Ketogenic Diet: Common Mistakes

There is nothing more frustrating when you’ve committed yourself to a better way of eating, set goals, and chart your progress just to find out you are not making any progress at all, or at least not to your expectations.  This post may help you identify possible sabotages or give insight in how to improve results even more.


The Ketogenic Diet and How to do it right

The Ketogenic Diet and How Digestion affects Ketogenesis

The Ketogenic Diet and Health Benefits



Reasons why you may be struggling to get into ketosis may include (but are not limited to) the following:Ketogenic pitfalls


Everyone is different.  Some people get into ketosis within 2 weeks, others can take up to 9 months.  Some of the factors discussed in this article could slow it down, but you’ll eventually get there.



The most common electrolyte deficiency seen with ketogenic diets are sodium deficiency.  This is because the drop in insulin secretion results in a drop in aldosterone and decreased salt retention in the body.  If you start getting cramps increase your salt intake, especially if you do a lot of sports.



Stress can be reflected in emotional stress, not sleeping enough, taking on too many tasks, over-training, infections…anything that stresses the body, puts it into sympathetic activation and stimulates ACTH and cortisol release.  This is because cortisol and adrenalin triggers gluconeogenesis in order to raise blood glucose levels which triggers the pancreas to secrete insulin.  Insulin is the hormone that will stop ketone production.



Small amounts of dairy is allowed on a ketogenic diet, but stay clear of dairy products high in lactose or sugar such as milk and yoghurt.  Hard cheeses or parmessan cheese are OK, and of course dairy fat such as ghee or butter is fine to use.



Caffeine does not raise fasting blood glucose levels as long as there are fats present, ie bulletproof coffees where MCT oil or butter/cream is used.



Protein in excess can be converted into glucose through a process called gluconeogensis which can spike blood sugar and insulin levels.  The general recommendation is 25g – 35g of protein per meal.  This is about the size of your palm or the size of a chicken breast.  If you stay around this level you should get and stay into ketosis.



Eating frequently will disrupt glycemic control, raise insulin response and take you out of ketosis.  You can eat the same amount of food but limit it to restricted times during the day with gaps in between meals.  Insulin may directly reduce β-HBA but doesn’t really affect general ketosis as long as carbohydrates are restricted to the evenings.



A lot of the negative studies around ketogenic diets warning about the dangers of high fat diets are done around high fat and LOW Omega 3 intake.  This can make it hard to judge whether the negative results were due to the high fat consumption, or because of omega-3 deficiency.  Nevertheless, it is important to not just consume lots of fat, but to make sure that the fat is balanced with high omega 3 intake.  Someone who is already inflamed (and who with chronic disease isn’t) will feel worse when fat intake is shifted towards omega 6 or arachidonic acid.  This also becomes an important factor in those with APOE gene mutations.

Dr. Nikolas Hedberg recommends the Spanish Mediterranean Ketogenic Diet version due to its emphasis on more fish and omega 3 fats rather than red meat and saturated fats.  According to Dr. Hedberg saturated fats in excess can increase insulin resistance even though ketogenic wise you would probably get the same result.  The ratio’s he likes to use is:

  • 1/3 omega-3 (fish, fish oil)
  • 1/3 mono-unsaturated fats (olive oil)
  • 1/3 saturated fats (coconut oil, macadamia oil, butter, ghee)



This is super important.  Pollutants, metals, chemicals, pesticides, organophosphates and many other nasty chemicals are stored in the fat of animals, plants and humans.  You will do yourself a great disservice if you consume fats containing these compounds.  Not only is it very harmful to your health, but it may also slow ketosis down as your body is using up resources to remove this extra toxic load.  Methylation will be compromised and genes involved with weight loss will not be expressed properly.  Testosterone may be aromatized to estrogen making it even harder for males to shift the excess weight.  These are just a few examples.

Don’t try and save money here.  Buy organic!



The vegetables need to be good quality.  The fats need to be good quality.  The protein needs to be good quality.  Don’t try and take short-cuts.  Buy organic, grass-fed or biodynamic.



Please don’t do this.  Do it properly or not at all.  You can do your health more harm than good by approaching it half-heartedly.  High blood glucose and high blood lipids combined is not going to do your health any favors.



Alcohol – this has the ability to raise glucose levels until noon the next day and negatively affect HRV especially if consumed an hour before bed time.

Poor sleep – this can decrease HRV and increase fasting glucose.

Injury, illness and inflammation – these all reduce HRV and increase both fasting and postprandial (after eating) glucose levels.


If you need guidance in the treatment of this or any other condition, please make an appointment with one of our practitioners.

This article is for information purposes only.  Please refer to our Medical Disclaimer policy for more information.  The opinions expressed here represents the author’s and not necessarily those of Realize Health.  In addition, thoughts and opinions change from time to time due to updates in research and as a necessary consequence of having an open mind.  Views expressed in out-of-date posts may not be the same to those we hold today.



Julien C, Tremblay C, Phivilay A, et al. High-fat diet aggravates amyloid-beta and tau pathologies in the 3xTg-AD mouse model. Neurobiol
Aging. 2010;31(9):1516-1531. doi:10.1016/j.neurobiolaging.2008.08.022
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Elizma Lambert

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