See also Creon's notes on lipidology, coronary heart disease risk, statins, and coronary calcium scans

Summary of my personal situation and progress:

I am a 62-year-old (started this document when I was 55) white male living in California who was at least 30 lbs overweight[1]. I went on a ketogenic diet (a.k.a. “keto”) and lost over 30 lbs without exercise and without restricting alcohol. My energy levels and mental state improved too. After ~18 months of that, I went onto a program of “time restricted eating” - an intermittent fasting protocol where I only eat during the same eight-hour window every day: 12:00 noon to 8:00pm (see below). I have since kept the weight off, gained muscle, stabilized my blood glucose at optimal levels, and feel better than I ever have in my life.

Although my weight has been stable and good for years now, I have continued to lose fat and gain muscle while doing minimal exercise: like 15 minutes a week. (I need to make another document discussing that).

While no longer strictly keto, I eat a very-low-carb zero-sugar diet. I now eat nose-to-tail animal foods, eggs, and a few low-carb low-lectin low-oxalate vegetables with 16/8 intermittent fasting. However, I recommend the ketogenic diet for several months initially, to achieve near-optimal weight, to learn about your metabolism, and to break carb-addiction (which is the root of all evil).

In my view the essential factors to increase your health, length and quality of life are:

1. Maintain relatively low and stable blood glucose levels all the time (as a result you will end up eating only nutritious food). Most of this document is about achieving that.

2. Eat only real foods. Don’t eat processed foods. Don’t eat sugar, seed oils, most carbs, lectin-containing or oxalate-containing foods. Eat only regeneratively raised foods, including at least some animal-based foods.

3. Get adequate amounts of high-quality sleep (1&2 will make this easier).

4. Increase and maintain physical strength.

5. Take the right supplements (you only need a few), and avoid the wrong ones.

6. Have lots of good times, good relationships, good sex, and meaning.

7. Engage in lifelong learning, including mindfulness and healthy introspection.

Of course all of the above are tied together and mutually reinforcing.

Last note of the summary section:

I have recently learned that the key concept which appears to tie together all the different “interventions” (low carb, high fat, low lectin, time-restricted eating, real foods, light exposure, and more) is mitochondrial uncoupling. It is both a powerful concept and well-established science. For a good, well-referenced, up-to-date smart layperson’s guide to mitochondrial uncoupling see Steven Gundry, MD’s recent book Unlocking the Keto Code.

Basics of the ketogenic diet:

The ketogenic diet is a great way for most people to lose weight fast and - even if they are happy with their weight - to transform their health for the better without restricting calories. You can eat as much as you want, but you have to rigorously restrict what you eat. Or more precisely: rigorously enforce what you do not eat. I easily lost 35 lbs and some of my more overweight friends lost 60 to 80 lbs or more. It is not only easy, but the food you can eat tastes really good. It is actually not a diet - it is a lifestyle, and very enjoyable.

And while it may not work for everyone, hundreds of thousands of people and hundreds of doctors are reporting near-miraculous results (not just weight loss but reversal of type 2 diabetes, decreased blood pressure, and much more). So it is certainly worth trying.

Top level basics:

* The point of the ketogenic diet is to be in the metabolic state known as ketosis (at least for a few hours a day).

* Ketosis is the fat-burning metabolic state which evolved for times of food scarcity. This was common for early humans. However, in modern affluent societies food is never scarce, so you are never in ketosis unless you explicitly engineer it.

* When in ketosis, the body and brain get their energy from fat. When carbs and proteins are plentiful you are not in ketosis and the body and brain get their energy from sugar (from dietary sugars and from metabolizing carbs and proteins into sugars),

* Excess calories (there are always excess calories in our society) are stored as fat when not in ketosis. When you are in ketosis, excess calories are mostly turned into heat (a simplification).

* Fat does not make you fat. Carbs make you fat. By restricting carbs (and restricting proteins if you’re young), but not restricting fat, you can enter ketosis and burn fat - both dietary fat and body fat.

* To be in ketosis (without fasting) you must get at least 75% of your calories from fat every day. Until you achieve metabolic flexibility (the ability to quickly turn ketosis on and off, which takes a while).

* To be in ketosis (without fasting) you must get no more than 10% of your calories from carbohydrates each day. Until you have metabolic flexibility. Then you can add more “good carbs” back into your diet (if you want).

* The most common error people make at first is to substitute protein calories for carb calories. That won’t work. You have to substitute fat calories for essentially all carbs, and substitute fat for much of your protein intake too. Once you have come close to your goal weight and have verified you are in ketosis at least a few hours a day, you can add more protein back.

* You should always avoid carbs. Particularly “bad carbs” (anything that has sugar, corn syrup, fructose, and any refined starches like most flours, rice, oats, etc. See any good book on the keto diet for extensive lists). Carbs are not an essential nutrient for humans (as opposed to, say, for cows where they are essential), and many carbs are basically poison. If your doctor or dietician tells you otherwise, find another one. Do your own research and you will see.

* It takes from several days to a week to get into ketosis the first time. The transition makes some people feel a little sick (“keto flu”). Once you’re over it it’s done - if you stay in ketosis. It is important to get enough salt to avoid the keto flu, and to live a long life in general. See this video segment. Don’t believe the medical/nutritional establishment's information about salt . Don’t believe their information about “benefits” of a low-fat diet (they have been proven completely wrong on these topics). Don’t believe pretty much anything the medical establishment has been pushing regarding nutrition for the last 45 years. Most of it has been invalidated by modern research and clinical practice.

* The other way to get into ketosis is to go on an extended fast > 3 days. I will discuss fasting later in this document.

* Rather than being about what you eat, the keto diet is more about what you don’t eat. It is an elimination diet. You eliminate sugar, starch, refined carbs, and carbs in general. I also highly recommend eliminating seed oils (so-called “vegetable oils” which are made from seeds, not vegetables), lectin-containing foods (more on this at the end of the document), oxalate-containing foods, and of course highly processed food. You can identify processed food because it always comes in a package and has more than two ingredients.

If this scares you because you think fat is harmful - especially saturated fat - see this summary of evidence that fat is not harmful. If you think it is hard to find delicious satisfying food that is very-low-carb-high-fat then read on and look into ketogenic recipes. You will be pleasantly surprised.

One common question is “is the ketogenic diet the same as the Atkins diet?” Answer: No it isn’t. They are similar, but not the same. The ketogenic diet has higher fat and lower lower protein- and carbohydrate-to-total calories ratios than Atkins. This means keto requires more discipline, though in some ways it is simpler.

The ketogenic diet has other names such as: VLCHF (very low carbohydrate high fat), HFLC (high fat low carb), Banting diet (historical), or “bulletproof” (a commercial trademark). There are also related diets such as Atkins, modified Atkins, modified Ketogenic, keto-carnivore, vegan keto, etc. These are subtle variations, mostly concerning the fat vs. protein caloric ratios. They are all low carb diets.

The near-miraculous benefits of carbohydrate restriction for controlling obesity and diabetes were well-known in medicine even 100 years ago and were taught to doctors and nurses. However, the medical establishment “lost the thread” about 50 years ago mostly due to political and personality forces and has been advocating for low-fat high-carb diets (the “opposite” of keto) in recent decades. This has resulted in an explosion in obesity and suffering from diabetes, metabolic syndrome, hypertension, heart disease, and most other degenerative diseases.

The “modern solution” has been to try and reverse these degenerative conditions using pharmaceuticals (drugs). This actually doesn’t work for patients in the long term, though it works very well for the drug companies. It may sound controversial or even paranoid, but I suspect if you study the history of the US dietary guidelines and many of the resources linked in this document (which contain state-of-the art information from very reputable sources) you will probably agree.

Back to less controversial topics:

Very low carb diets are not just about weight loss and disease prevention. They are a lifestyle that will keep you feeling good, looking good, and healthy. Even if you are already trim and/or healthy. (look up the concept of TOFI - thin outside, fat inside).

Lowering and stabilizing blood glucose (blood sugar) is one main purpose of the ketogenic diet, of low-carb diets in general, and of intermittent fasting (see below). Low stable blood glucose is one of the most import