Keto Calorie Counting Guide: A Comprehensive Approach to Weight Loss and Health

In a world saturated with weight-loss strategies and diet plans, the ketogenic diet, or "keto" diet, stands out as a low-carbohydrate, high-fat eating plan with a history rooted in medical treatments. This article provides a comprehensive guide to keto calorie counting, offering insights for both beginners and experienced dieters.

The Origins and Evolution of the Ketogenic Diet

The ketogenic diet has been around for centuries, initially used to treat specific medical conditions. In the 19th century, it was a common method for controlling diabetes. By 1920, it was recognized as an effective treatment for epilepsy in children when medication proved ineffective.

The diet gained popularity as a weight-loss strategy following the low-carb diet craze that began in the 1970s with the Atkins diet. This very low-carbohydrate, high-protein diet achieved commercial success, popularizing low-carb diets. Today, other low-carb diets like Paleo, South Beach, and Dukan are high in protein but moderate in fat.

The Science Behind Ketosis

The ketogenic diet's weight-loss premise is based on depriving the body of glucose, its primary energy source obtained from carbohydrate foods. This prompts the body to produce an alternative fuel called ketones from stored fat, hence the term "keto-genic."

The brain requires a steady supply of glucose, about 120 grams daily, as it cannot store it. During fasting or when carbohydrate intake is minimal, the body initially uses stored glucose from the liver and temporarily breaks down muscle to release glucose. If this continues for 3-4 days, and stored glucose is depleted, insulin levels decrease, and the body starts using fat as its primary fuel.

Read also: Metabolism and Weight Loss

The liver produces ketone bodies from fat, which can be used in the absence of glucose. When ketone bodies accumulate in the blood, it leads to a state called ketosis. Healthy individuals naturally experience mild ketosis during fasting periods (e.g., overnight) and during very strenuous exercise. Proponents of the ketogenic diet claim that if the diet is carefully followed, blood levels of ketones should not reach a harmful level (known as "ketoacidosis") because the brain will use ketones for fuel, and healthy individuals will typically produce enough insulin to prevent excessive ketones from forming.

The rate at which ketosis occurs and the amount of ketone bodies that accumulate vary from person to person, depending on factors such as body fat percentage and resting metabolic rate.

Understanding Ketoacidosis

Excessive ketone bodies can lead to ketoacidosis, a dangerously toxic level of acid in the blood. During ketoacidosis, the kidneys excrete ketone bodies along with body water in the urine, causing some fluid-related weight loss. Ketoacidosis most often occurs in individuals with type 1 diabetes because they do not produce insulin, a hormone that prevents the overproduction of ketones. However, in rare cases, ketoacidosis has been reported in nondiabetic individuals following a prolonged very low carbohydrate diet.

Macronutrient Ratios in the Ketogenic Diet

There is no one "standard" ketogenic diet with a specific ratio of macronutrients (carbohydrates, protein, fat). However, the ketogenic diet typically reduces total carbohydrate intake to less than 50 grams a day, which is less than the amount found in a medium plain bagel, and can be as low as 20 grams a day. Popular ketogenic resources suggest an average of 70-80% fat from total daily calories, 5-10% carbohydrate, and 10-20% protein. For a 2000-calorie diet, this translates to about 165 grams of fat, 40 grams of carbohydrate, and 75 grams of protein.

The protein amount on the ketogenic diet is kept moderate compared to other low-carb high-protein diets because eating too much protein can prevent ketosis. Many versions of ketogenic diets exist, but all restrict carb-rich foods.

Read also: Comprehensive Atkins Guide

Foods to Avoid and Include on a Ketogenic Diet

Some carb-rich foods that are banned on the ketogenic diet may be obvious, such as starches from refined and whole grains like breads, cereals, pasta, rice, and cookies; potatoes, corn, and other starchy vegetables; and fruit juices. Some less obvious foods to avoid are beans, legumes, and most fruits.

Most ketogenic plans allow foods high in saturated fat, such as fatty cuts of meat, processed meats, lard, and butter, as well as sources of unsaturated fats, such as nuts, seeds, avocados, plant oils, and oily fish. Strong emphasis is placed on fats at each meal and snack to meet the high-fat requirement. Some dairy foods may be allowed, but dairy can be a significant source of fat, and some are high in natural lactose sugar, such as cream, ice cream, and full-fat milk, so they are restricted. Protein stays moderate, and certain fruits in small portions like berries are allowed. Fruits other than from the allowed list should be factored into the designated carbohydrate restriction.

Understanding "Net Carbs" and "Impact Carbs"

"Net carbs" and "impact carbs" are familiar phrases in ketogenic diets as well as diabetic diets. They are unregulated interchangeable terms invented by food manufacturers as a marketing strategy, appearing on some food labels to claim that the product contains less "usable" carbohydrate than is listed.

Net carbs or impact carbs are the amount of carbohydrate that are directly absorbed by the body and contribute calories. They are calculated by subtracting the amount of indigestible carbohydrates from the total carbohydrate amount. Indigestible (unabsorbed) carbohydrates include insoluble fibers from whole grains, fruits, and vegetables; and sugar alcohols, such as mannitol, sorbitol, and xylitol commonly used in sugar-free diabetic food products. However, these calculations are not an exact or reliable science because the effect of sugar alcohols on absorption and blood sugar can vary. Some sugar alcohols may still contribute calories and raise blood sugar. The total calorie level also does not change despite the amount of net carbs, which is an important factor with weight loss.

Duration and Metabolic Changes

Programs suggest following a ketogenic diet until the desired amount of weight is lost. The ketogenic diet has been shown to produce beneficial metabolic changes in the short-term. Along with weight loss, health parameters associated with carrying excess weight have improved, such as insulin resistance, high blood pressure, and elevated cholesterol and triglycerides. There is also growing interest in the use of low-carbohydrate diets, including the ketogenic diet, for type 2 diabetes.

Read also: Low-Carb Lifestyle Guide

The findings below have been limited to research specific to the ketogenic diet: the studies listed contain about 70-80% fat, 10-20% protein, and 5-10% carbohydrate. Diets otherwise termed "low carbohydrate" may not include these specific ratios, allowing higher amounts of protein or carbohydrate. Therefore, only diets that specified the terms "ketogenic" or "keto," or followed the macronutrient ratios listed above were included in this list below. In addition, though extensive research exists on the use of the ketogenic diet for other medical conditions, only studies that examined ketogenic diets specific to obesity or overweight were included in this list.

Research on the Ketogenic Diet for Weight Loss

A meta-analysis of 13 randomized controlled trials following overweight and obese participants for 1-2 years on either low-fat diets or very-low-carbohydrate ketogenic diets found that the ketogenic diet produced a small but significantly greater reduction in weight, triglycerides, and blood pressure, and a greater increase in HDL and LDL cholesterol compared with the low-fat diet at one year.

A systematic review of 26 short-term intervention trials (varying from 4-12 weeks) evaluated the appetites of overweight and obese individuals on either a very low calorie (~800 calories daily) or ketogenic diet (no calorie restriction but ≤50 gm carbohydrate daily) using a standardized and validated appetite scale. None of the studies compared the two diets with each other; rather, the participants’ appetites were compared at baseline before starting the diet and at the end. Despite losing a significant amount of weight on both diets, participants reported less hunger and a reduced desire to eat compared with baseline measures. The authors noted the lack of increased hunger despite extreme restrictions of both diets, which they theorized were due to changes in appetite hormones such as ghrelin and leptin, ketone bodies, and increased fat and protein intakes. The authors suggested further studies exploring a threshold of ketone levels needed to suppress appetite; in other words, can a higher amount of carbohydrate be eaten with a milder level of ketosis that might still produce a satiating effect? This could allow inclusion of healthful higher carbohydrate foods like whole grains, legumes, and fruit.

A study of 39 obese adults placed on a ketogenic very low-calorie diet for 8 weeks found a mean loss of 13% of their starting weight and significant reductions in fat mass, insulin levels, blood pressure, and waist and hip circumferences. Their levels of ghrelin did not increase while they were in ketosis, which contributed to a decreased appetite. However, during the 2-week period when they came off the diet, ghrelin levels and urges to eat significantly increased.

A study of 89 obese adults who were placed on a two-phase diet regimen (6 months of a very-low-carbohydrate ketogenic diet and 6 months of a reintroduction phase on a normal calorie Mediterranean diet) showed a significant mean 10% weight loss with no weight regain at one year. The ketogenic diet provided about 980 calories with 12% carbohydrate, 36% protein, and 52% fat, while the Mediterranean diet provided about 1800 calories with 58% carbohydrate, 15% protein, and 27% fat. Eighty-eight percent of the participants were compliant with the entire regimen.

Potential Risks and Considerations

Following a very high-fat diet may be challenging to maintain. Some negative side effects of a long-term ketogenic diet have been suggested, including increased risk of kidney stones and osteoporosis, and increased blood levels of uric acid (a risk factor for gout). Possible nutrient deficiencies may arise if a variety of recommended foods on the ketogenic diet are not included. It is important to not solely focus on eating high-fat foods, but to include a daily variety of the allowed meats, fish, vegetables, fruits, nuts, and seeds to ensure adequate intakes of fiber, B vitamins, and minerals (iron, magnesium, zinc)—nutrients typically found in foods like whole grains that are restricted from the diet.

It is important to consider whether the diet’s health benefits extend to higher risk individuals with multiple health conditions and the elderly. As fat is the primary energy source, it is also important to consider whether there is a long-term impact on health from consuming different types of fats (saturated vs. unsaturated).

Available research on the ketogenic diet for weight loss is still limited. Most of the studies so far have had a small number of participants, were short-term (12 weeks or less), and did not include control groups. A ketogenic diet has been shown to provide short-term benefits in some people including weight loss and improvements in total cholesterol, blood sugar, and blood pressure. However, these effects after one year when compared with the effects of conventional weight loss diets are not significantly different. Eliminating several food groups and the potential for unpleasant symptoms may make compliance difficult. An emphasis on foods high in saturated fat also counters recommendations from the Dietary Guidelines for Americans and the American Heart Association and may have adverse effects on blood LDL cholesterol.

Recommendations and Conclusion

A ketogenic diet may be an option for some people who have had difficulty losing weight with other methods. The exact ratio of fat, carbohydrate, and protein that is needed to achieve health benefits will vary among individuals due to their genetic makeup and body composition. Therefore, if one chooses to start a ketogenic diet, it is recommended to consult with one’s physician and a dietitian to closely monitor any biochemical changes after starting the regimen, and to create a meal plan that is tailored to one’s existing health conditions and to prevent nutritional deficiencies or other health complications. A modified carbohydrate diet following the Healthy Eating Plate model may produce adequate health benefits and weight reduction in the general population.

The ketogenic diet involves consuming a very low amount of carbohydrates and replacing them with fat to help your body burn fat for energy. Health benefits can include weight loss and lowering your risk for certain diseases. In fact, many studies show that this type of diet can help you lose weight and improve your health. Ketogenic diets may even have benefits against diabetes, cancer, epilepsy, and Alzheimer’s disease.

Calculating Your Macros on Keto

Calculating your macros on keto means knowing the total amount of carbs, fat, and protein for everything you consume (food and drink) on any given day to stay on track with your goals. It’s easiest to track through food journaling or by using a tracking app. We recommend that beginners use an app as it will help give you a deeper understanding of what you are consuming while doing the work for you. Once you are comfortable with how it all works, you may try logging the information yourself.

If you opt for the journaling route, start by considering the macronutrient distribution percentages mentioned earlier (70 to 80% fat, 10 to 20% protein, and 5 to 10% carbohydrates). Ask yourself, what are my calorie needs? Am I looking to lose weight? Gain weight? Maintain? Then, determine your carbohydrate needs.

With an understanding of your calorie and carb needs, use the nutrition labels on your food and apps like My Fitness Pal to identify the nutrient content of both branded and generic foods.

Calculating Percent Calories from Macros:

• For fat: Multiply your total grams of fat by nine and divide the result by your total daily calories.
• For protein: Multiply your total grams of protein by four and divide the result by your total daily calories.
• For carbohydrates: Multiply your total grams of carbohydrates by four and divide the result by your total daily calories. Multiply this result by 100 to find your percent calories from carbohydrates.

How you choose to log is entirely up to you. Some keto dieters plan their meals at the start of their day, so they know exactly what is to come. With this method, there is little room for error. Others choose to log their meals as they go, keeping track of how many grams of each macronutrient they consume as they consume them, so they know what’s left for the remainder of the day.

Benefits of Macro Tracking

• Weight loss: Following a tailored macro tracking plan can help you eliminate excess calories.
• Mindful eating: Keto relies on conscious consumption, making you more mindful of what you eat.

While it may seem difficult to invest the time that is needed with a diet like keto, considering its strict attention to detail, there is no denying that it is effective. Reaching ketosis can be a challenge, even for the most dedicated person! However, the math doesn’t lie!

Adjusting Calorie Intake for Weight Loss vs. Muscle Gain

Your ideal calorie intake on keto will be specific to your body’s needs and your body composition goals. Although consuming fewer calories is necessary for weight loss, this doesn’t mean you have to count calories to lose weight. That said, other keto dieters have found calorie and macro tracking to be extremely helpful, particularly when they aren’t getting the results they expect.

When your body composition and weight are consistently trending in the wrong direction, calorie intake may be a driving factor. Most people feel more satisfied after eating keto due to the appetite-controlling effects of fat, protein, and ketones. If your goal is to lose weight but notice your weight is steadily climbing, this typically means that you have been in a sustained calorie surplus.

Calculating Your Total Energy Expenditure (TEE)

The first step to finding your optimal calorie intake is calculating your total energy expenditure.

• Non-Exercise Associated Thermogenesis [NEAT]: The calories used from doing daily activities.
• Exercise Associated Thermogenesis [EAT]: The calories needed when you do planned exercise.
• Thermic Effect of Feeding [TEF]: The calories used when eating and digesting your food. It is usually around 15% of your meal, which means it doesn’t matter if you eat three meals a day or six meals a day – it is still about 15% of your total caloric intake. Your TEF fluctuates depending on your macronutrient intake and the fiber that is in the food.
• Total Energy Expenditure [TEE]: The sum of BMR, NEAT, EAT, and TEF. Your TEE is the total daily calorie intake necessary to maintain your weight exactly as it is.

Fortunately, knowing your calorie needs to the decimal isn’t necessary to get the results you want. First, let’s calculate your BMR.

• Mifflin-St. Jeor: This was based on studies done in the 1990’s, but is more realistic in today’s diet setting. It doesn’t take into account your body fat percentages, so it will overestimate in the overweight.
• Katch-McArdle: This is the most accurate formula for those of you who are relatively lean.

Now that we have your BMR, we will need to factor in your total activity for the day. Multiply your BMR with the activity factor to give the TEE. That doesn’t mean how often you go to the gym, or for how long. You are accounting for everything you do during the day (active job vs. sedentary job).

After you’ve found your TEE, you will need to readjust based on your current goals. If you want to lose weight, you will need to decrease the number of calories you intake so that you are in a moderate calorie deficit. That said, don’t just flop a number out and say, “I’m going to take 300 calories off of my TEE”. Monitor your results over a steady period of 3-4 weeks and make adjustments from there. If you are gaining steadily or losing steadily, then you have hit your mark. The principles in this section apply to every diet.

Macronutrient Intake on Keto

• Fat intake: When we don’t eat enough healthy fat, we can impair hormonal health and overall energy levels. When we overeat fat, our body tends to store it as fat.
• Carbohydrate intake: To follow a ketogenic diet properly, your carb intake must be low enough to promote ketone production and stimulate more fat burning. However, keep in mind that you can lose several pounds of water weight when restricting carbs as well. In contrast, eating high amounts of carbs can cause us to retain more water.
• Protein intake: Eating the right amount of protein is essential for preventing lean body mass loss as you lose fat. When you are aiming for a calorie surplus, you’ll need plenty of protein to help build muscle mass instead of fat mass as well.

That said, I don’t recommend converting these percentages to calories from each macro as it will take too much time.

Your exact calorie intake will depend on your body size, activity levels, and goals. Though your overall calorie intake is the primary factor responsible for the number on the scale, your macro intake will determine how much of that weight is composed of lean body mass, fat mass, and water retention.

Keto Diet Variations

There are several versions of the ketogenic diet, and what you eat depends on the type. They include:

• Standard ketogenic diet (SKD): This is a very low carb, moderate protein and high fat diet. It typically contains 70% fat, 20% protein, and only 10% carbs.
• Cyclical ketogenic diet (CKD): This diet involves periods of higher carb refeeds, such as 5 ketogenic days followed by 2 high carb days.
• Targeted ketogenic diet (TKD): This diet allows you to add carbs around workouts.
• High protein ketogenic diet: This is similar to a standard ketogenic diet, but includes more protein. The ratio is often 60% fat, 35% protein, and 5% carbs.

However, only the standard and high protein ketogenic diets have been studied extensively. Cyclical or targeted ketogenic diets are more advanced methods and primarily used by bodybuilders or athletes. The information in this article mostly applies to the standard ketogenic diet (SKD), although many of the same principles also apply to the other versions.

The Importance of Food Quality

Even if you’re using macros for weight loss, food quality still matters. Increasing your body’s fat-burning potential while on keto can be done by increasing your activity level through exercise, eating more high-protein foods, fasting, and getting consistent quality sleep. Another strategy that helps significantly with weight loss is food journaling. You track what you eat, how much you eat, who you’re eating with, and how you feel.

Keto-Friendly Foods

You should base the majority of your meals around these foods:

• Meat: Red meat, steak, ham, sausage, bacon, chicken, and turkey.
• Fatty fish: Salmon, trout, tuna, and mackerel.
• Eggs: Pastured or omega-3 whole eggs.
• Butter and cream: Grass-fed butter and heavy cream.
• Cheese: Unprocessed cheeses like cheddar, goat, cream, blue, or mozzarella.
• Nuts and seeds: Almonds, walnuts, flaxseeds, pumpkin seeds, chia seeds, etc.
• Healthy oils: Extra virgin olive oil, and avocado oil.
• Avocados: Whole avocados or freshly made guacamole.
• Low carb veggies: Green veggies, tomatoes, onions, peppers, etc.
• Condiments: Salt, pepper, herbs, and spices.

Sample Keto Meal Plan

• Monday
  • Breakfast: Veggie and egg muffins with tomatoes
  • Lunch: Chicken salad with olive oil, feta cheese, olives, and a side salad
  • Dinner: Salmon with asparagus cooked in butter
• Tuesday
  • Breakfast: Egg, tomato, basil, and spinach omelet
  • Lunch: Almond milk, peanut butter, spinach, cocoa powder, and stevia milkshake with a side of sliced strawberries
  • Dinner: Cheese-shell tacos with salsa
• Wednesday
  • Breakfast: Nut milk chia pudding topped with coconut and blackberries
  • Lunch: Avocado shrimp salad
  • Dinner: Pork chops with Parmesan cheese, broccoli, and salad
• Thursday
  • Breakfast: Omelet with avocado, salsa, peppers, onion, and spices
  • Lunch: A handful of nuts and celery sticks with guacamole and salsa
  • Dinner: Chicken stuffed with pesto and cream cheese, and a side of grilled zucchini
• Friday
  • Breakfast: Sugar-free Greek, whole milk yogurt with peanut butter, cocoa powder, and berries
  • Lunch: Ground beef lettuce wrap tacos with sliced bell peppers
  • Dinner: Loaded cauliflower and mixed veggies
• Saturday
  • Breakfast: Cream cheese pancakes with blueberries and a side of grilled mushrooms
  • Lunch: Zucchini and beet “noodle” salad
  • Dinner: White fish cooked in olive oil with kale and toasted pine nuts
• Sunday
  • Breakfast: Fried eggs with and mushrooms
  • Lunch: Low carb sesame chicken and broccoli
  • Dinner: Spaghetti squash Bolognese

Always try to rotate the vegetables and meat over the long term, as each type provides different nutrients and health benefits.

Eating Out on Keto

When eating out, select a meat-, fish-, or egg-based dish. Order extra veggies instead of carbs or starches, and have cheese for dessert.

Potential Side Effects and How to Minimize Them

Although the ketogenic diet is usually safe for most healthy people, there may be some initial side effects while your body adapts. There’s some anecdotal evidence of these effects often referred to as the keto flu . Based on reports from some on the eating plan, it’s usually over within a few days.

Reported keto flu symptoms include diarrhea, constipation, and vomiting. Other less common symptoms include:

• Poor energy and mental function
• Increased hunger
• Sleep issues
• Nausea
• Digestive discomfort
• Decreased exercise performance

To minimize this, you can try a regular low carb diet for the first few weeks. This may teach your body to burn more fat before you completely eliminate carbs.

A ketogenic diet can also change the water and mineral balance of your body, so adding extra salt to your meals or taking mineral supplements may help. Talk to your doctor about your nutritional needs.

At least in the beginning, it’s important to eat until you’re full and avoid restricting calories too much. Usually, a ketogenic diet causes weight loss without intentional calorie restriction.

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