Some negative side effects of a long-term ketogenic diet have been suggested, including increased risk of kidney stones and osteoporosis, and increased blood levels of uric acid (a risk factor for gout). Possible nutrient deficiencies may arise if a variety of recommended foods on the ketogenic diet are not included. It is important to not solely focus on eating high-fat foods, but to include a daily variety of the allowed meats, fish, vegetables, fruits, nuts, and seeds to ensure adequate intakes of fiber, B vitamins, and minerals (iron, magnesium, zinc)—nutrients typically found in foods like whole grains that are restricted from the diet. Because whole food groups are excluded, assistance from a registered dietitian may be beneficial in creating a ketogenic diet that minimizes nutrient deficiencies.
Don’t eat too much protein — In addition to limiting your carb intake, you need to limit your protein intake as well. You should aim for about 20% of your calories to come from protein. If you eat more than that, your body will turn the excess protein into glucose in a process called gluconeogenesis. Your body will then try to burn this glucose off instead of fat and will kick your body out of ketosis.
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.
Katie Wells, CTNC, MCHC, Founder and CEO of Wellness Mama, has a background in research, journalism, and nutrition. As a mom of six, she turned to research and took health into her own hands to find answers to her health problems. WellnessMama.com is the culmination of her thousands of hours of research and all posts are medically reviewed and verified by the Wellness Mama research team. Katie is also the author of the bestselling books The Wellness Mama Cookbook and The Wellness Mama 5-Step Lifestyle Detox.
"I always make an assessment of whether or not the cheat is worth it and 99 percent of the time, it’s not. If I do have a cheat meal, I don't worry about what the scale says afterward. I want to be happy with the decision before I make it, during it, and after I make it. A lot of it is living with your decisions and not beating yourself up over it."
You still have to cap alcohol. The hallmark of a Mediterranean diet is that drinking red wine socially is thought to be one reason why the diet is so healthy. But women should still stick to one glass, and men two glasses. If you have a history of breast cancer in the family, know that any alcohol consumption raises that risk. (31) In that case, talk to your doctor to find out what’s right for you.

SOURCES: Environmental Nutrition, June 2003; May 2004; February 2005. The Journal of Pediatrics, July 1995. Journal of the American Dietetic Association, February 1997. Journal of the American Dietetic Association, July 1997. Journal of the American Medical Association, 2004; 292. Food Chemistry, May 2004, vol 85; issue 3. American Journal of Clinical Nutrition January 2005. FDA News, Nov. 1, 2004. The Olive Oil Source web site.
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