Keto is the diet of the decade. As with many things in nutrition, the ketogenic diet is surrounded by myths, misinformation, and exaggeration. The truth about keto is that it's better than the alarmists would have you believe, and not the panacea that your best friend thinks it is.



What are the benefits of keto? What are the risks? Is keto a diet you should follow long-term? What supplements should I use on keto?



I'll tackle these questions and a lot more in this complete guide to keto. Whether you're brand new to the diet, or you're a nutrition coach and need some talking points to use with clients, this guide will give you answers to questions you've been asking, and answers to questions you haven't asked yet.



Intro: Keto Experimentation, Experience, and Research



It’s been over a decade since I wrote my first article on low-carb or ketogenic diets. Since that time, I have years of personal experience, as well as insights from clients who've followed the diet. I've seen successes and failures.



Here's what I believe based on experimentation, experience with others, and from combing through the research:




The Ketogenic Diet is a powerful tool to help someone reclaim his or her health



In the short-term, the diet offers numerous health benefits



In the long-term, the benefits of the diet are less certain, and potential negative impact on mental and physical wellbeing need to be considered



I'm strongly in favor of the short-term use of the ketogenic diet, and feel for most people, long-term adherence to the diet is unnecessary and possibly detrimental




The average person today would benefit tremendously by following a ketogenic diet for three to twelve months. However, once they've improved their health and fitness, I recommend most people transition to a diet that includes some carbs.



What Is Keto?



Keto is short for "ketogenic diet," a diet pattern that significantly limits carbohydrates, emphasizes dietary fat, and causes low levels of glycogen in order to stimulate production of ketone bodies.



Elevated ketones make a ketogenic diet "ketogenic," and separate a ketogenic diet from a standard low-carb diet.



Your liver produces endogenous ketones (or ketone bodies) in response to starvation, fasting (even intermittent fasting), or when you’re on a very low-carb, high-fat diet. Exercise, when it’s intense enough and done for long enough, also stimulates ketone production.



In the absence of available carbs, ketones become a preferred energy source.



Ketosis Vs Ketoacidosis



For years, the medical community warned people against the ketogenic diet, confusing nutritional ketosis for ketoacidosis.



Ketoacidosis most often occurs in people with undiagnosed Type I diabetes, or in patients with Type I diabetes who don't use their insulin. For people with Type I diabetes, it can be life-threatening. In the complete absence of insulin, the body breaks down fat at an accelerated rate, and produces very high levels of ketones. The concentration gets so high that the blood becomes acidic.



In more rare cases, ketoacidosis occurs in people with severe Type II diabetes, in alcoholics, from starvation, and has even been seen during pregnancy.



Nutritional ketosis is a diet strategy used to maximize the use of stored body fat, which also increases production of ketone bodies. Though nutritional ketosis and ketoacidosis are both states where ketone bodies are elevated, the concentration is much, much higher in ketoacidosis.



Today, a plethora of research shows that a ketogenic diet is safe for most people, and distinctly different from ketoacidosis.



Keto For Disease Treatment



Keto has its roots in disease treatment, not as a health and fitness tool.



The ketogenic diet was first used in the 1920s as a treatment for epilepsy. Patients were put on diets consisting of 80% or more fat. Protein was limited to about 0.45 grams per pound body weight per day.