Ketogenic Diet: The Basics
- A ketogenic diet produces nutritional ketosis. This is where your body is efficiently burning fat as its main fuel source instead of glucose (sugar).
- With a ketogenic diet, you become primarily a ‘fat-burner’ rather than a ‘sugar-burner’.
- This is accomplished by eating a high-fat, moderate (adequate) protein, and low-carbohydrate diet.
10 Facts About Ketogenic Diets and Nutritional Ketosis
Ketogenic diets have re-emerged in popularity to treat a variety of conditions, including obesity and diabetes.
This nutritional approach has also been getting more attention and evaluation from the medical and scientific communities. This is true not just for obesity but in many other medical conditions.
In fact, a quick search of ‘ketogenic diet’ in PubMed, the free search engine for medical and scientific studies, demonstrates this. In 1987 there were two reported studies for ketogenic diet. Thirty years later, there are already 110 reported studies in the first four months of 2017.
Although this nutritional approach is not for everyone in all circumstances, it may be helpful in many specific situations.
Below are 10 basic facts about nutritional ketosis and what’s involved in a ketogenic diet. It will be updated as new information becomes available.
Any change in nutritional approach should be done under the supervision of a healthcare professional. This is particularly true for those with chronic medical conditions and on any medications.
1. What is nutritional ketosis?
At the most basic level, nutritional ketosis is a metabolic state where our bodies use fat as the main fuel instead of sugar (glucose). This means that when we are in nutritional ketosis, we become primarily ‘fat-burners’ rather than ‘sugar-burners’.
A ketogenic diet is a diet that includes the foods that help get us into nutritional ketosis. This generally consists of a diet that is high-fat, moderate (or adequate) protein, and low-carbohydrate.
The standard American diet includes a significant amount of sugar and carbohydrate, causing the body to rely on glucose, or sugar, as its primary energy source. In fact, Americans consume an average of 265 grams of carbohydrates each day – which accounts for approximately 50% of the total calories.
When the level of carbohydrates in the diet is restricted, there isn’t a high level of glucose to burn so the body switches to using fat as its primary fuel. This fat can come from both the diet and the fat reserves carried on the body. When this happens, the byproduct that is formed is called a ketone. Having these ketones in the blood produce nutritional ketosis.
The term ketosis was popularized in the Atkins diet, which was first published in 1972 but then gained mainstream popularity about 15 years ago. Since its debut, several editions of the Atkins book have been published, most recently in 2010 with co-authors Drs. Eric C. Westman, Stephen D. Phinney, and Jeff S. Volek.
And although ketogenic diets have been around for quite a long time, the actual term ‘nutritional ketosis’ seems to have been coined by Drs. Volek and Phinney in their book The Art and Science of Low Carbohydrate Living.
2. What are the basics of a ketogenic diet?
A ketogenic diet includes the types of food needed to get a person into nutritional ketosis. This generally consists of a diet that is high-fat, adequate (moderate) protein, and l0w-carbohydrate (low-carb).
The range of the percentages of fat, protein and carbohydrate used in a ketogenic diet has varied somewhat. Historically when this diet was used to treat seizures, it was very high-fat and very low-carb – about 90% fat, 8% protein and 2% carbohydrate.
The levels of carbohydrate restriction and fat consumption have varied from study to study. It is also different for individuals depending on their overall health and metabolic status. A general starting point includes decreasing daily carbohydrates to 20-50 grams each day (see below).
In addition to being low-carbohydrate, it is important to eat enough – but not too much – protein. Consuming too much protein can cause the body to convert the protein into glucose. This process is called gluconeogenesis and it can halt the process of nutritional ketosis.
Finally, the majority of the calories in this diet are made up of health fats – including saturated fats.
Low-Carb, Moderate-Protein, High-Fat
Once a ketogenic diet is followed for several days, the body starts mainly burning fat for fuel. (Sometimes longer is necessary.)
When this happens, ketone bodies are produced as a byproduct of the fat breakdown. This is demonstrated by seeing an increase of ketone bodies in the blood, urine, and breath. At this point, the body is in nutritional ketosis (*NOT the same as ketoacidosis, see below).
The majority of cells in the body can use either fatty acids or ketone bodies as an energy source.
However, there are a few cell types that are either completely or predominantly glucose dependent. Without glucose in the diet, these cells rely on the body making glucose from protein or fat (gluconeogenesis).
These glucose-dependent cells include: some of cells in the blood (red blood cells and white blood cells); some cells of the eye (the cornea, lens and retina); some of the kidney cells; and the testis.
Of note, a ketogenic diet is quite different from the recent USDA Dietary Guidelines for Americans 2015-2020, which still recommends limiting the intake of saturated fats to less than 10% of daily calories.
3. What is the history of the ketogenic diet?
Some indigenous cultures, such as the Inuit inhabiting the Artic regions of Greenland, Canada, and Alaska, have a traditional diet that has been documented to be high in fat and very low in carbohydrate. And prior to the availability of agriculture, populations had to subsist on fewer carbohydrates simply do to lack of access. This caused them to rely more on fat and protein in their diet.
Seizure Treatment
The first documented use of a ketogenic diet to treat illness appears to be the early 1920’s, when it was being used to treat seizures and epilepsy. This was prior to the development of the new anticonvulsant medications that are now commonly used.
At that time, a physician named Hugh Conklin started successfully treating epilepsy in children with fasting for up to 25 days. He would withhold all food in these patients, and just provide water (described as “water treatment”), and seizure activity would significantly improve.
Because of Dr. Conklin’s success with the fasting program for seizures, other physicians attempted to get similar results using food. They wanted to replicate the fasting program with food in order to avoid the difficulties with prolonged fasting. It turns out they had similar success by using a very low-carb and high-fat diet in these patients.
A ketogenic diet was used for seizures for the next two decades until the discovery of a new, now commonly used, seizure medication called phenytoin (Dilantin). After this, the ketogenic diet fell to the wayside in favor of medication therapy until the 1990’s.
At this time, some publicity from the movie “First Do No Harm” helped re-popularize the ketogenic diet for seizures. The movie was based on the story of producer Jim Abrahams’ son, Charlie, who was successfully treated with a ketogenic diet for refractory seizures that failed medical treatments.
Soon after, success from a multicenter study was reported, and nutritional ketosis has once again become more widespread in the treatment of seizures and epilepsy within the international community.
4. What has a ketogenic diet been used for?
As mentioned above, one of the first documented uses of a ketogenic diet was to treat seizures and epilepsy. There have been more studies evaluating a ketogenic diet as a treatment, or adjunct treatment, for a variety of different conditions.
Keep in mind that many of the studies are observational or case reports, and not necessarily randomized, controlled clinical trials (RCT). Many in the scientific community regard RCTs as the highest form of evidence. This does not mean that case reports and observational studies are not valuable – in fact, they contribute important information to the growing body of literature.
The below list is also not meant to be exhaustive. It provides some of the current evidence available for the ketogenic diet in various conditions.
Additionally, many of these studies tend to be short – generally from 3 to 24 months. Longer-term studies with more people are needed to adequately assess the safety and efficacy of a ketogenic diet.
With those caveats in mind, below is a brief look at some of the most recent data in support of low carbohydrate, ketogenic diets.
Type 2 Diabetes
In 2013, a randomized study of 32 overweight people with diabetes showed that a 3 month, very low carbohydrate, ketogenic, non calorie-restricted diet was better at improving diabetes control and weight loss than a moderate carbohydrate, low fat, calorie-restricted diet consistent with the American Diabetes Association guidelines.
As a follow-up to that, the same investigators showed similar results with an 8-month online intervention in 2017. In 25 overweight people with type 2 diabetes, a low carbohydrate, ketogenic and lifestyle diet was better at improving diabetes, weight loss and triglyceride levels when compared to a low-fat ‘Create your Plate’ diet from the American Diabetes Association.
In 2015, 25 physicians and researchers from 25 different institutions published a compelling evidence-based review recommending carbohydrate restriction as the first approach in diabetes management and as the most effective adjunct to medical therapy.
The paper lists twelve points of evidence to support this recommendation, including:
- Hyperglycemia is the most salient feature of diabetes. Dietary carbohydrate restriction has the greatest effect on decreasing blood glucose levels.
- Patients with type 2 diabetes on carbohydrate-restricted diets reduce and frequently eliminate medication. People with type 1 usually require lower insulin.
- Intensive glucose lowering by dietary carbohydrate restriction has no side effects comparable to the effects of intensive pharmacologic treatment.
Obesity
In addition to some of the studies noted above which addressed also weight loss, additional studies include:
A 2004 randomized, controlled 6-month study of 119 people demonstrated that a ketogenic diet (1461 kcal, carbohydrate: protein: fat — 8%: 26%: 68%) was better for weight loss than a low-fat diet (1502 kcal, carbohydrate: protein: fat – 52%: 19%: 29%).
That same year, a study of 28 people demonstrated that a ketogenic diet was superior to a low-fat diet of approximately the same daily calories in short-term weight and fat loss. There was also a preferential loss of fat in the trunk region.
Appetite Suppression
A 2014 systematic review and meta-analysis of multiple studies compared appetite suppression in people from two different types of ketogenic diets: those that used very low calorie diets of <800 kcal/day and those that used a low-carbohydrate approach but were not calorie restricted. Individuals were less hungry and had great fullness/satiety on both types of diets. The authors concluded that a clinical benefit of a ketogenic could be that it prevents an increase in appetite despite ongoing weight loss.
After this, a randomized study in 2015 of 148 people demonstrated that a low-carbohydrate, predominantly fat diet may do a better job of suppressing appetite than a low-fat diet. After 12 months, the people on the low-fat diet had a larger reduction in peptide YY, a protein secreted by the intestines after meals that reduces appetite and increases satiety.
Polycystic Ovary Syndrome (PCOS) & Fertility
For those unfamiliar with it, polycystic ovary syndrome (PCOS) is the most common endocrine disorder affecting reproductive-age women. It is associated with obesity, hyperinsulinemia, insulin resistance and infertility.
In 2005, a pilot study evaluated the effects of a 6-month low-carbohydrate, ketogenic diet (carbohydrates <20 grams/day) on overweight and obese women with PCOS. Of the 5 women who completed the study, there were significant reductions in body weight and other hormone parameters that showed improvement of PCOS including: decreased free testosterone, LH/FSH ratio and fasting insulin. Only about half of the original women (11 women) completed the study, but no one dropped out because of adverse effects. Two of the women weren’t able to complete the study due to food preferences.
A 2017 systematic review of the effect of low-carbohydrate diets on fertility hormones and outcomes in overweight and obese women showed an improvement in insulin levels and hormonal imbalances across 7 studies. Although not all of the included studies were ketogenic, the maximum allowed carbohydrate intake was 45% of total energy consumed.
Seizures
As mentioned above, the ketogenic diet was initially documented as a useful therapy for refractory seizures in children. Since then, it has been evaluated in multiple studies.
In 2017, a randomized controlled study of 48 children with refractory epilepsy evaluated the use of a ketogenic diet versus usual care with medications on the treatment of epilepsy. After four months, the group using the ketogenic diet had decreased seizure activity compared to the medication group. Those in the ketogenic group did have an increase in gastrointestinal symptoms.
A 2016 review of the ketogenic diet and other dietary treatments for epilepsy evaluated a total 7 randomized controlled trials that included children and adolescents. The authors concluded that there were some promising results for the use of a ketogenic diet in epilepsy. However, downsides identified included short-term gastrointestinal problems, attrition rates, the small number of participants, and the lack of adults in the studies.
Other Neurologic Conditions
Parkinson disease: In a small 2005 study of 7 patients with Parkinson’s disease, 5 people were able to stay on a ketogenic study for 28 days. In those 5 patients, scores on their Unified Parkinson’s Disease Rating Scale improved, in addition to symptoms such as resting tremor, freezing, balance, gait, mood and energy levels. In these open type studies, it is impossible to rule-out a placebo effect resulting in these findings.
Multiple sclerosis: A 2016 small, randomized pilot trial evaluated the effect of 3 different diets on 60 patients with relapsing-remitting multiple sclerosis over a 6 month period. The first diet was a ketogenic diet, the second diet was a fasting-mimicking diet for one week (low-calorie and low-protein) followed by a Mediterranean diet and the third diet was a control diet higher in carbohydrate. In the ketogenic and fasting mimicking diet, there were meaningful improvements in the health-related quality of life.
Alzheimer’s disease: In a 2009 randomized, controlled study, 152 patients with mild to moderate Alzheimer’s disease tested the use of an oral ketogenic compound – AC-1202. AC-1202 is a form of medium chain triglyceride developed to safely elevate serum ketone levels even with carbohydrates in the diet. After 90 days, patient who received daily dosing with AC-1202 showed improvements on the Alzheimer’s Disease Assessment Scale-Cog (ADAS-Cog).
Psychiatric Conditions
There have been anecdotal reports and small studies using a ketogenic diet in different psychiatric conditions. As with other conditions, further evaluations and studies are needed.
Schizophrenia: In 2009, there was a case report of an obese 70 year-old woman with a longstanding history of schizophrenia. After starting a ketogenic diet for weight loss, there was unexpected resolution of her schizophrenic symptoms with no recurrence of her auditory or visual hallucinations.
Bipolar Disorder: In a 2013 case report of two women with bipolar disorder type II, the women maintained ketosis for 2 and 3 years, respectively, and reported subjective mood stabilization. However in an earlier separate report, another woman with treatment-resistant bipolar disorder did not show clinical improvement on what was supposed to be a ketogenic diet, although no urine ketones were detected and the duration was only 1 month.
Autism Spectrum Disorder: In a 2003 pilot study of 30 children with autistic behavior, a ketogenic diet was used for 6 months in intervals of 4 weeks with 2 diet-free weeks. Although 40% didn’t tolerate or comply with the diet, those that finished all showed mild-to-moderate improvements on the Childhood Autism Rating Scale, and 2 children showed significant improvement.
Cancer
A recent paper reviewed the role of ketogenic diets as a treatment for cancer of different types and stages. The paper concluded that while there potentially is a positive role for ketogenic diets, the results are inconclusive. The studies ranged from having positive to negative results on a ketogenic diet. As with other conditions, more research is needed in this area.
Cardiovascular Risk Factors
A meta-analysis of the effects of low carbohydrate diets on cardiovascular risk factors in obese people was published in 2012, and showed an improvement in several risk factors. These included decreased weight, triglycerides, C-reactive protein and an increased high-density lipoprotein. Low-density lipoprotein didn’t change significantly. While many of the studies included appeared to be ketogenic, some of them had higher carbohydrate levels (40% of energy).
5. How do I start a ketogenic diet?
Below are the basics of starting a ketogenic diet. Before starting any new diet, it’s important to consult your health care professional, particularly if you have ongoing medical conditions.
Step One
The first step is to significantly decrease your carbohydrate intake. The exact number of daily carbohydrate grams varies for each person because it depends on an individual’s health and overall metabolic state. However, the number is generally much lower than the standard American diet.
A good starting point for those who are overweight is to limit carbs to fewer than 20 grams a day. This is the recommendation by Dr. Eric Westman, a Duke physician and expert in obesity and nutritional ketosis who has authored many of the works in this area. It is also what is recommended on the Atkin’s induction phase.
Some may be able to start with fewer than 50 grams of carbohydrates a day. A recent medical review characterized a low-carbohydrate ketogenic diet as having daily carbohydrates range from 20-50 grams or be less than 10% of a 2000 kcal/day diet.
Once in nutritional ketosis, some people may continue to have the benefits of ketosis while gradually adding back some carbohydrates. (Particularly non-starchy vegetables and low sugar fruits.) It’s important to monitor, though, because you may not realize when you have left nutritional ketosis.
Some people (such as athletes) may be able to maintain ketosis with 100 or 150 gram of carbohydrates a day. Others, particularly those who are overweight or insulin resistant, may need to stay on fewer than 20 grams a day.
Step Two
The second step is to make sure you are eating enough protein – but not too much. This is particularly true since you want most of your calories to come from fat. Additionally, having too much protein can cause it to convert to glucose in your body through gluconeogenesis (see above).
For protein, the current recommendations are for non-pregnant/lactating adults to get about 0.8 grams per kilogram of reference weight each day. In their book, Drs. Phinney and Volek recommend a slightly higher amount of 1.5-2 grams per kilogram. This would translate to about 90 to 150 grams per day for a range of adults. As a reference point, a 4-ounce piece of chicken contains about 36 grams of protein.
Step Three
The last step includes using fat for the rest of your calories – which should be the majority of your calories.
Some people, particularly as they are losing weight, will eat 80-90% of their calories from fat. Others may choose to do 50-60%.
You can do this through meats and fish, but also with the addition of other nutrient dense, healthy high-fat foods such as avocados, eggs, and oils.
Good Food Choices
One of the benefits of a ketogenic diet is the variety of delicious, natural, whole foods to choose from. Examples include:
- Poultry (with skin), fish, meats (including the fattier cuts), pork
- Eggs, butter
- Cream, cheese, full fat yogurt
- Nuts and seeds
- Avocados, healthy oils, olives
- Low-carb vegetables
Foods To Avoid
Generally the foods to avoid include:
- Grains and starches, sugary foods
- Fruit (although some low sugar fruit like berries may be acceptable)
- Starchy vegetables (like potatoes)
- Processed foods, including ones labeled ‘low-carb’ or ‘gluten-free’
- Juice, sugary drinks
- Candy
6. How do I know I’m in nutritional ketosis?
There are a couple of ways to measure the ketones on a ketogenic diet, which produces three types of ketones: acetoacetate, beta-hydroxybutyrate and acetone. They can be found in the urine, blood and breath.
Measuring Urine Ketones
The easiest and most common way is to use a urine dipstick ketone test. These can be purchased from your pharmacy or even online.
As you start to produce ketones, acetoacetone is excreted in urine. The acetoacetone changes the color on the stick. The best time of day to measure urine ketones has been found to be in the early morning and also post-dinner.
A few things to keep in mind with the dipstick test:
- It doesn’t always correlate well with blood levels.
- It only measures one type of ketone.
- Long-term ketosis may be hard to measure as urine ketones can decrease the longer you are in nutritional ketosis.
Measuring Blood Ketones
Measuring the ketone beta-hydrocybutyrate in the blood is the most accurate way to measure ketosis.
This test uses a finger prick to measure ketones and is also available online. It is similar to blood glucose monitoring, and users have to purchase individual strips in addition to the monitor.
Although considered the most accurate way to measure ketones, this method can be more difficult than the urine strips. The reasons include:
- The monitor is harder to find.
- The test strips can be expensive.
- You must prick your finger each time.
Measuring Breath Ketones
It is also possible to measure acetone released in the breath during ketosis. Breath acetone levels have been shown to be a good predictor of blood ketones
The main difficulties with this method is that it is not as commercially available and some machines are insensitive to different levels of ketosis. However, this holds promise as a useful method in the future.
Bottom Line
- When beginning a ketogenic diet, using the urine dipsticks is an easy and reasonable way to start. It can help guide your food choices and also provide positive reinforcement as the colors change on the stick.
- As you progress in nutritional ketosis or to get the most accurate results, it may be best to use a finger prick blood-testing monitor.
7. But I already eat a low-carb diet…
There are many effective nutritional approaches that limit daily carbohydrate intake but these can be very different from nutritional ketosis.
Many of these approaches eliminate sugar and processed carbohydrates. For anyone interested in losing weight and improving health, this is generally a good strategy. Some of these programs include Paleo diets, the Mediterranean diet, and clean eating.
Carbohydrate levels may be low in these diets, but a few things can keep them from being a true ketogenic diet:
1) The carbohydrates may not be low enough to start nutritional ketosis. (see above)
2) The protein intake may be too high, resulting in increase blood sugar (gluconeogenesis).
3) The diet may not have enough fat, which should make up the majority of calories.
These diets can provide excellent health benefits and weight loss. However, they are not necessarily the same as a ketogenic diet and may not provide the same benefits.
Bottom Line:
- All ketogenic diets are low-carb, but not all low-carb diets are ketogenic.
8. What are the main side effects or challenges with a ketogenic diet?
Lowering Carbohydrate Intake
A ketogenic diet is generally tolerate because of the wide variety of delicious, natural, whole foods available on it. However, because it is such a change for some people, it can be a difficult in the beginning.
Subjectively, one of the hardest parts of a ketogenic diet is keeping the carbohydrates to such a low level every day. For people used to the high carbohydrates in the standard American diet, this is especially true. In fact, on any given day Americans consume an average of 265 grams of carbohydrates for 50% of the total calories.
Going from 265 grams of carbohydrates to 20 grams may be a challenge for some people. Because of this, some people recommend first starting a basic low-carb diet (such as a Paleo diet) before jumping into a ketogenic diet.
Keto Flu
The “keto flu” is one of the most common issues in starting a ketogenic diet. This can occur as a person transitions from a high-carbohydrate diet to a ketogenic diet. (Or from being a sugar-burner to a fat-burner.)
Symptoms associated with the ‘keto-flu’ this can include: fatigue, lightneadedness, constipation, carb cravings, headaches and muscle cramps. These can last from a few days to a few weeks as you transition fully into nutritional ketosis and become ‘keto-adapated’.
You can avoid the constipation and muscle cramps associated with a ketogenic diet by adequately replacing salt and minerals, including potassium and magnesium. It’s also important to replace fluids by drinking enough water. Many nutrient dense foods are an excellent source of a variety of the necessary minerals.
Rare Side Effects
There have been additional rare side effects reported with a ketogenic diet, but none of these has yet been observed in a monitored clinical trial. These include kidney stones, electrolyte imbalances with potassium and magnesium, elevated fatty acids and gout. Additionally, most of the rare side effects have been reported in children and not adults.
9. What’s the difference between nutritional ketosis and ketoacidosis?
Ketoacidosis, also called diabetic ketoacidosis, is a dangerous medical condition that occurs mainly in people with type 1 diabetes.
Ketogenic diets, or nutritional ketosis, are completely different from ketoacidosis. (People often confuse the names because they sound similar).
People with type 1 diabetes have a malfunctioning pancreas and cannot produce insulin, so they must provide it with injections. Insulin helps regulate the level of glucose in the blood by helping to store any extra glucose as fat.
When type 1 diabetics don’t get enough insulin, their bodies think that there is no more glucose even though that’s not the case — their blood glucose level is actually rising. Because the body thinks there isn’t any more glucose, it starts burning fat instead, which produces ketones.
The problem is that ketones continue to rise in the background of high glucose levels. When the ketone levels approach the very high amount of 20 millimolars, ketoacidosis can occur which can be life-threatening. This amount of ketones in this situation is about 5 to 10 times higher than in nutritional ketosis.
People who can produce insulin and are in nutritional ketosis have a normal blood glucose level and lower levels of blood ketones. People with type 1 diabetes and some people with type 2 diabetes (those with severe disease and a pancreas that can’t produce insulin) are the ones at risk for ketoacidosis.
Bottom Line:
- Just having ketones in the blood is not harmful.
- What is harmful is having a very high level of ketones in the setting of high blood glucose levels. This is called ketoacidosis. People with type 1 diabetes generally develop this life-threatening condition.
10. Where can I learn more about ketogenic diets and nutritional ketosis?
There are many recent excellent resources on ketogenic diets, nutritional ketosis and obesity from leading international authorities. These resources add to the many published scientific and medical studies.
The list below includes some of these resources. It does not include everything and everyone, and will likely grow in the future.
Books
The Art and Science of Low Carbohydrate Living: An Expert Guide to Making the Life-Savings Benefits of Carbohydrate Restriction Sustainable and Enjoyable
- Jeff S. Volekm PhD, RD and Stephen D. Phinney, MD, PhD
Keto Clarity: Your Definitive Guide to the Benefits of a Low-Carb, High-Fat Diet
- Jimmy Moore and Eric C. Westman, MD
A Low Carbohydrate, Ketogenic Diet Manual: No Sugar, No Starch Diet
- Eric C. Westman, MD
The Big Fat Surprise: Why Butter, Meat & Cheese Belong in a Healthy Diet
- Nina Teicholz
Low Carb, High Fat Food Revolution: Advice and Recipes to Improve Your Health and Reduce Your Weight
- Andreas Eenfeldt, MD
Websites
This is website of Jimmy Moore who is an international low-carbohydrate and ketogenic diet expert. He has authored several books and runs an incredibly popular health podcast. The website and books feature an excellent combination of well-researched information and personal experience based on his life.
A popular and very informative website run by Mark Sisson since 2006. Mark’s mission is to “to empower people to take full responsibility of their own health and enjoyment of life by investigating, discussing, and critically rethinking everything we’ve assumed to be true about health and wellness.” At the fundamental level, he focuses on reaching ultimate health through ancestral health principles, and regularly incorporates cutting edge information.
Andreas Eenfeldt, MD (a Swedish family medicine doctor) started and runs this website. This informational website is one of the largest health blogs in Sweden. It focuses on low carbohydrate diets and current health research, including ketogenic diets.
Podcasts
Livin’ La Vida Low Carb
Jimmy Moore presents compelling and interesting interviews with experts in the areas of low-carbohydrate, nutritional ketosis, and paleo science. It is one of the longest running health podcasts, and is available on iTunes Podcasts and through his website.