Standard Ketogenic Diet - Metabolic Made Easy

Understanding the Standard Ketogenic Diet (SKD)

What SKD is

The Standard Ketogenic Diet is a very-low-carbohydrate, high-fat, moderate-protein pattern designed to sustain nutritional ketosis (blood β-hydroxybutyrate typically ~0.5–3.0 mmol/L). It differs from the classical therapeutic keto used in epilepsy (often a 4:1 fat:(protein+carb) ratio) but keeps carbs very low to promote fat-derived ketone production.

Who might consider SKD (and who should not)

May benefit:

Adults seeking weight loss or improved glycemic control/insulin resistance (T2D/metabolic syndrome) when supervised. Sustained 2-year data show improved HbA1c, weight, triglycerides, HDL, and reduced diabetes meds in a keto-supported program.
People needing steady energy/appetite control; some report improved mental clarity.
Patients using diet therapy for epilepsy (typically medical keto variants; supervision required).

Avoid or use only with specialist oversight:

Absolute/relative contraindications include pancreatitis, liver failure, disorders of fat metabolism (e.g., primary carnitine deficiency), porphyria, and other inborn errors of metabolism; pregnancy/breastfeeding and significant renal disease warrant individualized medical review.

Potential benefits (evidence snapshot)

Weight & appetite: Low-carb/keto can reduce appetite and support fat loss in the short to intermediate term.
Glycemic control in T2D: Multi-year non-randomized programs with remote care show sustained HbA1c and medication reductions up to 2 years (and beyond in follow-ups).
Epilepsy: Established therapy; classical keto and related variants reduce seizures in a substantial subset; duration and weaning are individualized.

Risks & what to monitor

Early “keto flu” (fatigue, headache): usually during week 1; hydration and electrolytes (sodium, potassium, magnesium) help. Constipation is common—use low-carb, high-fiber vegetables. Kidney stones occur in a minority (citrate and hydration can reduce risk).
Lipids: Triglycerides typically fall and HDL rises; LDL-C can increase in some individuals, with notable rises reported in subsets (“lean-mass hyper-responders”). Monitor ApoB/LDL-C and adjust fat quality (favor unsaturated fats) if needed.
Micronutrients: Potential gaps in folate, thiamin, electrolytes, fiber—plan produce and supplementation accordingly.

Suggested labs & follow-up

Baseline and periodic: fasting lipids (including ApoB if available), CMP, A1c/glucose, eGFR, and clinical review every 3–6 months when used therapeutically.

SKD macro ratios & daily carb targets

Fat: ~70–80% of energy
Protein: ~15–25% (≈1.2–1.7 g/kg reference body weight; individualized to LBM & goals)
Carbohydrate: ~5–10% (often 20–50 g net carbs/day)

Net carbs = total carbs − fiber.

How long to follow SKD?

Adaptation: Evaluate tolerance after 2–4 weeks as ketone production and electrolyte balance stabilize.
Active phase: 8–12+ weeks for weight/metabolic goals; reassess quarterly.
Longer-term: Multi-year outcomes exist under medical supervision, but periodic re-evaluation is prudent; epilepsy programs often consider weaning after ~2 years of good seizure control.

7-Day SKD meal ideas (adjust portions to your calories/macros)

Day	Breakfast	Lunch	Dinner
1	Scrambled eggs, avocado, bacon	Grilled chicken salad + olive oil, olives, feta	Baked salmon, broccoli, butter
2	Greek omelet (eggs, spinach, feta)	Tuna salad (mayo, celery) in lettuce cups	Ribeye, asparagus, herb butter
3	Chia pudding (unsweetened almond milk), walnuts	Turkey thigh, arugula salad, avocado oil	Chicken thighs, cauliflower mash
4	Cottage cheese* with pecans, cinnamon (*full-fat)	Shrimp salad with olive oil lemon	Pork chops, zucchini sauté in olive oil
5	“Bulletproof” coffee + 2 hard-boiled eggs	Cobb salad (chicken, egg, bacon, blue cheese, olive oil)	Ground beef & spinach skillet
6	Egg muffins (egg/cheddar/sausage)	Salmon salad (mayo, celery, dill)	Lamb chops, kale sauté
7	Smoked salmon roll-ups (cream cheese, cucumber)	Charcuterie plate (cheese, olives, nuts; veg crudités)	Grilled white fish, green beans, butter

Keep non-starchy veg daily for fiber/electrolytes. Add olive oil/avocado/nuts to “top up” fat.

One-day sample plan with per-item macros (~2,000 kcal target)

Breakfast – Scrambled eggs + avocado + bacon

3 eggs scrambled + 1 tsp butter: 250 kcal, 21 g fat, 19 g protein, 1 g net carb
½ avocado (medium): 120 kcal, 11 g fat, 1.5 g protein, 3 g net carb
2 bacon slices: 80 kcal, 7 g fat, 5 g protein, 0 g net carb

Meal total: ~450 kcal | 39 g fat, 25 g protein, 4 g net carb

Lunch – Grilled chicken salad (olive oil, feta, olives)

Chicken thigh ~5 oz cooked: 330 kcal, 22 g fat, 30 g protein, 0 g net carb
Greens/veg: 30 kcal, 0 g fat, 2 g protein, 3 g net carb
Olive oil 2 Tbsp: 240 kcal, 28 g fat
Feta 1 oz + olives (~6): 100 kcal, 9 g fat, 4 g protein, 2 g net carb

Meal total: ~700 kcal | 59 g fat, 36 g protein, 5 g net carb

Dinner – Baked salmon, broccoli, butter

Salmon 6 oz: 370 kcal, 22 g fat, 39 g protein, 0 g net carb
Broccoli 1 cup + 1 Tbsp butter: 160 kcal, 14 g fat, 4 g protein, 4 g net carb

Meal total: ~530 kcal | 36 g fat, 43 g protein, 4 g net carb

Snack – Macadamia nuts (1 oz)

~200 kcal, 21 g fat, 2 g protein, 2 g net carb

Daily total (approx.): 1,880–2,000 kcal | 155–165 g fat (70–79%), 100–106 g protein (19–22%), 15–20 g net carbs (3–5%) — within SKD ranges.

Practical tips

Electrolytes: Proactively include sodium (e.g., broth/salt to taste), potassium (avocado/leafy greens), and magnesium (nuts/greens) to reduce “keto flu.”
Fat quality: Favor olive oil, avocado, nuts, fatty fish; moderate saturated fat if LDL-C rises.
Protein: Keep moderate; adjust to body size and goals (don’t fear adequate protein—keto isn’t high-protein).
Medication: If on glucose-lowering agents or insulin, coordinate with your clinician to avoid hypoglycemia.

Resources & Further Reading

Recommended books (Amazon)

Book	Description, Rating, Approx. Price	Link
The Art and Science of Low Carbohydrate Living Jeff S. Volek & Stephen D. Phinney	Foundational science-forward guide to carbohydrate restriction and clinical use. Rating: ≈4.6/5 • Price: ≈$20–$30 (paperback).
End Your Carb Confusion Eric Westman & Amy Berger	Practical, stepwise approach to choosing and sustaining low-carb levels. Rating: ≈4.7/5 • Price: ≈$15–$25 (paperback).
The Ketogenic Bible Jacob Wilson & Ryan Lowery	Broad overview of keto science, applications, and recipes for everyday use. Rating: ≈4.6/5 • Price: ≈$20–$30 (paperback).
Ketogenic Diet Therapies for Epilepsy and Other Conditions Eric H. Kossoff et al.	Clinical reference focused on therapeutic keto in neurological care; best with clinician guidance. Rating: ≈4.8/5 • Price: ≈$40–$70 (paperback/hardcover).