own, 65/75+ ones, delicious. I have some low carb choc spread too. For snacks I gobble down peanuts mostly, occasional bag of crisp and an ice cream lolly at about 5-10 carbs each, you always have to keep an eye on it and work it out. If you eat 18 grams of high carb in the morning then you have to restrict it later in the day by eating idk meat, eggs and cheese.
Although amino acids from protein foods can be converted to glucose, under experimental conditions, only a small percentage actually are. This may be related to individual factors, such as degree of insulin resistance. However, even people with type 2 diabetes usually do well with the adequate levels of protein Diet Doctor recommends, if their diets are also low carb.

Allow me to affirm the benefits of LCHF DIETS as described in the article, with some suggestion and additions to it. Fats do clog arteries by the means of increasing the blood plasma aggregability, in other words it doesn’t increase the viscosity of blood but obstructs its rate of entrance within capillary vessels. But this is OK. not a problem, if it is continued for a reasonable period. However it is a big damaging clogging element, if the blood vessels are not giving sometime to heal. On the otherhand excessive carbs intake will finally be converted to visceral stored fat, and again this is absolutely OK, as long as this doesn’t continue fo ever, brcause it will start clogging body organs, like the liver, the pancreas, and the heart. However, if at a certain juncture, excessive carbs intake is disrupted, and a person alternates between LCHF & LFHC diets, this should periodically takes full advantage of each diet, and still give ample time to heal from its disadvantages… think about that. Nature usually forced all living beings to alternate between different categories of food depending on each season. And as a matter of fact, this is what body builders do. It’s called cyclic carbing….
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