What is the definition of ketosis, and what are the general macronutrient targets for a ketogenic diet?

Ketosis is a metabolic state where ketone bodies are produced. General ketogenic diets are moderate protein, with about 70% or more calories from fat, and very low carb, generally less than 25g of net carbs per day.

What are the four necessary preparations for starting a ketogenic lifestyle?

The four preparations are: constructing your environment to support the new way of eating (removing temptations), finding a supportive community, preparing a diet plan with go-to foods, and optionally, getting a meter to track blood ketones/glucose.

What are some specific recommendations for choosing high-quality extravirgin olive oil?

Top three tips are: look for a dark glass or metal bottle, look for a pressed or harvest date within the last two years, and look for transparency regarding the olive source, ideally a single source.

What is the most common reason for experiencing the 'keto flu' when starting keto?

The most common reason is a temporary imbalance in electrolytes as the body adjusts after removing sugar.

Can a person follow a ketogenic diet if they do not have a gallbladder?

Yes, the gallbladder only stores bile; it does not produce bile or fat-digesting enzymes, so many people successfully follow keto without one.

Will a ketogenic diet negatively affect the thyroid, specifically TSH, T4, or T3 levels?

Typically no, but thyroid hormone demands decrease on keto because it supports carb metabolism. This can result in low T4 or T3 (active thyroid hormone) even if TSH remains normal, usually without hypothyroid symptoms.

What ketone level range is generally recommended when starting out, and how should measurements be taken consistently?

Aiming for levels between 0.5 mmol/L and 4.0 mmol/L is a good start. For consistency, measure at the same time every day, such as 60 minutes after waking up but before eating, to avoid the morning cortisol dip.

When Diets Collide: Mediterranean Keto - A Practical Guide

Preparing for a Ketogenic Lifestyle
📌 Success in a new lifestyle minimizes the need for willpower by maximizing motivational factors and constructing an environment to support the change.
🗑️ First critical step is to purge the living space of temptations like sugar and processed carbohydrates, if feasible for all residents.
🤝 Find a community or accountability buddy (online groups, X/Twitter) to navigate the social stigma associated with avoiding carbs.
📊 Strongly recommend using a meter to track blood ketones and/or blood glucose to uncover hidden carbs in food preparation (e.g., pancake batter in scrambled eggs).

Mediterranean Keto (Medi Keto) Fundamentals & Favorite Foods
🥑 Medi Keto is presented as a low-friction entry point balancing Mediterranean benefits with ketogenic metabolic advantages (generally $\ge 70\%$ fat calories, $< 25$ g net carbs/day).
🐟 Fatty fish (SMASH acronym: Salmon, Mackerel, Anchovy, Sardine, Herring) are essential for protein, healthy fats, and micronutrients.
🥥 Macadamia nuts are highlighted as the "king of nuts" due to being the lowest carb, high in Monounsaturated Fat (MUFA), and rich in omega-7 fat, palmitoleic acid.
🍫 Dark chocolate should be $85\%$ cacao or above for health benefits; Taza Wicked Dark is recommended for being stone-ground and low in heavy metals.

Addressing Common Keto Questions
📈 For most individuals who are overweight or have obesity, keto generally does not cause lasting increases in LDL cholesterol; lean, insulin-sensitive individuals are more prone to increases.
🧂 The "keto flu" is usually caused by a temporary electrolyte imbalance; liberal salting and ensuring $\ge 3.5$ g of potassium daily (from foods like avocado, zucchini, or low-salt supplements) are advised.
🔍 Measuring ketone levels (aiming for $0.5$ mmol/L to $4.0$ mmol/L initially) using a blood meter like Keto Mojo is recommended for troubleshooting and observing subjective well-being correlations.

Key Points & Insights
➡️ Ketosis is a metabolic state of producing ketone bodies, not defined by specific foods; one can be keto on vegan or carnivorous diets.
🌿 A ketogenic diet does not inherently lack fiber; high-fiber options like avocado, flax seeds, and leafy greens allow for $30$ to $50$ g of fiber daily if desired.
🩺 Keto typically does not harm the thyroid; while T4/T3 may drop as carb metabolism demands decrease, TSH often remains normal, and metabolic rate can be maintained during weight loss.
👩‍⚕️ Always consult a doctor before starting a ketogenic lifestyle, especially when considering factors like gallbladder removal or monitoring hypothyroidism symptoms.

📸 Video summarized with SummaryTube.com on Oct 11, 2025, 16:33 UTC

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When Diets Collide: Mediterranean Keto - A Practical Guide

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