The Keto Diet for Weight Loss: Doing it Right

The Keto Diet for Weight Loss: Doing it Right

Florey Miller, MS, RD/N, CDE
Diabetes Educator and Registered Dietitian

Gigi Schloss
Nutrition Intern

The keto diet is extremely popular right now and some people’s claims make it seem like a weight loss miracle. This eating plan is actually a medical diet that comes with some health risks you should be informed about.

The ketogenic diet is a very low-carbohydrate, high-fat diet. On this eating plan, 70% of calories should come from fat and foods high in fat are supposed to replace the carbs in your diet. It’s actually pretty similar to the early stages of the Atkins diet (remember that one?). The keto diet is more restrictive than the Atkins diet though, and this is why carefully planning meals and tracking nutrients is needed. If you think you might like to try the keto diet, it is recommended that you talk with your doctor and your registered dietitian to determine if the potential benefits are worth the costs and to help you get started. There is a lot of erroneous and contradictory info on the internet these days regarding this popular diet – don’t rely on it.    

Ketosis: How it works

The usual way the body obtains energy is to burn carbohydrates (which break down into glucose) for fuel. When there are not enough carbohydrates to burn for fuel, the body will instead use ketones as an alternate energy source. This process is called ketosis whereby fat stores are utilized to make ketones and then burned for fuel.


The advantages include a decreased level of hunger and food cravings; an increase in calorie burning; and a loss of body fat which leads to weight loss.

The risks

Ketosis can be risky because ketones can build up without being burned and can be damaging to the body in several ways.

Those with type 1 diabetes and those with type 2 diabetes who use insulin are especially vulnerable because of the risk of ketoacidosis (a dangerously high level of acids in the bloodstream which can cause organ shutdown and coma).

Since the keto diet contains so much fat while fat stores are being broken down, the liver must now metabolize all this extra fat. This is a concern for those with fatty liver disease or other liver problems. In these cases, the liver may not be able to accomplish the breakdown and ketoacidosis can result.

Another concern with the keto diet is that nutrient deficiencies can occur with the restriction of carbohydrates, especially vitamins B, C and the minerals selenium, magnesium and phosphorus. Additionally, constipation can occur if fiber intake is insufficient.

Following this diet often gives you the “keto flu,” which includes body aches, nausea, dizziness and fatigue. These symptoms typically last about 3 to 10 days.

It is a very good idea to check your level of ketones daily to make sure you do not have too many ketones to be dangerous or too little to cause the desired decrease in hunger level. You can do this by purchasing urine ketone test strips at any drug store (cost is about $12.00). Ketone levels should be between 1.0 mmol/L and 5.0 mmol/L for success with this diet, with an ideal level of 1.5-3.0 mmol/L. Any higher than 5.0 mmol can be dangerous. A ketone level above 15.0 mmol means you could be in ketoacidosis.

How to start

Again, we emphasize the importance of having your doctor or registered dietitian help you to prevent the risks and to ensure you are meeting your nutritional needs.

A slow transition is recommended when you start on the Ketogenic Diet. Take about three to seven days to reduce carbs, increase healthy fat intake, and make sure your body gets used to it. Going too fast into ketosis, not drinking enough water, not getting enough sleep, or not eating healthy fats may cause keto flu symptoms.

Foods to eat on the Keto Diet


Avocados, nuts, seeds, butter, cream, unsweetened coconut, olives, coconut oil, olive oil,


Fish, chicken, turkey, beef, pork, eggs, shrimp


Full-fat cheese, full-fat plain Greek yogurt, cottage cheese


Strawberries, blueberries, blackberries, raspberries


All vegetables are acceptable except those listed in the table below


Unsweetened coffee, teas, water, sparkling water, wine

Foods to limit or avoid on the Keto Diet


Margarine, shortening, corn oil, canola oil


Lunch meats, hot dogs


Sweetened yogurts, milk, ice cream


Citrus, grapes, bananas, pineapples, apples


Corn, peas, potatoes, squash, sweet potatoes, yucca, plantain, beans (ex. black beans, kidney beans, chickpeas, pinto beans)


Soda, sweet tea, fruit juice, punch, Gatorade and other sports or energy drinks, lemonade, Kool-Aid, beer, sugary alcoholic mixed drinks


Bread, baked goods, pasta, rice, cereal, cake, donuts, candy, cookies, granola bars, other sweets

It is important to note that consuming too much protein (large portion sizes) will prevent the body from going into ketosis.

Further information

Since there is so much misinformation on the keto diet on the net, here are some reliable resources:    

The Keto Craze Bottom Line

The keto diet may be an option for some people who have had difficulty losing weight with other methods.  Although there are no long-term studies that show the keto diet is any better for weight loss than other styles of eating, people have found anecdotal success using this approach.  We strongly recommend working with your doctor or dietitian to ensure lab values stay within range and to address any issues or symptoms that can arise with this eating plan.

Want some personalized guidance on a healthy approach to Keto or weight loss in general? Adult YourChoice members get five visits with a Registered Dietitian (RD) each year at no cost to you. Visit more information.


Comments (1)

  • Vickie


    17 July 2019 at 09:55 | #

    Great article GiGi - Thank you!!


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