Meet Mark

Let me introduce myself. My name is Mark Sisson. I’m 63 years young. I live and work in Malibu, California. In a past life I was a professional marathoner and triathlete. Now my life goal is to help 100 million people get healthy. I started this blog in 2006 to empower people to take full responsibility for their own health and enjoyment of life by investigating, discussing, and critically rethinking everything we’ve assumed to be true about health and wellness...

Tell Me More
Stay Connected
October 04 2017

Where I Part Ways with the Popular Keto Movement

By Mark Sisson
173 Comments

Natural landscape image of forked asphalt roadThe explosive growth of interest in the ketogenic diet has been a net good for the state of nutrition. For one, people have accepted the fact that eating fat won’t kill you, and they’re even getting clued into the benefits of eating it.

But there are places where I part ways with the popular keto movement.

Let me explain….

Ketosis Isn’t the Point

Ketones themselves have beneficial mechanistic effects. It’s true.

The ketone body beta-hydroxybutyrate shows direct anti-inflammatory action, even blocking inflammatory diseases mediated by the NLRP inflammasome pathway. Ketogenic diets exert their protective effects on the brains of epilepsy patients through the anti-inflammatory actions of the ketone bodies, and type 1 diabetics who experience reduced cognitive function because of low blood sugar see those deficits erased by increasing BHB through dietary medium chain triglycerides. Another reason ketone bodies themselves are so therapeutic is that they represent an alternative fuel source for neurodegenerative disease patients whose brains can no longer process glucose effectively.

But epilepsy patients get results both from full-blown medical ketogenic diets where you count the carbs in heavy cream and “modified Atkins” diets where the carb count is relaxed. They’re both equally effective.

The obsession with ketosis as a desirable state of being—maybe the ideal state of being—for everyone misses the point. Consider how worked up people get over ketone measurements. Are they registering? Are the sticks purple? What am I doing wrong?

Some long-term ketogenic dieters have registered high numbers. I’m thinking of Peter Attia back when he was hardcore keto, Dominic D’Agostino, and folks like that. Others level off with keto adaptation to the point that they get very low readings despite eating a classically-keto diet and seeing huge benefits. We don’t know why this happens. I gave some possibilities, but the fact remains it’s a mystery.

I don’t find it all that compelling to speculate and pontificate. When we know, we’ll know. Until then, until we know what they actually mean, release your attachment to the numbers. Assuming you have a good grasp on keto eating and are getting tangible results, why waste your time?

Consider the fact that ketogenic diets increase brain mitochondrial biogenesis—the production of entirely new mitochondria. This improves energy metabolism in the brain and is probably a big reason why keto is so great for Alzheimer’s, epilepsy, and other brain disorders. But it’s not the only way to do it. After all, exercise is another way to increase mitochondrial biogenesis in the brain in non-keto rodents on standard lab chow. Is ketosis the prize, or is better brain health the prize?

The ultimate goal of any eating strategy is to increase metabolic flexibility. You want to be able to burn sugar during activity that warrants it. You want to be be able to skip meals and get by just fine on your own body fat. You want the benefit of having a few ketones around from time to time as alternate fuel for the brain and muscles—or at least have the ability to generate them without trouble.

Rather than micromanage your metabolism using incomplete information, you’d rather delegate and let your endocrine system regulate your calorie intake based on what your body requires. Most importantly, you want to regain the ancestral pathway of fat burning and actually put those massive storage depots to use. Every diet wants these things, but keto is the quickest, most direct way there.

Keto Doesn’t Require Gorging on Fat

It’s fun to post pictures of yourself next to a 4 inch stack of bacon or brandishing a cup of butter coffee with more calories than a Big Mac. There’s value in subverting the dominant narrative that dietary fat makes you fat and gives you heart disease. Sometimes using extreme imagery can do that most effectively. And being on a ketogenic diet means you do have to eat dietary fat and that a high percentage of your calories will come from fat, as the calories must come from somewhere. But keto doesn’t require that you eat large absolute amounts of fat.

The quickest way to reach ketosis is by not eating, by burning the fat you already have on your body. It’s when all the best things happen, and it’s why the various other diets that work, work. They allow (or force) you to burn your own body fat. It’s also the cheapest way. Just think: All the best keto biohacking supplements to jumpstart your new keto lifestyle already reside on your hips, your belly, your arms, and the rest of your body.

This isn’t a mistake, a fluke of evolution. It’s actually why the system evolved in the first place, to tide our ancestors over during times of food scarcity, when there simply wasn’t any carbohydrate fuel for our brains. Eating a low-carb, high-fat diet works because of the low-carb part, not the high-fat part per se.

Keto Doesn’t Have to Be Ketogenic—Allow Me to Explain

I call it the keto zone—a range of carbohydrate intake that causes you to drift in and out of ketosis without even realizing it. For most, the keto zone might correlate to consuming between 20-120 grams of carbs per day. Less one day, more the next. More ketones today, fewer tomorrow. You’re constantly on the verge of either leaving or entering ketosis, and it’s okay. When you’re in the keto zone, things get easier:

If you have a super intense training session and decide to eat a sweet potato (before or after), it goes toward fueling that workout or restocking the glycogen you just burned.

If you skip a meal or two, you can almost hear the whirr of your mitochondria processing your body fat for energy.

You maintain your ideal body weight/composition without counting much of anything—calories, carbs, ketones, or Instagram likes for your high fat coffee photos.

You eat less food than before but experience no negative symptoms. You retain (or gain) muscle and bone density, sleep like a rock, enjoy steady energy levels, and generally avoid the malaise of long-term calorie restriction.

You have the metabolic flexibility to complete a tough CrossFit workout, do a sprint interval session, hike for 7 miles, run a mile or two, go for a long slow bike ride, play a pickup game, or lift something heavy.

Ketosis isn’t the goal. It’s a tool to help you get to the real goals of metabolic flexibility, broad-based “Primal” athletic competency, protection against the epidemic of diet-influenced modern diseases—especially the alarming increase in cognitive decline conditions, and graceful aging.

The goal is and always has been to be an efficient fat-burner and to release your dependency on carbohydrates for fuel. A ketogenic diet simply represents the pinnacle of fat-burning: if you can get into ketosis, it’s a sure sign you are using fat for fuel. Many, even most, of the benefits of a ketogenic diet probably come from developing that capability.

Thanks for stopping by today, folks. I’m interested in your thoughts about the popular keto movement and my points above. Where do you land? Have an awesome day.

TAGS:  keto

If you'd like to add an avatar to all of your comments click here!

173 thoughts on “Where I Part Ways with the Popular Keto Movement”

Leave a Reply

Your email address will not be published. Required fields are marked *

  1. Mark, I just bought the book, waiting for it now, so am not sure the details of the diet, but it raises a question I have been meaning to ask you. I have been eating an apple a day for a long time now (love the taste, texture and its good fiber) and am wondering whether that is giving me too much sugar for a keto diet? So, what are your thoughts on apples, pears, etc, and a daily item?

    1. You’re probably best eating that apple in quarters divided throughout your day as it would constitute a significant proportion of your daily carb intake. And as always, if you eat it after exercising it’s a much better part of your diet

    2. I think you may have missed the point of the article and may need to read a little more on ketosis too and the fact your body will be in constant flux throughout the day regarding ketones. None the less- you could also consider that different apple varieties have different amounts of fructose. Green apples tend to have less, hence the tangy flavour instead of sweet.

  2. I love the non-dogmatic take on Ketosis. It is amazing, but some number on a Ketone meter isn’t the goal. The goal is being healthy, feeling healthy, having energy, and having the flexibility to eat or not eat depending on what is happening and available.

    1. I also feel that by so much focus on ketosis people miss out on expanding dietary choices. If you can eat fruit or even a potato (gasp) and maintain your health, that’s great. People never get there when so obsessed with ketosis while being loathe to experiment and listen to their bodies.

      1. That’s nice for the person who is already healthy, but focusing on ketosis and being very strict can literally be a lifesaver for someone trying to reverse a serious health condition like many cancers, serious cardio issues and of course neurological and autoimmune conditions. Feel free to dilly-dally if you are healthy, but GET SERIOUS if you want ketones to help a life-limiting affliction!!

        1. Absolutely! Nothing of what I said negates the fact that keto revolutionizes life for many. That’s part of listening to your body, health markers and finding what works.

        1. Yes it got me off insulin and meds, best thing I ever found and being obsessed with being healthy is a good thing. Who declared that all us ketonians are obsessed with meters. Open your minds a bit pleas?Your myths are showing.

          1. Canuck, I’m type one, but don’t really like meat, nor eggs. When trying to eat low carbs, I find myself limiting myself to olives, coconut oil, cheese, sauerkraut, butter, salad, etc. do you have any suggestions for me? Btm66 at yahoo . Com

          2. Do you eat fish or seafood Barb. There is a keto vegan fb group.i eat avacado,zucchini noodles, stir fry,duck, you need to find a way to get your protein, keep carbs down then enough fats to satiety, fats do not bump insulin. Only thing that doesn’t.

          3. I don’t like seafood either. Plus my son has a shellfish allergy, so I’m always worried that regular fish may be cross contaminated with shellfish. Could you share the name of the group? With regards to the zucchini and stir fry, doesn’t that take you out of ketosis if you eat enough to satisfy or are you just eating low carb?

            Thanks,
            Btm66 at yahoo . Com

  3. Good points. I tried ketosis a number of years ago and decided it wasn’t for me. It wasn’t that it didn’t work for weight loss. It did. I lost 20 pounds in just a few weeks. But I didn’t feel great. I was always a little worn out, in need of a nap even though I was getting plenty of sleep at night. There was also a nagging suspicion that I wasn’t getting enough nutrients due to the drastic limitation of carbs (including fruit and veggies). Extra fat and a handful of supplements aren’t the balanced equivalent of real, high-quality food.

    Obviously it works well for a lot of people, but my body didn’t like being in ketosis, not mentally or physically. Possibly I wasn’t getting enough calories, which can be a problem with keto. My personal feeling is that keto is best used short-term or cycled in and out of for the exact reason that it does limit necessary nutrients. I’ve found that I do much better in every respect on a less restrictive diet.

    The point here is this: Don’t force yourself into a ketogenic diet if your body reacts negatively to it just because you are convinced it’s the best way to eat. There’s little to be gained by pounding a square peg into a round hole. We are not all the same, and not everyone responds well to being in ketosis.

    1. Probably weren’t getting enough electrolytes. I think that is what threw me off of losing via ‘paleo’ years ago. Now following ketogains protocol and have dropped 55 lbs (first 25 doing ‘paleo’ but was eating too much fruit and losing muscle mass so did the research and went with ketogains). I’m 58 years old.

      1. Interesting comment. I, too, am 58 and just purchased electrolytes two days ago. The reason was, I burn about 1800 calories a day in workouts and the electrolytes did help. I would recommend their use if pushing yourself physically while doing keto. Great article, introducing a less dogmatic view.

      2. This is absolutely the problem. It sounds particularly like a lack of sodium. I’ve hit a couple “sodium holes” (as I call them) where I just felt like I wanted to sleep for days. I heated up some chicken broth, and within 20 minutes, I was feeling better than ever.

        1. I always read…drink pickle juice, drink chicken broth…but no one ever says how much. I bought Powerade Zero because so many recommend that. But again, no amounts. So last night I had 4 oz before bed, and I got so itchy! So, not trying that again! I have both pickle juice and chicken broth. But how much are you supposed to take to replenish electrolytes?

          1. Salt to taste. If the salt tastes good (referring to all four electrolytes here, not just sodium chloride), then eat it. When it stops tasting good, stop eating it.
            Does not work with junk food.

    2. Eat Crap fro years and then think your body will be adapted in a few weeks? Talk about wanting instant gratification. Give it six months or more. I am a year into it after
      Weight loss for the first six months. I wne through the same thing. It
      Can take a long time to recover but once tou do you will never go back! I suggest giving it another shot or are you just
      Making excuses for your sugar / carb addiction?

      1. Don, where do you get the idea that I was “eating crap for years”, or that I wasn’t fat-adapted? I don’t need to “make excuses for a sugar/carb addiction” because I don’t eat grains or sweets, and I didn’t need to “recover” from anything. I didn’t say any of those things. The keto diet DOES NOT WORK WELL for everyone. Is that too hard for you to understand?

        1. I guess I hit a nerve! Shat was the point of trying a keto diet then. 3 weeks is not enough time.

          1. Don, seriously, you need to learn to READ. I did NOT say I tried the keto diet for 3 weeks. I said I lost about 20# in 3 weeks. I was on the diet for considerably longer than that before deciding it was hurting more than helping me. Why are you jumping all over people when you can’t even comprehend what was written?

          2. Ok. I don’t read between the lines / what is not written, So how long was ‘considerably’ before you thought carbs were a healthier way to eat? The dirty little secret is that it can take several months amd probably over a year to be significantly and fully adapted depending on how much ‘damage’ was done. Unless you were acrually tested for deficiemcies your metabolism was likely still healing. If still a problem after a year then I would have been looking at the food sources as well.

            If you weren’t getting enough nutriemts then you were not following a well formulated ketogenic diet. I don’t know of anyone who is malnourished that is eating a ketogenic diet but I do know folks that are when eating a standard American diet.

            I eat berries from time to time and a lot more veg than I used to but not root veg, which are higher in starch and sugar so am eating healthier. I doubt anyone ever got fat from too many carbs in broccoli or cauliflower ao there is some leniency.

    3. I had a similar experience! Over several years, I kept at Keto more and more, tweaking things despite issues with hair loss, coldness, low energy, hormone issues. The Keto story sounded so good that it took me a while to accept that it wasn’t working, and try something else. Turns out that my body easily burns more of my own body fat on a low fat diet! High fat, even moderate fat diets make me insulin resistant, lethargic, and with high blood sugars. Again, so counter to what I expected based on all the hype! When I switched tactics, I lost weight effortlessly until it stabilized. I also gained strength, unlike with Keto, where I had to relentlessly restrict and found it hard to make fitness gains.

      1. “High fat, even moderate fat diets make me insulin resistant, lethargic, and with high blood sugars.”

        Yeah, i kinda doubt that.

        1. Insulin resistance is caused by other environmental insults besides food. I have been studying type 2 diabetes for a very long time. We know Agent Orange exposure induced insulin resistance in susceptible people irregardless of diet or amount of body fat.

          1. Some people have a genetic disorder that makes it difficult to process fats. It may be the case here. My daughter has one – a high fat diet would kill her eventually. Her body simply doesn’t know what to do with it. She does great with carbs, though. Many adults don’t know they have these disorders as they only began widespread testing on newborn screenings in the last several years. So if someone says they tried a high fat and didn’t do well remember this and extend them a little grace.

          2. Right. And there are often complexities or other hidden health issues that we don’t know about.

            After all, there are legitimate reasons why a keto diet won’t work for everyone. And there is no evidence that a single diet approach is best for every single person on the planet.

          3. Love your phrase
            ” extend them a little grace”….

          4. “…extend them a little grace.” Yes! Thank you TJJR I’ve been a healthnut all my life so I’ve never had to recover from a carb addiction, or learn to eat healthy. I did eliminate grains and legumes a few years ago, but that wasn’t hard except that they’re ubiquitous. Yet I have troubles that those who’ve never struggled for daily existence can’t even imagine. My Naturopath says it’s from childhood vaccines and mercury amalgam fillings and an extremely stressful life, from childhood on, and nutrient deficiencies brought about from gut malabsorption issues. Drastically short version: I’m severely chronically anemic, hypothyroid and adrenal fatigued to the point of debilitation these past 4 years, with mild congestive heart failure and enlarged liver. No medical explanation for anything but the anemia (and their remedies were killing me). I could write lengthy papers on the things that don’t work for me that the gurus have said would. Including keto. My body absolutely refuses to cooperate. But each anomaly has had a rational explanation upon studious research. I’m happier and healthier when I’m low carb, and hope that eventually I can get my body to burn fat. But one of the most frustrating parts of the frustrating existence I’ve been leading is having people who aren’t in nearly as bad shape be absolutely certain that something they hold sacred will DEFINITELY work if only “done right.” If I hadn’t been paleo and low carb I’d probably be dead, but they have not been able to overcome all this – the care of a good Naturopath and a reclusive life, and more supplements than I ever dreamed of taking, are slowly healing my poor ravaged body. Someday, when I’m back to my old strong self, and others are struggling, God strike me dead if I ever give them pat answers, much less wither them with derision for what they’re saying about their body’s reactions. I may not understand what somebody has going on, especially when what’s working for me is the opposite of what they’re saying, but MAYBE I don’t know everything yet!

          5. I believe that some races have this disorder so develop dangerously high cholesterol – the really bad kind. Maori and Pacific Islanders are prone to heart disease. Their natural food is/was fish, birds, leafy greens and a few root vegetables.

          6. My brother served in Vietnam Nam near the Demarcation Line and is now an insulin dependent diabetic – many Nam veterans exposed to Agent Orange are!

        2. Well, guess what, she’s not alone.low carb/keto/high fat was terrible for me too. NO energy, poor digestion, high cholesterol, cold intolerance which is a sign of thyroid problems, and on top of that I couldn’t lose weight. Now I eat high carbs low fat and I’m down to 120 lbs with perfect labs and restored energy levels. Don’t buy the keto hype.

          1. I can’t seem to adjust either. I notice all of us who have had trouble on keto diets are women. I am trying going for a couple days keto diet then upping carbs for a day, then back down. I guess that is Mark’s point in the article that started this conversation.

          2. I had all of the above but kept going because there were other benefits. After year (6 months of weight maintenance so now < 50g of carbs rather than 25g) I'm through it. No problem with eating higher carb as long as it's from vegetable sources and small amounts of fruit (engineered with a lot of sugar now). It's the processed food (rapidly digestible carbohydrates), sugar (poison) and wheat (more rapidly digestible carbs and hard on the gut although I didn't know it until I tried going back to it) that really messed me up and it's taken a while to get back to 'normal'. Not sure I'm quite there yet as my gut biome is still recovering! I have found it's taken a long time to really 'adapt' but a better word is probably 'heal'.

            High cholesterol is certainly not a problem since we have all been duped by statin manufacturers. Saying high LDL causes heart disease because it is found at the site is like saying firemen cause fires because they are found there. Reduced trigs is really what is important and the only real correlation is the ratio of trigs to HDL – the lower the better. I would therefore question your perfect labs..

            I'm glad you feel better though and found what works for you!

          3. Super low carb wasn’t doing it for me either but I am still low carb. Just not super low carb. And no, I am not insulin resistant.

      2. Out of statistical interest, could I ask which type, and frequency of exercise were you doing, and did you change it over the years ?

      3. Jenny can you tell me what you are doing instead of Keto? I tried Keto for a month and didn’t feel great while doing it. I also feel like a person should be able to eat more fruits than what is accepted with Keto.

        1. Now, I keep fat low, protein low/moderate, and carbs moderate. Lots of vegetables, legumes at every meal, less than an handful of fruit a day, meat/fish once every few days, little fat. That’s what’s working for now, for today, but I’m constantly tweaking. I like being able to eat healthy, non-processed carbs without my blood sugar going high, which is what happens when I have too much fat. I find that I feel best limiting processed carbs, including sugar, wheat, rice flour, bean flour, any flour. However, I don’t eliminate those 100%–when I did, I obsessed about having or not having foods, rather than enjoying small bits in moderation and feeling a sense of “with” friends, which is important to me.

          Also, I exercise–short spurts of exercise work best with my lifestyle–I’m homeschooling 3 fascinating kids. I do spurts of kettlebell swings, sprints, push-ups, and burpees when I get a chance. They help massively with blood sugar control and energy level. Currently, I also use potato starch, eat bitter melon, and do some other remedies to help with blood sugar.

    4. Yes, I would say you need to first be fat adapted or your body will be starved with little glucose and little ability to burn fat effectively. I’d say 3 months of fat adaption and MAF training to build up some mitos and THEN try keto…

      1. I did high level Keto for years. I definitely would have been fat adapted, but Keto does not work well for all bodies. My body went into starvation mode, so cold and lethargic, very slow digestion. I wished it had worked, but now am glad i’ve figured out what works for me!

        Every body is different, but I think we all do better with quality exercise, sleep, and nutrition. It’s a bummer that people get so into dietary dogma that they throw darts at each other instead of encouraging life affirming choices.

        The biggest bummer is that by being obstinately and extremely Keto, people close off options that might be better for them. Fortunately, that is not what Mark is promoting, which is why I read this blog. He acknowledges that bodies are different, and that women and growing bodies, especially, need to be cautious

  4. My main challenge on Keto promoting meals is sleeping my teenage boys satisfied and full. They still crave carbs and swear they still feel hungry without them.

    1. Somone, a few months back I did a post on counterindications and cautions for keto. I don’t recommend for keto for anyone who isn’t done growing (including teenagers). There’s just too many processes in play for them. So, unless they’re doing keto for medical reasons, I’d suggest keeping them on standard Primal but offering them ample fresh fruit and more veggies to round out healthy fats and protein. No need to be too restrictive on healthy carb sources for growing, active young ones. Best to you and your boys!

    2. They ARE hungry if they say they are. Read what Chris Masterjohn PhD in nutrition has to say about “fat burning in the flame of carbohydrate” . Your boys are still growing. Let their bodies speak. It doesn’t mean they will only eat chocolate cake. They will repay the rigid purist diet by stuffing themselves with carbs as soon as they get out from under your control. Hunger is a potent force. Then they’ll fell obligated to lie about it to avoid any drama with you It’s not what you want. Teenage metabolism is very different from middle age metabolism. Let them grow. Not everybody’s body is the same. If I even put half and half in my coffee and eat a little meat, my inflammation markers start to climb and I get insulin resistant almost immediately. – Oh, yes – and I am hungry, can’t get satisfied because for whatever reason, my body doesn’t have enough enzymes or something to burn fat well. I need some carbohydrates.

      1. I’m doing keto right now and feel great, but I am 55 and quite overweight. Don, it’s good to acknowledge that different bodies, sexes, hormonal and growth stages are different and may require different macros. Whatever works, right?

    3. A big reason to go on a ketogenic diet is because a person is insulin insensitive. If your teenagers are active and relatively lean I’m sure they’re insulin sensitive. They also have plenty of testosterone and growth hormone shooting through their bodies. I have a 12 year old daughter who plays club soccer and when I make her dinner I have her eat the protein and veggies first and then she can eat whatever carb is on the plate. I usually keep the carb portion a little smaller.

  5. I really like this perspective. It seems that the downfall of many good ideas is at least partially due to zealotry and extreme thinking. I’d like to hear more discussion on the specifics of how to keep from down-regulating the ability to burn sugar since this is a key concern for those of us in glycolytic sports. This has been given almost no discussion that I can find.

  6. Nice article on the keto diet. Very helpful and I like the points you make.

  7. One of my favorite blogs by you, that I have read yet. Two months here following your recommendations, and tremendous results. I currently have not eaten since 8 pm last night, and feel amazing, not even thinking about food, and it is 1230 pm est right now. I lifted this morning in a “fasted” state, and felt strong and energetic. Thank you for your diligent efforts to make people healthy and happy, rather effortlessly if I may say so…

  8. Love! I’m a long term keto eater and the current climate of dogma and hyperfocus on numbers is unsettling and misses the point. I’m glad to see you putting another way of thinking about it out there where people can stop with the constant ketosis anxiety.

    1. I definitely would like to join a group that’s not so dogmatic while staying away from “keto friendly” junk. It’s difficult to locate balanced information.

      1. Ive yet to find such a group unfortunately. There are some better than others but the popularity means more junk and more dogma.

  9. Thanks for the dose of sanity. I have been experimenting with a keto diet over the last couple months and I have seen definite benefits. Your focus on the benefits- how it makes one feel- makes way more sense than hitting a certain carb goal or fat %. One benefit I have been enjoying is my hot flashes have pretty much subsided. Are there any studies that look at the effects of a keto diet on menopause?

    1. Joan Burn, I’m glad you’ve experienced personal benefits from your own experiment with keto. And you said it exactly right – focus on those benefits rather than numbers. To answer your question about keto and menopause, I have two posts coming before the end of the year (written by women) that will cover keto and women, including questions around menopause. Thanks for your note, and Grok on!

    2. Joan, when I behave myself, my hot flashes are completely gone. However, on the downside, just one or two slip ups (whether a grain indulgence or too many carbs in general), and the hot flashes are one of the first symptoms that re-appear, usually that first night. It is one way to keep me on the straight and narrow as my sleeping suffers right away.

    3. Hi Joan – this may be of use to you. I am 67 slim and fit until got MS diagnosis in late 40s which caused restricted exercise and combined with menopause I developed ugly weight around my middle. However I have discovered through reading Jason Fung’s ‘complete guide to fasting’ that the body has natural insulin spikes throughout the day and because my main meal was in the evening it was combining with an evening high insulin production which, despite a large healthy meal, was causing severe munchies/ cravings. I now eat one meal a day at 1 or 2 pm when insulin production is low and no longer have cravings, spare tyre has disappeared and so much more energy. I find the one meal a day effortless and enjoy some berries or starchy veg too. This may help in the future.

  10. Mark– A philosophical question I’d love to hear your take on regarding ketosis…

    Feel free to correct me if I am incorrect on anything, but we evolved Ketosis as a way of maintaining brain and body function during times when food, all food, was scarce–hunter gatherer days.

    My understanding and experience with Ketosis as a state, is that it is not necessarily hard to get into, but is difficult to maintain for any period of time. By “difficult” I mean you have pay very close attention to everything you are eating, or you will easily slip out of Ketosis…

    So, my question is this. From an evolutionary perspective, is long term Ketosis something we “should” be aiming for? Assuming long term ketosis was optimal, it seems that we would have evolved to easily maintain it under a number of circumstances, and not easily slip out of it, instead of the opposite.

    Thanks for all you do!

    Ryan

  11. I think with all the marketing (about diet & Paleo) we forget why Paleo is so important. Our bodies have learned from over 30,000 years how to digest and use food in ways we still do not fully understand.

    Please don’t get me wrong, I love my Keto bulletproof Matcha Chi Tea Latte every once in a while. I do like to be flexible within healthy guidelines.

    Mike, I loved your article some months back about why eating from a wide range of foods is so important and believe focusing in on one diet will eventually send your body into a tailspin.

  12. Thanks for a very reasonable and well thought out blog and for not making keto a religion

  13. I see this way of eating can be dangerous for many who will go into it blindly. Without educating themselves or spending the time for research. There are those among us who buy a book & think the have discovered a “fountain of youth”.

    Eating as our ancestors ate,exercising the way of our ancestors,resting their way. Two & a half million years is an established track record. What is the next big thing? I don’t care. If it ain’t broke don’t fix it.

    1. Perhaps this isn’t the correct thread to share these thoughts. Forgive me if it’s not! I am 63 years old and have been dieting since I was 11 years old. Now and then I would lose weight, but never really keep it off. Dieting and weight has unfortunately consumed my life and my thoughts. With Primal eating (or maybe just my version of it), I keep the right foods in my house and I eat when I want. When I go out to eat, I eat meats and vegetables. No problem. I don’t worry about details. I have needed a way to eat that didn’t consume my thoughts, that didn’t give me something to rebel about. Primal has done that for me. I may not live it perfectly, but I feel better and am slowly losing weight and I don’t have food on my mind all day. Today, I didn’t even think about eating until almost noon. Did I go into ketosis? I don’t know and I don’t care! If I had to knowingly live a ketogenic diet, and actually spend time obsessed with it, I would last about half a day. I was distressed when I saw it being discussed and even encouraged on this site as it distracted me from the good thing that Primal is. Some people enjoy and perhaps need this, and I say, Good for you! Just not good for me :):):)

      1. +1. I agree completely. I don’t need to lose weight, and I feel fine. Drifting between 80/20 and 90/10 works very well for me. I don’t want or need anything more extreme.

  14. Just a quick question, Mark. Does being in ketosis cause bad breath? My daughter has an unusually acute olfactory sense and swears I have keto breath. Am old, sedentary, 25 lbs overweight (belly) and trying to slim down via intermittent fasting and carb restriction.

  15. I got my book yesterday. So far I am impressed. I have often tried keto or low carb, but if I ended up with too many carbs I felt defeated and gave up. I think just being conscious of what I am eating and how I am feeling is the key. I actually quit bacon because I LOVE it and it was so addicting! AND it gave me a backache! I know, crazy, however, it increased my inflammation due to my histamine intolerance. I am looking for a guide to get myself healthy and live healthy to an old age. Lots of late 90’s folks in my family. The fasting you mention in your book is the first thing I am trying today. Don’t eat until you are hungry. Simple enough. No clock eating and that is so freeing. AND I haven’t really been hungry yet. It’s almost 1 o’clock in the afternoon. I can’t wait to read the whole book and give it a whirl! Thanks for your research and dedication to making people healthy!!

  16. Hugely good. Thank you. I have eaten more or less this way for 2.5 years with almost all days keeping carbs below 50g, most days below 30g, BPC? 250g/fat per day? Not here… Just lots of meat and non-starchy veg and healthy fats. Much more moderate fat than popular keto. AT age 53 I am healthier than ever, many many health issues resolved or resolving. But am I ‘in ketosis” all this time? Is my pee strip a certain color? Who knows. I don’t track with strips and I don’t really care about what state I am in as long as I continue to get healthier, stronger, fitter, and leaner. And all of that is happening.

    1. What were your blood results like before and after? (if you don’t mind sharing)

  17. Mark, we have a mutual friend, Kim… She shared you with me when I inquired of the Keto Diet. I must say reading this and some of your other articles and recipes, I am relieved! Almost everything I have read of late does exactly what you said… I have even been told that Keto is Bacon… To that I asked… I thought we were supposed to focus on healthy fats… not that we could not have bacon… just not daily… Thank you for giving some clarity! It is much appreciated!

    1. Glad your friend referred you, Leslie. Yup, there’s a lot out there now that misdirects people toward an approach that will compromise their health and undermine their ability to stay keto for enough time to get a foothold in fat-burning. The way I do keto offers me the same nutritional density as my regular Primal diet does. No one should feel they have to compromise nutrition to use keto as a tool for their health and weight loss goals.

  18. I’m not sure about yo-yoing carbs up to 120g. No reason to go over 50 otherwise you will likely be getting them from poor choices.

  19. Love everything Mark said here. I have been high fat/low carb for years now. No idea if I have ever actually been in ketosis, but as Mark says that isn’t the point. The point is I feel great and have a ton of energy. My anxiety seemed to magically disappear. I listen to my body and eat when I’m hungry. And some days are higher carb than others. I’m not counting or measuring anything. Totally believe this lifestyle can work well for many people, but you can make yourself crazy counting and measuring everything.

  20. I’ve found that the more people try and keep track of a healthy life style, the more they feel as though they have failed, and they tell themselves if they can’t even do the small things, why try? That’s not how I’ve taken things. My personal goals are this: I want to feel great, I want to look great, I want to be able to play, I want to be healthy. Yes by all means pay attention to what you eat and try and stay on the right menu for the day, but don’t make it a do-or-die thing. I don’t know how many times I have skipped having a slice of pizza with everyone else just because I know I won’t feel great after eating it, and I’m not really hungry, I’m just wanting to eat because everyone else is. That’s what Ketosis is for me.

  21. Measure blood ketones, not urine ketones. Urine ketones tend to decrease over time as your body becomes keto-adapted. I like the resonably-priced “keto-mojo” which can be used to keep track of blood sugar AND blood ketones. I like the relaxed approach moving forward AFTER one gains confidence in the ketogenic lifestyle, but looking at “the numbers” is VERY helpful initially and certainly helped keep me motivated, accountable, and encouraged!

    1. I have the same experience. Tracking helps keep me motivated. I am learning more about my body all the time and how it responds to what I eat. I also know there will be a day when I don’t have to-nor want to track.

  22. Very well written Vance. Where can I find more info on the comments you made about “in and out of ketosis”. I tend to do this at times.

  23. I love the comment – The easiest way to get into Ketosis is to fast – Yep – low cost – zero carb and guaranteed to put you into ketosis. That is a no-brainer. Thanks Mark!!

  24. I’m going on 4.5 years in the “Keto-Zone” and I totally agree with your views. Obsession with numbers can be counterproductive and distract you from the real goal…healthy lifestyle. We evolved to survive periods of food shortage and diversity, just learn to use that to your advantage and your body will thank you.

  25. As a primal health coach in the UK I’ve been saying what Mark’s article says for the better part of this year.

    I have a client who is concerned that over 20g carbs a day will destroy all her efforts. I’ve been working with her for a month now and she was already keto for about a week when she came to me.

    I’ve just, a couple of nights ago, gotten the message through to her that going over 20g a day won’t break her keto streak. We did a comparison of the amount in grammes she used to take in on a standard diet with refined carbs, which amounted to approximately 700-800g daily. Compare that with the unrefined whole carbs she is on now, even if she consumed 100g per day she is in massive deficit and will still lose weight.

    I want her to NOT be stressed about her journey so that she can make this permanent not short term.

    This is a very well timed article Mark THANK YOU I’ll be referring it to her. The keto reset book is superb by the way, I’m half way through!

    And thank you for the primal health coaching course I regard it as the most important qualification I’ve ever earned. I highly recommend it to anyone with a desire to help anyone achieve better health.

    1. Gary, great to hear from you. Sounds like you’re doing solid work with your client, and I wish you both the best. I’m glad she has the guidance of one of our own coaches! Folks often make getting healthy harder than it needs to be, and we’re here to show them that living Primal is living the good life – whether that includes keto or not. Grok on!

  26. Thank you for posting this. It is well-written and informative. I enjoyed reading your point of view. I have been fat-adapted for a few weeks and now checking my Ketones via a Ketonix.

    It is good to know that I shouldn’t get hung up on the numbers. Losing the extra body fat is my main goal, and it’s going slow, but it is going. It is reassuring to see that I’m still burning Ketones and how that is affected by what I eat.

    Since I’m watching my carbs, as well as practicing intermittent fasting, and to make it little more complicated, I’m a Vegan and want to remain a Vegan.

    I’m reading your book now. I admire your lifestyle and how you are aging gracefully and becoming a public role model, etc. I’m 66, a personal trainer and plan to slow down the aging process as best I am able.

  27. Just wondering about something. Has anyone suggested anything about Lupus, an autoimmune disease. I’ve had Lupus for 27 years. After going on low carb I am in remission. Not sure, but it has to have something relevant. No longer on any of the medications. Thankful!

  28. You might want to link to this post in the Keto Reset Facebook group, because the crazies are over there shoveling in the fat and counting every last gram, macro, calorie and pound. Thank you for this, today’s post is the voice of reason, I don’t know why people insist on making it so difficult.

    1. Subconsciously they may be making it more difficult, so as to set up the grounds to justify giving up later on.

      If something is straightforward and simple, you remove all excuses for yourself – that’s why I like the primal diet/exercise/lifestyle approach, and I will be sticking with it.

      Sometimes on primal I might skip a meal or two, or three and maybe wind up in keto for a short time, but I would’t know,and wouldn’t care. My measurement is my belt size and how I feel.

      And one big point, Keto is only a diet, it does not seem to make any prescriptions for the type of exercise you need to combine with it and other lifestyle factors. This may be why it eventually fails in most cases.

  29. Echoing other comments, I also love the non-dogmatic “keto zone” concept. What I want to understand, though, is how going keto CHANGES how the body handles sugars. I’ve been non-dogmatically keto for about a year and my body now seems to handle sugars differently. They don’t taste as good (probably a good thing!) and my body also seems to process them more efficiently. What’s going on?

    1. It will be the “Man Diet” – just stop eating until you loose the fat.

  30. Picked up the book this morning at the post office (apparently UPS doesn’t come to my house) and am looking forward to reading it and starting. If I’m successful with this I’ll definitely start telling my patients about it and guiding them through the process.

  31. I have started checking my fasting blood glucose as a measurement of where I am metabolically. It’s cheap and fast and I’ve learned so much about my body and my intake needs by just trying to stay in the 80s, my green zone. As a lifetime obese 51 year old woman in early menopause, losing weight is Awfully Difficult. But I have lost 35 pounds, improved my joint pain 100%, and my energy levels 75%. I know my hair trigger foods and that protein turns to sugar for me worse than bread. Sigh. So much for red meat. I sprinkle it on my veggies! (And no, I don’t eat bread either!) I will likely check my BG every morning for the rest of my life. If I get Type 2, it won’t be because I didn’t see it coming!

  32. Mark, I have been going to Lindora Lean for Life for 2 years now. I believe it qualifies as a keto diet, but I am stuck and struggling. I battle emotional eating issues and poor habits, but am very motivated to stick with it for life because I want to avoid diabetes and dementia. My father died from compkications of diabetes. I also follow Dr. Brian Mowll online and still struggle. I exercise daily and play hard as well. I plan to purchase your keto book. I just cant give up. Thank you for your newsletter and your knowledge that you share.

  33. Hi Mark, I live in Australia and your book is only available as an audiobook on iTunes. Is the book available yet on iTunes or is it a quirk of geographical bias? I want to try this. I have Hashimotos, but I am gaining weight slowly, and need to rethink and reset.

    1. I had Hashi on three different medication. I was told that I will be on meds for the rest of my life. I didn’t take that as an answer. I cleaned up my eating with Paleo 7-8 years ago and nutropathic supplements. Bought one of Mark’s first books. It was much harder to be on paleo then. I make a lot of the meals at home. Now stores are carrying stuff and much more convenient to have access to good clean fats, veg and meats.

      Took me 2.5 years to ween off all the meds. And my hair stop falling out. Went from Size 10 back to a 0/2. I also started Crossfit a year ago and continued to sculpt my body. Be patient. It works but it takes time. Good luck to you.

  34. Thank you, excellent assessment. After 3 months of exposure to, deep research of, and diligent application of a ketogenic idea, I have landed right on what you describe – utilizing ketosis as a tool for health, and realizing it’s just the natural built-in tool of our physiology. Having a new relationship with food as fuel, being able to fast with relative ease, anddispelling the myth about fat and carbs has extremely liberating, the buttercream icing on the cake!

  35. Marketing Idea:
    Interact with Reddit’s keto group. It’s 410k strong and I see similar questions over and over. Perhaps a keto AMA.

  36. Great article Mark. I am a Primal Health Coach and Massage Therapist in Australia and I refer many of my clients to your wise words, so well researched.
    I started on a low carb experiment about 4 years ago and went into Ketosis about a year later to see how it really worked with endurance events. Once in ketosis I found the need to up the electrolytes to maintain energy as per the advice of Volek and Finney, but then it was fairly effortless. I completed two marathons, a half ironman and several half marathons without taking any in race nutrition except electrolytes and did not “hit the wall” or bonk as you would say, so a great success.

    I am a follower of the fb Keto reset group and am occasionally concerned about the focus on high fat as my experience is just keep carbs low and use fat for satiety and curbing hunger when needed. The ketone numbers drift up and down and then kick in during an endurance event. This all happens fairly naturally.

    I would encourage everyone to not worry about the Keto numbers or trying to be high fat, just eat ‘as grown’ non starchy carbs and focus on how you feel and the effects you are getting. Keep tweaking until the formula works for you. There is so much information that Mark has researched for you that will give you so many options to work with. But stay with it, it works!
    Thanks again Mark for your inspiring work.

  37. The attachment to numbers is an aspect that I find stressful as well. Not everyone does it, of course. But, it’s very easy to start getting obsessional about numbers, like carb levels and ketone readings. That pattern doesn’t promote a healthy relationship with food and might even be dangerous for some people.

  38. I went ketogenic for 8 months and I had the worst sleep of my life. I had difficulty falling asleep and awoke repeatedly during the night and had trouble falling back to sleep once awake. I assumed that my cortisol levels were chronically elevated by going keto. Any ideas?

    1. Yeah, stop doing a diet that’s hurting you. I also had many negative reactions to keto/ low carb. Now I just eat normally, focus on whole foods and feel great. My lab tests are also great even though I’m eating 70% carbs from potatoes, oats, beans, lentils, rice, fruits, veg etc.

  39. Dear Mark, Thanks for this thoughtful post. I’ve tried keto for about 8 weeks, and I’m wondering as a nursing mother if I were to start to incorporate some high starch vegetables, would that be okay? Is it best to consume them in the mornings or evenings? Some popular keto bloggers say to ‘carb up’ at night, but that seems non-intuitive to me. However, if I eat them during the day, will they make me hungrier? Before this way of eating, I was always hangry and insatiable, now so much better, and fewer blood sugar crashes, so I’m sensitive to that. Many thanks.

    1. Zee, I have a post on contraindications and cautions for keto that you might want to check out. I don’t recommend keto for nursing mothers, given the extra demands on the body and specific hormonal picture needed to support lactation (the post explains more). If your milk production is good, your baby is thriving, you’re feeling good, and your physician/midwife doesn’t have any objections, then you may be among those nursing mothers who can do keto without issue. Keep in mind that many women can do a moderate-low carb diet during nursing months and still remain in ketosis anyway. So by all means – if you’re looking to incorporate some starchy, nutrient-dense vegetables like sweet potato, squash (obviously good this time of year) I’d say most definitely do it. In terms of timing, I’d experiment and go with your body’s feedback. No right or wrong here. Especially with nursing, your body is busy pulling more energy throughout the day – and night. Thanks for writing!

      1. Thank you ever so much, Mark for your measured, balanced, and kind guidance. I’m so moved that you took the time to respond to my questions. I have certainly been lucky in that yes, milk production is good, baby is growing, and I feel a lot better than I did on a mostly carb heavy diet. I’m grateful for your giving me the go ahead to add starchy veggies, as I do think they will help me maintain my supply (baby is an avid nurser). And I’m glad I wrote because I was contemplating Intermittent Fasting to accelerate weight loss, but I think based on your knowledge and the contraindications that you shared, I will hold off for now. Thanks again!

  40. Hi I’ve been doing the paleo-keto diet for two months and still am dealing with mood swings, and times of total exhaustion. I saw in one of your articles the suggestion of electrolytes. Is there a certain one you recommend?

  41. What about a 57 yr old woman who had a sub-total thyroidectomy at 23 who has had horrible issues with her weight, & now has Hashimoto’s & CAN NOT lose weight?

    1. I don’t think women with thyroid problems should do keto or low carb. It makes things worse. I started developing thyroid problems from keto and recovered after after stopping keto/low carb.

    2. Go try some weight training, get coached in a gym to do it properly to avoid injuries, its low impact high return exercise.

  42. Great discussion! I started Keto in May, after not feeling my best on Paleo, and I am still learning (about what way of eating works for me). I’m grateful for both the Paleo & Keto communities, because I have come to discover a lot of things about myself, through both; mentally & physically. It has been fun & exciting, watching my body & feeling my brain tranform, but it has also been frustrating (not arriving at that “sweet spot” yet,; with what works perfectly for ME). One thing I hear over & over again, is to be patient, and I do believe that with patience & continued research, I will find the best way to eat, to thrive. Thank you for a great topic, and all you do. Heard about your book at Ketocon, and will definitely be checking it out!

  43. I always love these posts, very informative. I’ve been primal for 4 years with 2 Paleo/primal pregnancies during this time. Everything was going well except I couldn’t lose a few stubborn pounds. I gradually went lower carb to keto in June. Yes, I lost the weight, gained intense focus, and woke up energized. But, there is a dark side to keto for some people. I started waking up around 5 each morning wanting to work on something with only 6 hours of sleep. This happened everyday. Then, a few weeks ago, I noticed small bald spots in my scalp and my hair was thinning. The lack of sleep and nutrient deficiency caused me to stop. Fruits and veggies have so many great vitamins, and you have to choose fats over those to stay in ketosis. Once I added healthy carbs back, my sleep drastically improved. It will take some time for my hair to grow back, but I’m hopeful.

    1. I’ve noticed most negative side effects of keto being reported by women, myself included. This diet is a terrible idea for a lot of women and we should be careful. It’s much better to eat a balanced diet that includes whole foods including a variety of fruits, veg, tubers, lentils, beans, oats, rice etc instead of extreme/restrictive fad diets like keto that are causing harm.

  44. Great Post! However, as you probably know, there are proponents of a more strict approach. In particular, I remember Steven Phinney saying that once you bump out of ketosis it takes weeks for your body to get into the beneficial zone again. I would love to see a post addressing this explicitly.

    1. You also need to align you ketosis stages with the moon phases or it won’t work.

  45. You mention “modified Atkins” as a diet with a more relaxed count of carbs – but in fact it is still a diet where you are supposed to be in ketosis all the time, isn’t it?

    1. No. That’s not the point. You may or may not stay in ketosis all the time. It just depends on what you eat and each person is different. Once you’ve been able to achieve a state of ketosis your body will burn fat and heal. Let’s say your in keto for 2 weeks then go a vacation and eat a bunch of carbs and get out of ketosis. It will be much easier for you to go back into ketosis once you’ve achieved that status before. It’s kind of like muscle memory.
      Make sense?

  46. You state, “The ultimate goal of any eating strategy is to increase metabolic flexibility.” But why do you believe that flexibility is the ultimate goal? Because it gives people more food options?

  47. Just curious. Setting aside for the moment that this type of eating is beneficial, it is based on the idea that we are responding to food availability as our ancestors did thousands of years ago. If we evolved so much in the interim, why do we assume our metabolism did not?

  48. Awesome article!!! Thank you Sir… The cult like following of the Keto method of eating is in itself, a practice. A tool within your toolbox. I actually like the reverse paradigm of… How can I manipulate my insulin via macros and at certain times to promote better repair and hormone production. I am concerned and confused of all the bad info and “Keto Nazi-like zealotry” of groups popping up. You know the ones… Our group follows this micronutrient
    counter, or they base there beliefs on flawed information. A group-think mantra.

    I am not looking for the best diet. I am looking for the best diet FOR ME… But I digress… Great article Sir…

  49. I can say that my body does not appreciate it when i go full keto, but practicing it on and off for the past few years has shown me the insane amount of carbs i was consuming, and has helped me mitigate my portions. i have found that a good balance of carbs, fat and protein keeps me feeling great. too many carbs and i have crashes. too much protein and i feel sluggish. i’ve found that the “on and off” keto keeps me going strong

  50. I’ve been doing keto since July: I’ve not lost much weight according to the scale but according to my clothes I have: at first I would go 3 to 4 hours between meals: I was diagnosed pre diabetes 2011 and was taking metformin. I was able to get off metformin but found my appetite was worse without it. I guess metro was helping more then Keto: I’m doing both now and it’s working great! I’ve never gotten this mental clarity and or energy I hear about so I just feel the same.

  51. Ketosis, Key-smoshish. This is the part of the article I can relate to: Ketogenic diets exert their protective effects on the brains of epilepsy patients through the anti-inflammatory actions of the ketone bodies, and type 1 diabetics who experience reduced cognitive function because of low blood sugar see those deficits erased by increasing BHB through dietary medium chain triglycerides.

    Being a Type 1 Diabetic for more than 20 years, since I was 33, I can speak from experience on a low-carb diet and experiencing low blood sugars with a carb-rich diet compared to a low-carb diet.

    Low-carb diet, maybe in ketosis, wins hands down!

    When I was first diagnosed, I would go through massive blood sugar swings on a daily and even hourly basis. Not having a clue how to manage my blood sugars, and having little to no help from the Professional Medical Staff who were advising me. I was on a roller coaster ride and experiencing the shakes, sweating and “reduced cognitive function” that came along with these huge swings. (Going from maybe 300 mg/dl down to 40 within a short period of time is horrifying in your head. You feel like your sinking and nothing can save you.)

    Thankfully, I found Dr. Bernstein’s Diabetes Book, read it cover to cover, and implemented the plan. It took some doing, but it all made sense once I was under way.

    Eating a low-carb diet may or may not have put me into ketosis at the time, (round about 30 grams a day) I don’t know. (Wasn’t aware of the condition at the time.)

    But, now, after many years of going on and off the diet, (I have my weaknesses at times, but no longer) I’ve found that eating plenty of meat, fat, and green veggies, (how much I’m not sure), along with avoiding all sugar, grains and vegetable oils, my blood sugars are more stable than when playing carbohydrate-roulette.

    I’ve developed a good feel for what goes with how-much insulin. 2 Basil shots per day and regular on a sliding scale with Humalog, (fast-acting insulin) for any miss estimations to bring down my blood sugars rapidly to a normal range.

    Last A1c of 5.2 is the result. This is not perfect, but it sure puts me in the ballpark of normal non-diabetic people.

    So, my whole point is: following a low-carb diet, and avoiding the foods of civilization, along with a stringent insulin regiment, allows me to weather infrequent lows almost every Type 1 diabetic experiences from time to time. With minimal recovery time and less panic and confusion during the lows I do experience. The reduced cognitive function of my past is almost imperceptible.

    Its’ not perfect, but it does help to maintain my sanity leagues above the roller-coaster ride of the average Type 1, and often, Type 2 Diabetic.

    Hope this is not too long and helps some to understand the Type 1’s dilemma. And the results achieved by the need to eat low-carb because of the inability to accurately calculate insulin to a high-carb diet without experiencing the “roller-coaster” effect.

    Thanks Mark for another great article! We are surely on the same page, and not that far apart in age… ok, you’re the elder statesman here. I gotta give you the nod.

    Andrew

    P.S. Yeah, that may have been long winded.

  52. First off – cool article. This is definitely very close to my own feelings about keto. But damn Mark knows how to write a great article…

    What helped me improve metabolic flexibility was eating more initially! I have always exercised a lot so until I slept enough and ate enough for a couple months, I was still relying on carbs. Couple months of eating a sweet potato cooked in coconut oil on top of my regular diet and a dedication to sleeping earlier was what helped me! Now I notice I can go a day or 2 without food without any issues. I actually feel my best doing some pull ups+dips+push ups+squats around 12-1 and then eating afterwards. Sometimes I eat an apple and almond butter in the morning if I want.

  53. Wow, this wa great. I think what works for one, will not for another. Men and women may respond differently because of our innately different hormone balance. There is NO ONE WAY to achieve the better metabolic benefits in life. It really always boils down to ‘what works for your body’ – you, individually. Whenever I hear of ANY way of living that is all-or-nothing, it’s automatically a huge red flag. We exist and have continued to thrive on this planet because of a body that seeks homeostasis and has the flexibility to adapt (metabolically) to constantly changing circumstances. Not by eating by a structured, measured, rigid rule system.

  54. grok did not pee on a stick to check and see if he was in ketosis, so neither will I. He might pee on his foot to cure his foot fungus.. or his friends foot. That would be primal and acceptable. 🙂

  55. What about the “man diet” where you just pretty much eat nothing until you loose the fat.

  56. Great read and I agree with it. I don’t do keto and my way of eating is low carb, but not traditional low carb. It’s more accurately, if not more clumsily, called a “sugar free, grain free, potato/rice/pasta free and banana free lifestyle”. Low Carb is just so much easier to say LOL

  57. i have ended up in Ketosis, it was not my goal just, what happened. I am actually just counting sugar carbs. No more than 25 sugar carbs a day. No other numbers am I counting. I do make sure I consume healthy fats, of course and limit fruit intake. Usually just blackberries and blueberries. For now. The 25 carbs a day, (100 sugar carb calories) seems to be working for me, ok. I do have weight to lose, I do not feel hungry, at all, rarely. and I no longer eat emotionally. I eat until satisfied and I am done. The hardest part of me is actually eating. I get very busy and I just forget. SO that’s when I grab a hardboiled egg or an avocado. And keep on going.
    I like your article. It raised some interesting points. I am going to re-read it again. It seems to hold some reasonable truths. But I am new to this whole way of life. I have nothing to refute or support your info. But, it is good, and I will check it out further.

    I am down 16 lbs since 9/1/2017.

  58. I agree completely, but don’t overlook the fact that in the beginning, you probably need to force ketosis to get those metabolic pathways habitually activated. Anecdotally, it can take 6 months – two years to get into your “keto zone”. However, once you are in the zone, it should be an equally persistent and robust state. One plate of fries is not going to set you back into the carb zone.

    1. Not sure what to do since I have Fibromyalgia and am being treated with Synthroid for low thyroid. I have been not eating too many carbs – went on the Atkins diet and lost the 40 lbs from being low thyroid. I’m concerned about bone loss from being on a thyroid replacement rx. Also would like to find a way of eating that will help with inflammation from Fibromyalgia. I need to get more healthy carbs in my diet, but after being on the Atkins diet I am not sure which carbs I need to eat now! Should I try the Keto diet?

      1. Journi, you might want to stick with a more moderate way of eating and avoid the extremes. 90/10 Paleo should help with your fibro inflammation while still allowing a bit of dietary leeway. Eat lots of leafy green veggies. Broccoli, string beans, cauliflower, asparagus–basically any of the veggies available at any grocery store are good, including occasional sweet potatoes and winter squash. Mainly steer clear of grain products, white potatoes, and sweets. I don’t think thyroid replacement meds cause bone loss. Ask your doctor about it..

        1. Shary – Thanks for getting right back with me about my questions! I will check out the 90/10 Paleo! Just trying to find my own way back to the health I once had…and will have again! Your way of living is inspiring, Thanks! Journi

  59. Mark,
    I have a question.
    I have a really bad thyroid, and I read somewhere that if you have a nonfunctioning thyroid, KETO isn’t for You?
    Do you know anything on this? I started to work Keto in my diet, I’m already Paleo, but when I read this, I stopped doing keto.

    Can you help me out?

    Thank you!

  60. I agree with everything here. The problem is, I don’t know what is actionable here. If, after reading this post, I were going to go and do “this”, what is the “this” that I’m doing?

  61. Great article! I have been eating this way since April. Quick losses, off diabetic meds, regulated metabolism, working on shedding the fat on my body. Started back to working out in June. Found lots of strength, seeing huge changes in muscle development, size, fat actually shedding enough so that my abs are starting to make an appearance. Body weight has stagnated at about 235lbs but clearly the exercise is working. I am hoping that this might be my new setpoint with musculature to match. So many reasons to eat this way. My vegetable intake has greatly increased over any other way of eating. Now to tackle those primal movements.Thanks Mark!

  62. I couldn’t agree more. After the adaptation period (which was the hardest part of being in ketosis) I found myself burning out and fell into a more paleo way of eating. I found it really hard to not eat more fruit during the hot summer months. But what I’ve found is that after you adapt the first time it’s easier to go in and out of ketosis. I still haven’t eaten any bread, pasta or rice. Fruit seems to satisfy me now and every time I go back into ketosis I do it a little bit better than before. Now I’m just aware of my glucose levels (without measuring them) just by instinct and how many carbs I eat without measuring them either. It’s easier to adhere to the ketogenic diet now because I don’t feel obsessed with macros.

  63. One small point about the modified Atkins Diet, it doesn’t relax carbs – it just doesn’t restrict protein and calories in the same way as Classic KD. Great article. Congrats on the book Mark. All the best. Justin

  64. Mark…I’ve been experimenting with keto diet over last 6 months. I’ve seen significant improvements in my biomarkers, i.e. fasting glucose at 85, lipid profile and testosterone levels at 785….down to 185 lbs from 205 lbs and first time I’ve ever seen my abs! Pretty happy as I 57 yo. I’m an avid CrossFitter and bonked during a couple intense WODs when I first started keto. I do alright now during intense WODs; usually by taking in MCT oil, grass fed butter with coffee an hour prior. I’ve also PRed in several areas while on keto. What I don’t like is the flatness in my muscles. When I take in carbs, e.g. coconut water, sweet potatoes, etc my muscles feel full again. Any suggestion to keep muscles from going flat?

  65. thank you for this article, in july 4 mounts ago, Ive cut patato, bread, pasta, refined sugar, prepared meals, for my healt and because all my familly died from cancer and I said NOT me, read alot on keto for my dogs at first and then started to see it good for me also, so in august started ”keto” lost 18 pounds, my husband 15, but we do not calculate anything, but we eat well, I even started to cook with that way of life, and love it, eating healty is our goal, If one day I feel like eating an apple well I do, love my fruits and veggies and my FAT lol but dont go crazy, im pretty sure im fat addaptive, Ive been intermittent fasting for 1 year also, been drining my lemon water every day, my ACV at night, my bone broth to breack my fast, Im 51 and really love the way I feel, no more aches and pains, I even started to be regular in my pediot, that im not so happy about lol
    thank you cant wait to read more.

  66. I have been in keto for close to two months. I graduated from the course on September 14 and the last month still needed to hurry up and finish my studying from module 11 to 16 before a 15 Sept deadline (breath in). I did it because I wanted to better focus on my reading and comprehending. I can feel myself being able to focus better on ketone bodies in my brain…. ( I also talk more, they’ve told me). I like how Mark put it that is not the keto part, but the low carb detail. I feel many years younger and the fittest I’ve felt ever! Thank you IRON-Mark Sisson!

    #10881528 #Sakkoach®
    #LLDD

  67. How would someone start the keto diet as you explained? Is it just low carbs one day and more the next alternating each day?

  68. I don’t think there is a problem with “the numbers.” Unless there were some demonstrably prevalent obsession with ketosis and meter readings, to the detriment of a significant number of people, then what’s the big deal, if any?

    Some people do like to track things, and glory in all the data. Nothing wrong with that, and if their diet is working well for them, then fine.

    “Eating a low-carb, high-fat diet works because of the low-carb part, not the high-fat part per se.”

    Well – yes and no. Agreed that the carbohydrate restriction is massively important, and the prime mover behind some of the benefits. Yet if we do not have the “high fat” part, then we’ll either be restricting calories a lot, or eating more protein than is needed or desirable, many times. Both of those may have bad implications.

    Fat is very satisfying, and for a lot of people it’s a very important reason why the diet works. And given the vastly lower insulin response to eating fat, it’s essential for many of us.

  69. Not for everyone. Hovering on the edge of ketosis was miserable for me. (Wasn’t doing it for weight loss or anything, just that was what was left after eliminating for food intolerances and allergies.) It helped the original problems somewhat but I couldn’t gain strength/muscle and had no endurance, among other things. Eliminated the last sugars in my diet (again, wasn’t chasing ketosis, just coincidentally fell into it while eliminating FODMAPs etc.) and am finally feeling so much better. Can I prove ketosis is why? No. And I’m not going put myself through the back and forth (which I have read elsewhere may have deleterious consequences but is unpleasant enough regardless) trying to test it out.

    For healthy people who just want to optimize health/athletic performance trying this middling ground might make sense, but not sure it is good for anyone using diet, keto or other, to address any actual health problems. For us I think it’s better to find what works and stick to it like a religion. No cheat days, no flex meals.

  70. I’m following a keto group currently that isn’t so much about the fat. It’s keto, but they don’t go overboard with the fat. The general idea is that, you don’t need an excess of fat, especially while you are transitioning. They still keep to the macros of the diet.

  71. Carbohydrates directly cause cancer, obesity, heart disease and and diabetes. That alone should be enough for you never to eat them. Think of carbohydrates like you think about arsenic or cobra venom.

  72. You make so much sense to me. I have tried everything vegan, raw, no gluten and low GI, Fasting on tge famous mapple syrup and lemon cure (for 40 days !!!),weight watcher…
    I always ended upcraving something.
    My point is if you areon a diet and you have intense craving after 1 month or you need to supplement with a bunch of minerals and vitamins you are gooling yourself.
    Leaving meat for 5 years and ending up craving meat like a crazy carnivore led me to think that eating meat is in our animal nature.
    Afterall that is what we are: animals.
    Going low carb the 80’s Atkins way was no option for me, especially seeing some friends eating only bacon and cheese for days in the induction phase.
    I mean I am no expert but only eating that for 15 days, even boosting your ketosis doesn’t seem healthy.
    I’ll stick with common sense on that one.
    I have IBS and it is really a pain in the ass (littterally).
    I ended up with opiate on an hospital bed for Christmas (wonder if this was a sugar overdose) because colitis was so bad.
    The only 2 diet that did it for me before primal/keto were no gluten and low GI. I experienced increased energy and mood lift in both. But the bloated intestines were still there.

    9 days of dieting in keto reset mode and pain is gone. My poo is gine too, thanks for asking.

    I am also a chronic depressive and C-PTSD patient.
    I noticed that my mood lifted and that I can remain calm even when tired most of the day. I will need more time on that one to come to conclusion.

    I consider your approach on keto being the best I have read so far. It is full of common sense and healthy.
    Afterall you are not advicing people to eat only bacon eggs and fried veggies everyday.

    IF has always been a second nature to after hearing a specialist saying that eating without hunger was stupid. Eat when you are hungry do not if you don’t. Seeing my daighter breastfeeding was also a game changer for me. I gave the breast whenever she needed it and everything was fine.

    I all goes down to this , respect your nature, you’re an animal so respect your instincts. Love yourself est healthy, there is plenty of food to play with, green leafs biological meat, coconut oil …

    After my 6 weeks detox I am planning on going primal.
    I am not planning to stay strictly on ketosis all the time (I went into it in 2 days ! with no keto flu thanks to the advices you give in your book) I have an average of 3 since the beginning which I consider to be pretty high.

    If I manage that and maintain that diet more than one year I’ll be postimg on the success stories.

    Deal ? 😉

  73. This pretty much sums up my take on it as well. I did a few weeks of hard keto to get fat adapted. I still do intermittent fasting. Low carb is still important to me and I keep track of my blood sugar after starchy meals.

    I lost over 50 lbs on keto/intermittent fasting. Maintenance is a totally different ballgame. After going over a year and a half in a consistent calorie deficit it’s been hard eating enough to not lose more (I’m currently 3 pounds under my goal weight and I had to drop my goal weight 10 lbs from my initial goal). I’m just slightly under my high school weight and I was a cross country runner back then.

    I have never been able to maintain my body weight as easily as I can now. Low carb/ paleo/ intermittent fasting worked miracles for me. Other folks need to find their own sweet spot.

  74. I have a cousin with mitochondrial disease. He is on a liquid only diet. I’m wondering if you have heard of anyone with this disease trying a ketogentic diet and the effects? Obviously, I’m sure it would help, not hurt as I’m a huge believer in the keto/primal lifestyle myself. His whole life he has been given ensure drinks through a feeding tube. I’m ready purée him some good fatty drinks myself.

  75. I think it depends on the person. When I started the keto diet I was in the verge of diabetes and it was extremely important for me to be strict. Being dogmatic about my ketone levels created the motivation I needed to push on. Now after two years of being on ketogenic diet and having learned so much, it’s easier to relate to this article. However, I can seen people with sugar addiction starting on this journey, that may misread this article to mean cheating is OK. I was such a person and it took months of strict ketosis to wean myself off of the toxic sugar addiction. That meant sugar from any source, including fruits. The strict keton counting distracted me from my addiction.