Standard Ketogenic Diet (SKD) — Diets

Very low carbohydrate, high fat diet inducing nutritional ketosis for metabolic flexibility and neurological benefits.

Overview

The Standard Ketogenic Diet (SKD) restricts carbohydrates to 20-50 g/day (5-10% of calories), with 70-80% of calories from fat and 15-20% from protein. This macronutrient ratio shifts primary fuel utilization from glucose to ketone bodies (beta-hydroxybutyrate, acetoacetate, acetone). Originally developed for epilepsy treatment in the 1920s, SKD now has strong RCT evidence for type 2 diabetes management, weight loss, and neurological conditions. Meta-analyses confirm significant improvements in glycemic control, triglycerides, and HDL cholesterol, though LDL responses are variable.

Indications

  • Type 2 diabetes and insulin resistance
  • Weight loss and body composition improvement
  • Drug-resistant epilepsy
  • Neurological protection and cognitive support
  • Metabolic flexibility enhancement

Mechanism of Action

Severe carbohydrate limitation depletes glycogen and lowers insulin, triggering hepatic ketogenesis

Dosing

CompoundDoseFrequencyNotes
Standard Ketogenic Diet20-50 g carbs/day; 70-80% fat; 15-20% proteinDailyTarget blood ketones 0.5-3.0 mmol/L

Safety & Contraindications

  • Keto flu symptoms (fatigue, headache, nausea) during first 1-2 weeks of adaptation
  • Potential LDL cholesterol increase in some individuals (lean mass hyper-responders)
  • Risk of kidney stones with prolonged ketosis
  • Micronutrient deficiencies (magnesium, potassium, sodium) if not managed
  • Not recommended for type 1 diabetes, pancreatitis, or liver failure