Is low-carb the only way to lose weight?

No. It’s one of the most effective approaches for insulin resistance, but not the only one. Mediterranean-style eating, a calorie deficit combined with strength training, and high-protein diets all work too. In a consultation, we choose an approach based on your metabolism, lifestyle and preferences.

Is ketogenic eating dangerous?

For most healthy adults, no. But there are exceptions: pregnancy, breastfeeding, unsupervised type-1 diabetes, certain rare metabolic conditions, and a past history of eating disorders. If you take medication (especially for diabetes), talk to your doctor first – doses may need adjusting.

Why did my cholesterol go up?

In some people (often lean, athletic ones), ‘bad’ cholesterol (LDL) can rise noticeably. For assessing risk, ApoB, Lp(a) and inflammation markers (hs-CRP) matter more than LDL alone. If LDL and ApoB rise a lot, it’s worth choosing a milder approach or talking to a doctor.

Does this work for type-2 diabetes?

Yes. A 5-year Virta Health study found remission in about half of participants, along with improved HbA1c, lower medication doses and weight loss for most. But medications (especially insulin and some diabetes drugs) must be adjusted together with your treating doctor – otherwise there’s a risk of blood sugar dropping too low.

Do I need to be in ketosis to get any benefit?

No. Most of the health benefit – weight loss, better insulin sensitivity, lower triglycerides, less fat in the liver – already shows up with moderate low-carb eating (under 100 g of carbs a day). Strict ketosis is an extra option, not a requirement.

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Nutrition strategy

Low-carb and ketogenic nutrition

Cutting carbohydrates is one of the most effective non-drug ways to improve insulin resistance (when cells respond poorly to insulin), type-2 diabetes, fatty liver and metabolic syndrome. But ‘low-carb’ isn’t one strict rule – it ranges from moderate (100–150 g of carbs a day) to strict ketogenic (under 30 g a day) and therapeutic versions.

Type-2 diabetes remission is possible – shown in a 5-year Virta Health study
Ketogenic eating isn’t ‘lots of meat’ – it’s roughly 70% fat, 20% protein, 10% carbs
It’s not the only path to health – it doesn’t suit everyone

See webinars Low-carb starter checklist

What is low-carb and ketogenic nutrition?

Low-carb means eating noticeably fewer carbs than usual (250–350 g/day). Options range from moderate low-carb (100–150 g), to strict (50–100 g), to ketogenic (under 30–50 g), to therapeutic ketogenic (under 20 g, high fat).

With ketogenic eating, the body shifts into a state called ketosis: the liver starts making ketone bodies – substances that fuel the brain, heart and muscles instead of sugar. This isn’t starvation – it’s a natural metabolic state the human body has used for millennia.

Who tends to benefit most from low-carb?

Type-2 diabetes, pre-diabetes, insulin resistance (when cells respond poorly to insulin)
Metabolic syndrome, belly fat
Non-alcoholic fatty liver disease
High triglycerides, low ‘good’ cholesterol (HDL)
PCOS (polycystic ovary syndrome) with insulin resistance
Epilepsy – but only when prescribed and supervised by a doctor
Migraine, brain fog, trouble concentrating (in some people)
Constant hunger and cravings that are hard to control

Why low-carb helps with insulin resistance

Every carb you eat raises blood sugar, and with it, insulin. When insulin stays high all the time, it’s hard for the body to use its own fat stores – insulin actively blocks that process. Cutting carbs lowers insulin, so the body starts burning its own fat, weight and fat around internal organs go down, and insulin sensitivity improves.

This is why ‘calories are all that matter’ doesn’t fully explain things: the same number of calories from carbs versus fat or protein triggers a different hormonal response and affects weight and metabolism differently.

Ketogenic eating and the brain

The brain needs about 120 g of sugar a day, but up to 75% of that energy can come from ketones instead
Ketones are a ‘cleaner’ fuel – they create less oxidative stress than sugar does
There’s proven benefit for epilepsy and some types of migraine; researchers are also studying it for Alzheimer’s and Parkinson’s
Many people notice less brain fog and clearer thinking within 2–4 weeks

Four steps for a successful switch to low-carb

Low-carb isn’t a ‘meat feast’ – it’s a thoughtful change in how you eat. Here are four things that separate people who stick with low-carb successfully for years from those who get frustrated and quit.

Quality food

Leafy vegetables, avocado, olive oil, nuts, eggs, fatty fish, and good-quality meat and dairy – without seed oils. Packaged ‘keto products’ (bars, powders) are fine short-term, just for the transition.

Minerals and water

At the start of a ketogenic diet, fluid and mineral intake (sodium, potassium, magnesium) should be reviewed – most adaptation complaints relate to them. A physician decides the amounts based on blood pressure, kidney function and medications.

Supplements on low-carb / ketogenic diets

A well-planned low-carb diet already covers most of what your body needs. But these supplements are often useful too:

Electrolytes (sodium, potassium, magnesium) – especially important in the first months
Omega-3 (if fatty fish isn’t a regular part of your diet)
Vitamin D3 with K2 (relevant for Northern European populations generally)
Magnesium
MCT oil (gives quick energy from ketones during the transition)
Fiber (like psyllium) – if you’re eating few vegetables or having constipation
B-complex vitamins, zinc – for longer-term strict eating

Low-carb and time-restricted eating

Low-carb and a 16:8 schedule (16 hours without food, 8-hour eating window) work well together: both lower insulin, trigger the body’s cell-cleanup process, and make it easier to burn fat for fuel. Many people who switch to low-carb naturally end up eating just 2 meals a day because they stay full longer.

Longer fasts (over 24 hours) on a low-carb diet are usually easier to manage, but need the same caution and doctor’s supervision as any serious eating restriction.

Labs for the low-carb transition

Before starting: fasting glucose and insulin, HOMA-IR, HbA1c, lipid panel (including ApoB), liver markers (ALT, AST, GGT), thyroid hormones (TSH, free T3)
After 3 months: the same tests, plus waist circumference, weight and blood pressure
Measuring blood ketones is useful in the first month
For women: keep an eye on thyroid function and your menstrual cycle – temporarily adding carbs back in can help if things become irregular
For athletes: watch cortisol and testosterone to make sure recovery from training isn’t suffering

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