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"Keto is not a great long-term diet, as it is not a balanced diet," Nancy Rahnama, M.D., M.S., an internal medicine and bariatric specialist, told Reader's Digest. "A diet that is devoid of fruit and vegetables will result in long-term micronutrient deficiencies that can have other consequences. The keto diet can be used for short-term fat loss, as long as it is under medical supervision."
I'm at 240 now and actually weigh less than I did in high school. Have a decent amount of excess skin that skews my actual weight. Thankfully the government of Canada pays for plastic surgery in my case because it could lead to health problems in the future. Surgery is in about 8 or so months and I'm quite excited to start a completely new chapter of my life once it's done.
And what I’m writing has nothing to do with taking supplements to induce ketosis or whatever. I believe these things are covered in Volek & Phoney’s book The Art and Science of Low Carb Living, which I would have thought you to be very familiar with. The iodine stuff you can read about in Iodine, Why We Need, Why We Can’t Live Without It by Brownstein.
Shifting your metabolism and achieving ketosis may speed up weight loss and result in other health benefits, like more energy and a lower blood pressure. But while ketosis is a preferred nutritional state for some people, it isn’t recommended for everyone — and it’s not a good long-term eating approach due to its restrictive nature, which may lead to potentially dangerous nutritional deficiencies.
Take coconut oil for example. The coconut oil industry loves to market the idea that relatively inexpensive and abundant coconut oil is a great source of MCTs because it’s “62% MCT oil”, but the problem is that studies show you can’t get many useful ketogenic MCT’s from just eating coconut oil or even most brands of “MCT oil”, which are often is diluted with lauric acid, a cheap, hugely abundant part of coconut oil that is typically marketed as an MCT oil.

Long-term disruption of menstruation can bring on serious side effects, including low bone density. “This is because estrogen is very important to bone health,” says Yawitz. “Studies have also found prolonged menstrual irregularity to increase risk for cardiovascular disease, depression, anxiety, and sexual dysfunction. It’s important to contact your ob-gyn if your cycles become irregular or if you stop having periods.”
People use a ketogenic diet most often to lose weight, but it can help manage certain medical conditions, like epilepsy, too. It also may help people with heart disease, certain brain diseases, and even acne, but there needs to be more research in those areas. Talk with your doctor first to find out if it’s safe for you to try a ketogenic diet, especially if you have type 1 diabetes.
Great post!! I’m a 41 year old Master CrossFit athlete, been in keto / LCHF Primal lifestyle for the past 9 years. I feel that my performance has improved a lot and continues to improve pretty significantly. I was a top 200 Master Open Qualifier on 2016 and 2017 and I’m usually on the podium of local competitions so my performance is really not bad…and I’m totally fat adapted. I follow sort of a TKD where I sometimes eat carbs at night during the week, but never above 100g so It doesn’t even kick me out of ketosis due to activity level. I’ve been playing with some measurements and I noticed that my BG reading after high intensity training sessions is really high (up to 180mg/dl). But it goes down fast (sometimes it goes down to 50mg/dl but I show no side effect of hypo, function completely normal). From my research, the high glucose post high intensity is normal and due to the stressful response of the exercise and also because my liver is producing the glucose from gluconeogeneses to provide it for the workouts, when needed. This only happens when the workouts are long, above 30 minutes.
In the US especially, coconut oil and MCT oil manufacturers are legally allowed to claim that lauric acid is an MCT because chemists named it that way, even though it does not act like other true biological MCT oils. If you are relying on plain coconut oil or “MCT-labeled” oil to get enough useful MCTs, think again and check the label: odds are you’re getting very few of the potent, ketogenic shorter chain MCTs (also known as “C8” and “C10”), and instead getting mostly cheaper but ineffective lauric acid.
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.
Therefore, more people experiencing "keto crotch" need to visit doctors to determine what's really happening. It could be that some of the people claiming "keto crotch" are instead detecting smells that are not related to their diets. Many different smells could emanate from your crotch, some are normal, some are not. Conversely, who knows for sure what a drastic change in your diet may do to different parts of your body? There is still a lot unknown about the links between nutrition and your various bodily functions. You are a complex system with many unknowns. The keto crotch could be a real phenomenon, but more scientific evidence and studies are needed.
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 DNA test does not necessarily take into account your goals (e.g. breathholding, Ironman, cognition, etc.) and if your goals would benefit from ketosis, then you may want to choose it as a dietary strategy even though it could indeed be true that for FAT LOSS a higher carb intake may suit you. So it all depends on your goals. Or you could just us the supplements like ketones AND eat more carbs and get "best of both worlds".

On the ketogenic diet I feel very shaky/anxious from when I wake up til about noon. Eating doesn’t really help. It could be electrolyte related but seems possibly more related to excess cortisol/adrenaline as noon is also when I start to crash and get tired on a more normal diet, and because those 3 am awakenings that worsen simultaneously in ketosis seem to also have to do with HPA axis stuff. Does this side effect potentially also have to do with my fasting blood sugar being elevated?
People claiming huge benefits of these supplements – despite the lack of solid scientific support – may sometimes have a financial reason to believe in the supplements. Some of these products are sold under a multi-level marketing arrangement, where sales people are paid based on commission. For example, the company Prüvit sells drinkable ketones, called KETO//OS with a multi-level marketing structure.

I don’t know about you, but I find these risks pretty damn concerning. The fact is that I want to be around to play with my grandkids, and considering that my genetic testing with 23andMe has revealed that I have a higher-than-normal risk for type 2 diabetes, I doubt that shoving more gooey gels and sugary sports drinks into my pie hole is going to do my health any favors. So if I can achieve similar levels of performance and body composition with carbohydrate restriction, I’m all in.


I've been on the diet for about a month and a half now and I've noticed that my vaginal odors have gotten MUCH stronger... (It smells like a mix between urine and discharge... I'm not exactly sure how vaginas are 'supposed' to smell like. Many say 'musky' but I feel like that's too mild of a word... It's much stronger than 'musk' for me :/ ). My discharge is white in color and it doesn't smell fishy. Sometimes when it dries on my underwear it's a light yellow? Has this happened to anyone before? Is it because of my change in diet (if so, can anybody explain why?), or could it be something else?
Fairly recently, the diet was introduced as a weight-loss diet by an Italian professor of surgery, Dr. Gianfranco Cappello of Sapienza University in Rome. In his 2012 study, about 19,000 dieters received a high-fat liquid diet via a feeding tube inserted down the nose. The study showed an average weight loss of more than 20 pounds in participants, most of whom kept it off for at least a year. The researchers reported a few minor side effects, like fatigue.
Ben, great article! I recently did my own ketosis experiment and didn’t catch the 100-200g advise until later than I should have, I’m guessing. Great results for 1-2 months but after 3 months I quit sleeping through the night and would wake after about 4 hours of rest each night. My guess is that the extra carbs at night coupled with iodine supplements should allow me to “have my cake and eat it too?” Any other suggestions on the sleep issue? I’ve gone back to High Fat/Low Carb, have improved sleep but I do miss nutritional ketosis and want to try again once my sleep is stable. Thank YOU!!! 
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