Ultimate Guide to Ketogenic Diet 2021

What is Keto? 

Despite the recent hype, a ketogenic diet is not something new. In medicine, we have been using it for almost 100 years to treat drug-resistant epilepsy, especially in children. 

In the 1970s, Dr. Atkins popularized his very-low-carbohydrate diet for weight loss that began with a very strict two-week ketogenic phase.

A typical keto diet is around 70% fat, 20% protein and 10% carbohydrates. However this can vary depending on the person. 

In essence, the keto diet causes the body to release ketones into the bloodstream. Most cells prefer to use glucose as their primary source of energy and fuel. Glucose typically comes from sugar, carbohydrates or excess protein that hasn’t been used up. However in the absence of glucose in our blood stream, we start to break down stored fat into molecules called ketone bodies. This process is called ketosis. 

Once you reach ketosis, most cells will use ketone bodies to generate energy until we start eating carbohydrates or sugar again.  Ketosis is this shift from using glucose to fat and this typically happens over two to four days of eating fewer than 20-50 grams of carbohydrates per day. 

Fasting is another easy way of kicking your body into ketosis. So it’s important to clarify that keto(sis) is not a diet nor a type of food, it is a metabolic state . 

Read about the Advanced Keto Diet to understand how you can incorporate fasting into your keto lifestyle for greater effects and benefits. <later article>

Benefits of Keto

Keto, like the other popular diets, vegan/vegetarian, paleo and fasting, have many other benefits other than weight loss. 

Though many use the keto diet to lose weight, the history of keto actually started in its use in reducing seizures in children. There are many studies showing that a ketogenic diet can in fact reduce seizures in epileptic children as effectively as medication. Other well studied benefits of the keto diet include Alzheimers, Parkinsons, multiple sclerosis, autism and brain cancer. The keto diet is also being studied in cancer treatment with some positive results.

Looking at the scientific research done on the keto diet, it is clear that following a keto lifestyle can benefit the brain. The brain is made up of 70% fat so it makes sense that being fat adapted and giving fuel for our brain would help benefit issues related to the brain like Alzheimers, ADD and epilepsy. However one doesn’t need to have these conditions to benefit from a keto diet. Following a keto lifestyle for the healthy individual can also help improve concentration and energy levels. 

Other benefits of keto include:

  • controlled and lowered blood sugar/insulin levels
  • increased levels of HDL (good cholesterol)
  • decreased levels of triglycerides and total cholesterol
  • boosts metabolism
  • weight loss and fat loss
  • decreases inflammation
  • strengthens gut intestinal health
  • increased energy levels and stamina in training
  • increased cell and energy health
  • cancer

Scientific Research for Keto Diet

  • A study conducted on 83 obese patients on a ketogenic diet for 24 weeks showed lowered total cholesterol, LDL and triglycerides
  • A study of over 19,000 patients showed significant weight and fat loss in both short and long term
  • A small study of 20 obese patients on a ketogenic and low calorie diet intervention had significant positive changes in their visceral fat (belly fat which is the most dangerous), BMI, weight and cholesterol levels just after 8 weeks.

Although more research is needed, there have been increasingly more studies demonstrating the beneficial effects of the keto diet on cancer when combined with chemotherapy or/and radiotherapy.

Difficulties of Keto and Why Some People Fail


1. Inability to Adapt 

Modern carbs make up a large amount of our diet, in North America, around 50-70% and in Asia I’m sure it’s not any less, if not more considering our love of rice and noodles. The problem is that these carbs are extremely addicting and this addiction creates a psychological and physiological challenge when adopting a keto diet and lifestyle.

Moreover, if you’re a typical Asian who shys away from fats and oils and you’re not used to having large amounts of fat in your diet, you may end up with keto diarrhea throughout your cycle which is will likely prevent you from successfully adopting this new keto, high fat diet.

2. Overeating the Wrong Protein

Too much protein can trigger you right out of ketosis or prevent you from getting there in the first place. Most people when first starting on a keto diet rely on protein more than fat to satiate their hunger cravings. If you’re not burning off this protein, it will eventually turn into glucose, the preferred fuel for your cells.

3. Keto Flu

Some people get what is called the ‘keto flu’ after they have switched into ketosis or fat burning mode from sugar burning mode. This usually happens a week or so into the start of your keto plan. Not everyone gets the keto flu but for some they may experience symptoms of :

  • fatigue
  • headaches
  • mood swings
  • nauseous
  • constipation
  • brain fog
  • sugar cravings
  • muscle cramps

For some the symptoms from the keto flu are too much for them to handle and they end up giving up.



As you can see, switching to a keto lifestyle can be very difficult when you haven’t properly prepared your body for this change. Just like how you wouldn’t jump from the couch to run a marathon, when you are adopting a keto lifestyle, and any diet for that matter, it is best to prepare your body for it. Set yourself up for success! 

Signs You are Doing the Ketogenic Diet WRONG 

  • hair loss
  • brittle nails
  • drastic changes to your blood pressure
  • irregular periods
  • high cholesterol
  • constipation
  • bad breath
  • muscle cramps
  • muscle loss
  • nausea
  • diarrhea
  • dry mouth

Keto Diet Dangers

Whenever you are eliminating or avoiding a nutrient group, there will be some dangers and cautionary details that one should be aware of. Like vegans who don’t consume meat or dairy, those who follow a keto lifestyle should also be cautious of specific nutrients that are missing in their diet and the side effects of these deficiencies. 

However unlike vegan and vegetarians whose predominant foods are antioxidant and nutrient rich vegetables and fruits, keto dieters who don’t carefully plan out their keto meals can more easily encounter nutrient deficiencies. Not only that, but the focus of keto meals around fats and protein can also potentially be dangerous.

In general, the vegan and vegetarian diet promotes the consumption of vegetables while the keto diet is centered around fats with protein as a side. However this framework is generally too vague because we know that there are bad fats and protein sources that can do a lot of harm.

On the flip side, we typically do not hear of any vegetable consumed in normal amounts to cause harm to our bodies. The keto diet is a strict diet that requires very careful planning and execution, ideally with the guidance of a health professional. By understanding some of the dangers of keto, particularly if you have underlying conditions, you will know how best to plan for your new keto lifestyle. 

Keto Diet Dangers Explained

1. Development of diabetes and obesity when overconsuming fat and the wrong type of fat.

When your body is in a starving and not starving mode, fat storage is happening simultaneously with fat breakdown. A mice study found that ‘eating a high-fat, low carb diet beyond one week, the mice that consume more fat that they can burn end up developing diabetes and obesity.’

2. Muscle loss and unhealthy weight loss

For the elderly, those needing to gain weight, or have an eating disorder generally shouldn’t be adopting keto lifestyle. Having said that since the ketogenic diet has many more benefits to it other than weight loss, it doesn’t mean that these people cannot adopt a ketogenic lifestyle. These groups of people however should be working with a health professional that would know how to tweak the diet to serve their health needs and goals. For example by doing cyclical keto or adjusting the fat, protein and carbohydrate ratios.

3. Leaky gut symptoms and increasing the permeability of your gut lining with the wrong fats.

Keto done right can be extremely healing to our GI tract. However done wrong or implemented on somebody with underlying gut and digestive issues can bring harm rather than health. 

Lipopolysaccarides (LPS), a type of bacteria in healthy individuals usually stay inside the gut wall and don’t cause problems. However with leaky gut, LPS can be absorbed and can cause inflammation and an overreaction in the immune system. Saturated fats like coconut oil, mct oil and butter increases the permeability of the gut and increases the absorption of these LPS endotoxins. Another reason why we stress the right fats for the right person and a personalised keto meal plan. 

4.Extra pressure and strain on the kidneys which could potentially lead to kidney stones or gout.

Processed meat or too much protein with not enough fibre from vegetables can put a strain on your kidneys. In order to balance the acidity that comes from consuming proteins the body needs to release more calcium, other minerals and uric acid which can lead to the development of kidney stones and gout.

5. Genetic variant that increases absorption of saturated fat.

There is a genetic SNP (polypmorphism) that makes you absorb saturated fat 2-3 times more than the average person. This means that the butter in your coffee and cheese melts could end up raising your cholesterol levels. Those who have this SNP, would do better with ghee (clarified butter) and polyunsaturated fats like olive and avocado oils.

6. Liver

Too much unhealthy fats that’s not being broken down and used by the body can lead to non-alcoholic fatty liver. For people with diabetes that have low or no insulin, the ketogenic diet may trigger a dangerous condition called ketoacidosis. This is where the body produces and stores too many ketones which build up in the blood making it overly acidic. If left undealt with, this disease can be fatal for the liver, kidneys and brain.

Keto is not recommended for those who have: 

  • kidney or liver disease
  • eating disorders (past or present)
  • pregnant or nursing mothers

Work with a trained professional if you have: 

  • diabetes and on medication 
  • underlying cardiovascular issues
  • thyroid issues
  • adrenal issues
  • kidneys or liver issues (eg fatty liver)
  • elderly health issues like muscle wasting, inability to gain weight
  • cancer 

How to get started on Keto?

If you’re going to do keto, there’s a better and a worse way to do it. A preferred way of starting on any program be it a diet or exercise program is to prep the body for the changes and slowly adapt it to the new changes. You won’t run a marathon straight from being a couch potato, some could but there will likely be injuries and it will be painful. Others can do well by shocking the system but for the majority and for long term sustainability and commitment, it’s always best to ease into things.

I recommend starting on a low carb, higher protein diet first for a week or two prior to starting on your official keto program. While you’re doing this, set yourself up for success by preparing your mind and your environment to support you into this transition.

Prepare your mind

Failure begins with a faulty mindset. Success is guaranteed with a determined and clear mindset.

  • Before you begin, set out your goals and reasons for adopting this keto lifestyle. Is it weight loss, controlling insulin, gaining energy? Whatever the reason is make sure you write it down. It’s helpful to go back to it to refresh your mind during the keto flu (if you get it) or when you’re feeling discouraged.
  • Have a solid understanding of the basics of a healthy ketogenic diet so there’s no guesswork or questions when you're faced with making choices at the grocery store or restaurant.

Prepare your environment

  • Remove any foods that may throw you off track or tempt you.
  • Stock your pantry and kitchen with keto supporting foods and supplements so you don’t need to go searching for them after. Check out our healthy keto grocery list.
  • Tell your social circle you are embarking on this keto diet so you don’t need to explain why you are rejecting the beer or pizza
  • Find some restaurants that have some keto friendly dishes or at least restaurants that can be flexible with their menu

Once your body is more used to the low carbohydrate intake and the cravings of carbohydrates have subsided you can then shock the system and move into a full keto diet with very low carb, moderate protein and high fat. The ratios will be different for each person. Every individual will need to play around with the carbohydrate content depending on their body composition and genetic predisposition.

Every person will switch into ketosis in different times and stages depending on your baseline insulin resistance, how your body deals with stress and any other underlying conditions.

How do you know you’re in ketosis?

The best and most accurate way is to test your ketone levels in your urine, breath or blood. Keto strips seem to be the most cost effective where you just test with your urine on a strip. The breath and blood method requires a device and a finger prick for the blood. The advantage of testing with a device is obtaining quantifiable measurements whereas a keto urine strip will only tell you what spectrum of ketosis you are currency falling on.

It is best to test it every day for at least one month especially at the beginning to ensure both the accuracy, consistency of your strip or device but also to give you a better understanding of when your body is in ketosis. After you have established a consistency and pattern you can test once every month or so. These readings can be helpful in helping you formulate your keto plan and what foods or habits switch in and out of ketosis.

Other signs you are likely in a healthy ketosis state include :

Positive adaptation

  • weightloss
  • decreased appetite
  • fewer cravings
  • increased energy and focus

Negative adaptation

  • fatigue
  • bad breath
  • digestive issues (constipation/ diarrhea)
  • muscle cramps 

Top 4 Keto Products to get you started on Keto

If you’re following a ketogenic diet, I would recommend the following four products to start you off.

1. MCT oil (medium chain triglycerides)
MCT can help you make more ketones and possibly help you stay in the fat-burning state known as ketosis. Flora Organic MCT Oil, 100% from sustainably sourced and non-GMO coconuts by cold fraction, each serving provides 14 g medium-chain triglycerides.

2. Collagen 
You might find you’re eating less protein than you used to, and may start experiencing hair loss and muscle weakness. Collagen is beneficial and you may take it in conjunction with keto as your body needs protein (amino acids) to build muscle, bone, cartilage, skin, hair, and connective tissue. Locako Keto Collagen - Chocolate Peanut Butter provides the combination of collagen and coconut MCT and helps to promote a clean protein boost that supports ketosis as well as hair skin, nails, and joint health.

3. Digestive Supplement 
One of the common side effects during keto is constipation and poor gut health, so I recommend Super Diet Vivaflore, which can enhance digestion, promote bowels and reinforce intestinal flora with 100 % natural stimulating but gentle laxative.

4. Cacao Butter

Last but not least, obtained from the whole cacao bean, cacao butter is a nourishing edible oil containing healthy fats along with a host of antioxidants, it also great for making chocolate bars and drinks.



  • Olives 
  • Sauerkraut/Kimchi (freshly prepared) 
  • Wild fish
  • Organic Eggs 
  • Pasture raised meats
  • Avocado 
  • Cauliflower
  • Broccoli 
  • Artichokes 
  • Brussel Sprouts 
  • Zucchini
  • Celery 
  • Dairy if you’re having (goat yoghurt preferred)
  • Oils
  • Ghee
  • Olive oil 
  • Grass-fed butter
  • Flax Oil / Omega 3.6.9 Oil
  • Avocado Oil
  • Coconut Oil

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Written by: Denise Tam, Holistic Nutritionist

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