Instead of thinking about the total carbs you’re eating, assess what those carbs provide to you. Do the majority of your carbs come from fruit and vegetables, with a payload of fiber and disease-fighting antioxidants? Fantastic. Or are you consuming them in the form of added sugars (cookies, candy, soda) or refined flour? If you are, you know what to do.
Chapter 2 - Go Keto in 5 steps. 1-clean out your pantry. Egads! No dates or peas, 2 of my favorites! 2-Go shopping and stock up on the basics- water, coffee, tea, spices, herbs, non-sugar sweeteners, lemon & lime juice, mayo, mustard, pesto, sriracha, broths, pickled foods, nuts & seeds, meats, eggs, wild caught fish, nonstarchy veggies, berries, avocados, full fat dairy, avocado oil, olive oil, butter, lard, bacon fat. 3-set up your kitchen with a food scale, food processor, spiralizer, hand mixer, and cast iron pan. 4- plan your meals, and 5 -exercise!
• Potassium: With the approved list of foods being so brief, you might not be getting in enough fruits and veggies on keto. One of the biggest impacts? A potassium deficiency—and all of the lovely constipation and muscle cramps that accompanies it. Aim to up your intake of foods like spinach, avocado, tomatoes, kale and mushrooms to get your potassium fix.
Although a standard ketogenic diet is even more restrictive in terms of carb intake, a “moderate keto diet” (just as some folks have followed a modified Atkins diet) is another option that will very likely still be able to provide substantial weight loss results and other improvements in symptoms. Including slightly more carbs can be very useful for maintenance, allow for more flexibility, provide a higher fiber intake, and overall may feel more sustainable long term socially and psychologically.
“Eggs have a lot of vitamins like vitamin A, B complex, D, K, E, calcium, and zinc,” says Ryan Weaver, a personal trainer and keto enthusiast. “That’s why eggs are an excellent choice for breakfast when you follow the keto diet. To avoid getting bored, you can try different ways of preparing the eggs—boiled, fried, or baked. Also, you can combine the eggs with different foods like bacon, ham, cheddar cheese, butter, mayonnaise, so you get a different recipe each day although using the same main ingredient.”
Anecdotally speaking, people do lose weight on the keto diet. Heather Wharton, a 35-year-old business relationship manager from Tampa, Florida, lost 140 pounds since starting the keto diet in January 2016: “I plan on being on the keto diet for the rest of my life,” says Wharton. “My husband and I consider ourselves to be food addicts, and the keto diet is what we use as a form of abstinence from trigger foods that have sugar and other carbohydrates." A typical day of eating for Wharton includes coffee with a protein supplement, a cup of unsweetened cashew milk, cauliflower rice with ground turkey and liquid aminos (a carb-free substitute for soy sauce), spinach, six slices of turkey bacon, six eggs, and a little salsa.
• Cardiovascular Disease: This is definitely a point of confusion and controversy since a diet that relies so heavily on meat and fat is naturally thought to raise blood cholesterol and cause heart issues. However, some evidence suggests that this may not be the case. In fact, the keto diet may help improve triglyceride, HDL and LDL levels. A 2017 review looked at all of the available evidence around the ketogenic diet and cardiovascular health and found that the diet may be associated with some improvements in cardiovascular risk factors. Mind you, the authors also expressed their concerns with maintaining the diet in the long term, and they proposed that these benefits may not be long-lasting. It's clear that we need long-term studies to fill that gap.
Lots of apps and website offer keto diet challenges—basically, a blueprint for the keto diet with a fixed starting and ending point (they typically last for a week to a month, though some may be longer). Speaking of apps, plenty of keto-centric ones are right at your fingertips (a.k.a., your smartphone), like the KetoDiet app, which can help you calculate your macros and track your keto diet effectively.
Diets high in healthy fats and protein also tend to be very filling, which can help reduce overeating of empty calories, sweets and junk foods. (6) For most people eating a healthy low-carb diet, it’s easy to consume an appropriate amount of calories, but not too many, since things like sugary drinks, cookies, bread, cereals, ice cream or other desserts and snack bars are off-limits.
5) By now you should know both where you are and where you want to be. Those are the first steps. Now it’s time to start planning your meals. You can use these food lists to help you figure out what kinds of foods you should be eating. Remember this is not a diet plan that has an end date. This is a lifestyle change that you will pass on to your children.
Researchers believe that the ketogenic diet can also help patients with schizophrenia to normalize the pathophysiological processes that are causing symptoms like delusions, hallucinations, lack of restraint and unpredictable behavior. One study found that the ketogenic diet lead to elevated concentrations of kynurenic acid (KYNA) in the hippocampus and striatum, which promotes neuroactive activity. Some studies even point to the elimination of gluten under the ketogenic diet as a possible reason for improved symptoms, as researchers observed that patients with schizophrenia tended to eat more carbohydrates immediately before a psychotic episode. (15)
• Weight loss — If you're trying to lose weight, then a ketogenic diet is one of the best ways to do it, because it helps access your body fat so that it can be shed. Obese people in particular can benefit from this method. In one study, obese test subjects were given a low-carb ketogenic diet and a low-fat diet. After 24 weeks, researchers noted that the low-carb group lost more weight (9.4 kilograms or 20.7 pounds) compared to the low-fat group (4.8 kilograms or 10.5 pounds).1
This is one reason why tracking your food intake should be a priority. There are apps like Cronometer, MyFitnessPal, and LoseIt! that allow you to record all your foods for the day, and each has a large database of fresh foods, packaged foods, and restaurant meals, plus you can enter in your own recipes. This way you can know exactly what macro- and micro-nutrients you’re getting, with no guess work.
The average person's diet contain about 55% carbohydrates, 30% fat, and 15% protein. On the keto diet, you eat a whole lot more fat, and a lot less carbs: 80% of the diet is comprised of fat, 15% is protein, and a mere 5% of calories come from carbohydrates. For someone on a 1,500-calorie diet, that translates to 19 grams of carbohydrates per day, which is less than what you find in one medium-sized apple.
Before we discuss how to measure ketone levels, let’s set some guidelines for optimal ketone levels. Nutritional ketosis is detected when levels begin to read at 0.5 mmol/L of ketones in the blood, but your optimal ketone level will depend on your personal goals. For instance, if your goal is to lose weight, your target ketone level will be lower than someone who wants to improve mental performance. The following table provides some general guidelines based on your goal.
There are several medical studies — such as two conducted by the Department of Radiation Oncology at the Holden Comprehensive Cancer Center for the University of Iowa, and the National Institutes of Health’s National Institute of Neurological Disorders and Stroke, for example — that show the ketogenic diet is an effective treatment for cancer and other serious health problems. (12)
The electrolyte minerals are sodium, potassium, magnesium, and calcium, and you need all four. Sports drinks are full of sugars, and only have low amounts of these minerals, so it’s best to avoid them. Instead, focus on vegetables that contain high amounts of these minerals, and make sure to salt your food to taste. You can also make an electrolyte drink that contains all of these minerals. Lite Salt or No Salt is available in the grocery store as a salt substitute, and contains potassium. Magnesium and calcium powders are available in health food stores and online.
The best place to get started if you’re interested in the ketogenic diet is to first take a look at the fats you can incorporate, such as avocado, olive oil, or cacao butter. You could also take a look at more of an animal-based fat like grass-fed tallow or pasteurized lard or, if you are not too sensitive to butter, grass-fed butter is a really good option.
For a period of 3-4 days up to 2 weeks, you will be eating the minimal amount of carbohydrates and sugar (20 grams net carbs maximum per day). After this you may be able to add in small amounts of net carbs if your body can handle it, but probably not more than 50 net carbs total per day. This is tricky, because some people can't handle more than the 20 net carbs even after they have adjusted to ketosis. Others can handle 50 net carbs and easily stay in ketosis. If you feel fine at 20 net carbs and it doesn't bother you, than there's no reason to make any changes. You can test your ketosis by how you feel, or by actually testing - which is discussed in section 3.
Quick update – been doing a keto-type diet for a couple of months now. My BP is down to the lowest it’s been in something like 10 years, though still on 1/2 dose for my meds. I’ve lost about 30 pounds in the last 4 months (give or take a bit as I’m not sure exactly where I started). I’ll admit I still use Truvia and will have a Coke Zero every now and then, but eliminating the wheat and corn breads and sugars to reduce my carb intake to < 50g/day on average has made a huge difference. (I'm sure some still sneaks in with some of the food I eat out, but for the most part it's pretty good.)
The ketogenic diet — a high-fat and very low-carb eating plan — can be tough to start. After all, it’s likely a radical departure from the way you’re eating now (a typical standard American diet is high in carbohydrates and processed foods). But many people are trying the keto diet, which puts your body in a state of ketosis. That's what happens when your body’s carb-burning switch flips to a fat-burning one, a change that can cause weight loss and has even been credited with controlling diabetes. (1)
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