How To Use The Ketogenic Diet for Weight Loss The ketogenic diet puts your body into a state of ketosis, which ultimately allows you to use fat for energy. Fat burning is just one of the many benefits of ketosis that improves overall health and makes it an effective tool for weight loss. Keto has a cult following for a good reason: it makes you feel great. Keto-ers feel more satiated throughout the day and have increased energy levels, both physical and mental, leading to: Fewer cravings Lower caloric intake More self-control More physical activity. These benefits all contribute to weight loss; however, keto is not synonymous with weight loss. Far from being a magic tool, the ketogenic diet takes accurate and diligent tracking and adjustment to work. You need a balance of the right macros, realistic goal setting and tracking to take you closer to achieving your weight loss goals. In this guide, we’ll cover the following: What is Ketosis What are Ketones Benefits of Ketosis The Ketogenic Diet What is the Ketogenic Diet Ketogenic Foods: What to Eat and What to Avoid Designing a Keto Plan for Weight Loss Using a Keto Macro Calculator Exercise Intermittent Fasting Dealing with Plateaus Testing and Tracking Results How to Test Ketone Levels The Glucose-Ketone Index Body Fat Tracking/Photos Tape Measurements Using the Scale Making Adjustments to Your Keto Diet How to Adjust to Induce Ketosis Review Your Goals and Results By the end of this guide, you’ll have everything you need to get started on the ketogenic diet to lose weight the right way — for the long term. What is Ketosis & How Does It Promote Fat Loss? The ketogenic diet promotes and maintains ketosis. Ketosis is a metabolic state in which your body uses fat rather than glucose from carbohydrates as its primary source of energy. To achieve ketosis, you stop supplying your body with carbs and sugar. This depletes your stored glucose — also known as glycogen — and your blood sugar and insulin levels decrease. Your body starts to look for an alternate source of fuel (fat), releases it and burns it for energy. Hence, weight loss on keto. Because of the decrease of glucose and increase in the metabolism of fat, ketosis has a ton of benefits — its unique ability to induce weight loss is just one of them. Many people use ketosis as a treatment for epilepsy, diabetes and even cancer. When your body burns fat, it produces ketones. Without ketones, you’re not in ketosis. Therefore, the ketogenic diet’s sole purpose is to aid and promote ketone production. What are Ketones? Ketones are the metabolic fuel produced when your body shifts into fat-burning mode. Glucose and ketones are the only energy sources used by the brain. Think of ketones as the auxiliary power source of your body. Before the advent of agriculture, when our ancestors were hunter-gatherers, they fasted regularly. When food was scarce, they didn’t have a choice but to wait for an opportune time to hunt for food and cook it. They had a very low intake of carbs and protein and thus were unintentionally running on ketones. Converting stored fat into energy is hardwired for our survival and a natural part of human existence. Your body burns fat to use and produce ketones whenever glucose sources are low or depleted, such as: during fasting after prolonged exercise when you eat a ketogenic diet. Lipase (an enzyme responsible for fat breakdown) releases stored triglycerides (fats). These fatty acids go to your liver and your liver turns them into ketones. There are three types of ketone bodies: Acetoacetate – During the breakdown of long- and medium-chain fatty acids for energy, acetoacetate is produced first. Acetone – Spontaneously, acetone is also produced as a by-product of acetoacetate. Both of these ketone bodies, when not used, spill into your urine and breath, making urine and breath testing a promising measurement of whether or not you’re going into ketosis. More on this below in How to Test Ketone Levels. Beta-hydroxybutyrate (BHB) – Not technically a ketone but a molecule. Its essential role in the ketogenic diet makes it count as the important ketone body. BHB is synthesized by your liver from acetoacetate. BHB is important because it can freely float throughout your body in your blood, crossing many tissues where other molecules can’t. It enters the mitochondria and gets turned into ATP (adenosine triphosphate), the energy currency of your cells. BHB = ATP = energy! Now that you know what ketones are and how ketosis works, you probably want to know why you should consider eating a ketogenic diet — the diet that promotes ketosis. The Benefits of Ketosis The benefits of ketones come from your body burning fat for fuel and the lowered glucose and insulin in your blood. The benefits of ketosis include: Body fat burning Mental clarity and increased cognition Improved physical energy No feeling of deprivation because you experience less hunger[*] Steady blood sugar levels from little to no intake of refined carbs Skin improvements in those with acne[*] Improved triglyceride and cholesterol levels[*] Hormone regulation — women who go on keto report less severe symptoms of PMS[*]. Aside from the therapeutic benefits of ketones, many people fall in love with keto because of the way it makes them feel both mentally and physically. Recommended Reading The Biggest Ketogenic Diet Benefits Is Ketosis Safe? What Are Ketones? Perfect Keto Users Guide How to Maintain Ketosis When and How to Supplement With Ketones Why Supplement With Exogenous Ketones? The Different Types of Ketone Supplements What is AcetoAcetate? What is Beta-HydroxyButyrate (BHB)? What is Acetone? Perfect Keto Ketone Testing Strips The Ketogenic Diet Weight Loss Results The ketogenic diet is an effective tool for weight loss because of the dramatic decrease in carb intake, forcing your body to burn fat instead of carbs for energy. Results vary among individuals due to several factors such as insulin resistance and unique body composition. Nonetheless, keto has consistently lead to a reduction in weight and body fat percentage in a wide range of situations including but not limited to obesity, type 2 diabetes and athletic performance. A randomized control study in 2017 examined the effects of a ketogenic diet combined with Crossfit training on body composition and performance. Results from this study concluded that subjects following a low-carbohydrate ketogenic diet (LCKD) significantly decreased body weight, body fat percentage and fat mass compared to those in the control group[*]. The subjects following the ketogenic diet: Lost an average of 3.45 kilograms (7.6 pounds) compared to those in the control group who had no loss in body weight. Lost an average of 2.6% body fat while those in the control group did not lose any body fat. Lost on average 2.83 kilograms (6.2 pounds) of fat mass (the portion of the body composed strictly of fat) compared to the control group who did not lose any fat mass. Maintained lean body mass to the same degree as those in the control group. Improved Crossfit performance to the same degree as those in the control group. Dashti et al. performed a study in 2004 observing the long-term effects of a ketogenic diet in obese patients and found the following[*]: The weight and body mass index of the patients decreased significantly. The level of total cholesterol decreased from week 1 to week 24. HDL cholesterol (the good one) levels significantly increased. LDL cholesterol (the bad one) levels significantly decreased after treatment. The level of triglycerides (fat) decreased significantly following 24 weeks of treatment. The level of blood glucose significantly decreased. Partsalaki et al. carried out a study in 2012 comparing the effects of a ketogenic diet versus a hypocaloric diet in obese children and adolescents. Results showed[*]: Children following the ketogenic diet significantly reduced body weight, fat mass, waist circumference and fasting insulin levels. The children in the ketogenic diet group significantly reduced a marker of insulin resistance known as homeostatic model assessment-insulin resistance (HOMA-IR) to a greater degree than those following a hypocaloric diet. An important marker of insulin sensitivity and cardiovascular disease — known as high molecular weight (HMW) adiponectin — significantly increased in the ketogenic diet group but not in the hypocaloric diet group[*][*]. Additionally, a 2008 study looking at the effects of a low-carbohydrate ketogenic diet versus a low-glycemic index diet in type 2 diabetics was conducted. Results from this study concluded that participants following the ketogenic diet had significantly greater improvements in weight loss, hemoglobin A1c, and high density lipoprotein (HDL) cholesterol compared to the low-glycemic index diet group[*]: Those following a ketogenic diet: Lost on average 11.1 kilograms (24.5 pounds) compared to those following the low-glycemic index diet who lost on average 6.9 kilograms (15.2 pounds) Reduced their HbA1c levels by 1.5% compared to the low-glycemic index diet group who only reduced their HbA1c levels by 0.5%. Increased their HDL cholesterol on average 5.6 mg/dL compared to those in the low-glycemic index group who had no increases in HDL cholesterol. Diabetes medications were reduced or eliminated in 95.2% of participants in the ketogenic diet group vs. only 62% of participants in the low-glycemic index group. The ketogenic diet works for weight loss because it’s based around high fat, adequate protein and very low carb intake. But I Thought Fat Was Bad For You? There’s a common misconception that fat is bad for you; however, this misconception fails to adequately represent healthy fats which are actually good for you. Aside from other scientifically-proven benefits, saturated fats like medium-chain triglycerides (MCTs) go directly to your liver to be used for energy. The ketogenic diet, with its high percentage of good fats, leads to a fat-adaptive metabolic state. Fat-adaptation occurs when your body becomes more efficient at burning fat for fuel. The longer you maintain a fat-adaptive state, the more ketones you produce. The goal of a ketogenic diet is to maintain high amounts of ketones so you can reap all of the benefits that occur from being in ketosis. A high fat, ketogenic diet is also protein-sparing: your body keeps burning fat and doesn’t turn to protein as an energy source. How Much Protein Can I Really Eat? Protein is extremely important on keto as well. Ideally, you should consume 0.8 grams of protein per pound of lean body mass. This will prevent muscle loss. To calculate your lean body mass, you have to: Calculate your body fat percentage. Click here to read how. Subtract your body fat % from 100%. This will be your lean body mass %. Multiply your lean body mass % by your total weight. Worried that 0.8 grams per pound of lean body mass is too much protein? The truth is that on a keto diet, you can eat a lot more protein than the standard 10-15% of total calories (that some other sources promote) without being kicked out of ketosis. Too much protein won’t raise your blood glucose and decrease your ketone levels. That’s just a myth. Check out the video below by Perfect Keto founder Dr. Anthony Gustin to understand the role protein plays on keto, why we recommend a higher protein intake, and why gluconeogenesis is not a problem: Low-Carb is Not Ketogenic The difference between ketogenic and low-carb diets is that the ketogenic diet aims for ketosis. Other low-carb diets may not have a large enough decrease in carb intake to shift your metabolism into producing and burning ketones for fuel. But, certain types of keto diets do have some leeway with carb and protein intake. The 4 Types of Ketogenic Diets Like intermittent fasting, you can customize the ketogenic diet according to your goals or needs. There are four common types of ketogenic diets: The Standard Ketogenic Diet (SKD): Most common and recommended version of the diet:20-50 grams of net carbs per day, moderate protein intake and high fat intake. Targeted Ketogenic Diet (TKD): “Targeted” for energy around your workouts: 25-50 grams of net carbs or less around 30 minutes to an hour before exercise Cyclical Ketogenic Diet (CKD): Similar to intermittent fasting “Down Day Up Day” or the 5/2 cycle, CKD involves eating a low-carb, ketogenic diet for several days followed by a couple days of eating high-carb. High-Protein Ketogenic Diet: The SKD alternated with additional amounts of protein that could be ideal for more elite athletes What to Eat and What to Avoid on the Keto Diet Ketogenic foods are high quality, whole, natural foods processed as little as possible. To avoid processed foods, many keto-ers prefer to make everything themselves, from burgers to homemade ghee). Ketogenic foods are high in fat, adequate in protein and of course, low carb. The most common mistakes on a ketogenic diet include not watching the quality and composition of your food and being careless about your carb intake. To lose weight on keto you must: Count carbs — even hidden carbs found in spices, vegetables and drinks. Watch your sugar intake: this includes sweeteners, fruit and naturally occurring sugars in dairy. If you must use a sweetener, stick with stevia or opt for other keto-friendly sweeteners. Watch your calories. Don’t exceed your calorie budget. To lose weight you need to eat less than what you burn. All calculations and metrics are discussed below. Be conscious of your food in general. Avoid processed food. No matter how low-carb or “keto” it may be, if it’s full of junk you’re better off avoiding it. Drink plenty of water. Carbs are famous for retaining water, so keto’s very low-carb ratio can lead to faster dehydration and constipation. Compensate with water and keto-friendly drinks. Try intermittent fasting to avoid late night binges and speed up your ketone production and weight loss. Your carb and protein intake makes (or breaks) your ketogenic diet. You can tweak your macros according to what works for you, but the general macronutrient ranges are: These can vary according to your goals, needs and body composition. Designing your ketogenic diet involves calculating your macros. Recommended Reading: Full Ketogenic Diet Food List Full List of Foods to Avoid on A Ketogenic Diet Ketogenic Diet Meal Plans The Ultimate Heatlhy Keto Snack List How to Do the Ketogenic Diet on A Budget Can You Eat Healthy, Complex Carbs While In Ketosis? Net Carbs: The Difference Between Effective and Non-Impact Carbs Keto Macros: How to Calculate Your Optimal Ketogenic Macronutrients Finding Hidden Carbs on A Ketogenic Diet How to Keep It Simple on the Keto Diet Keto Diet Alcohol Rules: What to Drink, What to Avoid The Pros and Cons of Nuts on a Ketogenic Diet How Fast Will I Lose Weight on Keto? What to Expect When Dieting On Keto Good Fats vs Bad Fats on the Ketogenic Diet How Much Fat You Should Eat on A Ketogenic Diet How Much Protein Can You Eat on A Ketogenic Diet? Does A Ketogenic Diet Change Your Lipid Profile? What are the Best Vegetables to Eat on Keto? Keto vs. Popular Weight Loss Diets: Atkins, Paleo, Mediterranean Keto has been called “Atkins on steroids” and is often compared to other diets like paleo and the Mediterranean diet. What are the similarities and differences between keto, Atkins, paleo and the Mediterranean diets? Well, to start, all four diets are centered around whole food. Any of these diets can be used to achieve your desired weight and health goals but the main differences come down to the macro distributions and of course, ketosis. Keto and Atkins The Atkins diet, formally called the Atkins Nutritional Approach, was founded by cardiologist Dr. Robert Atkins as a weight loss tool based on the idea of “eating right, not less.” The similarities: Both the ketogenic and Atkins diets reduce your intake of carbs and sugar while shifting you toward eating whole, healthy foods. If done correctly, the result is ketosis, weight loss and better mental acuity and physical energy from the steady fuel of ketones. The difference: Atkins has four phases. The induction and balancing phases (Phase 1 and 2) resemble the ketogenic diet most closely. Phase 1 (Induction) includes consuming very low carbs at 20-25 grams of net carbs per day. After induction, you slowly reintroduce and increase your carb intake again, until you find the perfect amount that satisfies you without resulting in additional weight gain. Phase 2 (Balancing) has 25-50 grams net carbs per day. Phase 3 (Fine-tuning or pre-maintenance) has 50-80 grams net carbs per day. Phase 4 (Maintenance) has 80-100 grams of net carb intake daily. In the ketogenic diet, the carb, protein and fat macros are sustained in their allotted portions to induce and maintain a state of ketosis. The Pros of Atkins: Can be easier to maintain than keto, especially for people who have difficulty avoiding carbs. Ideal for beginners to experience ketosis and all the benefits in the initial phases while experimenting with different variables and then maintaining ketosis if they choose to. Keto and Paleo The paleo or paleolithic diet — also called the caveman diet, hunter-gatherer diet or Stone Age diet — is based on consuming the foods available to our ancestors in their hunter-gatherer days and the early days of agriculture,about 10,000 years ago. With paleo, processed food is out. This means no sugar or flour-based foods since producing sugar and milling wheat wasn’t invented yet back then. Anything you could hunt, catch, pick or dig from the ground easily is in, such as meat, seafood, fruits, nuts and vegetables. The similarities: Both the ketogenic and paleo diets are rich in non-starchy vegetables. Both also restrict sugar, grains, legumes and recommend high-quality animal proteins and fats. The differences: As long as your gut doesn’t have a problem breaking them down, keto is perfectly okay with full-fat, all natural dairy — cheese, butter, ghee. Conversely, paleo avoids anything that can compromise the gut like dairy. Compared to the very low carb restriction of the ketogenic diet, paleo does not restrict starchy vegetables and sugary fruits, making it close to impossible to get into ketosis. The Pros of Paleo: Can be ideal for fitness buffs who perform daily, high-intensity exercises. Good for vegetarians and vegans. Keto and the Mediterranean Diet Physiologist Dr. Ancel Keys noticed that the Mediterranean people living in southern Europe (Greece, Italy, Crete) had much lower risks of heart disease than Americans. He recorded what they ate and the Mediterranean diet was born. This diet consists predominantly of fish, vegetables, fruits, seeds, beans, olive oil, nuts, cheese, yogurt and grains. Poultry and eggs eaten every two days, red meat restricted to 3 ounces per week and a glass or two of wine daily. The similarities: Like keto, the Mediterranean diet emphasizes simple, whole foods. The differences: The Mediterranean diet is relatively low-fat, with non-ketogenic net carbs coming from grains like bread, quinoa, brown rice, starchy fruits and vegetables. The Pros of the Mediterranean Diet: The easiest of the four diets outlined here Avoids highly processed foods like paleo. The Takeaway The ketogenic diet has one purpose: to induce ketosis, burning fat instead of carbs. The other diets have their own share of health benefits, particularly the Mediterranean diet[*], and all of them help with weight loss, though only the ketogenic diet helps you induce and maintain ketosis. The focus of these diets is to eat healthy, whole foods that are as close to nature as possible. Even without the rigorous tracking involved on keto, you still have to watch the amount of food you are consuming on these diets in order to attain the benefits. Keto is already considered “Atkins on steroids.” If you’re eager to gain the benefits of being in ketosis, the paleo and Mediterranean diets can be customizable to induce a ketogenic state. Simply replace all of the bread and starchy root vegetables with more oil, fatty meats and fish and low-carb nuts. We feature all three of the above diets on Perfect Keto: Comparing Keto vs. the Mediterranean Diet The Ketogenic Diet vs. the Atkins Diet Paleo vs. Ketogenic Diet Designing a Keto Plan for Weight Loss Using the ketogenic diet for weight loss is all about tracking and calculating: Macros Ketone levels Stress Exercise output Sleep Anything out of balance — like too much protein or excessive exercise — can do something as simple as slow your progress into ketosis, or something more grave like disrupt your health. Your personal needs and goals determine a lot when using the ketogenic diet for weight loss. The most important step is calculating (and sticking to) your macros. Using a Keto Macro Calculator To calculate your macros, start with a macro calculator (Hint: we have one you can use for free). If you use a fitness app like MyFitnessPal, you’ve already used a macro calculator, although the free version of the app only gives you a calorie budget. In calculating your macros, you determine your intake of carbs, protein and fat according to your BMR (basal metabolic rate), activity level, body composition and weight loss goals. Calculating your macros is essential to achieving your goals. So what goes into calculating your macros? #1: Your Basal Metabolic Rate (BMR) Your BMR is the base number of calories you need to support your body’s vital functions (breathing, heart beating, digesting food) without counting the calories needed for daily activities and exercise. Your age, gender, height and weight determine your BMR. Weight and height: The bigger you are, the more calories you need so your organs can support you. Age: Muscle mass goes down as you age, which can decrease your BMR. Gender: Body composition differs between men and women. We get a close calculation of BMR using the Harris-Benedict equation: BMR formula for men = 66 + (6.2 x Weight in pounds) + (12.7 x Height in inches) – (6.76 x Age) BMR formula for women = 655.1 + (4.35 x Weight in pounds) + (4.7 x Height in inches) – (4.7 x Age) For example: A 28-year old woman weighing 130 pounds and standing at 5’2 would calculate her BMR as: 665.1 + 565.1 + 291.4 – 131.6 = 1390 calories needed to support bodily function A 28-year old man weighing 182 pounds and standing at 6’1 would calculate his BMR as: 66 + 1128.4 + 914.4 – 189.28 = 1919.52 calories needed to support bodily function #2: Your Total Daily Energy Expenditure (TDEE) Your TDEE includes all sorts of exercise, whether it’s your daily workout or physically demanding days at work or at home. This matters in calculating your calories and macros. Use these numbers as a guide: 1.2: Little to no exercise 1.375: Light exercise, 1-3 days per week 1.55: Moderate exercise, 3-5 days per week 1.725: Hard exercise, 6-7 days per week 1.9: Very intense exercise Which number best matches your activity level? Multiply that number by the BMR number you calculated above. The product is your total daily calorie expenditure, or total calorie burn. For example, a woman with a BMR of 1500 who does moderate exercise would have this formula: 1500 x 1.55 to get her total daily calorie expenditure, 2,325. She burns 2,325 calories to support her body and daily activities. #3: Your Body Composition: Body Fat Percentage and Lean Body Mass Your body fat percentage determines your lean body mass — the total weight of your body minus your fat mass — which in turn determines the amount of protein you need to maintain your muscles. This is why most gyms have skinfold calipers, which are surprisingly near-accurate. You can purchase a pair online. Other ways to measure body fat percentage are: DEXA scan. This stands for dual-energy x-ray absorptiometry, measures bone mineral density, but can also accurately measure your body fat percentage. It’s pricey and can take up to 30 minutes, but it is the gold standard for measuring body fat percentage. Body measurements. Apps and online tools provide body fat calculations using your height, weight and the tape measurements of your neck, waist, and hips. Photos. Visual estimates provide a more accurate estimate than body measurements. Take a full body photo of yourself and then compare it with the photos of other people. Keep taking photos. It will come in handy later as you track your progress. #4: Calculating Your Body Fat and Lean Body Mass Subtract your body fat from your weight and you get your lean body mass. Convert your body fat percentage into pounds first. For example, your body fat is 25% and you weigh 150 pounds. 150 pounds x .25 = 37.5 pounds of body fat. Next, subtract that from your weight. 150 pounds – 37.5 pounds of fat = 112.5 pounds of lean body mass. Save your number. You’ll use it later to calculate your protein. #5: Your Weight Loss Goals To achieve weight loss, your total calorie intake each day needs to be in a deficit: you consume less calories than your total daily expenditure. A 10%-20% deficit, or even 30% if you can manage, is a good range. Just don’t go over a 30% reduction each day because it can cause long term issues. For example, to reduce by 20%, multiply your total calorie expenditure by 0.20. Subtract that amount from your total calorie expenditure. That is your total daily calories, the maximum amount of calories you should consume each day. Eating less than what you burn daily would burn off the weight you want to lose. Calculating Your Carbs On the ketogenic diet, carbohydrates make up 5%-10% of total calories on average. For most people, that’s around 20-50 net grams per day. Formula: (total calorie intake x % of calories from carbs) / 4 Multiply your total calories by the percentage of carbs and divide it by 4 to get grams. For a total daily calorie intake of 2000 with the ketogenic 5% to 10% carbs, the formula would be: 2000 x 0.05 or 0.10 = 100 to 200 calories from carbs 200 / 4 = 25g to 50g of carbs each day. Calculating Your Protein On the ketogenic diet, your protein intake should be moderate at about 20% to 25% of your total calories, enough to maintain muscle, but not too much that it affects ketosis. Your protein intake should support your activity level and maintain your lean body mass, which you calculated above. Use these ranges to determine your optimal protein intake. Start with the lower grams number. For example, a moderately active female weighing 150 pounds and has 112.5 pounds of lean body mass will need 90-112.5 grams of protein per day. Multiply that by 4 to calculate 360-450 calories from protein per day. Next, multiply your total calories by 0.20 to 0.25 to make sure your protein from calories fit within that percentage. E.g., 2000 total calories x 0.20 or 0.25 = 400 to 500 calories from protein. Calculating Your Fat On the ketogenic diet, fat should comprise 70-80% of your total calories. Simply add up your total calories from protein and carbs, then subtract the total from 100 to get your total calories of fat. 100 to 200 calories of carbs + 400 to 500 calories of protein = 500 to 700 calories 2000 total calories – 500 to 700 = 1500 to 1300 calories from fat Fat has 9 calories per gram so we divide the calories by 9 to get grams. 1500 or 1300 / 9 = 167g or 144g of fat. The above calculations for your carbs, protein and fat macros give you a range to work in, not guaranteed exact and accurate, but you can adjust. Your body will tell you what it needs and what it likes. Some keto-ers report staying in ketosis in varying amounts of carbs and protein. Exercising on the Keto Diet The well-known formula of eating less and exercising more to lose weight is outdated, untrue and unsustainable. What you eat matters, and the ketogenic diet is one of the tools for weight loss where this is most prominently visible. Exercise promotes lean muscle building, greater bone strength and improved stamina and stability. Exercise also uses up your glycogen stores, helping you get into ketosis faster. So look at exercise as tool to achieve these benefits rather than solely to lose weight. 4 Types of Exercise in Ketosis Aerobic exercises: Cardio. Lasts over three minutes to raise your heart rate. Lower intensity, steady-state cardio is fat burning, making it very friendly for the keto dieter. Anaerobic exercises: HIIT or weight training to build muscle. Intense, short bursts of energy to promote strength and speed. Carbohydrates are the primary fuel for anaerobic exercise, so fat alone can’t provide enough energy for this type of workout. Flexibility exercises: Yoga and stretches, for improving muscle and joint movement, and preventing injuries from the shortening of muscles over time. Stability exercises: Core training, Pilates, balance exercises, yoga. Improves alignment, balance, muscle strength and movement control. When you’re in ketosis, the workout intensity matters: During low-intensity aerobic exercise, the body uses fat as its primary energy source. During high-intensity aerobic exercise, carbohydrates are normally the main energy source. This is why you take your activity level into account when calculating your macros. When you start out on the ketogenic diet, the SKD (standard ketogenic diet) may not be enough to fuel your workouts. Use the targeted ketogenic diet (TKD). Targeted Ketogenic Diet and Fat Adaptation In the TKD, you eat 15 to 30 grams of fast-acting carbs, like fruit, within 30 minutes before your workout and/or within 30 minutes after your workout. This provides your muscles with the proper amount of glycogen to perform during training and recover afterward. The carbs you consume are used directly for this purpose and prevent the risk of getting kicked out of ketosis. The good news is that the longer you stay in ketosis, the more your body becomes fat-adaptive and more efficient at burning fat for energy, a natural process that your body becomes lazy at when constantly supplied with carbs. Benefits of Exercising While In Ketosis Far from hindering workouts, ketosis adds benefits to exercise that enhance its help for overall fitness and weight loss. In one study, compared to those who ate a high-carb diet, ultra-endurance athletes who ate a low-carb diet for an average of 20 months burned 2-3 times more fat during a three-hour-long run. In the same study, the low-carb group used and replenished the same amount of muscle glycogen as the high-carb group[*][*] . Being in ketosis might also help prevent fatigue during longer periods of aerobic exercise. And ketosis has been shown to help with blood glucose maintenance during exercise in obese individuals[*]. As mentioned above, the power of keto-adaptation helps low-carb dieters perform better in all forms of exercise with less carbs over time[*]. Avoid overtraining. Overtraining raises your cortisol levels. Cortisol, the stress hormone, makes your body think you’re in fight or flight mode, raising your insulin and blood sugar, not something you want on keto. Intermittent Fasting with the Keto Diet Intermittent fasting is often done in conjunction with the ketogenic diet. The two methods help each other. Fasting helps you get into ketosis, and ketosis helps you fast more easily. Together, they burn a lot of fat and may help you lose weight faster. Read our guide on Intermittent Fasting for more information on how to use intermittent fasting with the ketogenic diet. Using Exogenous Ketones to Promote Weight Loss on Keto Exogenous ketones are ketone supplements that help your endogenous (internal) ketone production and simultaneously provide you with instant energy when you need it. They help your body enter ketosis by priming you with ketones, telling your body to switch to that energy source instead of glucose. They put you on a steady fat burn and give you energy to burn even more glycogen through exercise. Exogenous ketones are an effective tool for for weight loss because they help you with workouts and during fasting, give you a clean energy boost and fill you up with ketones, are great for exercise performance and satisfy your hunger without breaking your fast. You may have heard someone say they have to force down ketones because they taste awful. We explain why they often do, and that’s a large part of why Perfect Keto was founded: to make ketones more accessible (i.e., delicious) to everyone. To demonstrate, currently Perfect Keto Base comes in Chocolate, Peaches and Cream, Vanilla and Coffee flavors. Perfect Keto Perform Pre-Workout comes in a refreshing lemon flavor. To use ketones for fat burning: Take one scoop of Perfect Keto Base anytime in between meals for constant fat burning. To use ketones to get into ketosis (or get back into it after a cheat day): Take ½ a scoop of Perfect Keto Base whenever you want to get into ketosis quickly and/or right after a meal that’s heavier on carbohydrates than usual. To use ketones for energy during the keto transition or fasting: Before a workout that will be 45 minutes or longer, take a full scoop. Then take another ½ of a scoop for every hour exceedingtwo hours of continuous work you do. You can take either Perfect Keto Base or Perfect Keto Perform Pre-workout. Note that it’s not advised to do heavy workouts while transitioning to keto or during your fast. Using Other Supplements On A Ketogenic Diet Minerals/Electrolytes: Adopting a ketogenic diet will change the way your body uses (and loses) certain minerals. Not replacing these minerals can lead to symptoms of the “keto flu” such as lightheadedness, headaches, constipation, muscle cramps and fatigue. Refer to this article for tips on how to replace common minerals such as sodium, potassium, magnesium and calcium. Fish Oil Fish oil is a great source of omega 3s and a natural anti-inflammatory[*][*]. Consuming about 3000-5000 mg of fish oil per day with high EPA/DHA is recommended. One high quality source is Antarctic Krill Oil. Make sure that whichever source you choose, it has the IFOS five star rating and is stamped with an FOS approval. MCT Powder MCT oil powder is a unique form of dietary fat rapidly absorbed by the body and has a wide range of health benefits. Supplementation with MCT powder can help combat fatigue, suppress appetite[*], enhance thermogenesis (aka ‘fat burning’)[*] and help your body adapt to using ketones for fuel. A recent scientific review showed that MCTs can effectively decrease body weight, total body fat, hip circumference, waist circumference, total subcutaneous fat and visceral fat[*]. Check out this articlefor more information on how to supplement with MCTs. Collagen Collagen is a type of protein that has been shown to suppress appetite[*], provide fullness compared to other proteins like whey, casein, or soy[*], help retain muscle mass[*] and even help to reduce the appearance of cellulite due to it’s ability to improve skin elasticity and thickness[*]. Refer to this article for more information on the benefits of collagen and the best way to supplement it in your diet. Greens Powder Getting adequate amounts of vitamins is extremely important to support healthy weight loss and overall wellness. Taking a multivitamin with synthetic ingredients has been shown to be ineffective and a complete waste of money[*]. Alternatively, consuming a high-quality greens powder made from real, nutritious whole foods rich in vitamins, minerals, antioxidants, fiber and phytonutrients is a much better way to optimize health and longevity. Check out this article for more information on supplementing with a high quality, effective greens powder. Probiotics Gut health is extremely important for anyone looking to lose weight and increase overall health[*][*]. It is not uncommon for those who shift to a ketogenic diet to have a change in the production of bacteria in their colon (although not necessarily a bad thing – just a change)[*]. To help support this change and increase the healthy bacteria in your gut, try consuming more fermented foods such as sauerkraut, kimchi or kefir and/or supplement with a high-quality probiotic[*][*]. Vitamin D It’s estimated that over 50% of people are deficient in Vitamin D worldwide[*]. Although Vitamin D doesn’t play a major role in whether or not you are in ketosis, it is responsible for regulating immunity, inflammation, hormones and helping with electrolyte absorption[*][*] — all factors important for weight loss and overall health. Additionally, studies support the direct benefits of vitamin D for weight loss[*][*][*]. You can check your Vitamin D levels with a simple blood test and then supplement accordingly. When supplementing, choose Vitamin D3 as it is the form that’s best absorbed by your body[*][*]. L-Glutamine L-glutamine is an amino acid with many functions in your body including acting as a powerful antioxidant[*][*]. Research shows that L-glutamine can help stabilize blood glucose levels[*] and has been recommended to help reduce sugar cravings. Supplementing with L-glutamine (about ½-1 teaspoon powdered form or 500 mg dose) may help in reducing carb/sugar cravings and aid in your ketogenic weight-loss journey. Ox Bile Those who’ve had their gallbladder removed may need ox bile supplementation to support their body in breaking down fats[*] and aid in overall digestion. When taken with a meal, ox bile provides a concentrated source of bile which takes the place of the bile that would have been secreted by your gallbladder. As mentioned before, proper digestion is key to helping aid in weight loss and optimizing overall health and wellness. Dealing with Weight Loss Plateaus on the Ketogenic Diet Keto-ers delight in the fast progress they see with the ketogenic diet. There’s often a dramatic drop in weight as you lose all those carbs and water weight. The plateau comes next: your weight loss slows way down or even seems to stop as you start losing real fat. You can’t seem to break through it no matter how hard you try. A couple of important points: 1 to 2 pounds a week is healthy weight loss. You may be losing gradually, but you’re still losing weight. Not losing anything for a week now and then is okay. Plateaus happen for a reason. Troubleshoot your plateau so you can fix it. Troubleshooting Your Plateau Anytime you stop losing weight, see if any of the following could be the reasons and implement the necessary adjustments. Are you eating too many carbs? Are you missing hidden carbs? Are you eating too much protein? Are you in ketosis? Do you track your ketone levels often? Are you eating too many calories? Are you eating quality keto foods? Are you eating real, whole foods? Anything packaged could be full of hidden carbs and other artificial fillers. Are you eating too many nuts? Not all nuts are made equal, and some could be kicking you out of ketosis and your calorie budget. Are you fasting? Intermittent fasting is a great tool for breaking through weight loss plateaus. Are you getting closer to your goal weight? The deficit of energy needed for fat loss gets smaller as your weight goes down. You’ll keep losing, but it will slow down. Are you getting enough sleep? Are you managing your stress? Are your hormones in good shape? Adrenal or thyroid issues can affect weight loss. Save yourself the frustration and consult your doctor to treat the underlying cause. During the ketogenic diet, it’s crucial that you track. You should be able to answer the above troubleshooting questions with certainty. If not, it means you haven’t been tracking properly. Recommended Reading: Top 7 Basic Metrics to Track on a Low-Carb, Ketogenic Diet Keto Macros: How to Calculate Your Optimal Ketogenic Macronutrients Keto Macros: How to Make Your Own Keto Calculator Keto Diet Weight Loss Plateau: What to Consider and How to Break It Can You Eat Healthy, Complex Carbs While In Ketosis? Net Carbs: The Difference Between Effective and Non-Impact Carbs How Fast Will I Lose Weight on Keto? What to Expect When Dieting On Keto Fasting on Keto for Beginners How to Exercise When You’re in Ketosis Why Supplement With Exogenous Ketones The Different Types of Ketone Supplements Will Ketones Kick You Out of A Fast? How to Use (and Not to Use) Exogenous Ketones For Weight Loss When and How to Use Perfect Keto Base When and How to Use Perform Pre-workout Testing and Tracking Results You’re not in ketosis if you don’t produce enough ketones, and your diet may not be ketogenic at all if you can’t get into ketosis. Tracking and testing ketone levels is important so that you can adjust your macros, or try intermittent fasting and exogenous ketones. When folowing a ketogenic diet, the only way to see your progress is to check your ketones regularly. Maintaining your ketone levels is necessary to get into ketosis, and seeing ketones for the first time after you start gives you the encouragement you need to keep going. How to Test Ketone Levels All three types of ketones previously discussed in this guide– acetone, acetoacetate and BHB— are easily tracked using these tests for ketone levels. Urine Test – Acetoacetate When your liver starts synthesizing fatty acids into ketones, excess acetoacetate can spill into your urine. Urine strips are cheap, making this an easy though messy test. Perfect for keto beginners to see the transition, but not for long-term. As your body becomes fat-adapted, it would soon use acetoacetate as well, and you could be in ketosis without turning your urine strip its keto-color. How it’s done: Pee on the stick, tap out the excess and wait for the strip to change color. The darker the color, the more ketones. Pros: Affordable. Cons: Messy and only useful in the beginning stages of ketosis. Breath test – Acetone/Acetate Acetate is correlated with BHB in the blood, so a breath test for acetate/acetone can confirm a urine or blood test, or simply be your preferred test if you have an aversion for bodily fluids. How it’s done: Warm up the LEVL or Ketonix meter by plugging it in. Blow into it and wait for the flashing light indicating it’s reading your acetone levels. The software or the color and speed of the flashing light would tell your reading: green for least acetone, red for most acetone, less flashing for less acetone per color, more flashing for more acetone per color. Pros: Reusable device. No bodily fluids needed. Cons: Indirect and inaccurate measurement. Takes time to get a reading. Blood test – BHB Beta-hydroxybutyrate (BHB) is the primary ketone you produce in ketosis (or take supplementally). BHB floats in your blood and a blood test to measure BHB is the most accurate measurement of your ketone levels. How it’s done: You use a blood meter like those with diabetes use to track their blood glucose. Prick your finger, tap the drop of blood on the stick and set the blood meter to tell you your BHB levels. Pros: Precise, accurate measurement, the most reliable test of your ketone levels. Cons: Expensive. Some may have an aversion to finger pricking. Checking Ketone Levels by Symptoms When you’re fresh out of testing equipment, the following signs can indicate your progress or state of ketosis. You should still use the above tools to measure your ketones, but these signs can tell you’re on the right track, at least. Increased Thirst, Dry Tissues: On the ketogenic diet, your body will be using up excess glycogen and will be increasing the amount of urination. You’re also losing the water-retention aspect of carb intake. Compensate with water and electrolytes. Mental Clarity and Better Cognition: Your brain constantly uses a significant amount of energy. On carbs, the fluctuations in your insulin levels can cause energy swings. In ketosis, your brain will be using a more consistent source of fuel: ketones from your fat stores or your supplements, resulting in better productivity and mental performance. Less Hunger and Cravings: When your body becomes used to using ketones, you will begin using fat to break down into ketones to use for energy. Because your body has such a constant supply of energy, it doesn’t crave food the way it did when your energy was dependent on carbohydrate intake. More Sustained Energy: 90-120 minutes after you eat carbohydrates, your body doesn’t have readily available energy produced from the mitochondria in your cells, so you start “crashing” or lowering your energy. When you are in ketosis, your body can run off your body fat, which is an essentially limitless source of fuel. This prevents any type of crash. Not Breath: Acetone levels in the breath under nutritional ketosis should not be high enough to cause a detectable scent. One common misinformation we’ve been made aware of is that if your breath is fruity smelling, this is a good indication that you are in ketosis. This is not accurate. This is a closer reflection of ketoacidosis, which is not to be confused with nutritional ketosis. You may notice a metallic taste in your mouth when first starting keto which is usually fine and not a cause for concern, however, a fruity smell may indicate a problem. The Glucose-Ketone Index (GKI) The GKI is another measurement of ketone levels. It combines your blood glucose and ketone levels into one number, an accurate reading of your metabolic health. Athletes use it to track their progress for fitness and weight goals. Doctors prescribe the ketogenic diet for its ability to lower blood glucose, which helps manage diabetes and epilepsy and works as a cancer treatment. Cancer cells feed on glucose. No glucose means starving and killing cancer cells. High ketone levels can’t do its job unless glucose levels are also low. High blood glucose negatively affects your health. Carb intake and Stress Your blood glucose is affected by hormone peaks and dips (particularly for women), medical conditions like diabetes and glandular issues and by your carb intake and stress levels. You may need to adjust your carb macro to keep your blood glucose down. Stress triggers cortisol and epinephrine (stress hormones) into spiking your blood glucose for fight or flight. Ways of managing stress include yoga, meditation, hobbies like gardening, drawing, coloring and even something as simple as a long soak in the bath. How to Measure Your GKI The formula for calculating the GKI is: GKI = (Blood Glucose (mg/dL) / 18 ) / Blood Ketones (mmol/L) Measure your blood glucose the same way you measure your BHB levels on the blood meter (using the appropriate strips). Divide your glucose number by 18 to convert it to mmol/L. If it’s already in mmol/L, skip this step. Divide your glucose number by your ketone level number. The quotient is your GKI number. GKI Numbers by Goal or Treatment: A GKI between 3 and 8 would see you through your weight loss goals on the ketogenic diet. Here are the widely-accepted GKI measurements according to goals and conditions/treatment: GKI above 9: not in ketosis GKI 6-9, low level of ketosis: Beneficial for weight loss and optimal health and weight GKI 3-6, moderate ketosis: The desired level of ketosis for addressing insulin resistance, type 2 diabetes and obesity management GKI of less than 3, high level of ketosis: Typically used to address epilepsy and cancer treatment. It is desireable to enter this level of ketosis periodically every year for disease prevention. Body Fat Tracking Photos Next to ketone levels and your GKI, your body fat percentage is another metric to track for your weight loss progress on keto. You could either measure your body fat percentage again using skinfold calipers or a DEXA scan, or measure your progress from photos. Keep taking pictures, from the first photo to gouge your body fat percentage, to weekly and/or monthly progress photos. Depending on your initial measurements and any adjustment methods you implemented to induce ketosis, you would see how the ketogenic diet’s fat burning has altered your body composition. Tape Measurements Sometimes, the scale isn’t moving but that doesn’t mean you’re not losing weight. Your body weight is victim to hormonal fluctuations, water retention and other factors, so it’s a good idea to also take measurements. Measure on the same spot every time, using the same tape measure and laying it flat around your waist and hips. For your arms, thighs and calves, measure on the dominant side. (I.e., if you’re right handed, measure your right arm). Like body fat tracking, tape measurements can be gratifying in showing exactly how much body fat you’ve lost. Scale The scale is useful in determining your starting weight. However, because of the water weight you lose, and because muscle is heavier than fat, the scale is not as reliable as testing your ketones and the body fat and tape measurements when tracking your progress. Recommended Reading Top 7 Basic Metrics to Track on A Ketogenic Diet A Guide to Testing Ketone Levels Testing Ketone Levels After Taking Exogenous Ketones What is Glucose-Ketone Index and Why You Should Care The Glucose-Ketone Index and Why It Matters How to Easily Track Your GKI on Your Ketogenic Diet Making Adjustments to Your Keto Diet After following the ketogenic diet long enough to adjust your macros according to results, do you feel the need for further adjustments? For example, some keto-ers feel so good mentally and physically that they become fitness enthusiasts, and start to do cyclical ketogenic or targeted ketogenic diets as needed. Some keto-ers also learn to adjust their goal setting according to their results. Someone steadily losing 2 pounds a week adjusts his or her weight loss goals. When a plateau is reached, another adjustment breaks past it. The most common adjustment of all is to induce ketosis, or get back into it. How to Adjust to Induce Ketosis Measure and track everything, from your BMR to your ketone levels and GKI, to get an accurate idea of what you need to adjust. Results are highly individualistic: some get into ketosis fast, some don’t. To induce ketosis, or move up from low-level to moderate ketosis, use any of the following methods: Use coconut oil in your diet. Coconut oil is 50%-60% MCTs — medium-chain triglycerides — and contains lauric acid, which stimulates and sustains ketone production[*]. Including coconut oil in your diet can promote your endogenous ketone production. Increase your fat intake. Make sure you’re within the amount of fat you calculated above for your keto macros and weight loss goals. Choose high-quality, natural fats from both plant and animal sources. Avocados, eggs, full fat butter or ghee, dark chocolate, olive oil. Consuming at least 60% of calories from fat boosts your ketone production. Try intermittent fasting. Fasting anywhere from 8 to 23 hours increases your body’s fat synthesis and ketone production. Try fat fasting, a type of intermittent fasting also called fast mimicking. It mimics a complete fast because your body remains in a fasted state even if you’re eating good fats. This gives you the benefits of fasting (increase in ketone production) and the ketogenic diet– brain and body fueled by ketones. Minimize your carbs. Go as low-carb as you can manage to deplete your glycogen stores. Every individual has different levels of carb restriction needed to induce ketosis. Yours might not be what you previously thought it was. For example, some achieve ketosis at 20g of net carbs per day, while some can achieve or stay in ketosis at 40g. Increase your physical activity. This might do the trick of depleting your glycogen stores, raising your ketone production and getting you into ketosis. Note: It may take your body weeks to adjust to using ketones for energy. During this time, it’s ok to keep exercise at a minimum. You may experience some keto side effects which include lethargy. Maintain adequate protein intake. Too little protein and you lose muscle mass and starve the few parts of your body that can’t use ketones as an energy source, like portions of your red blood cells, kidneys and brain. Too much protein and you inhibit ketone production. Make sure you consume enough protein to support your vital functions, but not too much that protein becomes your alternate glycogen source. An adequate protein intake of 0.55 to 0.77 pounds per body weight induces and maintains ketosis. Take exogenous ketones. Exogenous ketones give you a dose of MCTs, raise your ketone levels and fat intake, promoting fat-adaptation and ketone production. If you do intermittent fasting, exogenous ketones help you fast. Review Your Goals and Results Review your goals and results. Were your goals SMART? Specific, Measurable, Attainable, Realistic, Trackable. Did you achieve your goal weight? What have you discovered about your body’s responses to the ketogenic diet and other tools you implemented, like intermittent fasting? Keep a record of your macros, your exercise, and your moods alongside your weight loss progress. You might discover you lost 3 pounds each week for every week you cycled to work and ate 10% more protein. Or you may discover you had more energy on those days you ate no carbs at all. It’s different for everyone, which is why the ketogenic diet is all about tracking. Reviewing your results can help you make any adjustments needed to achieve your goals. Recommended Reading: How to Track Ketogenic Diet Results 6 Tips To Get You Into Ketosis Quickly Make Sure You’re Supported At times, the difference between success and discouragement is a solid support base. If you face skepticism among friends and family, shrug it off and go beyond your circle. Social media has become a thriving community. Post on Instagram with the right hashtag and you can form new friendships with people across continents, with people in the exact same boat, with the exact same goals, who would hold you accountable for your commitment and be happy with you and your progress! The only downside is misinformation can happen. Remember to verify what you read or hear before believing, implementing or sharing anything. Join us in the Perfect Keto Community for a fun, supportive group, recipe ideas and to ensure you’re getting facts straight about the ketogenic diet. The giveaways and discounts on all things keto just sweeten the deal. The Ketogenic Diet is Not a “Weight Loss Diet” The ketogenic diet induces ketosis, a measurable state of metabolism that can be a great approach to losing weight through fat burning. Because it involves your metabolism, your results will be unique to you, whether or not it’s a faster or slower weight loss. The ketogenic diet is a regimen used to treat and manage disease and promote overall health– weight loss is just a bonus. But the healthiness of implementing keto still depends on how you implement it. Don’t give up if the going seems slow. Keep up your diligence in testing your ketone levels, tracking your macros and your results. You’re getting healthy. That’s great progress! Good luck!