Just how much water should I be drinking? "About one-half your body weight in ounces every day, especially if you're exercising," says Pamela Wartian Smith, M.D., the author of Why You Can't Lose Weight. So the eight-cups-a-day rule applies only to sedentary women who weigh 128 pounds (sure as hell not me!). If you're one to consume an aggressive amount of fiber (guilty), an additional 8 to 16 ounces per day is a good idea, she adds. Just be warned: That amount of liquid-for me, a liter at each meal, minimum-requires serious effort and will turn you into a peeing machine.

High-protein ketogenic diet (HPKD): This version of the keto diet is often followed by folks who want to preserve their muscle mass like bodybuilders and older people. Rather than protein making up 20 percent of the diet, here it’s 30 percent. Meanwhile, fat goes down to 65 percent of the diet and carbs stay at 5 percent. (Caution: folks with kidney issues shouldn’t up their protein too much.)

The classic ketogenic diet is not a balanced diet and only contains tiny portions of fresh fruit and vegetables, fortified cereals, and calcium-rich foods. In particular, the B vitamins, calcium, and vitamin D must be artificially supplemented. This is achieved by taking two sugar-free supplements designed for the patient's age: a multivitamin with minerals and calcium with vitamin D.[18] A typical day of food for a child on a 4:1 ratio, 1,500 kcal (6,300 kJ) ketogenic diet comprises three small meals and three small snacks:[28]
First, a little background: Eric Westman, MD, director of the Duke Lifestyle Medical Clinic, explained to Health in a previous interview that in order to successfully follow the keto diet, you need to eat moderate amounts of protein, reduce your carb intake, and increase fats. When you reduce your carb consumption, your body turns to stored fat as its new fuel source—a process called ketosis. To stay in ketosis, followers of the keto diet must limit their carbs to 50 grams a day, Dr. Westman says.

Chris Ryan, C.S.C.S., is a former Division I athlete and top fitness model who regularly appears in numerous magazines ranging from Men’s Fitness, Men’s Health, Men’s Journal, and Women’s Health. His diverse clientele includes Under Armour, Reebok, Nike, Everlast, and Cybex. After the 10,000th question about what he does to stay in shape, Chris thought it was time to put pen to paper, or finger to iPad, to share his years of fitness knowledge. Motivational and always fun, Chris is ready to help you blast through your road blocks and maximize your fitness potential. Your happy, healthy life awaits!

Dr. Campos, it is unfortunate that you retain the medical community’s negative stance on the ketogenic diet, probably picked up in medical school when you studied ketoacidosis, in the midst of an obesity and type II diabetes epidemic that is growing every year, especially among populations who will never see the Harvard Health Letter. The medical community has failed in reversing this trend, especially among children, and the public is picking up the tab, in the form of higher health insurance premiums to treat chronic metabolic diseases which doctors cannot cure. The ketogenic diet does not bid its adherents to eat unhealthy processed meats, and the green leafy vegetables that it emphasizes are important in a number of nutritional deficiencies. People lose weight on the ketogenic diet, they lose their craving for sugar, they feel more satiety, they may become less depressed, their insulin receptors sensitivity is improved, and these are all the good outcomes you fail to mention. There is a growing body of research which demonstrates the neuroprotective effects of the ketogenic diet to slow cancer progression, as well as diseases like Parkinson’s and Alzheimer’s, for which there are no effective medical treatments. Please respect your patients by providing them with evidence-based medical outcomes, not opinions.
^ Jump up to: a b c d e f g h i j k l m n o p q r s Kossoff EH, Zupec-Kania BA, Amark PE, Ballaban-Gil KR, Bergqvist AG, Blackford R, et al. Optimal clinical management of children receiving the ketogenic diet: recommendations of the International Ketogenic Diet Study Group. Epilepsia. 2009 Feb;50(2):304–17. doi:10.1111/j.1528-1167.2008.01765.x. PMID 18823325
While it’s important to eat your vegetables, everything is fine in moderation. If you have a sweet tooth, eat a small portion of candy or dessert once in a while. If you always deprive yourself, you might be more likely to binge. You also need to be honest with yourself about what you are eating, says Frank Overton, owner and founder of FasCat Coaching in Boulder, Colorado. “There is so much crap that people have in their diet that is just out of habit,” he says. “Try to reduce or cut out soda, sugar, and junk food. Have a few less beers each week, or drink wine since it typically has fewer calories.”
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