Fat isn’t unlimited either. As with wine, it's possible to get too much of a good thing when it comes to healthy fats. The American Heart Association points out that while the Mediterranean diet meets heart-healthy diet limits for saturated fat, your total fat consumption could be greater than the daily recommended amount if you aren't careful. That’s 65 g per day. (32)
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.
Minerals/Electrolytes: Adopting a ketogenic diet will change the way your body uses (and loses) certain minerals. Not replacing these minerals can lead to symptoms of the “keto flu” such as lightheadedness, headaches, constipation, muscle cramps and fatigue. Refer to this article for tips on how to replace common minerals such as sodium, potassium, magnesium and calcium.
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If you've been cooking with vegetable oil or coconut oil, make the switch to extra-virgin olive oil. Olive oil is rich in monounsaturated fatty acids which may improve HDL cholesterol, the "good" type of cholesterol. HDL cholesterol ferries "bad" LDL particles out of arteries, according to a 2017 study in Circulation. Use olive oil in homemade salad dressings and vinaigrettes. Drizzle it on finished dishes like fish or chicken to boost flavor. Swap butter for olive oil in mashed potatoes, pasta, and more.
Lift weights: While you can’t exercise your way out of a bad diet, adding in weight lifting will build muscle and increase your metabolism. “The more muscle you add, the better your insulin sensitivity, so any sort of resistant strain you can add to your muscle is great for weight loss,” says Dr. Naiman. The weight lifting doesn’t have to be a excessive — 90 seconds, twice a week can do it. But he notes it has to be a heavy enough weight that after about to 10 to 15 lifts (reps) you cannot do another rep. That is called lifting to muscle failure. “It is only if you go to absolute failure that you convince your body that you’re not strong enough. Your body won’t add muscle unless you send the message that it needs more,” Dr. Naiman says. Squats, push-ups and other body resistance methods are just as effective as hand held weights or weight machines.

Yes, in the 1950s Ancel Keys and fellow scientists observed that people living in the Mediterranean, especially on the isle of Crete, were lean and heart disease-free. And true, their diet consisted of olive oil, but it also had an abundance of fruits, vegetables, herbs and spices, coarse whole-grain breads, beans, and fish. And they walked about nine miles daily, often behind an ox and plow.


Dietary fiber keeps you full longer and contains prebiotic nutrients that support a healthy gut flora, creating a win-win for weight loss. Getting insufficient dietary fiber (yes, I'm talking to you, all-meat carnivore or cave-man diet folks) adversely shifts your healthy gut flora, which will increase inflammation, insulin resistance, fat deposition around the middle, and weight gain. Leafy green and cruciferous vegetables, avocado, coconut, and berries make great fiber-rich, keto-friendly foods.
Cancer — While we can’t say that being obese or overweight causes cancer, consistent evidence indicates that higher levels of body fat are associated with increased risks for certain types of cancer, including breast cancer, kidney cancer, colorectal cancer, and endometrial cancer. In fact, overweight women are two to four times more likely to develop endometrial cancer (a type of cancer that begins in the uterus).
After the initial drop in weight due to water loss, your body will then begin to adapt to using fat as its main energy source. At this stage, you’re becoming “fat adapted.” This is the point in the process when you achieve a state of ketosis, meaning your body switches from using glycogen as its fuel source to using fat. When your body starts burning fat for energy, it produces ketones (also called ketone bodies). You can test your body’s level of ketones to determine whether or not you’re in ketosis.
Another Nurses’ Health Study following 10,670 women ages 57-61 observed the effect of dietary patterns on aging. [13] Healthy aging was defined as living to 70 years or more, and having no chronic diseases (e.g., type 2 diabetes, kidney disease, lung disease, Parkinson’s disease, cancer) or major declines in mental health, cognition, and physical function. The study found that the women who followed a Mediterranean-type eating pattern were 46% more likely to age healthfully. Increased intake of plant foods, whole grains, and fish; moderate alcohol intake; and low intake of red and processed meats were believed to contribute to this finding.
In fact, the FDA now allows olive oil labels to carry the claim that its monounsaturated fat can reduce heart disease risks -- with a few strings attached. The claim says that "limited and not conclusive scientific evidence" suggests that eating about 2 tablespoons of olive oil daily may reduce the risk of heart disease. To give this possible benefit, it adds, the olive oil must replace a similar amount of saturated fat in your diet -- and must not increase the total calories you eat in a day.
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