The ketogenic (keto) diet: what it is, how to follow it and what to eat + discussion of pros and cons

The ketogenic diet (a.k.a. keto or ketogenic) is a diet based on eating very few carbohydrates and a huge amount of fats. It is designed to allow us to eat deliciously while making it easier to lose weight.

The ketogenic diet was created to help reduce body fat and also improve cardiovascular function. If you've heard good things about it from your friends, now you can read what the experts have to say about it.

The ketogenic diet is a great way to help you lose weight.

With Dr Witold Tomaszewski, M.D., and Julia Skrajda, clinical dietician, we present the most important information about the ketogenic diet.

See also:

• Mediterranean diet
• The DASH diet
• Digestible diet
• Dabrowski's Diet
• SIRT diet
• Diabetes diet
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What is the ketogenic diet?

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The ketogenic diet (otherwise known as the keto or ketogenic diet) is a diet very high in fat and low in carbohydratesand. Drastically reducing carbohydrate intake and increasing fat supply puts the body into a state of ketosis. In this state, we can produce energy from fat and therefore burn it.

What are types of ketogenic diet?

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There are several types of ketogenic diet. However, the most common are four typesand. 

• Standard ketogenic diet (SKD). It is characterised by a very low carbohydrate, moderate protein and high fat supply. In most cases, it consists of the following macronutrient breakdown: 70% fats, 20% protein and 10% carbohydrates - a distribution of kcal per day.
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• Cyclic ketogenic diet (CKD). This type of keto diet allows you to take in higher amounts of carbohydrates at selected times. An example would be five days on the keto diet, followed by two days when we can consume larger amounts of carbohydrates (from 60 to as much as 80% of calories per day in the form of carbs).
• Targeted ketogenic diet (TKD). This ketogenic diet allows you to add more than enough carbohydrates to your diet (15 to 50g) before increased physical exertion (training). 
• High-protein ketogenic diet (HPKD). This is, as the name suggests, a ketogenic diet that provides the body with a lot of protein. The most common macronutrient ratio is 60% fat, 35% protein and just 5% carbohydrates.
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Standard and high-protein ketogenic diets are popular types of keto diet that have been used for a long time. The cyclic and targeted ketogenic diets, on the other hand, are newer 'inventions'. They are most commonly used by bodybuilders or athletes. In today's article we look at the standard keto diet. Would you like to know more about the other types? Let us know in the comments!

One of the most important tenets of the ketogenic diet is what is known as ketosis. Find out what this metabolic state is and how to achieve it.

What is ketosis?

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Nutritional ketosis is a metabolic stateand in which the body uses ketones (instead of simple sugars) to produce energy. Ketones are formed by the breakdown of fat. Most often ketosis occurs after about 3-4 days of following a ketogenic diet. The result is the rapid burning of excess fat.

Why ketosis can lead to weight loss?

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Most cells in the human body produce energy from glucose (simple sugars). When this becomes scarce, it is necessary to find another source of energy. This becomes the aforementioned ketones, which are produced from fat. This is why the ketogenic diet can lead to weight loss.

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What is keto-flu?

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Keto flu is our body's 'rebellion' against carbohydrate withdrawal. It most commonly occurs around 24-48 hours after starting a ketogenic diet and produces the following symptoms.

Symptomsand keto-flu:

• headaches,
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• nausea,
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• constipation,
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• vomiting,
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• fatigue,
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• insomnia,
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• gastrointestinal problemsand,
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• weakness ,
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• irregular heartbeat ,
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The above symptoms are, of course, nothing pleasant. However, there are a few ways that can help you deal with keto-flu more quickly.

How to get rid ofand keto-flu?

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• Drink more water.
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• Avoid over-exertion (but don't cut back completely!).
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• Get good, healthy sleep.
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• Take electrolytes (besides water, tomato juices or a diet rich in sodium or potassium will provide you with them.
• Provide your body with electrolytes.
• Provide your body with "healthy" fats (seed or seed oils or olive oil will provide you with these).
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Don't give up! Most often, keto flu lasts for one to two weeks. However, if you are still experiencing discomfort after this time, see your doctor.

What is keto-adaptation?

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Keto-adaptation is a long-term processand in which your body "learns" to make full use of fats for energy. Keto-adaptation begins 4-12 weeks after entering a state of ketosis. Endurance athletes are an exception. For them, keto-adaptation can start as early as 2 weeks into a ketogenic diet.

Ketogenic diet - principles

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The most important rule of the keto diet you have already learnt - lots of fats and few carbohydrates. On a ketogenic diet, you shouldn't consume more than 50g of carbohydrates per dayand. In addition, sugars should be limited - so most vegetables and fruit are not recommended on this diet.

Macronutrients on the keto diet

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Macronutrients are the amount of fats, protein and carbohydrates you take in with your diet. On the keto diet, the basic 'macro' is 70/20/10and. This means that we should take in 70% of our calories with fats, 20% with protein and 10% with carbohydrates. Of course, this is a conventional 'golden ratio' that can be modified by 5 to 10% each way.

Assimilable and non-assimilable carbohydrates - what's the difference?

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The division of carbohydrates by digestion includes assimilable carbs, which affect the keto diet, and non-assimilable carbs (dietary fibre and sugar alcohols), which do not affect it. Digestible carbohydrates should be controlled by us. Their excessive consumption can disrupt ketosis.

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How to calculate assimilable carbohydrates?

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Calculating digestible carbohydrates (also known as net carbohydrates) is very simple. Subtract the fibre and half of the sugar alcohols (if present in the product) from all the carbohydrates.

Low glycaemic index carbohydrates - how do they affect the keto diet?

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The glycaemic index is an indicator that tells us how quickly blood glucose levels rise after eating a particular product. On a ketogenic diet, it is advisable to choose only carbohydrates with a low glycaemic index. More often than not, they do not have a large effect on blood glucose concentrations. However, do not forget the key rule - a keto diet is less than 50 g of carbohydrates per day.

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The ketogenic diet does not build a proper relationship with food. A diet is a way of eating that we are able to follow long-term. Keto is difficult and demanding, so the chance of sticking to this diet is low. Many people declare that they are on a ketogenic diet without having their ketone bodies tested.

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Keto diet - effects

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Aids weight loss

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The ketogenic diet can support weight loss by reducing appetite (affecting the satiety centre) and speeding up metabolismand. More often than not, a diet full of fat is more filling , and also reduces levels of hunger-stimulating hormones (leptin and ghrelin). 

Researchand suggests that people on the keto diet lost weight faster than others who were on a low-fat diet. It doesn't stop there, the ketogenic diet may also reduce the risk of obesityand.

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The ketogenic diet strongly restricts carbohydrate intake. Consequently, carbohydrate stores (glycogen) are used up very quickly by the body. - They can even be depleted in a few days. Glycogen is more than half as calorific as fat, and thus its loss is visible on the scale.

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Promotes heart health

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High levels of 'bad' cholesterol (LDL) lead to an increased risk of cardiovascular diseaseand. Studies  on animals and humans suggest that a keto diet can increase 'good' cholesterol (HDL) and decrease 'bad' cholesterol - particularly VLDL. Furthermore, the keto diet may reduce the risk of developing type 2 diabetes.

Promotes acne treatment

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Acne is an inflammatory skin disease. Lowering glycaemia (blood glucose levels) may have a positive impact on the treatment of this condition. Research indicates, that a diet low in carbohydrates (including, but not limited to, a ketogenic diet) may reduce acne symptomsand in some people.

Positive effects on brain function

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Research suggests that the ketone diet may provide us with neuroprotective benefits. This means that in some people, the keto diet strengthens and protects brain and nerve cellsand. Despite the promising results, further research is needed to confirm these assumptions.

Exactly yes, the ketone diet can treat epilepsy in the youngest children. What's more, as Dr Witold Tomaszewski, M.D., explains - this is why it was originally developed in the 1920s.

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The ketogenic diet may have its uses in the treatment of drug-resistant epilepsy. However, it should be conducted under the supervision of a doctor and a dietician. Only in this way can it be properly balanced. It is worth monitoring the renal profile during the ketogenic diet and examining the lipidogram, which can be disturbed by its use.

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Ketogenic diet - disadvantages

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If your enthusiasm for the ketogenic diet grows with every sentence you read, it's time to cool down a bit. Before you run to the shop to buy fat-rich products, know the main disadvantages of the keto diet. For some people, these may be so important that they will forgo a restrictive low-carbohydrate menu.

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The ketogenic diet is a very restrictive elimination diet (leading to weight loss). If not followed correctly, it can lead to nutritional deficiencies. On the other hand, weight loss will certainly be observed on it, and this promotes lower energy intake.

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The keto diet for beginners - tips on how to get started

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Giving up fast food or sweets is a much less restrictive dietary change than the ketogenic diet. Such a drastic carbohydrate restriction requires adequate preparation.

Restrictions on carbohydrates are a good idea.

Test yourself

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The ketogenic diet requires you to make dramatic changes to your daily diet. Therefore, it is essential that you have bloodand urine tests before starting it. These will help to verify any mineral or vitamin deficiencies. What's more, the tests also allow you to identify specific contraindications, such as heart, liver or kidney disease.

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Check what you will be able to eat

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The ketogenic diet is considered one of the more restrictive ones. It requires us to limit sweets or numerous snacks, for example. Before you embark on the keto diet, check what you will be able to eat. Some people will not be able to give up certain foods. 

Plan your first menu

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Before starting the ketogenic diet, plan all your meals for the next several days. Once you start the keto adventure, eating out won't be as easy as it was before. However, this doesn't mean you have to give it up completely. Most restaurant meals can be modified to fit the ketogenic diet.

Products allowed on the keto diet

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Eating less than 50 grams of carbohydrates per day (the basic premise of the keto diet) may seem impossible at first glance. However, contrary to appearances, the choice of products is not at all as limited as we might expect.

 

Animal proteins

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Animal proteins are the basis of the ketogenic diet. It is these foods that provide us with a lot of fat and protein, with negligible amounts of carbohydrates.

Meat

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Meat, whether beef, pork or poultry, is considered the foundation of the ketogenic diet. They are mostly low in carbohydrates and are a great source of protein and fats. 

What meats can we eat on a keto diet?

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• poultry (chicken , turkey ),
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• beef ,
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• pork ,
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• lamb ,
• lamb ,
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If you have the option, choose meat from grass-fed animals . It is much healthier than the equivalent from animals fed grain.

If you have the opportunity, choose meat from grass-fed animals.

Fish and seafood

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Fish and shellfish are very good sources of protein for those on a ketogenic diet. However, it should be noted, that seafood, such as oysters and octopus, will contain small amounts of carbohydrates, but these need to be controlled.

Fish and seafoodand that can be eaten on a keto diet are:

• beef ,
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• halibut ,
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• fish ,
• trout ,
• sardines ,
• mackerel ,
• shrimp ,
• flatfish ,
• herring ,
• tuna ,
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Hen's eggs

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A large hen's egg contains less than 0.5 grams of carbohydrates and over 6 grams of proteinand. This is why eggs are one of the most popular choices for people on a ketogenic diet. Remember to eat whole eggs, not just the egg white. Most of the beneficial nutrients are found in the egg yolkand.

Dairy

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Most dairy products are products that have great macros for people on a ketogenic diet. Which ones deserve a mention?

 

Cheese

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Most cheeses are high in fat and low in carbohydrates. A great example of this is cheddar cheese, which in 100 grams contains just under 4 grams of carbs, more than 22 grams of protein and more than 33 grams of fatand.

The best cheeseand on a ketogenic diet are:

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• gouda ,
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• goat ,
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• mushroom(blue) ,
• Camembert ,
• turtle ,
• feta ,
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And many more! These are just the most popular cheeses that I recommend to people on a ketogenic diet. In fact, most of the others have great 'macros' too. The only thing you need to do before choosing your favourite cheese is to check the carbohydrate, fat and protein content of a particular product.

Dairy products

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Cheese isn't everything, there are other dairy products that are worth eating on a ketogenic diet. These includeand:

• greek yoghurt,
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• cream 50% ,
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• unsweetened plant milks such as soy milk , almond milk  or coke milk .
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Vegetables

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We mainly associate vegetables with the basic weight loss diet, not the ketogenic diet. Nonetheless, they should not be absent from a full-fat menu either.

Green leafy vegetables

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Green leafy vegetables are low in carbohydrates, yet offer us a wealth of vitamins and minerals.

What green vegetablesand leafy vegetables can be eaten on a ketogenic diet?

• lettuceand,
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• spinach ,
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• cress ,
• cabbage ,
• kale ,
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• beet ,
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It is also worth mentioning the "safe"herbsand on the keto diet, which include:

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• thyme ,
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• oregano ,
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• dill ,
• parsley ,
• coriander ,
• basil ,
• sage ,
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Paprika

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Paprika comes in numerous varieties, and most of them are great for the ketogenic diet. Whether you opt for classic peppersand, for example, or jalapeños, you'll be able to make sure your keto recipe gains in flavour and the small amount of carbs won't upset your macro.

100 grams of red peppers provide us with 142 mg of vitamin C. This more than fills our daily requirement for this vitamin.

Zucchini

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Zucchini can be prepared in dozens of ways. Its low carbohydrate content has made this vegetable loved by many people on the ketogenic dietand. Courgette will work well in baking, can be an alternative to rice and can even be used to make pasta.

Zucchini provides us with a large amount of vitamin A. I invite you to read an article about this compound: Vitamin A - properties, effects, occurrence, deficiency symptoms

Other non-starchy vegetables

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There are several other non-starchy vegetables that are friendly to people on a ketogenic diet. These includeand:

• broccoli ,
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• asparagus ,
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• cauliflower ,
• cucumber ,
• aubergine ,
• radish ,
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Fruits

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Most fruits are high in carbohydrates, so on a keto diet they should be avoided. However, this does not mean that by putting ourselves on this diet, we will have to give up fruit altogether. 

 

Fruitsand that we can eat on a ketogenic diet are:

• avocado ,
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• carb ,
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• strawberries ,
• citrus ,
• raspberries ,
• peaches ,
• cantaloupe ,
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Other plant-based products

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The ketogenic diet is not only about meat and seafood. In addition to the aforementioned plant foods that fit into this menu, we have further suggestions for you. 

Nuts and seeds

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Some nuts and seeds are low in carbohydrates. Others should be especially avoided on a keto diet. 

On a ketogenic diet we can eat:

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• mondsand,
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• walnuts ,
• macadamia nuts ,
• pecan nuts ,
• flax seeds ,
• chia seeds ,
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Shirataki noodles

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Macaroni on a keto diet? That's right! Shirataki noodles contain only 2.5 grams of carbohydrates and 9 calories per 100 gand. It consists mainly of water, as well as glucomannanand. This viscous fibre reduces blood sugar spikes and can also reduce hunger.

Bitter chocolate

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The lack of sweets on a ketogenic diet can be bothersome, but dark chocolate should make up for it. This sweet can lower blood pressure and has a protective effect on the arterial endotheliumand. Remember to only choose chocolate that contains more than 70% cocoa solids.

Fats

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Frying, cooking or baking requires the use of the right fats or oils.

The best fats to use are the following.

The bestfatsand on the keto diet are:

• Olive oil.  It is a clean source of fat that contains no carbohydrates. Pioneering research recently conducted by a Polish team of scientists suggests that oleic acid (a component of olive oil) may reduce the risk of heart disease . 
• Butter.  Contains only trace amounts of carbohydrates, so there is nothing preventing you from using it on a ketogenic diet. 
• Ghee clarified butter.  It contains no carbohydrates in its composition, so it is great for the keto diet.

Beverages

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On a ketogenic diet, you won't have much choice when it comes to drinks. You will need to opt for one of three suggestions.

 

Allowed drinks on a ketogenic diet are:

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• unsweetened water,
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• unsweetened tea,
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• unsweetened coffee,
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Don't forget the aforementioned plant-based milks (soy, almond or coconut) either. These are also drinks you can drink on a keto diet without fear.

 

Alcohol

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On the ketogenic diet, we can consume alcohol. However, be careful and only choose liquors made from pure alcohol. 

Alcohols that we can drink on the ketogenic diet are:

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• rumand,
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• vodka ,
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• gin ,
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• tequila ,
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• whisky ,
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When consuming alcohols, even those on the above list, you should always be mindful of your carbohydrate supply. When it comes to other, more carbohydrate-rich alcoholic beverages, you should be even more vigilant.

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Keto-breakfast, or a recipe for a delicious salad from a nutritionist

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clinical nutritionist Joanna Serwińska-Jania has prepared a keto-breakfast recipe especially for you. Our suggestion is a salad with avocado and egg. 

Ingredients:

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• Avocado: 50 g (two handfuls)
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• An egg: 100 g (two pieces)
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• Spinach: 50 g (two handfuls)
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• Cocktail tomato: 120 g (about six pieces)
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• Pumpkin seeds: 20 g (two tablespoons)
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• Walnuts: 22 g (two tablespoons)
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• Olive oil: 10 g (one tablespoon)
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• Lemon juice: 6 g (one tbsp)
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• Dried oregano: 0.6 g (two pinches)
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• Fresh basil: 3 g (one handful)
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Preparation:

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• Hard boil the eggs.
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• Peel the avocado and cut it into smaller pieces.
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• Place the spinach in a bowl and add the eggs and avocado.
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• Add the chopped cherry tomatoes, pumpkin seeds and walnuts to the whole thing.
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• Blend the olive oil together with the lemon juice and oregano.
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• Pour the prepared mixture over the salad.
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• Add chopped basil to the top of the salad.
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After 15 minutes in the kitchen, your salad will be ready. It will provide you with 635.78 kcal and the following macronutrients:

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• Fat - 54.42g
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• Protein - 26.04 g
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• Carbohydrates - 19.25 g
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Ketogenic diet - prohibited products

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After the wealth of foods you can eat on the ketogenic diet, it's time to look at the other side of the coin. Forbidden foods are just as plentiful on keto.

 

Cereal products

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The aim of the ketogenic diet is to significantly restrict carbohydrates, huge swathes of which can be found in numerous cereals. Wheat, barley or maize are rich in carbohydrates, so foodstuffs made from these cereals should be avoided.

Cereal products that cannot be eaten on the keto diet are:

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• breadand,
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• macaroni ,
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• rice ,
• groats ,
• cakes ,
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• breakfast cereal ,
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Vegetables

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On a ketogenic diet, vegetables should also be limited. Most of them provide us with a lot of carbohydrates and very little fat.

Vegetables to avoid on a ketogenic diet:

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• potatoesand,
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• corn ,
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• batties (sweet potatoes) ,
• fasola ,
• peas ,
• carrots ,
• beets,
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• parsnip ,
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• peas ,
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Fruits

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As you already know, fruit consists largely of simple sugars. Therefore, most of them should not be eaten on keto.

Fruits you cannot eat on a ketogenic diet:

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• appleand,
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• grapes ,
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• mango ,
• dates ,
• banana ,
• pananas ,
• currants ,
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Sweets

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On a ketogenic diet you should avoid all sweets. They contain large amounts of carbohydrates. However, you can find sweets on the market that are designed for people on the keto diet. When choosing them, pay attention to the carb content and stick to a limit of 20-50 grams per day.

Beverages

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Beverages you cannot drink on a ketogenic diet:

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• colaand,
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• fruit juices ,
• energy drinks ,
• sweetened coffee and tea,
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• flavoured water (sweetened),
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• fruit beer,
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• alcoholic drinks (with a lot of sugar),
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Contraindications to the ketogenic diet

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The ketogenic diet involves restricting a huge range of products. In the long term, it can lead to vitamin or mineral deficiencies. For this reason, there are groups of people who should not opt for this diet.

How to safely end a ketogenic diet?

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Completing a ketogenic diet should mirror starting it. You should gradually increase your carbohydrate intake and reduce your fat intake. It is also a good idea to consult a specialist (doctor, dietician) who will monitor the whole process.

Stopping the keto diet too quickly (drastically reducing fats and increasing carbohydrate intake) can lead to unpleasant side effects. 

How to break the keto diet - tips

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• Choose quality carbohydrates. When you stop the ketogenic diet, choose carbohydrates rich in protein and fibre. Forget about crisps, biscuits or doughnuts. Bet on good quality carbohydrates that will take you a long time to digest. Your carbohydrate intake should be monitored together with your doctor. If you don't have one, try to increase your intake by around 10% each day.
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• Avoid sugar. After a few months on the ketogenic diet, your craving for sugar is certainly very low. You have become unaccustomed to it so try not to include sugar in your diet in large quantities. If a product contains more than 4-5 grams of sugar - don't eat it. However, remember that selected foods often contain healthy, natural sugars that you can safely eat in larger quantities (only if you want to raise your blood sugar). Sweeteners are also worth mentioning. Erythritol, for example, provides us with a great sweet feeling, and it has 0 kcal and does not affect sugar spikes.
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• Care for habits. Starting the keto diet required learning new habits. Ending it is exactly the same. Learn to choose healthy snacks and keep your body hydrated. Adapt your lifestyle to the new diet. Once you've gone on a "basic" diet, you may notice weight gain, but healthy habits will help you stop putting on more pounds.

See also:

• How to take care of your health?
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• Aspartame on the WHO blacklist
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Ketogenic diet reviews

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As it happens with opinions, they are divided. 

Specially for you, I have prepared the statements of three people about this diet - two specialists (Dr. n. med. Witold Tomaszewski and Julia Skrajda - clinical dietician) and Matthew, who decided to test the keto diet on his own skin.

What does Dr Witold Tomaszewski, M.D., think about the ketogenic diet?

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The ketogenic diet should be followed very carefully. Before starting it, a clinical nutritionist should be contacted, as well as a doctor dealing with metabolic diseases. An endocrinologist, a diabetologist and a hepatologist are specialists who can assess our state of health and decide whether we can undertake the keto diet.

As a doctor, I always lean towards a balanced diet in the first instance. It is impossible to 'cheat' a calorie deficit. A low calorie intake combined with physical activity is the first step to losing weight. Only when the 'classic' diet does not work, can we consider other suggestions - always under the guidance of a doctor and a dietician. 

Treating obesity is not an easy task.

Dieting obesity can easily deregulate our bodies and lead to serious illnesses. When the keto diet fails to produce the expected results in treating obesity, gastric ballooning may be the next step.

Gastrointestinal ballooning may be the next step.

Diets or surgery, however, are not always the best way to fight obesity. In some cases, psychotherapy can be very helpful. Excessive food intake can be the result of obsessive neurosis, personality disorders, depression or stress.

The following is an example.

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The keto diet through the eyes of a clinical nutritionist

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The ketogenic diet is an unbalanced and restrictive menu that often results in vitamin and mineral deficiencies. It does not teach us a rational and, above all, healthy approach to nutrition. 

I work as a clinical dietitian on a daily basis and advise my patients against the ketogenic diet. I don't practise it myself and I don't design menus under it. However, if you decide to follow the keto diet, it is essential to have continuous contact with an experienced specialist. 

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Short periods of carbohydrate restriction can have a positive effect on our mood and body function. Nevertheless, our main source of energy (necessary for daily functioning) is glucose and carbohydrates. Therefore, in the long term, we should not exclude them.

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Why did Matthew give up the ketogenic diet

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Matthew remained on the ketogenic diet for approximately 2 months. This 31-year-old is a frequent gym-goer. I asked him about his impressions so that you can get to know the keto diet "inside out".

 

Ludwik Jelonek: How do you recall your beginnings with the keto diet?

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Matthew: The ketogenic diet proved to be very demanding for me both time-wise and financially. Consulting a good nutritionist is a big expense. It is no different with dedicated keto food products, which include snacks or baked goods. 

Spontaneous outings with friends for shared meals were out of the question, and the keto docs and memes were becoming increasingly tiresome.

Why did you choose the ketogenic diet?

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I have been strength training for several years. The ketogenic diet became fashionable and I wanted to see for myself what it really was. I also intended to lose a few kilos after a period of mass. After consulting with a nutritionist, I started the keto diet. 

Without talking to a specialist first, I would not have decided to take this step. On a ketogenic diet it is easy to make a mistake and damage your health.

What was the hardest part?

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The period of entering ketosis was the worst for me. Headaches and unpleasant breathing were symptoms that hit me hard. The nutritionist recommended that I drink lots of water and suck on cloves. I did so too, unfortunately to no avail. 

My weight was dropping very quickly, and a significant lack of strength made it very difficult for me to train. I was missing my favourite carbohydrate-rich foods every day.

Why did you decide to end the ketogenic diet?

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After about 7-8 weeks of a targeted ketogenic diet, I was already very tired of it. I had also lost some of the muscle that I had been building up over many months.

I missed spontaneous outings with friends or simple dinners with my family. I had to consult a nutritionist for all dietary changes. That's why I asked a specialist to prepare me to go off the keto diet.

How to do it.

What advice would you give to people who are about to go on the keto diet?

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I recommend both starting and completing the ketogenic diet with one specialist. I do not recommend looking for answers on the internet. There is no shortage of so-called "keto-spies" on the web who scare me with some of the advice that leads to very unhealthy nutrition. Therefore, it is best to consult a single, specialised person.

See also:

• Piperine [properties + side effects and effects]
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• Berberine [properties + effects and side effects]
• Chromium [properties + use + supplementation]
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• Curcumin [what it is + properties and side effects]

Summary

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