Keto Diet: Tips to Implement It

Last month we demonstrated the beneficial effects for the ketogenic diet, and now we would like to provide successful tips for implementing it. As with any successful therapeutic plan, the goal is to adhere to simple planning and follow a few evidence-based rules of engagement.

# 1: Know your macronutrient breakdown

On the keto plan, one must adhere to a strict macronutrient breakdown. It is essential to consume the right proportions of fat, protein, and carbohydrates to ensure you actually remain in a state of ketosis. Otherwise, if you’re not consuming enough fat during your meals (or you accidentally consume too many carbohydrates during a meal), your body will always prioritize glucose as a primary source of fuel. If you remember from last month, the body does this because it won’t have to spend extra energy going out of its way to make glucose from fat or certain amino acids. The same is true if you eat too much protein at a meal; it will be converted to glucose and inhibit ketosis.

The macronutrient breakdown for a ketogenic diet is as follows, though it may change depending on each person’s needs and goals:


#2: Stay plant-based

One of the biggest misconceptions about the ketogenic diet is that you have to consume animal products in order to adhere to the diet. That’s not true. With proper planning and education, it’s possible to follow a plant-based keto plan. Even though you need not strictly cut out all animal products, it’s best to incorporate anti-inflammatory, plant-based foods such as nuts, seeds, coconut, and avocado since they are rich in anti-inflammatory fats.

#3: Quality is paramount

It is not necessary to consume animal products to be on a ketogenic diet. If you do choose to have animal protein, please lean towards having high quality products. For instance, go to your local farmers market and look for products with labels such as organic, free-range, pasture-raised, wild-caught or sustainable or speak with the farmer to see how they raise their livestock. But please note that even if you do consume high quality animal products, it is not possible in today’s world to avoid not being exposed to high concentrations of synthetic hormones, pesticides, antibiotic residues, petroleum-derived pollutants, heavy metals and pathogenic microorganisms when you consume any amount of animal protein. It is just the reality we are facing today based on current farming and agriculture conditions. 

#4: Organic produce only

As with most treatment plans, the goal is to heal the body in as many ways as possible. So choose organic produce whenever it's possible. The reason is to avoid excessive exposure to pesticides and herbicides which contributes to your body’s toxicant load. With a lifetime of exposure to toxins, it becomes increasingly difficult with time for your body to be able to effectively cleanse itself of toxins since most are stored in fat deposits located within your organs and tissues.

#5: Avoid refined products

To help your body maintain its repair mechanism and heal, it is best to skip refined foods. This includes items like deli meats and dairy products which are typically loaded with added preservatives and nitrates that cause extensive inflammation in the body, weight gain and numerous other chronic health conditions.

#6: Supplement your diet when needed

When beginning a ketogenic diet, you may experience something called “the keto flu”, which is characterized by flu-like symptoms such as nausea, headaches, fatigue, and dizziness within the first few weeks. This occurs when your body is getting used to shifting from burning glucose to fat. Therefore, staying hydrated and supplementing your diet with electrolytes and magnesium can help ameliorate some of these side effects (Masood & Uppaluri, 2018).

Another side effect commonly experienced in the early stages of a ketogenic diet is low energy because the body is adjusting to burning fuel in a different way. B vitamins and green protein powders (with Chlorophyll and Chlorella) can help provide the body with essential nutrients and an extra boost of energy. It’s no surprise that vitamin and mineral deficiencies have been noted as a potential negative side effect of the ketogenic diet (Masood & Uppaluri, 2018); and I’m willing to bet a lot of people who begin the diet are already nutritionally depleted. Again, going back to #1, a well-planned diet will prevent micronutrient deficiencies, and taking a multivitamin can help ensure the body is getting all the nutrients it needs to function optimally.

Is the keto diet safe for you?

Generally speaking, YES. Studies have found the beneficial effects and safety of a ketogenic diet for up to 6–12 months, with a gradual transition back to a standard, more balanced nutrient-dense whole foods plant-based diet. As previously mentioned, short-term side effects, such as the “keto flu” have been reported, but this is only temporary. Some long-term adverse effects may include hepatic steatosis (fatty liver), hypoproteinemia (low blood protein levels), and kidney stones especially in those consuming animal protein as a part of a ketogenic diet. 

Due to the ketogenic diet’s possible impact on the kidneys, it’s essential to know the status of your kidneys and monitor its functionality when you are on the plan (Paoli, 2014; Masood & Uppaluri, 2018). Because the kidneys are essential for bone health, monitoring bone density may also be recommended especially for those continuing to consume animal protein since long-term studies have shown progressive reduction in bone mineral content in children with epilepsy on a long-term ketogenic diet (Paoli, 2014). 

Unfortunately, those with the following conditions are advised to consult with an integrative functional medicine practitioner like Dr. Bhandari M.D. with a strong background in nutrition before starting a ketogenic diet. They include:

In diabetes, insulin or other hypoglycemic medications may need to be modified to account for carbohydrate restriction in order to prevent severe hypoglycemia from occurring (Masood & Uppaluri, 2018).


The benefits and safety of the keto diet have been well-reported with its benefits noted for up to 2 years and beyond (Masood & Uppaluri, 2018). Do note weight gain may occur once stopping this diet as one may return back to eating “normally”. The good news is that one study found people who followed the ketogenic diet for two brief periods (separated by the Mediterranean diet for maintenance) demonstrated improvements in health risk factors without regaining weight (Paoli, 2014).

Bottom line:  If you want to try any therapeutic diet, it’s important to consult a holistic integrative medicine healthcare provider to ensure the diet is right for you and troubleshoot problems that arise. Together, you can help plan your diet and monitor your progress to ensure the diet is followed safely and effectively.

Dr. Bhandari and the Advanced Health Team Are Here to Support Your Health.

Our expert team of integrative holistic functional medicine practitioners work with patients in addressing the root cause of any health concern. By taking the best in evidence based Eastern and Western medicine, we are able to optimize how the body functions and cure patients of their long-standing ailments. To learn more and book an appointment, contact Advanced Health or call 1-415-506-9393.


Masood, W., & Uppaluri, K.R. (2018). Ketogenic diet. Treasure Island, FL: StatPearls Publishing.

Paoli, A. (2014). Ketogenic diet for obesity: Friend or foe? International Journal of Environmental Research and Public Health, 11(2), 2092-2107.


Payal Bhandari M.D. Dr. Payal Bhandari M.D. Dr. Payal Bhandari M.D. is one of U.S.'s top leading integrative functional medical physicians and the founder of San Francisco' top ranked medical center, SF Advanced Health. Her well-experienced holistic healthcare team collaborates together to deliver whole-person personalized care and combines the best in Western and Eastern medicine. By being an expert of cell function, Dr. Bhandari defines the root cause of illness and is able to subside any disease within weeks to months. She specializes in cancer prevention and reversal, digestive & autoimmune disorders. Dr. Bhandari received her Bachelor of Arts degree in biology in 1997 and Doctor of Medicine degree in 2001 from West Virginia University. She the completed her Family Medicine residency in 2004 from the University of Massachusetts and joined a family medicine practice in 2005 which was eventually nationally recognized as San Francisco’s 1st patient-centered medical home. To learn more, go to

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