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.

Professor Jennie Brand-Miller, professor of human nutrition at The University of Sydney says, "There's not a lot in the scientific literature to judge [the health effects of the keto diet]. On the basis of current science, I wouldn't recommend it. Several observational studies suggest this diet [actually] increases mortality, diabetes and cardiovascular disease."
That said, you may find you have more stable energy on a low-carb diet, especially if you work out a lot. If that’s the case, try adding some carbs back into your diet, either by going low-carb or by trying a modified version of keto like targeted keto or cyclical keto. Both are great for athletes and still offer many of the benefits of being in ketosis. 
This content is for informational and educational purposes only. It is not intended to provide medical advice or to take the place of such advice or treatment from a personal physician. All readers/viewers of this content are advised to consult their doctors or qualified health professionals regarding specific health questions. Neither Dr. Axe nor the publisher of this content takes responsibility for possible health consequences of any person or persons reading or following the information in this educational content. All viewers of this content, especially those taking prescription or over-the-counter medications, should consult their physicians before beginning any nutrition, supplement or lifestyle program.
Definitely! To successfully maintain weight loss from either (or any) diet, Zeitlin advises focusing on doubling your veggies, eating lean proteins (fish, eggs, chicken, turkey, shellfish, lentils, tofu), healthy fats (nuts, seeds, avocado, olive oil), fresh fruit, and whole grains. “That is what is going to help the weight come off and stay off,” she says.
I too love your site. Your keto recipes are the best! ….I’ve been on Keto for over a year now and have lost 100 pounds. I still have another 100 to go, but I’m still losing……. Another thing to look at is the influence that the sugar industry has had on today’s high carb diets. When food went low-fat, they added extra sugar. The sugar industry has a lot of money and lobbyist tied up in the way Americans eat. They really don’t want us to know that doing without sugar and eating more fat is the healthy way to go.
Angel – Our bodies get used to doing the same thing all the time. Sometimes you have to keep it guessing. There are a lot of approaches to this. Some people to “carb up” days (where they eat a specific amount more in carbs), some people throw in a different exercise, some people do an egg fast or even do a zero carb day or two. Depends on what you feel is right for you. Keto stalls are tough. But don’t give up.
A 2008 study published in the American Journal of Clinical Nutrition compared a medium-carbohydrate, high-protein diet with a low-carbohydrate ketogenic diet and found that after 4–6 weeks the 17 subjects lost significantly more weight and were less hungry on the ketogenic diet than the medium-carbohydrate diet. However, according to another study published in the American Journal of Epidemiology, low-carb diets were found to be no more effective than low-fat diets in the long term (more than one year).
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.
Please share more info., e.g., starting weight, amount of time you exercise and what intensity; how many carbs/day and do you count net carbs? I started keto in April and did well (lost 12 lbs.), except I had some mood issues at first. I really struggle to stay in keto and I just don’t think I can long term. I can definitely stay around 50-75 carbs but not 20. I have maintained what I lost, but I can’t seem to lose any more. I take 1,000 mg. Metformin daily, weigh 163 and am 5’4”. I really want to lose at least 10-15 more pounds. Maybe I can if I do what you’re doing.
If you select Gain Muscle as your goal, then you can select the Gain (surplus). The macro calculator will then recommend that you eat this percentage more calories than you need. Eating more calories than you need will result in weight gain, which will be in the form of muscle if you do weight training. For example, if you select 10% as the gain, the calculator will output 10% more calories than your body needs for maintenance.

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.
Hi Michelle, You don’t necessarily have to “hit” macros to get into ketosis. Ketosis is achieved by restricting carbohydrates, that’s it. Fat is needed for satiety and protein is needed to prevent muscle loss. So make protein a goal and carbs a limit, then eat enough fat to stay satisfied and don’t go over your macros. You can get more individual help in our support group.

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.
Thanks for this low carb slash keto macro calculator! I’ve been on the keto diet for almost 7 months now, but I have to admit that whenever I use these calculators, I get confused when it comes to what I should put under activity level. Say, I work an office job, where sedentary could be the option to choose because I’m sitting down 6-8 hours a day, but I also go to the gym up to 5x a week, which I guess would fall under moderate active? What do you think?

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.
I now eat a lower carb, moderate protein and moderate fat diet. I even eat whole wheat pasta (only 1/3 cup when I do eat it), I eat Ezekiel bread (1 slice) and on occassion, I eat potatoes (white) and even rice. I just keep the amounts around 10 grams of carbs. My breakfast is about 4 grams of carbs (its a protein shake and I put avacado in it as well). Lunch is 4 oz. protein, steamed veggies and/or a salad, slice of my bread with 1/2 tbsp. grass fed butter, snacks are 1.5 oz. nuts (1 oz. macadamian and 1/2 oz. cashews). Dinner has carbs from green veggies. And that’s it. And I drink a protein shake once a day because I lift weights along with doing cardio. In that shake I put 1/2 tbsp. nut butter and mix the shake with water. Sometimes I’ll add 1 to 2 oz. banana (yes, I weigh all of my food). And guess what?? I lose as much weight per week as if I was doing keto. I truly believe that eating a minimal amount of carbs per day makes a huge impact with weight loss. You don’t have to go into full blown keto to lose weight.
If you select Gain Muscle as your goal, then you can select the Gain (surplus). The macro calculator will then recommend that you eat this percentage more calories than you need. Eating more calories than you need will result in weight gain, which will be in the form of muscle if you do weight training. For example, if you select 10% as the gain, the calculator will output 10% more calories than your body needs for maintenance.
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.
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