The Ketogenic Diet: A Complete Beginner’s Guide to Keto

The ketogenic (keto) diet is a low-carb, high-fat meal plan linked with many potential health benefits.

In recent years many people have turned to the ketogenic diet to help with weight loss and improve many other health conditions.

With a large number of foods off-limits, the keto diet requires a lot of meal planning and attention to detail to get into the correct metabolic state and turn your body into a fat-burning machine.

How do you get started on a keto diet? Is it a fad or a sustainable long-term eating pattern? Does it actually help you lose weight? 

Here is the ultimate guide to the keto diet for beginners. 

What Is a Ketogenic Diet?

A ketogenic diet is a high fat, moderate protein, low carb diet plan.

The concept of the ketogenic diet first emerged in the early 1920s as a treatment for childhood epilepsy (1).

Researchers found that when children with epilepsy followed a very high fat keto diet, their seizures became more manageable or stopped altogether.

The keto diet remained a popular treatment for epilepsy until the 1940’s when new anti-seizure medications became available.

These medications were easier for children to stick with. As a result, the keto diet saw its popularity decline over time.

It remained relatively forgotten until the early 1970s. Then Dr. Robert Atkins published his first book “Diet Revolution.” 

This book highlighted the benefits of the Atkins diet, a low carb, high-fat eating plan.

The Atkins diet quickly became a very popular option for weight loss.

This generated interest in low-carb diets as a treatment for many other health conditions such as heart disease and diabetes.

Since then the keto diet, a low carb high-fat diet similar to Atkins, has become a popular choice for people trying to lose weight and improve their health. 

(would be a great place to link to an article about Atkins or Atkins vs. Keto comparison)

Following a ketogenic diet is not only about limiting carbohydrate intake. The goal is to transition our body into a fat-burning mode known as ketosis.

To do this the majority of your calories have to come from fat. 

In ketosis, our body burns fat for energy instead of sugar. Some parts of our body such as our brain can only use blood sugar as an energy source.

On a very low-carb diet, our liver starts to create compounds known as ketone bodies to supply the necessary energy to these glucose-reliant cells.

The health benefits of following a ketogenic diet come from both the overall reduction in energy intake and the low carb-driven state of ketosis.

How Do I Start a Keto Diet? 

To start on a keto diet and reach ketosis, most people need to limit their total carb intake to somewhere between 20 and 50 grams per day.

For most this means 5% to 10% of total energy intake can come from carbs. 

Begin by reading nutrition labels and accurately counting how many carbs you are currently eating each day.

It is best to track your food intake to help ensure you are getting the correct ratio of macronutrients.

The recommended macronutrient ranges for a ketogenic diet are 10% carbs, 20% protein, and 70% fat (2).

It is important to point out that there is no “standard” ketogenic diet.

The constant factors are moderate protein and low enough carb intake to enter a state of ketosis. 

The average American diet is composed of 55% carbs, 15% protein, and 30% fat (3).

Switching to a ketogenic low-carb eating plan requires a significant change in our food intake because most people do not eat a very high-fat diet.

Daily intake of protein needs to remain moderate at around 20% of total calories. For a 2,000 calorie diet, this translates to around 100 grams of protein per day.

Too much protein can prevent our body from entering into ketosis and burning fat as a fuel source.

Our bodies are able to create blood sugar from components of proteins called amino acids.

We need to make sure we provide our bodies with enough protein to maintain muscle mass but avoid having too much that ends up being converted into blood sugar.

Ketogenic diets are different from other trendy low-carb diets like Paleo which have more balance between carbs, proteins, and fats.

When you first start on a keto diet, your body has to go through many changes before it can enter a fat-burning mode. 

Our body stores a small amount of sugar in cells, mostly in the liver.

The storage form of blood sugar in the body is called glycogen.

After you start a very low carb diet it takes one to two days for the body to use up all of its stored glycogen.

Once glycogen stores have been depleted, our body begins burning fat for energy. At the same time, our liver begins creating ketones and we are in a state of ketosis.

We can tell if our body is in a state of ketosis when there are measurable ketone levels in our blood and urine.

What Foods Contain Carbs?

Here is a list of high-carb foods. Most of these foods need to be eliminated on a diet for keto. 

• Bread and Grains
• Fruit and Fruit Juice
• Starchy Vegetables (potatoes, corn, peas)  
• Beans and Legumes
• Pasta 
• Cereal
• Dairy   
• Beer
• Salad dressings with added sugar
• Honey, granulated sugar or other calorie-containing sweeteners
• Chips, crackers
• Baked goods
• Ice cream

One serving of fruit, equal to a tennis ball-sized orange or apple, one cup of berries or half of a banana contains 15 grams of carbs.

Remember the goal is 20 to 50 grams of total carbs per day on a ketogenic diet.

One cup of milk, a slice of bread or 1/3 cup of cooked rice also contains 15 grams of carbs.

When making a keto diet menu, make sure you’re accounting for these foods and limit them to no more than one serving per day.

Depending on how many carbs you are getting from other foods you may not be able to have any in the beginning stages.

You may have heard people talking about total carbs and others talking about net carbs when discussing ketogenic diets. 

Total carbs refers to the number of carbs in food. For example, an avocado has 11.6 grams of total carbs. Here is how to calculate net carbs.

What Are Net Carbs?

Many foods that contain carbs also contain fiber. While fiber intake is incredibly important for gut health, fiber is not digestible by our bodies therefore it will not increase blood sugar levels or provide energy for our body.

Some people suggest subtracting the amount of fiber in food and only counting the carbs that are digestible toward the daily limit of 20 to 50 grams per day.

This number is called net carbs.

For example, a whole avocado has 11.6 grams of total carbs. However, it contains 9.1 grams of fiber. One whole avocado contains just 2.5 grams of net carbs (4).

What Should You Do? 

Most proponents of ketogenic diets recommend starting with 20 to 50 grams of total carbs per day.

After a period of time where you are consistently in ketosis, you can begin increasing your carb count and carefully track your levels of ketones.

Continue to adjust your intake until you find the right total number of net carbs each day that works for your body. If you come out of ketosis you are eating too many carbs.

While there are many high carb foods that need to be avoided, there are a wide variety of foods that are keto-friendly. 

What Are Keto-Friendly Foods?

Most of your calories on a ketogenic diet will come from eating a lot of fat and a moderate amount of protein. Here are the keto foods that fit with a ketogenic diet.

• Meats and proteins including beef, chicken, turkey, and pork
• Cheese
• Fatty fish
• Eggs
• Avocados
• Mushrooms
• Dark Chocolate
• Nuts and Seeds including walnuts, almonds, and peanuts
• Oils including coconut oil, olive oil, and butter

One ounce of meat and seafood contains 7 grams of protein.

One egg contains 6 grams of protein. Nuts and nut butter and cheese are also excellent low-carb protein sources. 

For a 2,000 calorie diet, you need around 100 grams of protein each day.

You will have to monitor your ketone levels once you are in ketosis and adjust your protein intake if necessary.

Avocados are packed full of healthy fatty acids.

The ketogenic diet also includes the liberal use of added fats like butter, coconut oil, and olive oil. 

On a keto diet fat will make up at least 70% of total energy intake. For a 2,000 calorie diet, this is around 155 grams of fat each day. 

Keto-Friendly Vegetables

You may be wondering if vegetables are ok on a ketogenic diet.

They are full of beneficial nutrients that our bodies need, but also contain a small amount of carbs.

On a ketogenic diet, it’s generally recommended to avoid root vegetables, at least in the beginning.

These vegetables which include carrots, sweet potatoes, onions, parsnips, and beets tend to be higher in total carbs.

An easy rule to remember is to stick with above-ground vegetables like leafy greens to start. Avoid any food that grows below the ground.

You can still include a small amount of root vegetables in your low-carb meals, for example, you can add chopped carrots to a healthy keto stir fry.

You just want to avoid munching on raw carrots as a snack food.

What Are the Benefits of a Keto Diet?

The ketogenic diet requires you to cut many foods to be successful. This is also one of the reasons why people have so much success with a ketogenic diet.

A lot of people struggle with eating too many snack foods. When following a ketogenic low-carb eating pattern you completely eliminate them.

Moderation may sound like a good plan but many people find it easier to follow low-carb diets that require them to completely drop troublesome foods.

Many people start a keto diet in order to lose weight.

One recent analysis found that people following a ketogenic diet lost more weight than those following a low-fat diet and maintained that weight loss for up to 24 months.

The keto dieters also had improvements in markers of heart disease risk such as lower blood pressure and improved triglyceride levels (5).

There are many ways that a ketogenic diet can lead to weight loss. One is through a reduction in appetite.

High-fat foods tend to be more filling. A recent analysis showed that individuals following a ketogenic diet were less hungry and had better appetite control (6).

This is important because typically when we lose weight we feel more hungry.

Being in ketosis and eating more fat seems to help stop this increase in hunger from happening (7).

Besides being an effective choice for weight loss, being in fat-burning mode with the keto diet can also help reduce belly fat. 

A recent study assigned 148 individuals to either of two groups for a period of 12 months.

The first group followed a low-carb keto diet and the other followed a low-fat diet.

At the end of the study, people who followed a low-carb keto diet lost more belly fat than those following a low-fat diet (8). 

There are other studies showing that a ketogenic diet may be beneficial for polycystic ovary syndrome (9), potentially help treat cancer and slow tumor growth and improve acne (10, 11). 

A recent analysis found that following a low-carb diet reduced many of the risk factors associated with heart disease including lowering triglyceride levels and raising HDL cholesterol levels (12).

A low-carb ketogenic diet can also help individuals with diabetes manage blood glucose levels.

A recent analysis published in 2020 found that a ketogenic diet was more effective for blood sugar control and led to a higher amount of weight loss than a low-fat diet (13). 

Know the Potential Side Effects

While many are quick to praise the ketogenic diet as a miracle, it is important to point out that there are potential side effects keto beginners may experience. 

The most common side effect is called keto flu.

The keto flu happens due to an internal shift when your body is adapting to a new low-carb high-fat diet.

Much like withdrawals when you stop drinking caffeine, a sudden change in carb intake can be a shock to your body.

Keto flu symptoms may include brain fog, dry mouth, fatigue, low energy levels, constipation, headaches, dizziness, and sugar cravings.

Keto flu may last for the first week but it’s usually temporary. 

Headaches are another one of common side effect. They are often due to dehydration. 

Glycogen is the body is stored with water. When we use up our glycogen stores in the first couple of days after starting a keto diet that excess water is excreted from our body through urination.

This leads to a quick initial weight loss of water weight but also increases the risk of dehydration (2).

It’s essential to drink enough water while on a ketogenic diet, especially in the early stages.

Some studies also see elevated levels of LDL cholesterol in individuals following a ketogenic diet (5). 

The long-term effects of high LDL cholesterol while following a keto diet and the potential impact on heart disease is unknown.

It’s best to check your cholesterol levels closely and adjust your diet if you see a significant increase in LDL levels. 

One of the potentially serious side effects of starting a keto diet can come from a drop in blood sugar levels and insulin levels.

If you are diabetic be sure to carefully monitor for blood sugar swings and work with a medical professional to adjust your insulin intake. 

Fill Your Kitchen with Keto Staples

For a successful start to keto diets, you need to make sure you’re stocked up on many staple foods.

The full list of keto-friendly foods is extensive, but you can start with the essentials first. 

Make sure you have plenty of healthy fats on hand including nuts, seeds, olive oil, ghee, grass-fed butter, and avocado oil.

Also stock up on lean proteins including wild fish, eggs, grass-fed beef and cheese, and organic poultry.

For veggies, you need to be selective and avoid root vegetables and starchy vegetables including corn and peas.

Low-calorie, low-sugar veggies like kale, broccoli, cauliflower, cucumbers, zucchini, asparagus, cabbage, and leafy veggies can all be included.

If you would like to add fruits, start with a small serving of berries as those are the highest in fiber. 

There are foods that are off-limits too. The list includes all grain products such as pasta, rice, bread, and even tortillas.

Fruits like bananas, peaches, and oranges should be avoided at first.

Also plan for alternative ways to sweeten common foods like coffee because sugar and alternative sweeteners like maple syrup, honey, and agave are off-limits. 

A popular keto diet alternative to sweetened coffee is bulletproof coffee which contains grass-fed butter and MCT oil.

If you are ready to test the water and get started on a keto journey, here is the perfect four-day keto meal plan with lots of keto recipes and meal ideas. 

 4-Day Sample Ketogenic Diet Meal Plan

Day: 1

Breakfast: Cheese Omelet

• 1 tbsp of coconut oil
• 2 whole eggs
• 2 tbsp shredded cheddar cheese
• 1/2 cup Spinach

Lunch: Grilled Salmon Salad

• 4 oz of salmon
• 2 cups of kale, washed and chopped
• 1/2 avocado, diced
• 1/4 cucumber, sliced
• Cilantro leaves, chopped

Dressing

• 1 tbsp of olive oil
• 1 tbsp of balsamic vinegar

Dinner: Chicken with Asparagus

• 3 oz grilled chicken thigh
• 6-8 asparagus spears
• 1 tbsp of vegetable oils to cook
• Side salad

Day: 2

Breakfast: Greek Yogurt, Full-Fat

• 1 cup of Greek yogurt
• 1 tsp sunflower seeds to top
• Monk fruit sweetener (optional)

Lunch: Beef and Veggie Chili

• 1/2 lb ground beef
• 1/2 cup tomato sauce
• 1/2 cup beef bone broth 
• 1 bell pepper, chopped
• 1 stalk celery
• 1/4 onion, chopped
• Chili mix
• Hot sauce (optional)
• Sour cream(optional)

Cooked the ground beef. Once browned, add chopped vegetables.

When they are soft and onions are transparent, add the chili mix and tomato sauce. Top with hot sauce and sour cream as you like.

Dinner: Grilled Chicken with Bell Peppers

• 3-4 oz chicken
• Lemon poultry seasoning
• 1 bell pepper, chopped into big chunks
• 1 tbsp coconut oil

Marinade the chicken in the lemon seasoning with coconut oil. Rest it for 30 minutes. When the grill is hot and ready, grill until fully cooked. You can grill the bell pepper next to the chicken.

Day: 3

Breakfast: Baked Egg Muffin

• 3 whole eggs
• A handful of spinach
• 1/4 cup cheese
• 1 red bell pepper, chopped
• Salt and pepper

Mix all the ingredients in a bowl and season it with salt and pepper. Pour it evenly into 6 muffin cups and bake for 20 mins in the oven.

Lunch: Tuna Caesar Salad

• 1/2 can tuna
• 1/4 onion, chopped
• 1/2 tbsp mayonnaise
• salt and pepper
• 2 cups of romaine lettuce, chopped
• 1 tbsp Parmesan cheese
• 1/2 tbsp Caesar dressing

Dinner: Steak with Broccoli

• 4 oz beef steak, however way you like 
• 2 cups of steamed broccoli with butter 

Day: 4

Breakfast: Avocado Cup

• 1 avocado
• 2 whole eggs
• salt and pepper

Cut the avocado in half. if the seed is small, scoop out extra avocado to make enough room for an egg. Drop one egg per half of avocado and season with salt and pepper. Bake in the oven for 20 mins.

Lunch: Sausages with Cole Slaw

• 1/2 lb sausage links, fried or grilled
• 1 cup cabbage coleslaw with mayonnaise

Dinner: Green Beans and Pork Chop

• 1/4-1/2 lb of cut pork chop
• Salt and pepper to taste
• 1/2 lb of fresh string beans, steamed

Pan-fry the pork with 1 tbsp coconut oil and after season it with salt and pepper. Steam the string beans to the plate with the chop.

Wrapping Up

Can the ketogenic diet be effective for improving your health problems and helping with weight loss? Definitely.

Studies show that people lose weight faster on a low-carb keto diet compared to a low-fat diet (5). 

If you are considering a long-term low-carb diet, be careful. Keto dieting can be hard to do for a long period of time. 

That’s because 55% of the modern American diet relies on carbohydrates(3). Many of those carbs are high energy nutrient-poor foods that lead to unwanted body weight gain.

By minimizing everyday carb intake to 10% of your total energy on a keto diet, fat and protein intake will naturally go up.

Ketogenic diets require at least 70% fat if not higher. 

These ratios are necessary to get into a state of ketosis, which can add to the benefits of a high-fat keto diet.

Be careful not to fall into the trap of “lazy keto.”

If your keto lifestyle is full of high fat processed red meat, low-quality proteins, and salty food the diet can be unhealthy.

While you may still see the weight loss, you are not getting the full-body benefits of being on a keto diet. You want to be making healthy food choices and developing clean eating habits. 

There is not a lot of good long-term data on keto and maintaining weight loss. There is a small sample of case studies to look at, but the lack of long-term data may be due to the diet being hard to stick to.

The keto diet may provide rapid weight loss, improve risk factors for heart disease, and help control blood sugar levels.

But its long-term effects are not fully known and a high-fat diet can be hard to stick with over the long run.

Sources:

1. Sampaio, Letícia Pereira de Brito. “Ketogenic Diet for Epilepsy Treatment.” Arquivos de Neuro-Psiquiatria, vol. 74, no. 10, 2016, pp. 842–48. Crossref, doi:10.1590/0004-282×20160116.
2. Ketogenic Diets: Boon or Bane?” Indian Journal of Medical Research, vol. 148, no. 3, 2018, p. 251. Crossref, doi:10.4103/ijmr.ijmr_1666_18.
3. Abbasi, Jennifer. “Interest in the Ketogenic Diet Grows for Weight Loss and Type 2 Diabetes.” JAMA, vol. 319, no. 3, 2018, p. 215. Crossref, doi:10.1001/jama.2017.20639.
4. “FoodData Central.” Avocado, Raw, fdc.nal.usda.gov/fdc-app.html#/food-details/786651/nutrients. Accessed 8 Aug. 2020.
5. Bueno, Nassib Bezerra, et al. “Very-Low-Carbohydrate Ketogenic Diet v. Low-Fat Diet for Long-Term Weight Loss: A Meta-Analysis of Randomised Controlled Trials.” British Journal of Nutrition, vol. 110, no. 7, 2013, pp. 1178–87. Crossref, doi:10.1017/s0007114513000548.
6. Gibson, A. A., et al. “Do Ketogenic Diets Really Suppress Appetite? A Systematic Review and Meta-Analysis.” Obesity Reviews, vol. 16, no. 1, 2014, pp. 64–76. Crossref, doi:10.1111/obr.12230. 
7. Nymo, S., et al. “Timeline of Changes in Appetite during Weight Loss with a Ketogenic Diet.” International Journal of Obesity, vol. 41, no. 8, 2017, pp. 1224–31. Crossref, doi:10.1038/ijo.2017.96.
8. Bazzano, Lydia A., et al. “Effects of Low-Carbohydrate and Low-Fat Diets.” Annals of Internal Medicine, vol. 161, no. 5, 2014, p. 309. Crossref, doi:10.7326/m14-0180.
9. Mavropoulos, JohnC, et al. “The Effects of a Low-Carbohydrate, Ketogenic Diet on the Polycystic Ovary Syndrome: A Pilot Study.” Nutrition & Metabolism, vol. 2, no. 1, 2005, p. 35. Crossref, doi:10.1186/1743-7075-2-35.
10. Vidali, Silvia, et al. “Mitochondria: The Ketogenic Diet—A Metabolism-Based Therapy.” The International Journal of Biochemistry & Cell Biology, vol. 63, 2015, pp. 55–59. Crossref, doi:10.1016/j.biocel.2015.01.022.
11. Paoli, A., et al. “Nutrition and Acne: Therapeutic Potential of Ketogenic Diets.” Skin Pharmacology and Physiology, vol. 25, no. 3, 2012, pp. 111–17. Crossref, doi:10.1159/000336404.
12. Dong, Tingting, et al. “The Effects of Low-Carbohydrate Diets on Cardiovascular Risk Factors: A Meta-Analysis.” PLOS ONE, edited by Wisit Cheungpasitporn, vol. 15, no. 1, 2020, p. e0225348. Crossref, doi:10.1371/journal.pone.0225348.
13. Choi, Yeo Jin, et al. “Impact of a Ketogenic Diet on Metabolic Parameters in Patients with Obesity or Overweight and with or without Type 2 Diabetes: A Meta-Analysis of Randomized Controlled Trials.” Nutrients, vol. 12, no. 7, 2020, p. 2005. Crossref, doi:10.3390/nu12072005.