Are you considering trying the ketogenic diet? Before you start filling your shopping cart with grass-fed butter and bacon, know this: While you’ve likely heard about this high-fat, very low carbohydrate diet — and you probably even have a friend or two who have tried it — there’s still a lot of confusion about what it really takes to follow keto.
“In general, people say they’re on the ketogenic diet, but it’s not actually the case — a lot of times they’re just doing a low-carb plan,“ says Seattle-based Ginger Hultin, RDN, owner of Ginger Hultin Nutrition and author of the Anti-Inflammatory Diet Meal Prep e-book. The reason for this, says Hultin, is that the diet itself is challenging to follow. “Because 80 percent or more of your calories must come from fat, if you’re doing the diet correctly, you need to be calculating, weighing, tracking, and measuring what you’re eating,” she says.
While there are no official rules about the proportion of macronutrients that’s required to follow the ketogenic diet, popular resources suggest that an average of between 70 and 80 percent of your total calories come from fat, up to 20 percent come from protein, and only 10 percent or fewer come from carbohydrates, Harvard Health reports. For a 2000-calorie diet, this translates to about 165 grams fat, 40 grams carbohydrate, and 75 grams protein.
Keto Health Risks to Know
Also, the diet isn’t without risks. “People often don’t know it’s a medically prescribed diet for patients with epilepsy,“ says Hultin. People with epilepsy, most commonly children, get regular blood work and lab tests, and are under medical supervision so that doctors and dietitians can confirm they’re getting the vitamins and minerals they need to stay healthy, she says. Keto beginners may follow the diet incorrectly and miss out on potassium, calcium, magnesium, and fiber — essential nutrients that are commonly found in whole grains, certain veggies, and fruits, which are limited on a keto menu. “So when people decide to try the diet to lose weight, they’re often doing so without the medical specialists they would otherwise need,“ Hultin explains.
Another risk? The diet can strain the kidneys if they’re already damaged. “If you already have kidney issues, the diet is likely not going to be right for you,“ says Hultin. Beyond that, people at risk for heart disease will probably want to avoid the diet or consult their doctor before trying it, because many foods on a ketogenic diet are high in saturated fat. The American Heart Association recommends saturated fat because it raises your LDL, or “bad“ cholesterol, which increases your risk of heart disease. People with type 1 diabetes, women who are pregnant or breastfeeding, individuals with a history of eating disorders, and those whose gallbladder has been removed are among the other people whom dietitians advise to avoid the keto diet. Also, a review published in the September–October 2019 issue of the Journal of Clinical Lipidology found that a low-carb diet (like the ketogenic diet), may help lower blood sugar, but at the same time could raise that LDL cholesterol. (Overall, the research on keto’s effect on cholesterol is mixed, however.) More studies on keto are needed.
Scientists are looking into whether the ketogenic diet might be promising for those suffering with brain tumors, although the study, published in July 2021 in the journal Neurology, was conducted in a laboratory setting, not on humans.
Keto May Help You Lose Weight in the Short Term
Despite the potential dangers of the keto diet, the craze surrounding the approach continues, with more and more people espousing this philosophy for weight loss and other purported health benefits. “I think people are attracted to the diet because you often lose a lot of weight in the beginning, but it’s actually water weight at first,” says Pegah Jalali, RDN, a registered dietitian in New York City and an adjunct professor at New York University.
“Also, if people do have weight loss success on the diet — which is very restrictive — many people don’t have a plan for what’s next, after that phase,“ says Jalali. “And when you start to add carbs again and return to how you ate in the past, you’ll likely start gaining weight,“ she says. So-called yo-yo dieting, studies show, can be harmful to your health, even upping your risk for a heart attack, according to one study.
While there’s ample research on the perks of the keto diet for epilepsy, there’s limited research on humans when it comes to other touted health benefits, says Jalali. The trials haven’t covered long periods of time, and often people are in the same place, weight loss–wise, as those on other diets after six months, Jalali says. For example, a short-term study published in August 2020 in the journal Nutrition and Metabolism found that older adults with obesity on a very low carbohydrate diet (that included high amounts of fat) lost more weight and total fat than the control group. While the results seem promising, the study lasted only eight weeks.
An article published in July 2019 in JAMA Internal Medicine explained that “the enthusiasm for its potential benefits exceeds the current evidence supporting its use for these conditions,“ like treating obesity and type 2 diabetes. Thus, Jalali says, it’s an effective diet for people with epilepsy who can take advantage of the health benefits and have medical supervision and a lifetime motivation to stay on the plan. But people who don’t have a medical reason to be on the ketogenic diet may want to reconsider.
“I think there’s a more sustainable way to lose weight, even for people who have a lot to lose, such as with plant-based diets, the Mediterranean diet, and the DASH diet,“ says Hultin. “I don’t recommend the ketogenic diet for anyone unless it’s medically necessary.“
Keto Diet Books to Consider
Regardless, the popularity of low-carb living isn’t going anywhere, what with the ever-expanding crop of keto bloggers, keto podcasters, and keto Instagrammers sharing their experiences online. Not to mention, there’s a growing number of books on the keto diet hitting the shelves. Here, discover 12 of the most talked-about keto books, and learn what registered dietitians think of them.
The Case for Keto
If you’ve been on the fence about trying the keto diet, this book may give you the push you need to discuss it with a registered dietitian. Author Gary Taubes, an investigative reporter, explores why fad diets of the past typically don’t work, and why simply eating less and exercising more isn’t necessarily the key to weight loss for many. Taubes interviewed 100 current physicians who have found that the keto diet keeps their patients in good physical health, and he explores why eating a high-fat, low-carbohydrate diet could be so effective in weight reduction. Still, going keto isn’t necessarily a weight loss slam dunk. “The ketogenic diet can help some individuals lose and maintain weight loss, but it is definitely not for everyone,“ says Kristen Smith, RDN, an Atlanta-based registered dietitian and the creator of 360 Family Nutrition. “For some individuals the ketogenic diet can be difficult to follow for the long haul, therefore does not offer a long-term weight loss solution.“ Consider this book a think piece on the keto way of eating, but don’t look to it necessarily as a how-to guide for following the plan.
The New Keto-Friendly South Beach Diet
If you like the South Beach diet, you don’t have to abandon it to go on the ketogenic diet. That’s the premise behind this keto-friendly South Beach diet plan, which combines good fats with healthy carbs and quality protein, and promises to be easier to follow than the traditional ketogenic diet. This way of eating falls in line with recommendations from Abbey Sharp, RD, the Toronto-based creator of Abbey’s Kitchen. “I recommend sticking to high-fiber veggies and plant-based sources of fat, like olive oil, avocado, and nuts,“ says Sharp.
Author Arthur Agatston, MD, provides readers with a 28-day plan, plus 100 recipes that fuse the South Beach and ketogenic styles of eating. And according to Mayo Clinic, the South Beach diet is a healthy style of eating, whether or not you want to lose weight. Plus, the South Beach diet already discourages simple carbs (typically off-limits on the keto diet, too), like sugar, syrup, and baked goods made from white flour, the Mayo Clinic adds.
Also, Dr. Agatston’s medical background gives the book some extra credibility. “People should choose books written by licensed health professionals that offer practical tips and recipes,“ says Smith.
Anti-Inflammatory Keto Cookbook
What you eat can play an important role in how your body battles inflammation. According to Harvard Health Publishing, your immune system “turns on” when it recognizes a foreign invader, whether that’s a microbe, chemical, or pollen, and that activation triggers inflammation. The occasional inflammation supports your health, but continual inflammation can cause damage to your body, and lead to diseases like cancer, diabetes, arthritis, and heart disease, Harvard notes. Meanwhile, certain foods, like fatty fish and olive oil, can combat that chronic inflammation (though other keto-approved foods may cause inflammation, like red meat and lard).
Thus, if you’re concerned about chronic inflammation, it’s important to select inflammation-fighting foods, even if you’re on a keto diet. And worry not: There are plenty of substitutions you can make to be sure you’re combating inflammation (and not creating it). “You can consider swapping out the butter and the protein choices rich in saturated fats for heart-healthy oils such as olive and canola oil and protein sources such as fish,“ says Smith. “Consider more of the fatty fish choices such as salmon and mackerel,“ Smith adds.
For more ideas, Molly Devine’s book offers over 100 recipes that are both anti-inflammatory and keto-friendly, like Seared Citrus Scallops and Southwestern Stuffed Peppers. And her two-week meal plan and grocery list may make starting the diet just a little easier.
Keto Diet Hacks
While going on the keto diet sounds feasible in theory, it can be a challenge to make it sustainable, because of all the restrictions. “In my experience it’s one of the hardest diets to stick to,“ says Sharp.
Lindsay Boyers’s book offers solutions to make the diet simpler to navigate, whether that’s ordering your favorite burger at the drive-through without the bun and sauce, or adding butter to your a.m. coffee to meet the high-fat requirements of the diet.
While these tips may make your life less stressful, it’s important to carefully choose which hacks you decide to follow. “Increasing your intake of highly processed foods to meet your fat intake may help you stay full, and could even result in weight loss, but I do not believe they promote health or good overall nutrition,“ says Sharp. Instead, try and opt for hacks that up your intake of good-for-you ingredients. For example, a tip in the book suggests freezing cooked cauliflower in muffin tins for easy use in meals.
Southern Keto: Beyond the Basics
Don’t want to give up your comfort food favorites, but still want to eat the keto way? Natasha Newton’s latest keto-friendly cookbook (a follow-up to her bestselling Southern Keto) comes filled with keto-friendly takes on indulgent foods, not just from the South, but from all over the United States and beyond. You’ll find recipes for everything from slow cooker chicken tacos to zucchini Parmesan, plus low-carb desserts.
And if you’re concerned about whether seemingly indulgent foods can indeed be keto compliant, here’s some good news: “With a few ingredient substitutions, it is possible to enjoy some of your favorite comfort foods,“ says Smith. If you’re making comfort food dishes without a keto-specific recipe, Smith suggests familiarizing yourself with easy substitutions like cauliflower for rice or potatoes. “Almond flour can be a substitute for wheat flour, letting you still enjoy baked cookies — just remember a sugar substitute is needed to also comply with ketogenic guidelines,“ Smith adds.
Squeaky Clean Keto
One common critique about the ketogenic diet, from Harvard Health and others, is that people sometimes turn to processed foods (particularly processed meats) that still fall under the ketogenic diet guidelines but aren’t necessarily healthy.
This cookbook, Squeaky Clean Keto, looks to address that issue — with more than 160 recipes that all could be considered “clean.” Though the exact definition of what’s considered “clean” varies, Mayo Clinic notes that it’s generally defined as limited processed and packaged foods, and eating food close to its natural form — such as grass-fed chicken versus a chicken nugget.
In addition to following ketogenic guidelines, the recipes and meal plans in Mellissa Sevigny’s cookbook also avoid grains, dairy, alcohol, sweeteners, and nuts. The point of avoiding them? According to the author, people who eat those foods (or drink alcohol) may have inflammation or intolerances to them, which could hinder weight loss. (This isn’t supported by research, however.) Considering that nuts, in moderation, are a health food (unless, of course, you have allergies) and may even help aid weight loss, according to past research, avoiding them may take the diet too far.
The Dirty, Lazy, Keto No Time to Cook Cookbook
On the opposite end of the “clean keto“ spectrum, there’s the dirty, lazy version of the diet. Coauthor Stephanie Laska found success following the ketogenic diet — losing 140 pounds — but did so with the occasional Diet Coke, low-carb beer, and chocolate-covered protein bar.
After the success of the Laskas’ Dirty, Lazy, Keto Cookbook, which showed readers how to bend the keto rules and potentially still lose weight, comes the No Time to Cook edition, which includes 100 new recipes readers can make in 30 minutes or less. And all the recipes include easy-to-find ingredients, so you don’t have to scour the grocery store for obscure seasonings.
Though the book does make following the diet more realistic and approachable — and keto beginners might like that it’s not so stringent — it’s unclear whether stretching some of the keto rules makes for a healthy way of eating. “This modified form of the keto diet could help with compliance, but could also lead to a greater chance of nutrient deficiencies,“ says Smith. “If you decide to go this route, remember that you still need to pay attention to the quality of your food intake,” she adds.
Also, a small study of nine healthy men published in February 2019 in Nutrients found that a “cheat day” on the ketogenic diet may cause blood vessel damage.
Unlocking The Keto Code
Rather than a strict interpretation of the ketogenic diet, Steven Gundry, MD, takes a slightly different approach in this book. In addition to helping your body produce more ketones (recommending, for example, eating sheep and goat milk products for that), he encourages boosting the health of your gut microbiome (which, according to Harvard T.H. Chan School of Public Health, includes trillions of microorganisms, like bacteria, fungi, and parasites).
Also, he suggests you “feast” on plant-based foods, whether that’s seeds, nuts, and leafy greens, which do contain carbs and thus aren’t always recommended on the ketogenic diet (and some other ketogenic diet books recommend avoiding or limiting them). This may be a good option for vegetarians (or even vegans) who want to try the ketogenic diet but have been told it’s not possible, considering this version isn’t so strict about your plant-based carbohydrate intake.
Keto Kitchen
Trying to find delicious keto recipes isn’t always easy, to say the least. But author Monya Palmer put her culinary expertise to use (she’s worked at Le Cordon Bleu and Heston Blumenthal’s Fat Duck Group outside of London) to create ketogenic diet-friendly recipes that actually taste rich and decadent. Plus, she’s a “keto devotee” herself.
The book includes slow-cooked lamb shoulder with roast cherry tomatoes, salmon eggs Benedict, brown butter scrambled eggs, and even a dark chocolate and raspberry tart. (With Palmer’s take on keto, dessert isn’t off the table.)
The Easy 5-Ingredient Ketogenic Diet Cookbook
While indulgent ketogenic diet meals sound great for the weekends, on busy weekdays, something quick and easy is probably ideal. Not to mention, following the ketogenic diet, with all of the calculating and tracking is a job in itself! That’s why Jen Fisch’s keto cookbook has gained so much traction.
The goal of her cookbook is to help you simplify the process, with each meal containing just a handful of ingredients (not including basics like salt and pepper). You’ll also, hypothetically, be able to make the meals (whether that’s fish taco bowls or chicken-basil Alfredo with shirataki noodles), in 30 minutes or less, and many can be made in just one pot or pan. The end result, in theory? You’ll be better able to stick to the diet when you can make simple (and also tasty) meals — fast.
The Complete Ketogenic Diet for Beginners
After you’ve talked to your doctor about the ketogenic diet, what are your next steps? If your doctor has given you the green light to give it a try, you might have received materials, or your doctor may have suggested getting a book like this one — a comprehensive guide that breaks down the basics about the ketogenic diet.
The goal of Amy Ramos’s book is to make it simpler for people to get started — and stick with — the diet, so you’ll find all the key things to make life easier for you on keto, whether that’s meal plans, shopping lists, or easy recipes (75 of them, like bacon-artichoke omelets and pesto zucchini noodles).
East Coast Keto 2
If you’re closely following the ketogenic diet, you likely have a few tried-and-true recipes up your sleeve, but you may be getting a little bored with the lack of variety. Enter: East Coast Keto 2. Blogger Bobbi Pike of the website East Coast Keto wrote the book (along with her husband), after her successful first book. It’s filled with more than 100 new keto recipes that the authors claim don’t sacrifice taste. You’ll find keto recipes like Pan-Seared Scallops with Celeriac, and Pork Meatloaf with Asian Glaze. Plus, the book takes its inspiration from the Canadian province of Newfoundland — there’s even a recipe for a keto version of the traditional Newfoundland Jiggs Dinner Croquettes.
“For people who need to be on the diet for health reasons, I’m happy that they can follow the keto diet and have these foods, and that there are good options for them,” says Hultin. “They’re going to need fat, and recipes like these will allow them to get that.“ While some of the recipes may seem non-keto, swaps like almond flour for regular flour let you have the feeling of eating decadent foods like White Forest Cake without coming out of ketosis.
Just be sure you’re keeping track of how much saturated fat you’re getting when you’re trying these creative keto recipes. “It’s fine as long as it’s done responsibly,“ says Jalali.
A Final Word Before You Choose a Keto Diet Book or Try This Eating Plan
Still not sure if keto — or these diet books — are right for you? “Keto may be great for some people, but it’s important to understand the risks, and think of yourself as a unique individual who has specialized health needs,” says Hultin. So consider using the books for the occasional recipe, but for medical recommendations, see your doctor.
Kayli Anderson, RDN
Medical Reviewer
Kayli Anderson has over a decade of experience in nutrition, culinary education, and lifestyle medicine. She believes that eating well should be simple, pleasurable, and sustainable. Anderson has worked with clients from all walks of life, but she currently specializes in nutrition therapy and lifestyle medicine for women. She’s the founder of PlantBasedMavens.com, a hub for women to get evidence-based, practical, and woman-centered guidance on nutrition and cooking, hormone health, fertility, pregnancy, movement, mental well-being, nontoxic living, and more.
Anderson is board-certified in lifestyle medicine and serves as lead faculty of the American College of Lifestyle Medicine’s (ACLM) "Food as Medicine" course. She is past chair of the ACLM's registered dietitian member interest group, secretary of the women's health member interest group, and nutrition faculty for many of ACLM's other course offerings. She is the coauthor of the Plant-Based Nutrition Quick Start Guide and works with many of the leading organizations in nutrition and lifestyle medicine to develop nutrition content, recipes, and educational programs.
Anderson frequently speaks on the topics of women’s health and plant-based nutrition and has coauthored two lifestyle medicine textbooks, including the first one on women’s health, Improving Women's Health Across the Lifespan.
She received a master's degree in nutrition and physical performance and is certified as an exercise physiologist and intuitive eating counselor. She's a student of herbal medicine and women's integrative and functional medicine. She lives with her husband in the Colorado Rocky Mountains, where you’ll find her out on a trail or in her garden.
