Plan Custom Keto Diet Outlet Deals April 2020

Plan Custom Keto Diet Outlet Deals April 2020

In the world of weight-loss diets, low-carbohydrate, high-protein eating plans typically get attention. The Paleo, South Beach, and Atkins diet plans all suit that classification. They are often referred to as ketogenic or “keto” diets. But a real ketogenic diet plan is various. Unlike other low-carb diet plans, which concentrate on protein, a keto plan centers on fat, which provides as much as 90% of daily calories.

” The keto diet is primarily used to help in reducing the frequency of epileptic seizures in kids. While it also has actually been attempted for weight loss, only short-term results have actually been studied, and the results have been mixed. We do not understand if it works in the long term, nor whether it’s safe,” cautions signed up dietitian Kathy McManus, director of the Department of Nutrition at Harvard-affiliated Brigham and Women’s Health center.

Instead of counting on sugar (glucose) that comes from carbohydrates (such as grains, vegetables, veggies, and fruits), the keto diet plan counts on ketone bodies, a kind of fuel that the liver produces from kept fat. Plan Custom Keto Diet Outlet Deals April 2020. Burning fat appears like an ideal way to lose pounds. However getting the liver to make ketone bodies is tricky: It needs that you deprive yourself of carbs, less than 20 to 50 grams of carbohydrates each day (bear in mind that a medium-sized banana has about 27 grams of carbohydrates).

Plan Custom Keto Diet Outlet Deals April 2020

Consuming too much protein can disrupt ketosis. Since the keto diet plan has such a high fat requirement, followers must consume fat at each meal. In an everyday 2,000-calorie diet plan, that may appear like 165 grams of fat, 40 grams of carbohydrates, and 75 grams of protein. However, the specific ratio depends upon your particular needs.

Plan Custom Keto Diet Outlet Deals April  2020Plan Custom Keto Diet Outlet Deals April 2020

However saturated fats from oils (palm, coconut), lard, butter, and cocoa butter are encouraged in high amounts. Protein belongs to the keto diet plan, but it doesn’t usually discriminate in between lean protein foods and protein sources high in saturated fat such as beef, pork, and bacon. What about vegetables and fruits? All fruits are abundant in carbohydrates, but you can have particular fruits (generally berries) in little parts.

A cup of chopped broccoli has about 6 carbohydrates. A ketogenic diet has various risks. Top of the list: it’s high in saturated fat. McManus advises that you keep saturated fats to no more than 7% of your daily calories due to the fact that of the link to cardiovascular disease. And undoubtedly, the keto diet is connected with an increase in “bad” LDL cholesterol, which is likewise linked to cardiovascular disease.

Plan Custom Keto Diet Outlet Deals April 2020

With a lot fat to metabolize, the diet might make any existing liver conditions worse. The kidneys assist metabolize protein, and McManus says the keto diet may overload them. (The current suggested intake for protein averages 46 grams per day for ladies, and 56 grams for males). The keto diet is low in fibrous foods like grains and vegetables.

Low-carb diet plans may trigger confusion and irritability,” McManus says. Those threats add up so make sure that you speak with a doctor and a signed up dietitian before ever trying a ketogenic diet. The popular low-carb diets (such as Atkins or Paleo) modify a real keto diet (Plan Custom Keto Diet Outlet Deals April 2020). But they feature the very same threats if you exaggerate it on fats and proteins and lay off the carbohydrates.

Theories about short-term low-carb diet plan success include lower appetite because fat burns slower than carbohydrates. “But once again, we do not understand about the long term,” she says. “And eating a limiting diet, no matter what the plan, is difficult to sustain. Once you resume a regular diet plan, the weight will likely return.” As a service to our readers, Harvard Health Publishing offers access to our library of archived material.

Plan Custom Keto Diet Outlet Deals April 2020

No material on this website, regardless of date, should ever be utilized as a substitute for direct medical advice from your physician or other qualified clinician (Plan Custom Keto Diet Outlet Deals April 2020).

The ketogenic diet plan (or keto diet, for short) is a low-carb, high-fat diet that uses numerous health benefits. In reality, over 20 research studies show that this type of diet plan can assist you lose weight and improve your health (). Ketogenic diet plans may even have advantages against diabetes, cancer, epilepsy and Alzheimer’s illness (,,, ). Here is an in-depth newbie’s guide to the keto diet plan.

It includes dramatically reducing carbohydrate consumption and replacing it with fat. This decrease in carbohydrates puts your body into a metabolic state called ketosis. When this takes place, your body ends up being incredibly efficient at burning fat for energy. It likewise turns fat into ketones in the liver, which can provide energy for the brain (, ). Ketogenic diets can trigger huge decreases in blood sugar level and insulin levels – Plan Custom Keto Diet Outlet Deals April 2020.

Plan Custom Keto Diet Outlet Deals April 2020

Plan Custom Keto Diet Outlet Deals April  2020Plan Custom Keto Diet Outlet Deals April 2020

It decreases blood sugar level and insulin levels, and shifts the body’s metabolic process away from carbohydrates and towards fat and ketones (Plan Custom Keto Diet Outlet Deals April 2020). There are numerous versions of the ketogenic diet plan, consisting of: This is an extremely low-carb, moderate-protein and high-fat diet. It normally contains 75% fat, 20% protein and only 5% carbohydrates ().

This diet enables you to include carbs around exercises. This resembles a basic ketogenic diet plan, but consists of more protein. The ratio is typically 60% fat, 35% protein and 5% carbs. However, just the standard and high-protein ketogenic diet plans have been studied thoroughly. Cyclical or targeted ketogenic diet plans are advanced approaches and mostly used by bodybuilders or professional athletes.

There are a number of versions of the keto diet plan. The standard (SKD) variation is the most researched and most suggested. A ketogenic diet plan is an effective method to slim down and lower risk aspects for disease (,,,,, ). In truth, research reveals that the ketogenic diet plan is far remarkable to the often advised low-fat diet plan (,,, ). What’s more, the diet plan is so filling that you can lose weight without counting calories or tracking your food consumption (). One study discovered that individuals on a ketogenic diet lost 2.2 times more weight than those on a calorie-restricted low-fat diet.

Plan Custom Keto Diet Outlet Deals April 2020

This typically takes place without appetite. Diabetes is defined by changes in metabolism, high blood glucose and impaired insulin function (). The ketogenic diet plan can assist you lose excess fat, which is closely connected to type 2 diabetes, prediabetes and metabolic syndrome (,, ). One study found that the ketogenic diet improved insulin sensitivity by a massive 75% (). Another study in individuals with type 2 diabetes discovered that 7 of the 21 participants had the ability to stop utilizing all diabetes medications (). In yet another study, the ketogenic group lost 24.4 pounds (11.1 kg), compared to 15.2 pounds (6.9 kg) in the higher-carb group.

Plan Custom Keto Diet Outlet Deals April  2020Plan Custom Keto Diet Outlet Deals April 2020

The ketogenic diet plan can improve insulin sensitivity and trigger fat loss, leading to considerable health advantages for people with type 2 diabetes or prediabetes. The ketogenic diet in fact originated as a tool for dealing with neurological diseases such as epilepsy. Research studies have now shown that the diet can have advantages for a variety of different health conditions: The ketogenic diet can improve danger elements like body fat, HDL cholesterol levels, blood pressure and blood glucose (, ).

The keto diet plan may minimize signs of Alzheimer’s disease and slow its progression (,, ). Research has actually revealed that the ketogenic diet can trigger enormous decreases in seizures in epileptic kids (). One research study found that the diet helped improve symptoms of Parkinson’s disease (). The ketogenic diet can help in reducing insulin levels, which might play a key role in polycystic ovary syndrome ().

Plan Custom Keto Diet Outlet Deals April 2020

Lower insulin levels and consuming less sugar or processed foods might assist improve acne (). However, keep in mind that research study into a lot of these areas is far from conclusive. A ketogenic diet plan may provide lots of health benefits, particularly with metabolic, neurological or insulin-related diseases. Any food that is high in carbohydrates need to be limited.

Wheat-based products, rice, pasta, cereal, and so on. All fruit, other than small portions of berries like strawberries. Peas, kidney beans, lentils, chickpeas, and so on. Potatoes, sweet potatoes, carrots, parsnips, etc. These are highly processed and typically high in carbohydrates. These frequently include sugar and unhealthy fat. Limitation your consumption of processed vegetable oils, mayo, etc.

These are often high in sugar alcohols, which can impact ketone levels sometimes. These foods also tend to be highly processed. Prevent carb-based foods like grains, sugars, legumes, rice, potatoes, candy, juice and even most fruits. You need to base the bulk of your meals around these foods: Red meat, steak, ham, sausage, bacon, chicken and turkey.

Plan Custom Keto Diet Outlet Deals April 2020

Look for pastured or omega-3 whole eggs. Look for grass-fed when possible. Unprocessed cheese (cheddar, goat, cream, blue or mozzarella). Almonds, walnuts, flax seeds, pumpkin seeds, chia seeds, and so on. Mainly additional virgin olive oil, coconut oil and avocado oil. Entire avocados or newly made guacamole. The majority of green veggies, tomatoes, onions, peppers, etc.

It is best to base your diet mainly on whole, single-ingredient foods. Here is a list of 44 healthy low-carb foods. Base most of your diet on foods such as meat, fish, eggs, butter, nuts, healthy oils, avocados and a lot of low-carb veggies. To assist get you started, here is a sample ketogenic diet plan meal strategy for one week: Bacon, eggs and tomatoes.

Salmon with asparagus cooked in butter. Egg, tomato, basil and goat cheese omelet. Almond milk, peanut butter, cocoa powder and stevia milkshake. Meatballs, cheddar cheese and veggies. A ketogenic milkshake (attempt this or this). Shrimp salad with olive oil and avocado. Pork chops with Parmesan cheese, broccoli and salad. Omelet with avocado, salsa, peppers, onion and spices.

Plan Custom Keto Diet Outlet Deals April 2020

Chicken stuffed with pesto and cream cheese, along with veggies. Sugar-free yogurt with peanut butter, cocoa powder and stevia. Beef stir-fry prepared in coconut oil with vegetables. Bun-less burger with bacon, egg and cheese. Ham and cheese omelet with vegetables. Ham and cheese pieces with nuts. White fish, egg and spinach prepared in coconut oil.

Hamburger with salsa, cheese and guacamole. Steak and eggs with a side salad. Always attempt to rotate the veggies and meat over the long term, as each type supplies different nutrients and health benefits. For tons of dishes, take a look at these 101 healthy low-carb dishes. You can eat a variety of yummy and nutritious meals on a ketogenic diet.

It is not very tough to make most dining establishment meals keto-friendly when eating in restaurants. Plan Custom Keto Diet Outlet Deals April 2020. Many dining establishments offer some sort of meat or fish-based dish. Order this, and replace any high-carb food with additional vegetables. Egg-based meals are also an excellent choice, such as an omelet or eggs and bacon. Another favorite is bun-less hamburgers.

Plan Custom Keto Diet Outlet Deals April 2020

Plan Custom Keto Diet Outlet Deals April  2020Plan Custom Keto Diet Outlet Deals April 2020

Include additional avocado, cheese, bacon or eggs. At Mexican restaurants, you can take pleasure in any type of meat with additional cheese, guacamole, salsa and sour cream. For dessert, request for a combined cheese board or berries with cream. When eating in restaurants, select a meat-, fish- or egg-based meal. Order extra veggies rather of carbohydrates or starches, and have cheese for dessert.

This is typically referred to as the keto influenza and is normally over within a few days. Keto influenza includes poor energy and mental function, increased hunger, sleep problems, nausea, gastrointestinal pain and decreased exercise efficiency. To lessen this, you can try a routine low-carb diet plan for the first couple of weeks.

A ketogenic diet plan can likewise change the water and mineral balance of your body, so including additional salt to your meals or taking mineral supplements can help. For minerals, try taking 3,0004,000 mg of sodium, 1,000 mg of potassium and 300 mg of magnesium each day to minimize negative effects.

Plan Custom Keto Diet Outlet Deals April 2020

Typically, a ketogenic diet triggers weight loss without intentional calorie limitation. Numerous of the negative effects of beginning a ketogenic diet plan can be limited. Reducing into the diet plan and taking mineral supplements can assist. Although no supplements are needed, some can be beneficial. Added to beverages or yogurt, MCT oil offers energy and helps increase ketone levels.

Added salt and other minerals can be crucial when beginning due to shifts in water and mineral balance. Caffeine can have advantages for energy, fat loss and performance. This supplement might assist raise the body’s ketone levels. Creatine provides many benefits for health and efficiency. This can help if you are integrating a ketogenic diet plan with workout.

Plan Custom Keto Diet Outlet Deals April 2020

Plan Custom Keto Diet Outlet Deals April 2020

Worldwide of weight-loss diets, low-carbohydrate, high-protein eating plans often grab attention. The Paleo, South Beach, and Atkins diet plans all suit that category. They are sometimes described as ketogenic or “keto” diet plans. However a true ketogenic diet is different. Unlike other low-carb diet plans, which concentrate on protein, a keto plan centers on fat, which provides as much as 90% of day-to-day calories.

” The keto diet is mostly utilized to assist minimize the frequency of epileptic seizures in children. While it likewise has been tried for weight loss, only short-term results have been studied, and the outcomes have actually been mixed. We do not understand if it works in the long term, nor whether it’s safe,” warns registered dietitian Kathy McManus, director of the Department of Nutrition at Harvard-affiliated Brigham and Women’s Healthcare facility.

Rather of relying on sugar (glucose) that comes from carbs (such as grains, beans, veggies, and fruits), the keto diet depends on ketone bodies, a type of fuel that the liver produces from kept fat. Plan Custom Keto Diet Outlet Deals April 2020. Burning fat seems like a perfect method to lose pounds. But getting the liver to make ketone bodies is challenging: It needs that you deny yourself of carbohydrates, less than 20 to 50 grams of carbohydrates daily (remember that a medium-sized banana has about 27 grams of carbohydrates).

Plan Custom Keto Diet Outlet Deals April 2020

Eating excessive protein can interfere with ketosis. Due to the fact that the keto diet has such a high fat requirement, followers need to consume fat at each meal. In a day-to-day 2,000-calorie diet, that may appear like 165 grams of fat, 40 grams of carbohydrates, and 75 grams of protein. However, the exact ratio depends on your particular needs.

Plan Custom Keto Diet Outlet Deals April  2020Plan Custom Keto Diet Outlet Deals April 2020

However saturated fats from oils (palm, coconut), lard, butter, and cocoa butter are encouraged in high quantities. Protein belongs to the keto diet, however it doesn’t typically discriminate between lean protein foods and protein sources high in hydrogenated fat such as beef, pork, and bacon. What about fruits and veggies? All fruits are rich in carbohydrates, however you can have certain fruits (typically berries) in little portions.

A cup of chopped broccoli has about 6 carbs. A ketogenic diet plan has numerous risks. Top of the list: it’s high in saturated fat. McManus advises that you keep saturated fats to no more than 7% of your everyday calories since of the link to cardiovascular disease. And indeed, the keto diet plan is related to an increase in “bad” LDL cholesterol, which is likewise connected to heart illness.

Plan Custom Keto Diet Outlet Deals April 2020

With a lot fat to metabolize, the diet plan might make any existing liver conditions even worse. The kidneys help metabolize protein, and McManus states the keto diet might overload them. (The present recommended consumption for protein averages 46 grams daily for women, and 56 grams for males). The keto diet is low in fibrous foods like grains and beans.

Low-carb diets might cause confusion and irritation,” McManus states. Those threats accumulate so ensure that you speak with a medical professional and a signed up dietitian before ever attempting a ketogenic diet plan. The popular low-carb diet plans (such as Atkins or Paleo) customize a real keto diet plan (Plan Custom Keto Diet Outlet Deals April 2020). But they include the same risks if you exaggerate it on fats and proteins and lay off the carbohydrates.

Theories about short-term low-carb diet plan success include lower hunger since fat burns slower than carbohydrates. “However again, we don’t understand about the long term,” she states. “And eating a restrictive diet, no matter what the plan, is tough to sustain. When you resume a regular diet, the weight will likely return.” As a service to our readers, Harvard Health Publishing supplies access to our library of archived material.

Plan Custom Keto Diet Outlet Deals April 2020

No content on this website, regardless of date, need to ever be utilized as an alternative for direct medical recommendations from your doctor or other certified clinician (Plan Custom Keto Diet Outlet Deals April 2020).

The ketogenic diet (or keto diet plan, for short) is a low-carb, high-fat diet plan that provides many health benefits. In reality, over 20 research studies show that this kind of diet can assist you reduce weight and improve your health (). Ketogenic diet plans might even have benefits versus diabetes, cancer, epilepsy and Alzheimer’s illness (,,, ). Here is an in-depth beginner’s guide to the keto diet plan.

It includes significantly decreasing carbohydrate consumption and changing it with fat. This reduction in carbohydrates puts your body into a metabolic state called ketosis. When this takes place, your body becomes incredibly effective at burning fat for energy. It also turns fat into ketones in the liver, which can supply energy for the brain (, ). Ketogenic diet plans can trigger huge decreases in blood glucose and insulin levels – Plan Custom Keto Diet Outlet Deals April 2020.

Plan Custom Keto Diet Outlet Deals April 2020

Plan Custom Keto Diet Outlet Deals April  2020Plan Custom Keto Diet Outlet Deals April 2020

It lowers blood sugar and insulin levels, and moves the body’s metabolism far from carbohydrates and towards fat and ketones (Plan Custom Keto Diet Outlet Deals April 2020). There are several versions of the ketogenic diet, including: This is an extremely low-carb, moderate-protein and high-fat diet. It typically contains 75% fat, 20% protein and just 5% carbohydrates ().

This diet permits you to add carbohydrates around workouts. This resembles a basic ketogenic diet, but includes more protein. The ratio is typically 60% fat, 35% protein and 5% carbs. However, only the basic and high-protein ketogenic diets have actually been studied thoroughly. Cyclical or targeted ketogenic diets are more advanced approaches and mainly utilized by bodybuilders or athletes.

There are a number of variations of the keto diet plan. The standard (SKD) variation is the most researched and most advised. A ketogenic diet is an efficient method to reduce weight and lower threat elements for disease (,,,,, ). In truth, research study reveals that the ketogenic diet is far superior to the often advised low-fat diet plan (,,, ). What’s more, the diet plan is so filling that you can drop weight without counting calories or tracking your food consumption (). One research study discovered that people on a ketogenic diet plan lost 2.2 times more weight than those on a calorie-restricted low-fat diet plan.

Plan Custom Keto Diet Outlet Deals April 2020

This often occurs without hunger. Diabetes is defined by modifications in metabolic process, high blood glucose and impaired insulin function (). The ketogenic diet can assist you lose excess fat, which is carefully linked to type 2 diabetes, prediabetes and metabolic syndrome (,, ). One study discovered that the ketogenic diet improved insulin sensitivity by a tremendous 75% (). Another research study in people with type 2 diabetes discovered that 7 of the 21 participants were able to stop using all diabetes medications (). In yet another study, the ketogenic group lost 24.4 pounds (11.1 kg), compared to 15.2 pounds (6.9 kg) in the higher-carb group.

Plan Custom Keto Diet Outlet Deals April  2020Plan Custom Keto Diet Outlet Deals April 2020

The ketogenic diet plan can increase insulin level of sensitivity and cause fat loss, leading to substantial health advantages for individuals with type 2 diabetes or prediabetes. The ketogenic diet in fact originated as a tool for treating neurological diseases such as epilepsy. Research studies have actually now shown that the diet plan can have advantages for a wide array of various health conditions: The ketogenic diet plan can improve threat elements like body fat, HDL cholesterol levels, high blood pressure and blood glucose (, ).

The keto diet may minimize symptoms of Alzheimer’s illness and slow its development (,, ). Research study has shown that the ketogenic diet plan can cause massive reductions in seizures in epileptic children (). One study found that the diet assisted improve symptoms of Parkinson’s disease (). The ketogenic diet plan can help minimize insulin levels, which may play a key role in polycystic ovary syndrome ().

Plan Custom Keto Diet Outlet Deals April 2020

Lower insulin levels and consuming less sugar or processed foods might help improve acne (). However, bear in mind that research into much of these locations is far from definitive. A ketogenic diet might supply numerous health advantages, particularly with metabolic, neurological or insulin-related illness. Any food that is high in carbs must be restricted.

Wheat-based products, rice, pasta, cereal, and so on. All fruit, except small portions of berries like strawberries. Peas, kidney beans, lentils, chickpeas, and so on. Potatoes, sweet potatoes, carrots, parsnips, and so on. These are highly processed and frequently high in carbs. These often consist of sugar and unhealthy fat. Limitation your intake of processed vegetable oils, mayo, and so on.

These are typically high in sugar alcohols, which can impact ketone levels sometimes. These foods also tend to be highly processed. Avoid carb-based foods like grains, sugars, beans, rice, potatoes, sweet, juice and even most fruits. You should base most of your meals around these foods: Red meat, steak, ham, sausage, bacon, chicken and turkey.

Plan Custom Keto Diet Outlet Deals April 2020

Look for pastured or omega-3 whole eggs. Try to find grass-fed when possible. Unprocessed cheese (cheddar, goat, cream, blue or mozzarella). Almonds, walnuts, flax seeds, pumpkin seeds, chia seeds, and so on. Mainly extra virgin olive oil, coconut oil and avocado oil. Entire avocados or freshly made guacamole. Many green veggies, tomatoes, onions, peppers, etc.

It is best to base your diet primarily on whole, single-ingredient foods. Here is a list of 44 healthy low-carb foods. Base most of your diet on foods such as meat, fish, eggs, butter, nuts, healthy oils, avocados and lots of low-carb veggies. To assist get you started, here is a sample ketogenic diet plan meal prepare for one week: Bacon, eggs and tomatoes.

Salmon with asparagus cooked in butter. Egg, tomato, basil and goat cheese omelet. Almond milk, peanut butter, cocoa powder and stevia milkshake. Meatballs, cheddar cheese and veggies. A ketogenic milkshake (try this or this). Shrimp salad with olive oil and avocado. Pork chops with Parmesan cheese, broccoli and salad. Omelet with avocado, salsa, peppers, onion and spices.

Plan Custom Keto Diet Outlet Deals April 2020

Chicken stuffed with pesto and cream cheese, in addition to vegetables. Sugar-free yogurt with peanut butter, cocoa powder and stevia. Beef stir-fry cooked in coconut oil with veggies. Bun-less burger with bacon, egg and cheese. Ham and cheese omelet with vegetables. Ham and cheese slices with nuts. White fish, egg and spinach cooked in coconut oil.

Hamburger with salsa, cheese and guacamole. Steak and eggs with a side salad. Constantly try to turn the veggies and meat over the long term, as each type provides various nutrients and health advantages. For lots of dishes, inspect out these 101 healthy low-carb dishes. You can consume a variety of yummy and healthy meals on a ketogenic diet.

It is not really hard to make most restaurant meals keto-friendly when eating in restaurants. Plan Custom Keto Diet Outlet Deals April 2020. Many dining establishments provide some type of meat or fish-based meal. Order this, and change any high-carb food with extra veggies. Egg-based meals are also a terrific option, such as an omelet or eggs and bacon. Another favorite is bun-less burgers.

Plan Custom Keto Diet Outlet Deals April 2020

Plan Custom Keto Diet Outlet Deals April  2020Plan Custom Keto Diet Outlet Deals April 2020

Include extra avocado, cheese, bacon or eggs. At Mexican dining establishments, you can enjoy any type of meat with additional cheese, guacamole, salsa and sour cream. For dessert, request a blended cheese board or berries with cream. When eating in restaurants, select a meat-, fish- or egg-based meal. Order additional veggies rather of carbs or starches, and have cheese for dessert.

This is frequently referred to as the keto flu and is normally over within a couple of days. Keto influenza includes poor energy and psychological function, increased appetite, sleep problems, nausea, digestion pain and reduced workout efficiency. To reduce this, you can attempt a regular low-carb diet plan for the very first couple of weeks.

A ketogenic diet can also alter the water and mineral balance of your body, so adding extra salt to your meals or taking mineral supplements can assist. For minerals, attempt taking 3,0004,000 mg of salt, 1,000 mg of potassium and 300 mg of magnesium per day to lessen side impacts.

Plan Custom Keto Diet Outlet Deals April 2020

Usually, a ketogenic diet triggers weight loss without intentional calorie limitation. Many of the adverse effects of beginning a ketogenic diet plan can be restricted. Alleviating into the diet plan and taking mineral supplements can assist. Although no supplements are required, some can be beneficial. Contributed to beverages or yogurt, MCT oil offers energy and assists increase ketone levels.

Added salt and other minerals can be essential when starting out due to shifts in water and mineral balance. Caffeine can have benefits for energy, weight loss and performance. This supplement might help raise the body’s ketone levels. Creatine supplies various benefits for health and efficiency. This can assist if you are combining a ketogenic diet with exercise.