There's no denying that the keto diet still reigns as one of the most popular—and highly researched—diets out there right now. In fact, keto was one of the top 10 diets listed as part of Google’s 2019 Year in Search report. And per Reddit's 2019 Year in Review, keto was the most-discussed diet trend of 2019, plus the r/keto sub-Reddit was the number-two overall fitness/wellness community in 2019 and saw a 65 percent increase in subscribers from last year. Wowza.

A systematic review in 2018 looked at 16 studies on the ketogenic diet in adults. It concluded that the treatment was becoming more popular for that group of patients, that the efficacy in adults was similar to children, the side effects relatively mild. However, many patients gave up with the diet, for various reasons, and the quality of evidence was inferior to studies on children. Health issues include high levels of low-density lipoprotein, high total cholesterol, and weight loss.[24]

First, a little background: Eric Westman, MD, director of the Duke Lifestyle Medical Clinic, explained to Health in a previous interview that in order to successfully follow the keto diet, you need to eat moderate amounts of protein, reduce your carb intake, and increase fats. When you reduce your carb consumption, your body turns to stored fat as its new fuel source—a process called ketosis. To stay in ketosis, followers of the keto diet must limit their carbs to 50 grams a day, Dr. Westman says.
Although many people find that their energy and stamina improve on a keto lifestyle, trying to do too much in the early stages can worsen keto flu symptoms. Well-known ketogenic researcher Dr. Steve Phinney has conducted studies in endurance athletes as well as obese individuals demonstrating that physical performance decreases during the first week of very-low-carb eating. Fortunately, his research also shows that by week 4, people typically perform better than before they started keto.
Why the heck does it happen? Normally, the body uses glucose—or sugar—as its main source of energy. When you cut your carbs below 50 grams per day (the typical threshold for a ketogenic diet), you enter a metabolic state called ketosis: Instead of burning carbs for fuel, your body begins burning ketones—an alternative fuel source that the liver makes by breaking down fat. In turn, this can make you feel run down.
Maintain a moderate protein intake. A keto diet is not meant to be a very high protein diet. We recommend 1.2 to 1.7 grams per kg of reference body weight per day. This means about 100 grams of protein per day if your lean body mass weight is around 70 kilos (155 pounds). Check out our target protein ranges to find out how much protein you should be aiming for each day.
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