Vitamin B12: Like folate, vitamin B12 is needed for producing and maintaining new cells. It is also needed to maintain the sheaths that surround and protect nerve fibers. An inadequate amount of B12 causes pernicious anemia. Signs of vitamin B12 deficiency are fatigue, weakness, constipation, loss of appetite, weight loss, and numbness and tingling in the hands and feet. An excess intake of folate can mask the symptoms of B12 deficiency, so it's important to have your levels checked by a blood test, especially if you consume a vegetarian diet. Vitamin B12 is found in animal products like trout, salmon, beef, and dairy foods. There are fortified cereals that provide B12 as well. Doctors do not routinely check vitamin B12 levels.
Josh Axe, a doctor of natural medicine and clinical nutritionist, estimates that about 25% of people who try a ketogenic diet experience these symptoms, with fatigue being the most common. “That happens because your body runs out of sugar to burn for energy, and it has to start using fat,” he says. “That transition alone is enough to make your body feel tired for a few days.”
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If you are struggling to eat enough or are eating too much, nutrition counseling may help you get essential nutrients, such as protein, vitamins, and minerals into your diet and maintain a healthy body weight. Ask your health care team for a referral to a registered dietitian or nutritionist. Dietitians and other members of the health care team work with people to meet their nutritional needs.
And another thing: Sit less throughout the day. A 2012 study published in the journal Diabetologia revealed that the more sedentary you are, the more you increase your risk of heart disease (as well as diabetes). “When we sit for long periods, enzymes in the postural muscles change. This affects how the body metabolizes glucose and lipids, which leads to higher levels of bad cholesterol and glucose, among other things,” says Emma Wilmot, Ph.D., of the University of Leicester, in England, the lead researcher of the study. Avoid sitting for more than two hours at a stretch. To cut down on sitting time, stand during coffee breaks; set a timer to go off every hour, then get up and move around for a few minutes; or switch to a height-adjustable desk and stand periodically as you work.
One downside to a ketogenic diet for weight loss is the difficulty maintaining it. “Studies show that weight loss results from being on a low-carb diet for more than 12 months tend to be the same as being on a normal, healthy diet,” says Mattinson. While you may be eating more satiating fats (like peanut butter, regular butter, or avocado), you’re also way more limited in what’s allowed on the diet, which can make everyday situations, like eating dinner with family or going out with friends, far more difficult. Because people often find it tough to sustain, it’s easy to rely on it as a short-term diet rather than a long-term lifestyle.
The ketogenic diet is indicated as an adjunctive (additional) treatment in children and young people with drug-resistant epilepsy. It is approved by national clinical guidelines in Scotland, England, and Wales and reimbursed by nearly all US insurance companies. Children with a focal lesion (a single point of brain abnormality causing the epilepsy) who would make suitable candidates for surgery are more likely to become seizure-free with surgery than with the ketogenic diet. About a third of epilepsy centres that offer the ketogenic diet also offer a dietary therapy to adults. Some clinicians consider the two less restrictive dietary variants—the low glycaemic index treatment and the modified Atkins diet—to be more appropriate for adolescents and adults. A liquid form of the ketogenic diet is particularly easy to prepare for, and well tolerated by, infants on formula and children who are tube-fed.
“The alkaline diet often has a focus on eating lots of fresh produce and unprocessed foods, which could be a good thing,” says Hultin. “However, keep in mind that this is not an evidence-based therapeutic diet. When people take it too far — for instance, drinking baking soda — or become too restrictive or obsessive over food choices, it can definitely turn negative.”
“As a rule of thumb, weight loss is generally 75 percent diet and 25 percent exercise. An analysis of more than 700 weight loss studies found that people see the biggest short-term results when they eat smart. On average, people who dieted without exercising for 15 weeks lost 23 pounds; the exercisers lost only six over about 21 weeks. It’s much easier to cut calories than to burn them off. For example, if you eat a fast-food steak quesadilla, which can pack 500-plus calories, you need to run more than four miles to ‘undo’ it!
Having ready-to-eat snacks and meals-in-minutes on hand sets you up for success. You'll be less likely to hit the drive-through or order a pizza if you can throw together a healthy meal in five or 10 minutes. Here are some essentials to keep on hand: frozen vegetables, whole-grain pasta, reduced-fat cheese, canned tomatoes, canned beans, pre-cooked grilled chicken breast, whole grain tortillas or pitas, and bags of salad greens.