The retention and need for a diuretic in the past may have been from excessive carb/wheat/dairy intake… Something you may find resolves with a ketogenic diet. Decreasing iodized salt and increasing sea salt, especially himilayian pink salt might help you to maintain sodium levels without the fluid retention effects also. For example I always buy unsalted butter and add pink salt for the flavour/sodium component. It’s made a big difference for me (a fellow massive found retainer haha)

Plagued by pimples? You may start to notice a difference in your skin on the keto diet, especially if you were a former sugar addict. Consuming lots of empty carbs is linked to worse acne—in part because these foods trigger inflammation and signal the release of hormones that up the production of pore-clogging oils, according to a review published in the Journal of the Academy of Nutrition and Dietetics. Some findings suggest that curbing your carb intake could help solve these problems, improving your skin as a result.


After 12 weeks, the decrease in body weight and body fat was significantly greater in the MCT group than in the LCT group. The decrease in the area of subcutaneous fat in the MCT group was also significantly greater than that in the LCT group, which suggests that the MCT diet might be able to help reduce body weight and fat in individuals who need to lose weight. (3)
The cost of the Mediterranean diet, like most aspects of the diet, depends on how you shape it. While some ingredients (olive oil, nuts, fish and fresh produce in particular) can be expensive, you can find ways to keep the tab reasonable – especially if you're replacing red meats and meals with plant-based home cooking, some research suggests. Your shopping choices matter, too. Can't spring for the $50 bottle of wine? Grab one for $15 instead. And snag whatever veggies are on sale that day, rather than the $3-a-piece artichokes.

In 2014, a group of three Brazilian researchers assessed the available literature on the effectiveness of low-carbohydrate diets in a meta-analysis. They specifically looked at trials that compared a ketogenic diet that consisted of no more than 50 grams of carbs per day with a conventional, low-fat diet with less than 30% of calories from fat. The researchers included 13 studies that lasted 12 months or more with a total of 1577 subjects.


Mediterranean diet is a generic term based on the typical eating habits in the countries that border the Mediterranean Sea. Elements include dairy products, fish and poultry being more common than red meat; fruits, vegetables, bread and other cereals, potatoes, beans, nuts and seeds; use of olive oil; wine consumed in low to moderate amounts. These diets have similarities to the American Heart Association's dietary recommendations, except a relatively high percentage of calories in Mediterranean-style diets come from fat.
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Yet it’s an incredibly well-rounded way to lose weight that ditches gimmicks and doesn’t require calorie or macronutrient counting as other diets do. And with the emphasis on healthy fat, it’s satisfying, too. That said, the 2019 U.S. News & World Report Best Diets ranked the Mediterranean diet as No. 1 for Best Diets Overall and it ranks 17 in their list of Best Weight-Loss Diets. (3) The reviewers note that it’s not a slam dunk, and all depends on how you eat. Even healthy diets like the Mediterranean aren’t free-for-all eating plans.
My dad was diabetic even though he was a competitive cyclist and ate "healthy". I grew up in a Weight Watchers household where everything was sugar-free and fat-free. Back then, if you had diabetes, you switched your white bread, rice, and pasta to whole wheat and you were fine. My dad died of pancreatic cancer when I was 19 years old. They say there’s no cause for this cancer, but I think the stress from his diabetes on his pancreas had a lot to do with it.
According to the US FDA, having two tablespoons of extra virgin olive oil daily may reduce the risk of heart disease, due to its monounsaturated fat content. Some of the antioxidants present in extra virgin olive oil like oleocanthal and oleuropein are known for their anti-inflammatory action and help in reducing the levels of bad cholesterol which can be a risk factor for heart disease.
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Mamalaki, E., Anastasiou, C. A., Ntanasi, E., Tsapanou, A., Kosmidis, M. H., Dardiotis, E., ... Yannakoulia, M. (2018, September 5). Associations between the mediterranean diet and sleep in older adults: Results from the hellenic longitudinal investigation of aging and diet study. Geriatrics & Gerontology International, 18(11), 1543–1548. Retrieved from https://onlinelibrary.wiley.com/doi/10.1111/ggi.13521
That doesn’t mean you’ll go hungry on a diet. It’s quite the opposite! You’re not starving yourself of calories but of carbohydrates. Your body won’t go into what’s known as starvation mode, which is where your metabolic rate drops considerably. You’re adding more fat to the diet and taking out the carbs, so the metabolism can still work, and you get the energy you need.
Research supports the health benefits of a Mediterranean-style eating pattern that includes several different foods. It is the combination of these foods that appear protective against disease, as the benefit is not as strong when looking at single foods or nutrients included in the Mediterranean diet. [12] Therefore it is important to not simply add olive oil or nuts to one’s current diet but to adopt the plan in its entirety.
Day 13: I have a love-hate relationship with this intermittent fasting thing. I think it's "working," and by that I mean I'm losing some weight. (Plus, improved body composition and definition can come with weight loss.) When I ask Dr. Axe if I should attribute my success to keto or IF, he says both. "I would say 80/20 it's more strongly in the favor of keto, but intermittent fasting does help as well," he says. The fat-burning capabilities of keto have more strength behind it when it comes to weight loss, specifically, he adds, but the intermittent fasting can be great for digestion and just feeling good.
10 pound weight loss , chicken broth works to relieve . But have to be careful of salt intake . I retain fluid, Dr gave script for dieuretic before I even started Keto . I have had the retention problem for a long time , when I took the dieuretic on a normal high carb diet ( I would drop 4 lbs ) but would make me really tired , afraid if I take it now on Keto I will pass out. Any idea what I should try other than the chicken broth

The FDA appears to agree with data showing that replacing butter with olive oil generally improves blood lipids, “but it also recognizes that this improvement might or might not reduce the risk of coronary heart disease,” points out Gomer “There is no convincing evidence at this time that those better-looking blood lipids necessarily lead to a lot less atherosclerosis or fewer heart attacks.”
The Mediterranean diet wasn’t built as a weight loss plan — in fact, because it wasn’t developed at all, but is a style of eating of a region of people that evolved naturally over centuries, there’s no official way to follow it. But it’s popular because it’s a well-rounded approach to eating that isn’t restrictive. Two of the five Blue Zones — areas where people live longer and have lower rates of disease — are located in Mediterranean cities (Ikaria, Greece and Sardinia, Italy). (2) These places are known for having some of the lowest rates of heart disease and cancer worldwide. (3)
Still, I enjoy cooking and I plan my meals on the regular anyway. With a keto food list in hand and advice from Dr. Axe in my mind, I filled my grocery cart with family-size versions of what I regularly buy (apples, berries, nut butter, kale), and a lot more meat than I ever have in my cart at one time (ground lamb, chicken, REAL bacon). What was missing? Some of my usual high-carb items, like whole-grain English muffins, orange juice, butternut squash, and tortilla chips.
Armed with the 411 on how the keto diet works, I felt encouraged and relieved. The concept is rooted in nutrition- and weight-loss science. And from my initial conversations with Dr. Axe, I liked knowing that ketogenic diet results are always meant to be time-bound-eating this way is not a lifestyle and that makes sense. You may have heard that the keto diet was ranked last in the U.S. News & World Report's 2018 list of the best and the worst diets. While I embarked on this journey before that news came out, I would have given the keto diet a try regardless. Part of the criteria for that ranked list was whether a diet was sustainable and easy to follow-the keto diet is neither, but it's not designed to be. "I don't recommend people follow strict ketogenic diets for their life," says Dr. Axe. "I recommend 30- to 90-day periods, and after that moving into more of a 'cycling' phase, where you can cycle in and out of keto." Dr. Axe admits that following a keto diet will be difficult for most people, since many Americans have diets high in sugar, salt, and carbs. But he says that the potential benefits-boosting brain health, supporting muscles and overall improved performance at the gym, at the office, and in life-are worth putting in the hard work. (Just Look at the Keto Diet Results Jen Widerstrom Saw After 17 Days.)

Now you’ve made the decision to follow the diet, it’s time to choose the type. There are four options. The standard ketogenic diet is the ones that we’ve already looked into, where your diet consists of 70% fat, 25% protein and the rest carbs. You can also follow a high protein option, which cuts your fat intake to 60% and your protein intake up to 35%.

In the Mediterranean, many people start their day with a quarter cup of olive oil. The oleic acid in olive oil has a satiating effect. As mentioned above, it also slows the absorption of other nutrients, so you’ll feel full longer and won’t need to reach for that mid-morning sugary snack. While the calories in olive oil may be high, the overall consumption of calories throughout the day will drop when you’re just not that hungry.
On a less serious (but still important) note, it is important to start using MCT oil slowly. Because it is so readily and quickly used by the body, it can lead to all kinds of (temporary but embarrassing) digestive disturbances if you jump in to quickly. I’ve even stumbled across entire threads in online forums bemoaning the “disaster pants” that resulted from using too much MCT oil too quickly. It is generally considered safe to start with 1/2 to 1 teaspoon and work up as the stomach permits.

Now, in the Journal of the American Geriatrics Society, scientists have found that seniors who adhered most closely to the Mediterranean diet were the least likely to be become frail over a four-year study period. Recently, in the Journal of Urology, researchers also found that men who followed a diet rich in fish, produce and olive oil—and low in juice—had a lower risk of aggressive prostate cancer than those who followed low-fat or typical Western diets.


I really enjoyed your article. I do have a couple questions (sorry if I missed the answers in any of the comments above), how would someone calculate their personal macros? At 5’1″ female, I am not going to consume the same amount of food you do so I would think my macros would be considerably less than 150 – 200 grams of fat and so on a day? I am in week 3 and really haven’t lost much. I dropped just over 3 lbs the first week, less than 1 the 2nd week and not sure this week as I weigh on Mondays. Also, did you have to make any adjustments for heavy lifting days?
It requires a pit stop in the liver rather than getting immediately converted into energy like the other MCTs above. This is why it is more accurately described as an LCT, not an MCT like marketers claim. It raises cholesterol more than any other fatty acid (not necessarily a bad thing.) It is also commonly cited as having antimicrobial benefits, which it does…except the shorter chain MCTs are more effective against aggressive candida yeast and even gonorrhea and chlamydia (as a monoglyceride).[3][4]
The solution? One way of approaching this issue is through dieting. To adapt to such an abundant food environment, you need to give your brain new food rules to follow (e.g, a diet). Your brain needs you to tell it what to eat and what not to eat to meet your health goals. One of the best ways to do this is by finding a diet with simple rules that you can follow for the rest of your life.
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It's important to realize that MCT oil will not produce weight loss miracles all on its own. However, it is an excellent addition to an otherwise healthy diet. Moreover, many consider MCTs "the ultimate ketogenic fat," as it allows you to eat slightly more net carbs while still staying in nutritional ketosis. Without MCTs, you'd have to cut carbs more drastically in order to maintain ketosis.
However, there is one caveat when it comes to weight loss. In response to a calorie deficit, the body will typically burn some of its muscle mass for fuel by using a process called gluconeogenesis. As a result, many people will lose muscle along with the fat when they diet. Luckily, there is a way to preserve muscle mass, even in the midst of extreme caloric deficits.
After investigating 20 controlled feeding studies, Hall and Guo found that both low-carb and high-carb diets had similar effects on body fatness and energy expenditure. The results of this meta-analysis provide us with high-quality evidence that supports the widely-believed theory that calories matter much more than the fat or carbohydrate content of the diet when it comes to weight loss. [24]
When your body goes into ketosis, it will start to produce by-products called ketones. This includes acetone—yes, the same chemical found in nail polish remover, which your body actually naturally makes on its own, according to a 2015 review of research. Because acetone is a smaller molecule, it tends to make its way into your lungs. You’ll eventually exhale them out, resulting in “keto breath.” Your mouth might also have a metallic taste, but it won’t last forever as you adjust to the diet. Just be diligent about brushing your teeth!
Some studies have proposed that women’s weight gain in midlife is more a factor of aging — which impacts both sexes — than of menopausal changes in hormones. Other studies note, however, that declining estrogen (estradiol or E2) at menopause changes women’s energy needs and metabolism, changes their location of body-fat accumulation from the hips to abdomen, and is associated with an increased rate of metabolic syndrome.
It requires a pit stop in the liver rather than getting immediately converted into energy like the other MCTs above. This is why it is more accurately described as an LCT, not an MCT like marketers claim. It raises cholesterol more than any other fatty acid (not necessarily a bad thing.) It is also commonly cited as having antimicrobial benefits, which it does…except the shorter chain MCTs are more effective against aggressive candida yeast and even gonorrhea and chlamydia (as a monoglyceride).[3][4]
“However, it may be time to question the wisdom of promoting diets with 20 to 35% fat or more for people with cardiovascular disease and/or type 2 diabetes. Diets this high in fat appear to greatly increase both acute and chronic low–grade inflammation in the body. Increasingly, inflammation is being linked to not only more cardiovascular disease but also insulin resistance and type 2 diabetes.”

Caution: Palm oil is a controversial source of MCTs, not because it’s bad for your body, but because there are major issues involved in the process of procuring this oil. These include deforestation, loss of wildlife diversity and unethical treatment of workers. That’s why I only recommend RSPO-certified palm oil, which comes from producers who prioritize sustainability practices.
The Mediterranean diet is most famous for its benefit to heart health, decreasing the risk of heart disease by, in part, lowering levels of “bad” LDL cholesterol, and reducing mortality from cardiovascular conditions. It’s also been credited with a lower likelihood of certain cancers, like breast cancer, as well as conditions like Parkinson’s disease and Alzheimer’s disease. (1)
As a gut health doctor, this is my biggest pet peeve about keto diets: They sometimes overemphasize foods high in dietary fat like meat and full-fat dairy at the expense of gut-supporting plant foods. Knock your gut flora out of balance and you're almost sure to hit a plateau since gut health affects weight loss. Even on the strictest keto diet, you can incorporate fermented and cultured foods including sauerkraut, kimchi, and kefir.
This supposedly “good” monounsaturated fat-rich meal, in effect, elevated blood fats and crippled the workings of the endothelium (the inside skin of the arteries), putting the squeeze on blood flow and reducing the arteries’ ability to deliver more blood to tissues. Research has shown that things that impair endothelial function in the short term usually contribute to clogged arteries in the long run. No problems with impaired endothelial function occurred with meals enriched in other parts of the Mediterranean diet, such as vegetables and fruits.
Includes Beta-Hydroxybutyrate (BHB) – When You Drop Your Carbs, You’re Eliminating a Source of Energy for Your Brain as Well as Your Body. Your Brain Requires About 100g of Glucose a Day to Function, So on Low-Carb Diets, You Can Feel a Bit Slow or Fuzzy. BHB is an Exogenous Source of Ketones That Will Help Combat This by Providing Fuel for Your Brain.

On a high-fat ketogenic diet, you can easily eat 3,000 calories or more daily with high-calorie foods like cheese and nuts. Sure, your body will shift into ketosis on a high-fat diet, but eating too many calories means your body will utilize dietary fat instead of body fat. A food journal can help you pinpoint high-calorie foods that might sabotage your weight loss. You don't need to be on an old Atkins diet plan to lose weight the keto way.
I am researching keto plans and was so pleased to read your perspectives and personal story. It seems many over complicate things. I am 44, 5 ft 8 in and 236 pounds. I had kids at 35 and 48 yrs old and have had a really tough time with my body changes and overcoming this “doomed” feeling when it comes to weight. I want to be confident that this can happen but not sure where to start. I am a nurse, want to run and play with my 2 boys and really want to feel confident and show my horses again. This extra 60 pounds has got a hold of me! What do u recommend I do to start. Thank you for your inspiration!
Technically, you can eat any food and lose weight. The key to weight loss is not eating “fat burning foods,” the key to weight loss is a sustained calorie deficit. When you are in a calorie deficit (i.e., eating fewer calories than you need to maintain your weight), your body will be forced to use its energy stores, which includes glycogen (stored sugar) and body fat (stored triglycerides).
A 2013 study conducted by the German Research Center for Food Chemistry indicates that even just smelling EVOO may lead to greater feelings of fullness: when the scent was added to foods via an aromatic extract, it lowered the number of calories consumed by study participants, and improved blood sugar response. Additionally, compared to other oils and fats, when EVOO was added to yogurt, the group that had eaten the yogurt enriched with olive oil showed the largest increases in blood levels of serotonin, a hormone associated with satiety.

I just started keto this past week and I am on day 7. I am down 4lbs, but have a long way to go to reach my goal (40lbs). I was wondering about certain foods….are tomatoes/onions okay on a keto diet? I’ve read quite a few conflicting reports that claim you should not eat those while on keto. I’m not very good at tracking macros and calories yet. I’m just trying to stay focused on eating all the right foods. It has been a rough week with brain fog, headaches, fatigue, the works…and barely enough energy to get in any exercise. Still I try. I have two little ones and that tends to take up more of my time. I recently found out that milk is pretty high in carbs and replaced that as well. I was wondering if after your reaching your goal, whether or not I could transition to paleo and still keep the weight off. Do you think that would work? I love fruits and the occassional glass of milk that allows me to make a smoothie haha….I was just wondering, what are your thoughts on this?
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Unlike coconut oil, MCT oil is liquid at room temperature and is tasteless. It is better for rapid energy and metabolism than coconut oil and it may also be a great choice for those who don’t like the taste of coconut oil or who need a liquid oil at room temperature. It is a great neutral oil for use in homemade mayonnaise or as an unflavored oil in homemade salad dressings.
Too many "legal" high-calorie foods can sabotage your keto diet. So can lots of other things. One way to pinpoint those potential glitches is through a food journal. One study found people who tracked everything they ate lost twice the amount of weight as those who didn't track what they ate. A food journal also keeps you honest and compliant with your keto plan.
On the other hand, coconut oil does have some well-documented health benefits that concentrated MCT oils might be lacking. The biggest drawback to buying manufactured MCT oil is that you might not really know what you’re getting. In order to produce a liquid MCT oil that does not become solid at colder temps, it might need to be more refined than regular coconut oil.
At this point, you probably already know that the Mediterranean diet is good for your health. Research proves over and over again that people who put an emphasis on produce, fish, whole grains, and healthy fats not only weigh less, but also have a decreased risk for heart disease, depression, and dementia. So what are you waiting for? Here are the basics: Shop the market perimeter, eat seasonally, and break (whole-grain) bread with people who make you smile. Now for the nitty-gritty.
MCTs have antiviral and antibacterial properties and there is some evidence that they may help balance gut bacteria and combat pathogenic bacteria. They also offer the digestive system a break because they are so easily utilized by the body. When used with a healthy diet and other ways to support gut bacteria, MCTs may help improve gut health over time. (Though regular coconut oil may be more effective for this, see below).
Coconut oil is blowing up in the health and wellness scene, but there’s a catch to all the so-called benefits. Coconut oil contains different strains of fats and not all of these strains are equally effective for energy and fat loss. That’s why I specify the exact types of oils that work best in “The Bulletproof Diet,” and why Bulletproof makes Brain Octane Oil and XCT Oil, neither of which is the plain MCT oil found in coconut oil.
The “PREDIMED” study, published in the New England Journal of Medicine in 2013 conclusively showed that the Mediterranean diet group had a third less heart disease, diabetes and stroke than the low-fat group. They also lost a little weight and had less memory loss. The most recent results showed that it also reduced chances of breast cancer, albeit in a small number of women.
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