Top 20 Keto Myths Debunked by Science

Keto Myths | Science | Conclusion | FAQ | Studies

We’ve all seen diets come and go over the years. The ketogenic diet has already been out there for a surprisingly long time. Is the keto diet made to last?

Have you heard many positive and negative things about keto and wondered what’s true? Then you’ve come to the right place!

In this article, I’ll clear up ketogenic diet myths based on contemporary science and separate fact from fiction.

Myths and Facts: What Does the Science Say About Keto?

Nutrition is a complex subject. You won’t find more conflicting advice than in food and health.

Hence, people approach the keto diet with healthy skepticism. After all, it has similar traits to other diets that have not been effective in the long run. You may have also heard about potential side effects.

Moreover, it has gained immense popularity recently, which is not always a good sign. Is ketogenic dieting the next fad diet we’ll have forgotten in five years?

Keto is exciting precisely because this diet has existed for over 100 years. Few people know it was invented not to lose weight but to cure diseases in a clinical setting.

Did this fact make you curious?

Then let’s move on to the myths because the first deals with the origin and the scientific provability of potential health benefits.

Top 20 Keto Myths Debunked by Science

The list of nutrition myths is long, especially regarding keto. Ultimately, keto turns countless conventional wisdom we’ve heard about healthy eating on its head.

A high-fat, low-carb diet may be new to many people. However, research on the topic is much further along than you might think.

Here are the 20 biggest myths about the keto diet that have already been debunked by science.

Myth #1: Health Benefits of Keto Are Not Proven

There is no other diet where science can precisely explain why it is healthy.

Ketogenic diets have been used successfully since the 1920s to treat children with drug-resistant epilepsy (Neal et al. 2008¹).

But clinical studies on epilepsy don’t stop there. The list of proven health benefits of keto is even longer than that of myths.

Myth #2: Carbohydrates Are Essential

Most people are aware of how important protein is. We need it to build and repair organs, muscles, and tissue (Rissland 2017²).

The proteins in our bodies are made of 20 amino acids. Nine of them, your body cannot produce independently (Lopez et al. 2022³).

Therefore, these nine essential amino acids must be obtained from food.

There are also groups of fatty acids that the body cannot produce itself. Probably the most important are omega-3 fatty acids (Di Pasquale et al. 2009⁴).

Omega-3s are so crucial for the brain that it comprises almost two-thirds of fatty acids (Chang et al. 2009⁵).

Humans need essential fatty acids to make cells and hormones, produce energy, and absorb vitamins (Ahmed et al. 2022⁶).

Now we are missing one of the three macronutrients. What is the purpose of essential carbohydrates?

If you’ve yet to hear of it, it’s not a knowledge gap. There are simply no essential carbohydrates.

No human being needs to eat even one gram of carbohydrates in their lifetime to survive. But how can the body maintain blood sugar?

No need to worry. Nature designed humans smartly. There were times without supermarkets when carbohydrates were only available in summer and fall.

That’s why our bodies use a process called gluconeogenesis. The term means making new glucose.

This process converts glycerol, lactate, and amino acids into glucose, keeping blood sugar stable even if you don’t eat carbohydrates (Melkonian et al. 2020⁷).

Myth #3: You Lack Energy on Keto

The body indeed uses energy from glucose first if it’s available.

The same is true for those from carbohydrate stores in liver and muscle cells, which alone provide an entire day’s worth of energy (Anton et al. 2017⁸).

When these glycogen stores are emptied, gluconeogenesis and ketone production are stimulated.

The problem with glucose metabolism is that carbohydrates must be constantly supplied to avoid energy slumps.

We know this as the blood sugar roller coaster. Glucose metabolism has highs and lows that can affect mood.

In ketosis, people can continuously break down fat as an energy source. Stored body fat is significantly more abundant than glycogen in most people.

Therefore, with a ketogenic diet, energy levels, blood sugar, and mood remain far more constant than sugar metabolism.

Keto-adapted athletes can even practice exhaustive endurance sports without depleting glycogen stores in their muscles. Fat can be the ultimate fuel for the body (Phinney et al. 1980⁹).

Myth #4: Your Brain Only Works on Glucose

Fat energy yields can feed about 75% of the brain’s energy supply because ketones can cross the blood-brain barrier (Hallböök et al. 2014¹⁰).

The liver provides the remaining 25% of glucose the brain needs through gluconeogenesis.

Ketones are also why people who eat a ketogenic diet report increased mental clarity. Ketones are a superfood for the brain.

Because the brain and other organs can use ketones more efficiently than carbohydrates for energy, many people report improved mental clarity, mood, and cravings in ketosis (LaManna et al. 2010¹¹).

As a result, researchers consider ketones a more efficient fuel than glucose  (Prince et al. 2013¹²).

Myth #5: Ketosis Is Dangerous

Ketosis is not dangerous. Studies confirm that a keto diet does not lead to significant side effects, even over a long period (Dashti et al. 2004¹³).

The widespread fear of ketosis stems from confusion about diabetic ketoacidosis. This serious complication can occur in people with type 1 diabetes if they do not regulate their blood glucose.

Diabetic ketoacidosis can lead to serious health problems such as brain edema, lung fluid, or kidney damage (Eledrisi et al. 2020¹⁴).

The natural metabolic state of ketosis can reverse insulin resistance and type 2 diabetes (Volek et al. 2005¹⁵).

Myth #6: Fat Makes You Fat

The idea that dietary fats make you fat sounds logical, if only because of the name similarity. It might also make sense from an energy intake perspective.

Dietary fat contains nine calories per gram. Carbohydrates and protein have only four calories per gram.

Nevertheless, livestock shows us that this calculation is not so simple.

Cardiovascular and biomedical research uses pigs because they represent human physiology better than other animals (Swindle at al. 1998¹⁶).

If eating fat inevitably leads to weight gain, why isn’t it used to fatten livestock?

The answer is simple: this idea does not work. Feeding corn, soy, and grains can achieve slaughter weight in half the time.

Humans and pigs do not work like a combustion engine. They are not a closed system from a thermodynamic point of view.

Our bodies represent an open, dynamic system to which the biological principle of homeostasis applies. Hence, hormones play a crucial role as signaling agents.

Insulin is our essential fat-storage hormone. It has an antilipolytic effect (Jensen et al. 1989¹⁷).

In short, it prevents fat breakdown by enzymes (lipolysis) and promotes fat gain (Meijssen et al. 2001¹⁸).

Regularly consuming carbohydrates, such as cereals, ensures that blood glucose and insulin levels remain high. The pig diet takes advantage of this fact.

High-fat diets like keto keep insulin levels at bay. As a result, a ketogenic diet sets the hormonal system’s course for fat loss.

Myth #7: Keto Provides Unhealthy Fats

Keto is known as a low-carb healthy fat diet. If you lack the basic knowledge, even keto is not inevitably healthy.

Eating low-carb and high-fat is not enough. It depends on fats you eat.

Few people know that seed oils, such as soybean, corn, sunflower, canola, and peanut oil, are among the world’s unhealthiest foods.

Simply inhaling vapors from seed oils causes DNA damage (Ke et al. 2009¹⁹).

However, polyunsaturated fatty acids oxidize not only during cooking but even during the production of these seed oils, leading to cellular damage and heart disease (Staprans et al. 2005²⁰).

Moreover, refined seed oils contain high levels of omega-6 linoleic acid, which causes inflammation and obesity (Patterson et al. 2012²¹; Simopoulos 2016²²).

Unfortunately, these unhealthy fats are enjoying immense demand due to the vegan hype.

Because they are plant-based and cheap to produce, they serve as flavor, shelf-life, and consistency enhancers, especially for substitute products.

Seed oils are now hiding in almost all processed products containing a fat: from oat milk to vegan butter.

Alongside sugar, they are the new general unhealthy additive. They also hide in marinated meats for barbecue, where they oxidize quickly.

Reputable keto sources will keep you away from these refined products.

However, there are also healthy vegetable fats:

• Saturated fats found in extra virgin coconut oil and MCT oil
• Monounsaturated fats such as virgin olive oil or avocado oil

Moreover, you’ll find countless healthy fats from animal sources:

• Saturated fats like those found in pastured butter and ghee
• Monounsaturated fats such as organic lard or beef tallow
• Omega-3 polyunsaturated fatty acids found in fatty fish

Not all fat is the same. Those who properly practice keto give a wide berth to pro-inflammatory seed oils and other processed foods.

Myth #8: Saturated Fats Are Bad for Your Heart

Keto recipes contain saturated fats like virgin coconut oil or pastured butter. Medially, saturated fats have been the bogeyman of food for decades. There were several reasons for this:

The marketing of artificial trans fats from vegetable oils as heart-healthy began in the USA as early as 1911

The media-savvy scientist Ancel Keys manipulated studies in the 1950s to support his flawed hypothesis against saturated fats.

Also, numerous low-fat campaigns were initiated by the American Heart Association, which the world’s biggest soft drink and pharma giants have heavily funded.

However, the scientific evidence is now so overwhelming that even those health authorities who declared saturated fat public enemy #1 in the 1970s have had to officially revise their flawed recommendations (Hite et al. 2010²³).

Accordingly, recent studies show that saturated fats reduce heart disease while increasing carbohydrates (Mozaffarian et al. 2004²⁴).

Today, we know that saturated fats protect against strokes rather than cause them (Siri-Tariano et al. 2010²⁵).

Myth #9: Keto Causes Bad Cholesterol

One of the most persistent nutrition myths is that eating fat causes dangerous cholesterol levels.

The idea was also born in the 1950s, especially since it sounds logical. However, biochemists have made it clear through their research over the years that this assumption is entirely false.

Research shows that a low-carbohydrate, high-fat diet causes HDL levels to rise and triglyceride levels to fall (Foster et al. 2003²⁶).

The more high-density lipoprotein (HDL), or good cholesterol, is in the blood compared to triglycerides, the lower the risk of heart disease (Marotta et al. 2010²⁷).

Low-density lipoprotein (LDL), on the other hand, is known as bad cholesterol. However, cholesterol, per se, is not a bad thing.

Cholesterol is an essential building block for all cells, hormones, vitamin D, and bile acids (Craig et al. 2022²⁸).

HDL and LDL are not cholesterol at all. They are proteins that transport cholesterol through our blood.

Adding to this incorrect terminology that has become conventional wisdom is that even bad LDL cholesterol is not always evil. LDL performs tasks that are essential for survival.

Today, our advances in biochemistry have clarified that even LDL per se is not bad, but only LDL with small particle size, as they can lodge in the arterial wall (Pichler et al. 2018²⁹).

This fact makes the ketogenic diet an effective strategy for preventing cardiovascular disease. Studies show that keto significantly reduces the number of small LDL particles by increasing the particle size of HDL and LDL particles (Creighton et al. 2018³⁰).

Myth #10: Keto Leads to Nutrient Deficiencies

Micronutrient deficiencies are a general health concern.

Unfortunately, many people who follow a low-fat, low-calorie diet, such as the USDA MyPlate guidelines, suffer from nutrient deficiencies.

Such diets mainly rely on starchy vegetables and grains. These foods with low nutrient density do not make it to the table on the keto diet.

When people switch from a Standard American Diet (SAD) to a ketogenic diet, the nutrient density usually increases dramatically.

As with any diet, you can make mistakes on keto as well. Regardless of the diet, the basic rule should be to avoid processed foods.

Nevertheless, avoiding foods with high nutrient density becomes difficult, especially with keto. With a whole foods keto diet, the most nutrient-dense foods in the world come to the table:

• Fatty fish
• Grass-fed beef
• Offal
• Olives
• Pistachios
• Walnuts
• Broccoli
• Leafy Greens

Cereals and fruits, such as apples, perform much worse regarding vitamins and minerals.

Good examples of micronutrient deficiencies are electrolytes. Magnesium and potassium are rarely found in the SAD (Cogswell et al. 2012³¹).

Without them, muscles, nerves, heart, kidneys, and DNA suffer (Castro et al. 2022³²; Zhang et al. 2017³³).

Magnesium and potassium are found precisely in the foods listed above. Therefore, even with keto, eat natural foods and not processed low-carb substitutes.

Myth #11: You’re Missing Fiber on Keto

If you’ve ever calculated how many net carbs are in foods, you’ll know that keto doesn’t require you to miss out on fiber – quite the opposite.

Fiber is those carbs you can consume in unlimited quantities on a ketogenic diet. That’s why you must subtract them from the total carbohydrates in food to get the net carbohydrates.

Since you excrete dietary fiber, you must not count it as carbohydrates. This kind of carbs does not enter the bloodstream and causes an insulin response.

100 grams of cauliflower have 5.3 grams of carbohydrates but 2.5 grams of fiber. Therefore, they provide only 2.8 grams of net carbohydrates, which must be considered for our daily balance (*).

Low-carb vegetables, which we eat in raucous quantities in keto, are fiber-rich. Carbohydrates always dominate vegetables. However, high fiber reduces the net carbohydrate content to a minimum.

In addition, dietary fiber helps minimize blood glucose and insulin spikes (Chandalia et al. 2000³⁴).

However, this is only true for dietary fiber that occurs naturally in foods. Adding fiber to a protein bar will give you constipation at best.

For this reason, one should not separate fiber from a plant by machine, such as by juicing. If you’re seeking inspiration for whole-fiber-rich foods, check out my keto food list.

Myth #12: Keto Is Bad for Your Gut

There are several compelling reasons why keto can boost gut health instead of harming it.

The most substantial is the reduction of antinutrients. In addition to fiber, plants contain other nutrients the body can’t use.

For our intestines, lectins are especially harmful. Plants use these sticky proteins to defend themselves against pests, insects, and microorganisms (Dolan et al. 2010³⁵).

The best-known representative among them is gluten. Gluten is dangerous because it destroys the protein that holds the intestinal wall together (Sturgeon et al. 2016³⁶).

The result is a leaky gut.

In addition to gluten, it is primarily wheat germ agglutinin (WGA) that damages the intestinal wall.

Because it is tiny, WGA passes more quickly through the gaps in the intestinal wall, allowing bacteria and viruses to cross the intestinal barrier and reach organs (Dalla Pellegrina et al. 2009³⁷).

For example, lectins in grains enable various pathogens to trigger autoimmune diseases (Saeki et al. 2014³⁸).

Since they hide in carbohydrate-rich vegetables, grains, legumes, and fruits, the ketogenic diet drastically reduces lectin sources.

Myth #13: Diets Without Whole Grains Are Unhealthy

Whole grains have been one of the biggest marketing coups of the past few decades. Not only are they a health risk, but it’s also one of the biggest fatteners around.

Wheat germ agglutinin (WGA) can bind to insulin and leptin receptors, helping to store body fat more efficiently (Shechter 1983³⁹).

In addition, WGA increases insulin resistance, leading to weight gain and, in the long term, type 2 diabetes (Kamikubo et al. 2008⁴⁰).

Recently, researchers even suspect that WGA keeps glucose from entering the muscles.

Unlike gluten, WGA primarily hides in bran. That’s why white bread contains gluten but not wheat germ agglutinin.

For this reason, white bread is traditionally eaten in most countries. People understood early that whole grains are not easily digestible. That is why the wheat was separated from the chaff.

But don’t whole grain products contain more nutrients?

At the end of the last century, cereal producers landed a brilliant marketing coup. They saved themselves a laborious production step by not removing the bran and sold us a cheaper product for a higher price. That’s how you maximize profit!

The selling point was more nutrients, above all, proteins. Most people are unaware that the proteins were harmful lectins from the bran, such as WGA.

But lectins are by no means the end of the story. Whole grains contain even more antinutrients, such as phytic acid.

Phytic acid can insolubly bind minerals in the digestive tract, limiting nutrient absorption (Gibson et al. 2010⁴¹).

That whole grains could provide the body with many nutrients is ultimately disproven. The diet myth of healthy whole grains is one of the most extensive.

Myth #14: Ketogenic Diets Are Restrictive

Now more than ever, we can dispel the myth that a low-carb diet has to be restrictive.

When people ask me what they can eat after making the switch, I smile at them with a copy of my keto food list.

Most people who don’t stick to any diet eat no more than 50 foods. Regarding vegetables, most people eat no more than five varieties.

On my ketogenic food shopping list, you’ll find over 275 foods, so you’ll never get bored eating.

You’ll find eggs, dairy, meat, fish, low-carb vegetables, healthy fats like grass-fed butter, virgin coconut and olive oil, nuts and seeds, avocados, berries, and more.

The number of new delicious foods you can try is guaranteed to exceed the high-carb foods you must limit.

Furthermore, recipe developers have recognized the need for low-carb versions. Low-carb versions of everything from ice cream to birthday cakes are unproblematic today.

Have fun trying them out!

Myth #15: Keto Decreases Performance

Many people believe that you need carbohydrates to fuel energy for sports. This idea is one of many half-truths in the nutrition field.

Professional athletes can benefit from targeted carbohydrate intake here and there. They do it to train three times a day and thus continually get better at their sport.

To confuse professional with amateur athletes is a fatal mistake. A Rafael Nadal is not the proper benchmark for me and you, even if we go to the gym several times a week.

Switching from a Standard American Diet to keto may temporarily decrease your athletic performance.

But what’s much more interesting is what happens in your body once it gets used to the metabolic state of ketosis.

Researchers have discovered that fat-adapted people consume dramatically fewer carbohydrates for exercise (Phinney et al. 1980⁴²).

They learn to use fat more efficiently as a muscle substrate, improving athletic performance.

Some researchers and coaches have therefore been using ketogenic diets specifically for decades. For example, Stephen Phinney showed that cyclists performed better after six weeks of fat adaptation (Phinney et al. 1983⁴³).

Some trainers use ketogenic diets to improve fat utilization during the training phase. In the competition phase, their protégés can then eat carbohydrates again.

In this way, both muscle substrates, fat and glycogen, can be optimally utilized and performance increased.

Myth #16: You Can’t Build Muscle With Keto

Among bodybuilders, you will always find someone who claims that you can’t build muscle without carbohydrates.

They argue that you need insulin to grow.

Bodybuilders should know that low insulin levels increase muscle gains through other means. That’s why 16/8 intermittent fasting was once used primarily by bodybuilders.

Researchers show that strict low-carb diets also increase growth hormone release (Manninen et al. 2006⁴⁴).

This benefits muscle recovery, growth, organs, and life expectancy (Besson et al. 2003⁴⁵).

A metabolic study shows keto diets are better for muscle building than high-carbohydrate diets (Harber et al. 2005⁴⁶).

With keto, as with intermittent fasting, you can build muscle while losing body fat. That’s why combining the two methods is particularly effective.

Myth #17: Low-Carb Always Means Keto

By calories, ketogenic diets typically comprise 60% fat, 30% protein, and 10% carbohydrates (Masood et al. 2022⁴⁷).

Low-carb diets, on the other hand, focus on only one thing: reducing carbohydrates.

But that is where their problem lies. They neglect the role of fats and proteins. Because of the ubiquitous demonization of fats, low-carb diets have usually been paired with lean proteins.

Moreover, until the 1990s, it was unknown that protein also stimulates insulin (Nuttall et al. 1991⁴⁸).

In contrast, pure fats such as extra virgin olive oil cause almost no insulin response.

For this reason, classic low-carb diets such as the Atkins diet are not nearly as effective for weight loss as the keto diet.

Other low-carb diets often chronically restrict calorie intake, which is unsustainable in the long run.

In addition, high-fat diets can also make you sick if misused. In animal studies, researchers have consistently added fructose to high-fat diets to achieve negative results (Warden et al. 2008⁴⁹).

Fructose is a guarantor of hunger and weight gain and the #1 driver of fatty liver disease – not fat or alcohol (Jensen et al. 2018⁵⁰).

Therefore, don’t trust any study you haven’t checked.

Myth #18: Reducing Carbs Leads to Depression

People often feel sluggish when the body relearns how to use fat instead of sugar as a primary energy source.

The reason is not a lack of nutrients but the turn away from high-carbohydrate foods and sugar.

Sugar is a powerfully addictive substance. It is eight times more addictive than cocaine (Lenoir et al. 2007⁵¹).

As with drugs, the body can react for days to weeks with unpleasant symptoms when you turn away from sugar (Wiss et al. 2008⁵²).

Individuals also experience physical discomfort when first switching to a ketogenic diet. Symptoms, such as headaches, fatigue, and dizziness, are known collectively as keto flu.

The keto flu occurs because keto depletes the body’s carbohydrate stores. This way, water depots leave the body, flushing out electrolytes, especially sodium.

Since the keto flu isn’t depression but a sodium deficiency, you can also get rid of it quickly. You must increase your salt intake (Bostock et al. 2020⁵³).

Myth #19: You Can’t Drink Alcohol on Keto

Another myth is that you must altogether avoid alcohol on a ketogenic diet.

Many people enjoy alcohol in moderation during the keto diet. With alcohol, too, the devil is in the details. Most of the time, the hidden carbohydrates prevent you from losing weight when drinking.

Most long drinks are full of glucose and fructose. That’s why you should avoid cocktails and other mixed beverages on keto.

However, many people enjoy dry low-carb wines or clear spirits in moderation. These drinks are extremely low in carbohydrates. You can also mix them with sparkling water without any problems.

On a ketogenic diet, you can enjoy vodka with soda. It’s called Skinny Bitch for a reason.

Still, it would help if you didn’t overdo it with alcohol, as it keeps the liver from doing other tasks.

Myth #20: Long-Term Keto Is Harmful

Data from clinical studies on the ketogenic diet can prove countless health benefits. Critics complain that there are no long-term studies to prove these effects.

The ketogenic diet was invented in the 1920s to mimic the benefits of fasting and thereby successfully treat epilepsy. For the first two decades, the keto diet was widely used to treat epilepsy clinically.

However, due to the enormous supply of medications, it fell into oblivion again at the end of the 20th century. It was not until the current millennium that people rediscovered the natural treatment (Wheless et al. 2008⁵⁴).

Therefore, few studies exist that go over several years. Nevertheless, medium- to long-term keto studies are rapidly increasing.

Several clinical trials have compared the effects of ketogenic and low-fat diets over six months.

The keto diet caused participants to lose significantly more body fat and improved blood lipid levels and insulin sensitivity without triggering side effects (Brehm et al. 2003⁵⁵; Samaha et al. 2003⁵⁶).

Some researchers further confirm that the ketogenic diet is a safe method to lose weight successfully, especially over extended periods (Dashti et al. 2004⁵⁷).

If that’s not proof enough, you can turn your eye to people practicing keto for centuries.

Inuit in Canada and Greenland traditionally eat a high-fat, low-carbohydrate diet mainly consisting of fish and meat.

Researchers note that the Inuit had to be in a permanent state of ketosis because of their diet (Clemente et al. 2014⁵⁸).

The Science Shows Clear Evidence for Keto

Let me briefly summarize the 58 studies cited above. Ketogenic diets are an antidote to those problems we struggle with today due to the Standard American Diet (SAD):

• Keto reduces sugar, refined carbohydrates, and industrial foods
• Ketogenic foods increase the average nutrient density
• They replace highly processed vegetable oils with healthy, natural fats
• Ketogenic diets improve blood lipid levels and insulin resistance
• As a result, they can prevent cardiovascular disease and diabetes
• You can build muscles and exercise with it in the long run
• The keto diet doesn’t have to restrict you or lower your mood

After practicing Keto for over five years, I can only confirm the last two findings. I am in the physical and mental shape of my life.

In the last 18 months alone, I have written and published 8 books. I look far younger and fitter at 36 today than at 26.

Accordingly, the idea that ketogenic diets are unworkable or even dangerous in the long run is one of the biggest myths.

Studies Click to expand!

#1-6

¹Neal EG, Chaffe H, Schwartz RH, Lawson MS, Edwards N, Fitzsimmons G, Whitney A, Cross JH. The ketogenic diet for the treatment of childhood epilepsy: a randomised controlled trial. Lancet Neurol. 2008 Jun;7(6):500-6. doi: 10.1016/S1474-4422(08)70092-9. Epub 2008 May 2. PubMed PMID: 18456557.

²Rissland OS. The organization and regulation of mRNA-protein complexes. Wiley Interdiscip Rev RNA. 2017 Jan;8(1). doi: 10.1002/wrna.1369. Epub 2016 Jun 21. Review. PubMed PMID: 27324829; PubMed Central PMCID: PMC5213448.

 ³Lopez MJ, Mohiuddin SS. Biochemistry, Essential Amino Acids. 2022 Jan;. PubMed PMID: 32496725.

⁴Di Pasquale MG. The essentials of essential fatty acids. J Diet Suppl. 2009;6(2):143-61. doi: 10.1080/19390210902861841. PubMed PMID: 22435414.

⁵Chang CY, Ke DS, Chen JY. Essential fatty acids and human brain. Acta Neurol Taiwan. 2009 Dec;18(4):231-41. Review. PubMed PMID: 20329590.

⁶Ahmed S, Shah P, Ahmed O. Biochemistry, Lipids. 2022 Jan;. PubMed PMID: 30247827.

#7-13

⁷Melkonian EA, Asuka E, Schury MP. Physiology, Gluconeogenesis. 2022 Jan;. PubMed PMID: 31082163.

⁸Anton SD, Moehl K, Donahoo WT, Marosi K, Lee SA, Mainous AG 3rd, Leeuwenburgh C, Mattson MP. Flipping the Metabolic Switch: Understanding and Applying the Health Benefits of Fasting. Obesity (Silver Spring). 2018 Feb;26(2):254-268. doi: 10.1002/oby.22065. Epub 2017 Oct 31. Review. PubMed PMID: 29086496; PubMed Central PMCID: PMC5783752.

⁹Phinney SD, Horton ES, Sims EA, Hanson JS, Danforth E Jr, LaGrange BM. Capacity for moderate exercise in obese subjects after adaptation to a hypocaloric, ketogenic diet. J Clin Invest. 1980 Nov;66(5):1152-61. doi: 10.1172/JCI109945. PubMed PMID: 7000826; PubMed Central PMCID: PMC371554.

¹⁰Hallböök T, Ji S, Maudsley S, Martin B. The effects of the ketogenic diet on behavior and cognition. Epilepsy Res. 2012 Jul;100(3):304-9. doi: 10.1016/j.eplepsyres.2011.04.017. Epub 2011 Aug 27. Review. PubMed PMID: 21872440; PubMed Central PMCID: PMC4112040. 

¹¹LaManna JC, Salem N, Puchowicz M, Erokwu B, Koppaka S, Flask C, Lee Z. Ketones suppress brain glucose consumption. Adv Exp Med Biol. 2009;645:301-6. doi: 10.1007/978-0-387-85998-9_45. PubMed PMID: 19227486; PubMed Central PMCID: PMC2874681.

¹²Prince A, Zhang Y, Croniger C, Puchowicz M. Oxidative metabolism: glucose versus ketones. Adv Exp Med Biol. 2013;789:323-328. doi: 10.1007/978-1-4614-7411-1_43. PubMed PMID: 23852511.

¹³Dashti HM, Mathew TC, Hussein T, Asfar SK, Behbahani A, Khoursheed MA, Al-Sayer HM, Bo-Abbas YY, Al-Zaid NS. Long-term effects of a ketogenic diet in obese patients. Exp Clin Cardiol. 2004 Fall;9(3):200-5. PubMed PMID: 19641727; PubMed Central PMCID: PMC2716748.

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¹⁴Eledrisi MS, Elzouki AN. Management of Diabetic Ketoacidosis in Adults: A Narrative Review. Saudi J Med Med Sci. 2020 Sep-Dec;8(3):165-173. doi: 10.4103/sjmms.sjmms_478_19. Epub 2020 Aug 20. Review. PubMed PMID: 32952507; PubMed Central PMCID: PMC7485658.

¹⁵Volek JS, Feinman RD. Carbohydrate restriction improves the features of Metabolic Syndrome. Metabolic Syndrome may be defined by the response to carbohydrate restriction. Nutr Metab (Lond). 2005 Nov 16;2:31. doi: 10.1186/1743-7075-2-31. PubMed PMID: 16288655; PubMed Central PMCID: PMC1323303.

¹⁶Swindle M, Smith AC. Comparative anatomy and physiology of the pig. Scandinavian Journal of Laboratory Animal Science. 25. 11-21. 1998.

¹⁷Jensen MD, Caruso M, Heiling V, Miles JM. Insulin regulation of lipolysis in nondiabetic and IDDM subjects. Diabetes. 1989 Dec;38(12):1595-601. doi: 10.2337/diab.38.12.1595. PubMed PMID: 2573554.

¹⁸Meijssen S, Cabezas MC, Ballieux CG, Derksen RJ, Bilecen S, Erkelens DW. Insulin mediated inhibition of hormone sensitive lipase activity in vivo in relation to endogenous catecholamines in healthy subjects. J Clin Endocrinol Metab. 2001 Sep;86(9):4193-7. doi: 10.1210/jcem.86.9.7794. PubMed PMID: 11549649.

¹⁹Ke Y, Cheng J, Zhang Z, Zhang R, Zhang Z, Shuai Z, Wu T. Increased levels of oxidative DNA damage attributable to cooking-oil fumes exposure among cooks. Inhal Toxicol. 2009 Jul;21(8):682-7. doi: 10.1080/08958370802474728. PubMed PMID: 19225966.

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#21-27

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