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The Ketogenic Diet: Common Questions Answered

Authors: Sarah M. Rice, Douglas B. Reynolds

The Ketogenic Diet: Resources

The resources below expand on the content of this guide. The full reference list for all four parts follows; every superscript number in the series links to its entry here.

The SMHP Website

https://thesmhp.org

The Society for Metabolic Health Practitioners provides support and training for clinicians as well as general resources.

Patient Resources:

https://thesmhp.org/patient-tools-handouts/

Clinician resources

https://thesmhp.org/practitioner-tools-handouts/

See our article published in the Journal of Metabolic Health:

Rice, S.M. and Reynolds, D.B. (2025) ‘Practical guidelines for addressing common questions and misconceptions about the ketogenic diet’, Journal of Metabolic Health, 8(1), p. 10. Available at: https://doi.org/10.4102/jmh.v8i1.113.

This peer-reviewed paper serves as a guideline for the implementation of TCR in metabolic disorders. Read the background here. [link to Delphi SMHP landing page]

Or go directly to the journal article:

Rice SM, Buchanan LA, Calkins MW, et al. A Delphi consensus-based guideline for the implementation of therapeutic carbohydrate reduction in metabolic disorders. J. metab. health. 2026;9(1), a152. https://doi.org/10.4102/jmh.v9i1.152.

View Journal Article

https://thesmhp.org/directory/

The SMHP has a list of practitioners who consider metabolic health and lifestyle interventions alongside the standard medical approach and are available to support you on your journey.

https://nutrition-network.org/references-resource/

The Nutrition Network is an online accredited education, connection, and learning platform. It provides training and resources for coaches and healthcare practitioners wanting to gain skills and certification in the use of therapeutic carbohydrate restriction (including a ketogenic approach) in practice.

The Nutrition Network Scientific References and Research Resources – Therapeutic Carbohydrate Restriction website provides evidence streams pertaining to metabolic health and various degrees of therapeutic carbohydrate restriction across a broad range of conditions. These research articles provide more information and expand on the points listed in this document.

It is important to receive appropriate support and medical oversight if you are struggling with a mental health condition—especially if you are taking medication. Ketogenic metabolic therapy is a powerful intervention and may require medication adjustments or monitoring during the adaptation phase. The following resources provide additional information and list providers who are experienced in providing support and are able to work with a medical team to ensure safe application of this approach.

Metabolic Mind

https://www.metabolicmind.org/

Metabolic Mind is a nonprofit organization pursuing the science of metabolic psychiatry and collecting personal stories to offer education, and hope to people struggling with mental health. Their resources section may be particularly useful (https://www.metabolicmind.org/families-and-peers)

Dr. Georgia Ede – Diagnosis:Diet

https://www.diagnosisdiet.com/about

Dr. Ede is a Harvard-trained psychiatrist specializing in nutritional and metabolic psychiatry with 25 years of clinical experience. She is the author of Change Your Diet, Change Your Mind which unpacks the science behind how your food choices can affect your mood via their influence on brain metabolism. She also provides a clinician directory (https://www.diagnosisdiet.com/directory) for those looking for someone to support them on their journey, and a training program (https://www.diagnosisdiet.com/training) for those practitioners wanting to upskill in the use of ketogenic nutritional therapy for mental health.

Ede G. Change Your Diet, Change Your Mind: A Powerful Plan to Improve Mood, Overcome Anxiety, and Protect Memory for a Lifetime of Optimal Mental Health. Balance; 2024. 464 p.

Dr Chris Palmer

https://www.chrispalmermd.com/

Dr. Palmer is an Assistant Professor of Psychiatry at Harvard Medical School and the founder and director of the Metabolic and Mental Health Program at McLean Hospital. His book presents a unifying theory of the cause of mental illness, integrating the fields of clinical medicine, neuroscience and metabolic research. Brain Energy explores the concept that mental disorders are metabolic disorders of the brain presenting a clear and cohesive theory and suggestions for implementing metabolic therapies.

Palmer CM. Brain Energy: A Revolutionary Breakthrough in Understanding Mental Health–and Improving Treatment for Anxiety, Depression, OCD, PTSD, and More. Dallas, TX: BenBella Books; 2022. 320 p.

Bitten Jonsson – Bitten’s Addiction

https://www.bittensaddiction.com/en/

Bitten Jonsson has worked in the field of addiction medicine for 37 years and is a registered nurse, addiction specialist, ADDIS®/SUGAR®-authorized (addiction screening, assessment, and diagnostic tools), and Nutrition Network practitioner. Jonsson believes all addiction begins in the brain and works with ASAM’s definition of Addiction Interaction Disorder which aims to correct the dysfunctions of the brain’s circuitry through a combination of traditional medicine and integrative functional medicine. Jonsson has developed a training program for healthcare providers who encounter individuals requiring this additional level of support and has a list of providers certified in the use of this approach.

Dr Jen Unwin – Fork in the Road

https://forkintheroad.co.uk/

Dr. Jen Unwin is a consultant clinical and health psychologist with over 35 years of experience, mostly working for the NHS (UK). Dr. Unwin has struggled with her own addiction to processed foods and carbohydrates and her own journey, combined with input from top clinicians, has led to the publication of Fork in the Road: A Hopeful Guide to Food Freedom. This book guides individuals on a journey—identifying if you have a carbohydrate addiction, finding motivation for change, implementing the right eating plan, and providing strategies for long term success.

Unwin J. Fork in the Road: A Hopeful Guide to Food Freedom. Independently published; 2021. 150 p.

Dr Rob Cywes

https://obesityunderstood.com/

Dr. Cywes is dual board certified in general surgery and pediatric surgery with a special interest in obesity, diabetes, and metabolic management—including bariatric surgery. His focus is on helping people understand and treat the causes of obesity and diabetes, considering surgery as a tool along the journey of becoming carbohydrate-free. Dr. Cywes recognized the treatment model primarily used in obesity management—the calories in, calories out (CICO) model—was flawed and developed the carbohydrate insulin model of obesity and diabetes (CIMOD). Combining this model with his understanding of the psychology of addiction, led to the development of a clinical program for treating obese adolescents. Dr. Cywes is a board member of the SMHP and releases regular videos on his YouTube channel as a resource for those struggling with carbohydrate addiction (https://www.youtube.com/@DrCywesCarbAddictionDoc).

Dr. Tro Kalayjian

https://doctortro.com/

Dr. Kalayjian is a board-certified physician in internal medicine and obesity medicine. His personal journey with weight loss, which began in childhood, has led to a deep understanding of the challenges faced by those on a weight-loss journey. His practice uses telemedicine, state-of-the-art patient monitoring technology, a fully integrated medical and coaching team, and access to support, education, and community through the Toward Health App. This includes an innovative Get Help Now! board to provide immediate support and encouragement in moments of struggle. The app ensures an exceptional level of individualized care and support, which is reflected in the success of the various wellness programs, the results of which appear in published literature. Dr. Kalayjian is a board member of the Society of Metabolic Health Practitioners and is committed to patient care and the promotion of TCR through research publications and advocacy.

Miriam Kalamian EdM, MS, CNS – Dietary Therapies

https://www.dietarytherapies.com/

Miriam Kalamian is a nutrition consultant and author specializing in the implementation of therapeutic carbohydrate reduction and ketogenic nutrition plans. Her passion for helping others implement nutritional strategies comes from her personal journey with her young son, Raffi, who fought his own battle with cancer.

Kalamiam M, Seyfried TN. Keto for Cancer: Ketogenic Metabolic Therapy as a Targeted Nutritional Strategy. Illustrated edition. Chelsea Green Publishing; 2017. 400 p.

Dr Nasha Winters

https://www.drnasha.com/

Dr. Winters is a licensed Naturopathic Doctor (ND) and a Fellow of the American Board of Naturopathic Oncology (FABNO) with nearly 30 years of experience in the field of integrative oncology. Winters co-authored the book The Metabolic Approach to Cancer and offers consultations, and training programs for fellow clinicians. Her passion for helping others stems from her own recovery from a terminal cancer diagnosis.

Winters N, Higgins Kelley J, Turner K. The Metabolic Approach to Cancer: Integrating Deep Nutrition, the Ketogenic Diet, and Nontoxic Bio-Individualized Therapies. White River Junction, Vermont: Chelsea Green Publishing; 2017. 408 p.

Dr Thomas Seyfried

https://tomseyfried.com/

Dr. Seyfried is a professor of biology, genetics, and biochemistry at Boston College. His research program focuses on mechanisms by which metabolic therapy can be applied to chronic diseases such as epilepsy, neurodegenerative diseases, and cancer. The metabolic therapies considered include calorie restriction, fasting, and ketogenic diets. In his book Cancer as a Metabolic Disease: On the Origin, Management, and Prevention of Cancer, Dr Seyfried addresses controversies related to the origins of cancer and provides solutions to cancer management and treatment.

Seyfried T. Cancer as a Metabolic Disease: On the Origin, Management, and Prevention of Cancer. 1st edition. Wiley; 2012. 877 p.

Expert Consensus Paper

A recent paper (authors include Miriam Kalamian and Dr Seyfried) presents a comprehensive overview of the application of the ketogenic diet for glioblastoma that includes background, implementation strategies, trouble-shooting, and research challenges.

Duraj, T. et al. (2024) ‘Clinical research framework proposal for ketogenic metabolic therapy in glioblastoma’, BMC Medicine, 22(1), p. 578. Available at: https://doi.org/10.1186/s12916-024-03775-4.

The Art and Science of Low Carbohydrate Living: An Expert Guide to Making the Life-Saving Benefits of Carbohydrate Restriction Sustainable and Enjoyable

Written by Doctors Volek and Phinney, who together have more than 50 years of clinical experience in using a low carbohydrate or ketogenic approach, this book covers the science and application of the approach in detail.

Phinney SD, Volek JS. The Art and Science of Low Carbohydrate Living: An Expert Guide to Making the Life-Saving Benefits of Carbohydrate Restriction Sustainable and Enjoyable. 1st edition. Lexington, KY: Beyond Obesity LLC; 2011. 316 p.

Why We Get Sick: The Hidden Epidemic at the Root of Most Chronic Disease―and How to Fight It

Professor Bikman is an internationally renowned scientist looking at the pathophysiology of disease with a special interest in the role of insulin and ketones on metabolic function. In his book, Why We Get Sick, he explores why insulin resistance affects so many people and how it connects many diseases together through a singular root cause. These include type 2 diabetes, obesity, cancer, neurological disease, and inflammatory disorders. Bikman also covers gut health and aging, and explains the effect of hormonal and insulin signaling pathways on the disease process.

Bikman B, Fung J. Why We Get Sick: The Hidden Epidemic at the Root of Most Chronic Disease―and How to Fight It. Dallas, TX: BenBella Books; 2020. 270 p.

Ketogenic: The Science of Therapeutic Carbohydrate Restriction in Human Health

The Nutrition Network brought together experts from around the world to produce a textbook, collating an extensive resource including background and clinical knowledge in the field of therapeutic carbohydrate reduction. This is an academic publication with a high level of medical content and terminology and is more suitable for clinicians or those who want an in-depth look at the subject. Ketogenic: The Science of Therapeutic Carbohydrate Restriction in Human Health is available through various platforms.

Noakes TD, Murphy T, Wellington N, Kajee H, Rice SM, editors. Ketogenic: The Science of Therapeutic Carbohydrate Restriction in Human Health [Internet]. Academic Press; 2023 [cited 2023 Jul 26]. Available from: https://www.sciencedirect.com/science/article/pii/B978018216170000218

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